Preventive Medicine

Preventive Medicine

The practice places focus on preventive measures, especially screening and immunizations.  While this list does not include all the needs patients have, below are examples of some clinically important aspects of preventive health care.  Using our state of the art electronic medical records system, we are able to regularly identify and communicate with patients who are in need of many of these measures.

Screening Tests

Mammography   

Approximately 1 of every 8 women born in the USA will develop Breast Cancer.  Risk increases directly with age.  While the value of mammography improves with age, it is recommended that women of average risk begin screening at age 40, and repeat the test every 1-2 years, until age 50 when annual examinations are recommended. 

Breast Mass seen on Mammogram

Colonoscopy

Over 50,000 people in the USA die annually from Colorectal Cancer, which is when cancer develops in the lining of the large intestine or the rectum.  The earlier it is found, the more successful the treatment is.  People with Colorectal Cancer are usually unaware of it, until it has progressed.  Once symptoms occur, survival rates decrease.

Screening of individuals with no symptoms can identify certain growths called polyps, which can be removed, and may prevent over 90% of Colon Cancers.  Those of average risk should begin screening at age 50.

Stages of Colon Cancer Lesion

Pap Test (Cervical Cancer Screening)

Cervical Cancer, while it is the 2nd most common Cancer in the world, it is preventable, and treatable.  The goal is to detect abnormalities on routine Pap testing, while they are pre-cancerous lesions.  Cervical Cancer rarely causes pain or other symptoms until the cancer is advanced, making it more difficult to treat.  

Most related deaths could be prevented with appropriate screening.  Death due to Cervical Cancer has been reduced as much as 80% due to improved screening.  Testing should begin at age 18, or sooner, when sexual activity begins. 

About three quarters of women diagnosed with Cervical Cancer had not had a Pap test within the last five years. 

Internal view of Cervical Cancer

 

Immunizations

Pneumococcal Vaccine

Pneumococcal vaccine in adults is used to reduce the risk of the most common type of bacterial pneumonia.  Pneumonia is an infection of the lungs which can be associated with severe complications.  Adults age 65 and over should receive this vaccine.  Those who are at higher risk of complications of pneumonia, such as patients with chronic lung disease (asthma, emphysema/COPD), heart failure, Diabetes, chronic liver disease, alcoholism, transplants, HIV, Leukemia, Lymphoma and other states of reduced immunity, should receive this vaccine sooner.

Influenza (Flu) Vaccine

Influenza is a viral infection of the respiratory system that infects millions of people per year, and is associated with over 25,000 deaths in the USA annually.  Influenza vaccine should be given to individuals ages 50yrs and older.  Younger persons should be immunized sooner: those with chronic lung or heart disease, chronic liver or kidney disease, Diabetes, HIV infection, residents of long term care facilities and others with reduced immunity as mentioned above.  Also, household contacts, caregivers and workplace contacts of those mentioned should receive Influenza vaccine.  Many other groups of people should be immunized such as medical personnel and travelers to areas with current Influenza illness.

Hepatitis A Vaccine

Hepatitis A is a viral infection, predominantly affecting the liver that causes fever, severe joint pain, fatigue and jaundice. It is transmitted by contact with food or water contaminated with feces of an infected person.  Those who should receive Hepatitis A vaccine include:  those with chronic liver disease, recipients of clotting factor concentrates, gay men, drug abusers, adults who have had recent contact with Hepatitis A, certain food handlers, persons who work or travel in areas of high risk, and all persons wishing to be protected from hepatitis A virus infection. 

Hepatitis B Vaccine

Hepatitis B is a viral infection, predominantly affecting the liver, with similar symptoms to Hepatitis A, however Hepatitis B is transmitted by contact with blood and other body fluids.  In some cases, it goes on to cause a persistent inflammation of the liver, called Chronic Hepatitis B.  This puts an individual at increased risk to develop Cirrhosis of the Liver (permanent scarring), liver failure, and Cancer of the Liver.  Everyone up to age 18 years should receive the 3 shot series.  Others who should be immunized include:  those with chronic liver disease, household contacts of patients with Hepatitis B infection, gay men, sexually active people not in monogamous, long-term relationships, health care personnel, clients and staff of long term care institutions, patients receiving hemodialysis, some international travelers, prison inmates, and those seeking care for sexually transmitted diseases.

Pertussis (Whooping Cough)

Pertussis (Whooping Cough) is a highly contagious bacterial respiratory infection that is transmitted by direct contact with droplets of respiratory mucus of infected persons.  It is characterized by severe episodes of coughing, a “whooping” sound, and vomiting after coughing.  Complications can be serious in children, including pneumonia, respiratory failure, and seizures; and may be fatal in children under 12 months of age.  The incidence of Pertussis has been increasing in the last few years; therefore recommendations for vaccination now include adults under 65 years of age, especially those with contact with children under 1 year of age, who have not had Pertussis vaccine since childhood.  In addition, health care personnel should be vaccinated.

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