Chancroid

Heart Disease

CORONARY heart disease is still America's No. 1 killer, and it's a condition that continues to hit the Black community especially hard. More specifically, doctors say, is the fact that not only are Black women with heart disease at higher risk for heart attack or death, but they are also being seriously undertreated when compared to White women. One study indicates that Black women are twice as likely as White women to have heart attacks or die. There have been similar studies indicating almost identical results among Black men.

Doctors say Black women and Black men are less likely to receive aspirin or medications to lower cholesterol or blood pressure, two primary conditions associated with heart disease. The American Heart Association and other health organizations say all--but especially certain groups--need to be aware of their risk for heart disease so they can be more proactive, which will allow them to be treated more aggressively and control their risk factors.

While there are continuous research studies that focus on the mystery of heart disease, medical experts continue to stress the importance of prevention, and that includes proper diet, regular exercise and routine checkups. In regard to diet, doctors still tout the benefits of a diet that includes cold-water fish (such as salmon, mackerel and herring). Several studies have shown that a diet rich in fatty fish or use of fish-oil supplements containing omega-3 fatty acids can contribute to a healthier heart.

In one apparent breakthrough, researchers recently revealed that there could be a connection between fish oil and the prevention of arrhythmias, the quickening of the heart that could lead to cardiac arrest and death. The American Heart Association recommends that people eat at least two servings of fish a week, and medical findings indicate that certain other foods are especially heart-healthy. For instance, broccoli and broccoli sprouts are among a group of plant-based foods that apparently raise the body's antioxidant defense systems and lessen risk of heart disease, stroke and cancer.

When it comes to heart disease, doctors say, like other medical conditions, prevention is the best cure.

Prostate Cancer

OTHER than skin cancer, no cancer so disproportionately affects Black men as much as prostate cancer. Striking Brothers of all socioeconomic levels and educational backgrounds at a 50 percent higher rate than White men, prostate cancer among Black males, according to the National Cancer Institute, is almost at "epidemic" levels. In fact, the prostate cancer rate for African-American men is the highest in the world. In recent years, the likes of Nelson Mandela, Harry Belafonte, Minister Louis Farrakhan, Sidney Poitier, Dr. Louis Sullivan, Dr. Benjamin Carson and Ambassador Andrew Young have been diagnosed with prostate cancer. And earlier this year, Black Enterprise Founder and Publisher Earl G. Graves St. revealed he had the disease.

Prostate cancer may have no symptoms, so routine testing is important for men over 40. Treatments for prostate cancer include surgery and external beam radiation therapy. Surgeons at Howard University Hospital in Washington, D.C., have successfully implanted high-dose radioactive seeds into the prostate, while doctors at Henry Ford Hospital in Detroit are using a robot equipped with a 3-D camera to perform prostate surgery. Graves received a new nerve-sparing procedure at Johns Hopkins University's urological institute that allows for prostate removal with the preservation of sexual potency and continence. And researchers at the University of Illinois at Chicago are testing a vaccine that prompts the patient's immune system to attack only the prostate-cancer cells.

Dr. Terry Mason, author of the forthcoming book Prostate Cancer: A Conversation With Dr. Terry Mason-What You Need to Understand, and other experts say there is evidence that diet may be related to prostate cancer risk.

Prostate cancer accounts for 40 percent of all cancers diagnosed among Black men, and it is more likely to kill them than any other cancer. It is estimated that about 1 in 5 Black men will develop prostate cancer sometime during his life. One in 22 Black men will die of prostate cancer, with the mortality rates among Blacks being twice as high as that for Whites. and this rate is increasing almost 2 percent a year, according to medical experts.

Diabetes

MORE than 18 million people--3 million Blacks--have diabetes. In the last30 years, the rate among African-Americans has tripled, with Blacks now twice as likely to have diabetes as Whites. Left untreated, diabetes can often lead to numbness of feet, loss of eyesight, nerve damage, heart disease and even death. In order to control the condition, diabetics often must take insulin injections twice daily and monitor their blood sugar levels closely. But within the past few years, promising treatments have been developed, offering the hope of eliminating insulin injections altogether.

One treatment is stem-cell therapy. Still in the development stage, clinical evidence has shown that injecting stem cells with proteins can in fact trigger an insulin response. While these studies have yet to be tested on humans, the belief is that within 5 years, diabetes can be controlled and in some cases totally "cured." Inhaled insulin is also a treatment that offers relief from daily injections. It is administered by breathing in a dry powdered form of the drug using an apparatus similar to an asthma inhaler. The insulin goes directly into the lungs, and then is distributed into the bloodstream.

Researchers at the University of Kentucky College of Medicine have developed a new sustained-release treatment that may be effective for treating several sight-threatening retinal disorders, such as diabetic macular edema. The treatment involves a simple surgical procedure to place a tiny implant containing medicine into the back of the eye. The implant is designed to deliver sustained and consistent therapeutic levels of drugs directly to the diseased area of the eye for up to three years.

