DEAR DR. ROACH: What are your thoughts on the pros and cons of HPV vaccine for boys? — L.P.B.
ANSWER: There are risks and benefits to the individual, but also benefits to society.
The HPV vaccine should really be considered an anticancer vaccine, since its goal is to reduce infection from the kinds of human papilloma virus strains that can lead to cancer. Cervical cancer is the most common HPV-related cancer, but some throat, anal and genital cancers also are HPV-related. The Centers for Disease Control and Prevention estimates that there are about 30,000 HPV-related cancers in the U.S. annually. It is possible but unproven that the HPV vaccine will provide protection against some or all of these.
When given to girls or women who have not been infected with HPV, the HPV vaccine is nearly 100 percent effective at preventing persistent infection with the strains most likely to lead to cancer. In males age 16-26 years, the efficacy of the vaccine at preventing high-risk HPV-related warts was about 90 percent. However, the HPV vaccine is relatively new, and it is not clear how long immunity will last. It has been proven to last only eight to nine years, but studies looking at protection up to 15 years are ongoing. It is possible that additional boosters may be necessary.
The most serious risk of HPV vaccine is anaphylaxis, a possibly fatal allergic reaction. There have been 36 cases of anaphylaxis reported in the world literature and through the Vaccine Adverse Event Reporting system, according to the Institute of Medicine’s 2012 report on adverse effects of vaccines. There have been 67 million doses given, with a 0.003 percent rate of all adverse events, 90 percent of which were not considered serious. The most common nonserious adverse events in men were redness and soreness at the injection site, dizziness, headache and fainting. Among the adverse events considered serious, the most common were headache, nausea, vomiting and fever.
The societal benefit to vaccinating boys is that they are less likely to spread infection to others. Since essentially all cases of cervical cancer are HPV-related, males are the most common source of infection (although it can be transmitted female to female).
By vaccinating your boy, you are reducing his risk of developing HPV infection and might be decreasing his risk of several types of HPV-related cancer, at a small risk of an adverse event, which is usually minor. However, probably the most compelling reason is to protect your son’s future sexual partners. Put in the starkest terms, you are reducing the risk that your future daughter-in-law will develop cervical cancer.
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DR. ROACH WRITES:Several people wrote to me about the symptom of burping. One physician recalled several cases where burping, not chest discomfort, was the major sign of a heart blockage. A reader observed belching in a family member who was later diagnosed with stomach cancer, and another noted gastroparesis as the cause. I think these are all unlikely but possible causes to be considered when the cause can’t be found and symptoms persist.
Finally, one person wrote in that ginger solved her burping problem.
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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com.
The perfect holiday party appetizer, and so easy to make.
1 tube crescent dough Cooking spray, for pan Flour, for rolling out dough 8 ounce wheel Brie 1 cup whole berry cranberry sauce 1/2 cup chopped pecans 6 sprigs of rosemary, cut into 1 inch pieces.
1. Heat oven to 375 F and grease a mini muffin tin with cooking spray. On a lightly floured surface, roll out crescent dough, and pinch seams together. Cut into 24 squares. Place squares into muffin tin slots.
2. Cut brie into small pieces and place inside the crescent dough. Top with a spoonful of cranberry sauce, some chopped pecans and one little sprig of rosemary.
3. Bake until the crescent is golden, about 15 minutes.
1. Grease 13-by-9-inch glass baking dish. In 10-inch skillet over medium heat, cook pork-sausage meat, stirring frequently to break up sausage, until thoroughly cooked and no longer pink. Using slotted spoon, remove sausage to paper towels to drain.
2. Cut French bread into 1/2-inch cubes. Drain and chop mushrooms. In baking dish, combine sausage, bread cubes and mushrooms. In large bowl, whisk together eggs, milk, Italian seasoning, garlic powder and pepper. Pour egg mixture over sausage mixture. Cover with plastic wrap and refrigerate overnight.
ABOUT 1 3/4 HOURS BEFORE SERVING:
3. Heat oven to 350 F. Bake strata, uncovered, 1 hour. Remove from oven and sprinkle evenly with mozzarella and Cheddar cheeses. Bake 15 minutes longer or until knife inserted in center comes out clean. Remove strata from oven; let stand 10 minutes for easier serving. Garnish with chopped parsley.
• Each serving: About 390 calories, 24 g fat, 170 mg cholesterol, 855 mg sodium.
AMES, Iowa – Another day, another act of incivility, anger or violence. Ever-pervasive attitudes of self-centeredness and disregard for others seem to symbolize our times. But what if we could flip the script from callousness to kindness? That is one way to make a difference at the grassroots level.
Simply be kind. Remember the old adage of walking a mile in someone else’s shoes. This can help us more fully appreciate the unique and diverse aspects of our world.
The Center for Inclusion, Diversity and Equity at the University of Missouri suggests that people seek first to understand. For example:
Read a book about a different person, culture, country or experience.
Listen to local, regional, international or a different genre of music.
Explore your heritage, family history and personal cultural worldview.
Visit a local cultural center.
Interact with people from different backgrounds and cultures by becoming a language partner.
Challenge yourself to learn 10 new words in another language.
Another critical component to kindness is how we speak to and about each other. Being respectful of self and others in our words and actions is living kindness.
The following techniques can help build an atmosphere of respect:
Listen to others actively and intentionally.
