When in Doubt, Toss It Out

Some bacteria are not harmful. But others can torture you with miserable stuff like diarrhea. Even if there's no visible dirt on your food, you can still get sick. You just can't tell what kinds of bacteria may be lurking on the floor.

So what are you to do with the piece of watermelon that just slipped from your grip? The safest choice is to throw it out. Or let the dog have it. (And there's another thing to consider — even the 5-second rule can't get around the fact that your food may have landed right in a spot where Fido parked his butt.)

 

The Basics on Genes and Genetic Disorders

Have people ever said to you, "It's in your genes?" They were probably talking about a physical characteristic, personality trait, or talent that you share with other members of your family. We know that genes play an important role in shaping how we look and act and even whether we get sick. Now scientists are trying to use that knowledge in exciting new ways, such as preventing and treating health problems.

What Is a Gene?

To understand how genes (pronounced: jeens) work, let's review some biology basics. Most living organisms are made up of cells that contain a substance called deoxyribonucleic (pronounced: dee-ahk-see-rye-bow-noo-klee-ik) acid (DNA). DNA is wrapped together to form structures called chromosomes (pronounced: krow-muh-soams).

Most cells in the human body have 23 pairs of chromosomes, making a total of 46. Individual sperm and egg cells, however, have just 23 unpaired chromosomes. You received half of your chromosomes from your mother's egg and the other half from your father's sperm cell. A male child receives an X chromosome from his mother and a Y chromosome from his father; females get an X chromosome from each parent.

So where do genes come in? Genes are sections or segments of DNA that are carried on the chromosomes and determine specific human characteristics, such as height or hair color. Because each parent gives you one chromosome in each pair, you have two of every gene (except for some of the genes on the X and Y chromosomes in boys because boys have only one of each).

Some characteristics come from a single gene, whereas others come from gene combinations. Because every person has from 25,000 to 35,000 different genes, there is an almost endless number of possible combinations!

Genes and Heredity

Heredity is the passing of genes from one generation to the next. You inherit your parents' genes. Heredity helps to make you the person you are today: short or tall, with black hair or blond, with green eyes or blue.

Can your genes determine whether you'll be a straight-A student or a great athlete? Heredity plays an important role, but your environment (including things like the foods you eat and the people you interact with) also influences your abilities and interests.

How Do Genes Work?

DNA contains four chemicals (adenine, thymine, cytosine, and guanine — called A, T, C, and G for short) that are strung in patterns on extremely thin, coiled strands in the cell. How thin? Cells are tiny — invisible to the naked eye — and each cell in your body contains about 6 feet of DNA thread, for a total of about 3 billion miles (if all your DNA threads were stretched out straight) of DNA inside you! The DNA patterns are the codes for manufacturing proteins, chemicals that enable the body to work and grow.

Genes hold the instructions for making protein products (like the enzymes to digest food or the pigment that gives your eyes their color). As your cells duplicate, they pass this genetic information to the new cells. Genes can be dominant or recessive. Dominant genes show their effect even if there is only one copy of that gene in the pair. For a person to have a recessive disease or characteristic, the person must have the gene on both chromosomes of the pair.

What Are Genetic Disorders?

Cells can sometimes contain changes or variants in the information in their genes. This is called gene mutation, and it often occurs when cells are aging or have been exposed to certain chemicals or radiation. Fortunately, cells usually recognize these mutations and repair them by themselves. Other times, however, they can cause illnesses, such as some types of cancer. And if the gene mutation exists in egg or sperm cells, children can inherit the mutated gene from their parents.

Researchers have identified more than 4,000 diseases that are caused by genetic variants. But having a genetic mutation that may cause disease doesn't always mean that a person will actually get that disease. Because you inherit a gene from each parent, having one disease gene usually does not cause any problems because the normal gene can allow your body to make the normal protein it needs.

On average, people probably carry from 5 to 10 variant or disease genes in their cells. Problems arise when the disease gene is dominant or when the same recessive disease gene is present on both chromosomes in a pair. Problems can also occur when several variant genes interact with each other — or with the environment — to increase susceptibility to diseases.

If a person carries the dominant gene for a disease, he or she will usually have the disease and each of the person's children will have a 1 in 2 (50%) chance of inheriting the gene and getting the disease. Diseases caused by a dominant gene include achondroplasia (pronounced: ay-kon-druh-play-zhuh, a form of dwarfism), Marfan syndrome (a connective tissue disorder), and Huntington disease (a degenerative disease of the nervous system).