Traditionally, diabetes treatment has focused on regulating blood sugar levels by careful control of diet or through insulin injections. But researchers have come to understand that heart disease is, in fact, the more serious threat. Up to 80 percent of diabetes patients will develop heart problems or die as a result of them. Therefore controlling hypertension is now a high priority. Control of lipids (the fats in the blood stream that can affect coronary health) and glucose regulation are also major concerns.

If diabetics have a family history of heart disease, high blood pressure, weight problems or if they smoke, new guidelines call for moderate doses of cholesterol-lowering statins.

STDs

WARNING! Sex can make you sick and even kill you. While this might seem like a tired and worn statement, too many people today do not realize the frequency, severity and fatal consequences of having unprotected sex. Sexually transmitted diseases are thriving and affecting the health, childbearing abilities and lives of millions of Americans. STDs disproportionately affect African-American teens and women.

For several years now, there have been warnings that the U.S. is in the midst of an STD epidemic. More than 65 million people in the U.S. are living with an STD, the majority of which are incurable viral infections. It is estimated that 15 million new sexually transmitted infections occur each year, with teens, women and "people of color" most at risk. According to a new report in the Journal of the America n Medical Association, 1 in 25 young Americans are infected with chlamydia, considered the most common bacterial STD in the U.S. Blacks are six times more likely to be infected than Whites. It can be cured with a single dose of antibiotics, but most people don't know they have chlamydia because there are no symptoms. Left untreated in women, chlamydia may cause pelvic inflammatory disease, infertility and ectopic pregnancy.

Other common sexually transmitted diseases are: AIDS/HIV, which attacks the immune system; chancroid, a treatable bacterial infection that causes painful sores; crabs, parasites that live on pubic hair; gonorrhea ("the clap"), a treatable bacterial infection that causes pain and a discharge; hepatitis, a disease that affects the liver; genital herpes, a recurrent skin condition that causes irritation and blisters; human papillomavirus/genital warts, which affects skin in genital area and in female cervix; molluscum contagiosum, a viral skin disease that causes bumps and lesions; pelvic inflammatory disease (PID), a bacterial infection, of the female reproductive organs; syphilis, a treatable bacterial infection that can affect heart, brain and nerves; and vaginitis, a bacterial infection of the vagina that causes itching, burning and discharge.

According to a government report, condom use is the only method to reduce the risk of HIV and STDs in sexually active individuals. Many STDs in women have no symptoms, so you must get regular medical checkups. If you notice a discharge, rash, blister or anything unusual in association with your genital area, see a doctor immediately. Left untreated, sexually transmitted diseases can have serious consequences, especially for pregnant women and their babies.

Asthma

ASTHMA is a chronic, inflammatory lung disease characterized by recurrent breathing problems due to inflammation of the air passages. African-Americans are more likely than Whites to get the disease, which tends to run in families and is also nearing epidemic proportions among children. Rates of asthma have more than doubled since 1980, and asthma is this country's most common and costly illness, according to the Asthma and Allergy Foundation of America.

Common asthma symptoms include periodic cough, wheezing, tightness in the chest and shortness of breath. The Centers for Disease Control and Prevention released a study this year confirming an increase in asthma among African-Americans, and also an increase in the severity of asthma symptoms among African-Americans. The racial differences in asthma hospitalization and death statistics are related to "poverty, urban air quality, indoor allergens and lack of patient education and inadequate medical care," says the Asthma and Allergy Foundation of America.

This year two promising drug developments were approved. In April the FDA approved the first dual-action asthma drug for use in young children. The agency approved Advair for the treatment in children 4 to 11 years old with asthma that isn't adequately controlled by inhaled corticosteroid therapy alone. The drug has been approved for treating asthma in adults and children over age 12 since 2001. Another drug, Xolair, was recently approved for the estimated half a million people with severe allergic asthma not controlled by other medications. Xolair is able to cut asthma attacks by nearly one-third, experts say, by blocking the inflammation chain reaction. It is expensive--between $5,000 and $10,000 a year--and requires shots administered in a doctor's office every 2 to 4 weeks. According to one specialist, the medication is being used to treat the "sickest of the sick," but shows promise in blocking the root cause of an asthma breathing attack, instead of trying to treat the attack once it has begun.

Asthma patients should take the disease seriously and aggressively take control by following an Asthma Control Plan developed by their doctor. This includes monitoring lung function using a peak flow meter, learning what triggers their asthma and how to avoid those triggers, taking their medication as prescribed--even when they feel well--and learning how to adjust medications based on their symptoms and peak flow readings.

Arthritis

FORGET the image of arthritis as a disease of the elderly. Today's arthritis attacks all age groups (including children), and it has a downright sexy face. Professional dancer Debbie Allen is an arthritis sufferer and presents a new and vital image for a disease that's often misunderstood. Arthritis actually refers to more than 100 different diseases that affect the joints and tissues around the joints. According to the Arthritis Foundation, some of these diseases also can affect other parts of the body, including the skin and internal organs. The disease can be mild and affect only a few joints or it can be chronic, lasting years or throughout a lifetime.