Speak from personal experience and use “I” statements.
Withhold judgment and ask genuine questions for understanding.
Check your biases and assumptions.
Seek to understand your own communication and conflict style.
Finally, take good care of yourself. This may seem to be at odds with ‘making the world a better place.’ However, we must care for ourselves in order to have the stamina, energy and desire to live kindness. Get enough sleep, eat well, exercise, connect with friends or family, and engage in spiritual practices.
If you find yourself overwhelmed with the negativity, seek professional help. A counselor can help you in a trusting, non-judgmental setting. Call Iowa Concern at 800-447-1985 for help.
ISU Extension and Outreach’s Iowa Concern hotline provides access to stress counselors and an attorney for legal education, as well as information and referral services for a wide variety of topics. With a toll-free phone number, live chat capabilities and a website, Iowa Concern (https://www.extension.iastate.edu/iowaconcern/) services are available 24 hours a day, seven days per week at no charge.
“All About Stress: Taking Charge (PM1660 A)” (https://store.extension.iastate.edu/product/5165) is available for free download from the Extension Store. The publication offers tips for coping with stress, managing stress and building resources to help.
• With the holidays approaching, now is a good time to run the self-cleaning cycle on your oven. Wipe out any bits first and remove as much grease as you can. Then make sure to open a window to air out fumes.
• To get cloudy glassware sparkling for the holidays, soak in hot vinegar for 15 minutes to clear them up. Wash good crystal by hand only, never in the dishwasher.
• Since you know it’s coming anyway, take the opportunity to clean out the fridge a day or two before a big family dinner. It’s a good idea to eat up any leftovers for dinner the day before. You’ll have plenty to replace them on Thanksgiving, right?
• “If you have one person responsible for putting prep dishes and pots and pans in the dishwasher while you are preparing the bird and side dishes for the table, you will be halfway done with dishes by the time the meal is over.” — M.A. in Washington
• “I buy extra supplies for Thanksgiving dinner as items go on sale. We always make extra-large portions of our side dishes and even put in an extra turkey while we’re eating! Freeze meals in individual containers for quick dinners throughout the busy weeks from Turkey Day to Christmas. Potatoes and vegetable casseroles freeze well, and they taste better than microwave dinners from the grocery store.” — E.S. in Oregon
• In the fridge, it takes 24 hours of defrosting for every 5 pounds of turkey. When defrosting in water (only birds in a leakproof plastic wrapper), allow 30 minutes per pound and change the water every half-hour.
• Get kids in on the act of cooking. There’s no better time than the holidays to get budding chefs into your family’s holiday traditions. Let them help prep, and as they get older, assign cherished side dishes to appropriate-age children.
• Candles will burn more evenly if you refrigerate them for a few hours before lighting.
• For a tailgating favorite, make this: Prepare a batch of macaroni and cheese, then add an egg and stir in. Butter the wells of a muffin tin and fill with the mac and cheese. Top with a bit of shredded cheddar and bake for 20 minutes at 400 F. You can even make them super portable by using muffin liners. The gang loves these —no fork necessary!
• “In my family, you come to a holiday dinner with your own plastic containers for leftovers. If you don’t bring your own, you don’t go home with tomorrow’s lunch. Mom instituted this rule after the first Thanksgiving when all the kids had moved out. We practically cleaned her out of Tupperware!” — E.Y. in New Mexico
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Dos And Don’ts For Managing High Blood Pressure During Cold And Flu Season
People with high blood pressure should consult a doctor before taking any cold medicine.
(NAPS)—Colds and flu bring special considerations for people with high blood pressure, especially those on blood pressure medication. Here’s how to keep your blood pressure stable:
DO: Keep track of medication. The American Heart Association’s online tools at www.heart.org/hbp include a downloadable chart to manage medications and a tracker that lets people set up text message reminders, text in their readings, track their blood pressure and connect with providers.
DON’T: Miss your flu shot. People who get a flu shot may reduce their risk of heart attack or stroke. Stay away from people who are sick and wash your hands regularly.
DO: Read labels on over-the-counter (OTC) cold and flu medicines. Look for warnings to those with high blood pressure and who take blood pressure medications. Some ingredients in cold and flu medicines can affect blood pressure. Decongestants, used for a stuffy nose or congestion, and some pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), are known to raise blood pressure.
Check with your doctor before taking these medicines. A decongestant should be used for only the shortest amount of time possible—and never by someone with severe or uncontrolled high blood pressure.
DON’T: Try to replace your prescriptions with supplements. There are no special pills, vitamins or drinks that can substitute for prescription medications and lifestyle modifications. Talk to your health care provider before taking any over-the-counter drug or supplement that claims to lower blood pressure. “Your doctor and other health care providers should know which over-the-counter medicines or supplements you are taking,” said Willie E. Lawrence, M.D., chief of cardiology at Research Medical Center, Kansas City, Mo. “If something claims to be ‘natural’ or you don’t need a prescription, it’s not necessarily benign. It’s still a substance that has an effect on your body.”
DO: Work with your health care practitioner. “If you have high blood pressure, it’s important to know that some medicines, even supplements, will affect you differently,” Dr. Lawrence adds. “If you’re struggling to keep your pressure controlled, review your routines—including over-the-counter medicines and supplements—and talk with your doctor about changes you can make. You should never be too busy to manage your blood pressure.”