Friday, April 29, 2016

Shistosomiasis and HIV (Caution X rated article)

Drudge links to an article about a "worm" associated with HIV.

 Seems that some smart people actually noticed that women with shistosomiasis in the GU tract might have mini sores that let in the HIV virus.

 Duh.

 Wait til they find a lot ofwomen use herbs to "treat" their vaginal dischage and dry the secretions so the men get more pleasure with sex (something the Village Voice noticed 20 years ago).

 This "dryness" might also be why the HIV rate is so much higher in women who use the DepoProvera shot: The progesterone leads to sticky mucus and less lubrication.

 Like circumcision, one wonders why no one put two and two together.

But it's like the taboo with gay sex: That recctal intercourse leads to more abraisions and bleeding (women: Think hard bm when you are pregnant and bleed). and that this sex practice might have something to do with HIV sread in Gays in the USA.

That practice, and the huge increase in gay promiscuity with the sexual revolution, were why HIV spread so quickly.... it's not like docs didn't notice: They tried to get the bath houses closed because of the Hepatitis B and syphillis epidemics in San Francisco before the first cases of HIV were noticed...but the gays did  a recall election against the mayor for what one would now call "homophobia".


 And I am still waiting for smart scientists to figure that another reason for HIV might be that some women practice anal intercourse as a means of brith control.... when you are pregnant or nursing, there is a taboo against vaginal intercourse, since breast milk is the only protein source for young children, so nursing continutes to 2 to 3 years. When the kid is weaned, he is fed the usual diet, which is low in protein, and we see "kwashiorkor", a disease of protein deficiency with enough carbohydrate calories.

If the woman gets pregnant before then, usualy the kids can't digest the "porridge" made from corn (Sadza) so we saw "marasmus" (thin and starved of calories and protein).

Well, anyway, if a woman gets pregnant too soon, she weans the kid and he usually dies. So intercourse is taboo.

Local joke: Poor man: Five wives, all pregnant or breast feeding. He might as well be single.

In traditional villages, the husband of a woman who got pregnant too soon would be ridiculed. Hence other practices, such as intracrural intercourse and rectal intercourse.

But with colonial economic changes, men often had to work outside the home, so when they came home once every few months, there is no way the woman would say no....


Some might blame Christianity, but even before Christianity, polygamy was limited, but since poor men rarely had several wives, this was not as big a problem for the poor as for the middle class, who were educated enough not to worry about taboos and rich enough to think they were entited to sex, so promptly switched to prostitutes and got HIV.... HIV essentially wiped out the educated and urban middle class in many of these African countries.

There was a push to encourage regular mistresses in some countries awhile back for this reason.


Saturday, April 23, 2016

FGM: A report from one woman

there are several types of female genital mutilation, the smallest being just a ritual cut, as is done in Indonesia, but the main one used in Africa/Somalia/Egypt and parts of the Middle East is truly a mutilation that affects the woman's ability to pee, have sex, and have babies.

BBC article on one woman's quest to pee without pain.

The repercussions of a procedure that either involves removing the clitoris (type one), removing the clitoris and the inner smaller labia (type two), a cut and a forced narrowing of the vaginal opening (type three), or any kind of harmful mutilation in the genitals (sometimes referred to as type four), are wide-ranging. The day-to-day reality for survivors can be bleak. ...
TheNHS lists urinary tract infections, uterine infections, kidney infections, cysts, reproductive issues and pain during sex as just some of the consequences. A "reversal" surgery, as defibulation is sometimes termed, can help to relieve some of the symptoms by opening up the lower vagina.

"But it's not as simple as carrying out the physical care, which we can carry out as clinicians," says Fyle, who comes from Sierra Leone, where FGM is widespread. "It's about the long-term (psychological) consequences - some people describe it as worse than PTS (post-traumatic stress), which soldiers in the battlefield have."

Monday, April 18, 2016

Ear infection update: Another reason to have your kids get their shots

NYTimes has an article about the huge decrease in ear infections, due to giving babies a pneumonia vaccine

there was a Scandanavian study 20 yrs back that insisted we didn't need to treat them with antibiotics, but given the complications, we usually did anyway.

Why? Because in the Scandanavian study, they followed up cases and only treated them if the infection persisted.

In my practice, with lower class rural folks or on "the Res" that was not something that was practical. So better to overtreat than risk a complication.

What was the first game changer was the H Flu vaccine, a common cause of ear infections and meningitis.