Nearly 4 million African-Americans have arthritis or a related condition, and after age 35, African-American women report a higher rate of arthritis than White women. It is the leading cause of disability among Americans over age 15. There are several forms of arthritis, but osteoarthritis, a degenerative joint disease that limits daily activities, is the most common form in African-Americans. Managing this chronic and painful disease requires a comprehensive approach, experts say, and has advanced far beyond the old-school home remedies of smelly wraps and poultices to ease the pain.

Actress and dancer Debbie Allen has joined with the Society of Women's Health Research to provide an update on the new medical guidelines for the treatment of arthritis and to focus on the potential danger of mixing arthritis pain medicines with commonly used prescription drugs. According to information released by the group, an interdisciplinary panel of arthritis pain specialists has the following recommendations: All arthritis treatment should begin with a comprehensive assessment of pain and function; pain medications are important in managing arthritis symptoms and should be used concurrently with education, nutritional and physical therapy; for mild to moderate arthritis pain, acetaminophen is recommended because of its mild side effects, low cost and over-the-counter availability; for moderate-to-severe arthritis pain, the use of non-steroidal anti-inflammatory drugs like ibuprofen and naproxen sodium should be considered if the patient is not responding to acetaminophen and the newer prescription C0X-2 (Cycloxygenase-2) specific inhibiters.

Hepatitis C

HEPATITIS C is an often-chronic, slow-progressing liver disease caused by the Hepatitis C virus (HCV). Known as a "silent killer-" because of the lack of disease-specific signs and symptoms, Hepatitis C is the most common blood-borne viral infection in the United States, and it is now the leading cause for liver transplantation in the United States.

A recent study estimated that 1.8 percent (3.9 million) of the U.S. population tested positive for the HCV antibody. That percentage was higher in Blacks (3.2 percent) than among Whites (1.5 percent). Because testing for the virus didn't become available until the late 1980s, experts say they aren't sure why it seems to affect Blacks at such higher rates. As a result, doctors say there must be a focus on prevention and education.

"Most people who have Hepatitis C don't have any symptoms," says Dr. Thelma E. Wiley Lucas, a hepatologist at Rush University Medical Center in Chicago. "And if they do, they just have symptoms of fatigue." Risk factors for Hepatitis C include, but are not limited to, IV drug use, having unprotected sex with multiple partners, and the use of unsterilized equipment for tattoos and body-piercings. In the past, before testing began, Hepatitis C could be transmitted through blood transfusions. About 40 percent of Hepatitis C patients don't know how they became infected, Dr. Wiley Lucas says.

The signs and symptoms are jaundice, fatigue, dark urine, abdominal pain, loss of appetite and nausea. Those infected with the Hepatitis C virus for many years may develop symptoms of cirrhosis (severe liver scarring) or even kidney disease.

The current and best treatment, specialists say, is the Interferon injection and the Ribavirin tablet. But some research indicates that African-Americans do not respond well to drug therapy. The reason, at least for now, remains a mystery.

"The 'whys' are not known," Dr. Wiley Lucas says. "Over the last few years, a lot of researchers have taken an interest in looking at the response [to drug therapy] according to race. That's a good thing."

Hypertension

HYPERTENSION, or high blood pressure, occurs when the force of blood against your artery walls is too strong. The condition is also a major risk factor for heart attack, stroke and kidney failure, experts say. And for African-Americans, those risks are even greater. High blood pressure affects one out of three African-Americans, according to the American Heart Association, and develops earlier in Blacks than in Whites.

Early detection and treatment are key factors in living with high blood pressure. Recently, the suggested guidelines for high blood pressure changed. In the past, the normal range for the systolic measurement, the pressure of blood against your artery walls when the heart has finished pumping--the top reading--has been anything lower than 130. For the diastolic reading on the bottom, the pressure of blood against your artery walls between heartbeats, normal had been considered to be anything lower than 85. Now, according to the latest research from the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure, a normal reading for a healthy adult is 119/79. Patients are considered pre-hypertensive at 120/80 to 139/89.

Millions of people whose blood pressure was considered borderline or normal may now fall into the "pre-hypertension range." That means that they, too, must have their blood pressure monitored regularly and consider some lifestyle changes to bring their blood pressure in line with the new "normal" range.

Although researchers don't always know the exact causes of hypertension, several factors can contribute to the condition: obesity, heavy alcohol consumption, family history of high blood pressure, high salt intake and aging. Treatment options include lifestyle modifications--including weight loss, exercising, limiting alcohol, cutting back on salt, and quitting smoking. If lifestyle modifications aren't enough, your doctor may prescribe a combination of medications, such as ACE inhibitors, Beta-blockers and diuretics. The longer hypertension is left untreated, the greater its complications can become.

COPYRIGHT 2004 Johnson Publishing Co.
COPYRIGHT 2004 Gale Group