People who have one recessive gene for a disease are called carriers, and they don't usually have the disease because they have a normal gene of that pair that can do the job. When two carriers have a child together, however, the child has a 1 in 4 (25%) chance of getting the disease gene from both parents, which results in the child having the disease. Cystic fibrosis (a lung disease), sickle cell anemia (a blood disease), and Tay-Sachs disease (which causes nervous system problems) are caused by recessive disease genes from both parents coming together in a child.

Some recessive genetic variants are carried only on the X chromosome, which means that usually only guys can develop the disease because they have only one X chromosome. Girls have two X chromosomes, so they would need to inherit two copies of the recessive gene to get the disease. X-linked disorders include the bleeding disorder hemophilia (pronounced: hee-muh-fih-lee-uh) and color blindness.

Sometimes when an egg and sperm unite, the new cell gets too many or too few chromosomes. Most children born with Down syndrome, which is associated with mental retardation, have an extra chromosome number 21.

In some cases, people who are concerned that they might carry certain variant genes can have genetic testing so they can learn their children's risk of having a disease. Pregnant women can also have tests done to see if the fetus they are carrying might have certain genetic illnesses. Genetic testing usually involves taking a sample of someone's blood, skin, or amniotic fluid, and checking it for signs of genetic diseases or disorders.

Changing Genes

Sometimes scientists alter genes on purpose. For many years, researchers have altered the genes in microbes and plants to produce offspring with special characteristics, such as an increased resistance to disease or pests, or the ability to grow in difficult environments. We call this genetic engineering.

Gene therapy is a promising new field of medical research. In gene therapy, researchers try to supply copies of healthy genes to cells with variant or missing genes so that the "good" genes will take over. Viruses are often used to carry the healthy genes into the targeted cells because many viruses can insert their own DNA into targeted cells.

But there are problems with gene therapy. Scientists haven't yet identified every gene in the human body or what each one does. Huge scientific efforts like The Human Genome (pronounced: jee-nome) Project and related projects have recently completed a map of the entire human genome (all of the genetic material on a living thing's chromosomes), but it will take many more years to find out what each gene does and how they interact with one another. For most diseases, scientists don't know if and how genes play a role. Plus, there are major difficulties inserting the normal genes into the proper cells without causing problems for the rest of the body.

There are also concerns that people might try changing genes for ethically troubling reasons, such as to make smarter or more athletic children. No one knows what the long-term effects of that kind of change would be.

Still, for many people who have genetic diseases, gene therapy holds the hope that they — or their children — will be able to live better, healthier lives.

 

What's the Difference Between Infectious and Contagious?

What's the difference between infectious and contagious?

- Nick

Infections are diseases that are caused by microscopic germs (such as bacteria or viruses) that get into the body and cause problems. Some — but not all — infectious diseases spread directly from one person to another. Infections and other diseases that spread from person to person are said to be contagious.

Some infections spread to people from an animal or insect, not another human. Lyme disease is an example: You can't catch it from someone you're hanging out with or pass in the street. It comes from the bite of an infected tick.

Contagious diseases (such as the flu, colds, or other infections) spread from person to person in several ways. One way is through direct physical contact, like touching or kissing a person who has the infection. Another way is when an infectious microbe travels through the air after someone nearby sneezes or coughs. Sometimes people get contagious diseases by touching or using something an infected person has touched or used — like sharing a straw with someone who has mono or stepping into the shower after someone who has athlete's foot.

Even if an infection or other disease is contagious, being exposed to it does not mean a person will automatically get sick. Our immune systems do a great job of warding off the germs that cause many diseases, often because we've had the disease before or because we're up to date on our shots!

 

 

Why Should I Care About Germs?

You may think germs are something you don't have to worry about — only the people selling toilet cleaners on TV are concerned with germs.

But germs are tiny organisms that can cause disease — and they're so small that they can creep into your system without you noticing. You even need a microscope to see them. To stay healthy, it helps to give some thought to germs.

Germs Basics

The term germs is really just a generic word for four different types of organisms: bacteria, viruses, fungi, and protozoa.

Bacteria are tiny, single-celled organisms that are found throughout nature, including in the bodies of human beings. A certain number of bacteria are good for our bodies — they help keep the digestive system in working order and keep harmful bacteria from moving in. Some bacteria are even used to produce medicines and vaccines.

But bacteria can cause trouble, too — ever had a urinary tract infection or strep throat? These infections are caused by bacteria.