Then came the pneumonia vaccine.

Soon we not only saw fewer ear infections but fewer cases of draining ears and meningitis. How fewer cases? Well, so few that I lost my skill in doing spinal taps in squirming toddlers and had to ask the pediatrician to do it. (if you do fewer than 6 procedures a year, you should drop the procedure, unless you can practice it on a dummy, as in CPR training).

It also has to do with other practices: Breast feeding not only increases the kid's immune system, but it keeps kids away from the custom of putting them to bed with a bottle, leading to both ear infections and bottle teeth in toddlers.

The reason goes back to the parents and the good decisions they’re making, to immunize their children, to breast-feed their children, to not smoke around their children,” Dr. Byington said. “It’s parents making these good decisions for their kids, and it’s paying off.”

and yes, even poor parents will take the cigarettes outside.

Alas, in poor rural area, another risk factor is the wood stove...not the stove per se, but the mold on the wood sitting by the stove, and the ashes in the atmosphere when you cleaned it out, and of course the fumes when you went outside.

But I don't know of any scientific studies on this off the top of my head...it's just something docs in rural areas "know".

Wednesday, April 13, 2016

Neanderthal extinction: rewrite the books

There are various theories why the Neanderthals went extinct, most of them implying that aggressive newcomers pushed the off their hunting grounds to genocide.

But the latest theory wonders if the newcomers brought in new infectious disease did them in, in the same way that infectious disease caused millions of indigenous Amerindians to die after the Spanish arrived.

. “Humans migrating out of Africa would have been a significant reservoir of tropical diseases. For the Neanderthal population of Eurasia, adapted to that geographical infectious disease environment, exposure to new pathogens carried out of Africa may have been catastrophic,” Charlotte Houldcroft of the University of Cambridge told The Guardian
this was sort of ignored because "experts" insisted that cavemen didn't have infectious disease, and only after en settled down in houses with a pig in the parlor did disease become a problem.

Now there is a question if disease could have been there all along.

Archeology org link

UKGuardian has more details.

The DNA suggestion that sexual relationships might have occured also suggests STD's like herpes simplex might be behind the problem. But they also note TB in there.

the problem: This is only theory. Awaiting proof...

The STD syphillis came into Europe with Colombus' sailors (who when out of work went to Italy, had fun with the lovely ladies of Naples who then entertained the German mercenaries, if I remember the history correctly)

But what about those pre 1492 cases of syphillis found in a few skeletons?

I always assumed it was Yaws, a related disease, but now that DNA suggests some Norwegians and/or Icelanders have Amerindian female ancestry, the theory is that maybe the Vikings brought back not only Amerindian women but syphillis, and that was the source of why a few pre 1492 cases were found.

From Science Frontiers

Recently, however, several additional syphilitic skeletons were dug up at a medieval friary in northeastern Britain. The earliest of these bones date back to about 1300. In fact, the new evidence suggests that there was a geographically limited mini-epidemic of syphilis in Britain about this time. Columbus was now off the hook, but who should be hung on it instead? The Vikings, of course. Viking merchants began visiting this part of England about 1300. And it is now admitted that the Vikings had made it to the New World source of the disease circa 1000. Case closed!? (Malakoff, David; "Columbus, Syphilis, and English Monks," Science. 289:723, 2000.)

The DNA article LINK 

I like the part that she came "Voluntarily or non voluntarily": Both Indians and Vikings routinely captured women to use as slaves, a job that included sexual work. Some of course would later marry and be accepted into society, (hence the high amount of Celtic genes in Icelanders)



Monday, April 11, 2016

ZIKA

NYT has a long article on Zika

if Zika came from Africa why didn't it affect babies there is one question comes to mind.

I suspect it is because, like Rubella, you caught it as a child, and became immune, so by the time you got pregnant you couldn't catch the disease.


POlio vaccines

LINK

three types of polio virus

Type 2 polio is essentially eradicated, but the type 2 attenuated virus in the vaccine can mutate to cause polio in one out of a million cases. Most of the cases traced back to the vaccine are of type 2 virus (and I should note most of  in cases were not in the kids immunized but in playmates who didn't get the vaccine, ocaretakers etc. who had no immunity to polio or had weakened immune systems due to malnutrition, cancer, pregnancy etc).

But to put it into perspective: there were 32 cases of paralysis from the vaccine last year.

so the hope is that the oral vaccine will work just as well with fewer paralysis cases.