Viruses are even smaller than bacteria and can't live on their own. In order to survive, grow, and reproduce, they need to be inside other living organisms. Most viruses can only live for a very short time outside other living cells. For example, they can stay on surfaces like a countertop or toilet seat in infected bodily fluids for a short period of time, but they quickly die there unless a live host comes along. But some viruses, such as the kind that cause hepatitis (an infection of the liver), can survive on surfaces for a week or longer and still be able to cause infections.

Once they've moved into your body, viruses spread easily and can make you quite sick. Viruses are responsible for not-so-serious diseases like colds as well as extremely serious diseases like smallpox.

Fungi (pronounced: fun-jye) are multi-celled, plant-like organisms that usually aren't dangerous in a healthy person. Fungi can't produce their own food from soil, water, and air, so instead, they get nutrition from plants, food, and animals in damp, warm environments.

Two common fungal infections are athlete's foot and ringworm. People who have weakened immune systems (from diseases like AIDS or cancer) may develop more serious fungal infections.

Protozoa (pronounced: pro-toe-zo-uh) are one-celled organisms like bacteria. Protozoa love moisture, so intestinal infections and other diseases they cause are often spread through contaminated water.

Once organisms like bacteria, viruses, fungi, and protozoa invade your body, they get ready to stay for a while. These germs draw all their energy from you! They may damage or destroy some of your own healthy cells. As they use up your nutrients and energy, most will produce waste products, known as toxins.

Some toxins cause the annoying symptoms of common colds or flu-like infections, such as sniffles, sneezing, coughing, and diarrhea. But other toxins can cause high fever, increased heart rate, and even life-threatening illness.

If you're not feeling well and visit your doctor, he or she may order testing to examine your blood and other fluids under a microscope or perform cultures to determine which germs (if any) are making you sick.

How Can I Protect Myself From Germs?

The best way to prevent the infections that germs cause is by protecting yourself. Because most germs are spread through the air in sneezes or coughs or through bodily fluids like saliva, semen, vaginal fluid, or blood. If you or someone else is sick, your best bet is to limit contact with those substances.

Washing your hands often is absolutely the best way to stop germs from getting into your body. When should you wash? After using the bathroom, after blowing your nose or coughing, after touching any pets or animals, after gardening, or before and after visiting a sick relative or friend. And of course you should wash your hands before eating or cooking.

There's a right way to wash hands, too — you need to soap up well using warm water and plenty of soap, then rub your hands vigorously together for 15 seconds (away from the water). Rinse your hands and finish by drying them thoroughly on a clean towel. It's a good idea to carry hand sanitizer with you for times when you are eating out or not near a sink.

If you spend any time in the kitchen, you'll have many opportunities to get rid of germs. Be sure to use proper food-handling techniques, like using separate cutting boards, utensils, and towels for preparing uncooked meat and poultry.

Another way to fight infections from germs is to make sure you have the right immunizations, especially if you'll be traveling to other countries. Other yearly immunizations, such as the flu vaccine, are strongly recommended unless your doctor tells you otherwise.

With a little prevention, you can keep harmful germs out of your way!

 

 

Your Medical Records

Don't look now, but you're being followed. You have been, in fact, since the day you were born. The good news is that the people following you are doctors, nurses, and other health care providers. And the way they're tracking you is on paper, through your personal medical history.

What Are Medical Records?

Each time you hop up on a doctor's exam table or roll up your sleeve for a blood draw, somebody makes a note of it in your medical records. All that scribbling adds up over time. Even if you're the healthiest person alive, you'll still manage to accumulate crate upon crate of paperwork by your 21st birthday.

Chances are you won't ever pore over all those pages. But there might come a time when you want to get information from your medical records: Maybe you'll need to provide your college or new job with a record of immunizations before you can start. Or perhaps you want a new doctor to know your full medical history.

As you start taking charge of your own medical care, it helps to know what's in your medical records, how you can get them when you need to, who else is allowed to see them, and what laws are in place to keep them private.

What's in My Medical Records?

You might picture your medical records as one big file in a central storage facility somewhere. But actually they're in lots of different places. Each specialist who treats you keeps his or her own file, and each of these is part of your medical records.

Your medical records contain the basics, like your name and your date of birth. They also include the information you give to your family physician, dentist, or other specialist during an examination.

You know how doctors often ask a series of questions — like about how you're feeling that day or your family medical history? Well, all of your answers go into your doctors' records, along with the results of any medical exams, test results, treatments, medications, and any notes doctors make about you and your health.

Medical records aren't just about your physical health. They also include mental health care. So if you went to family therapy back when you were 6 and your parents were divorcing, it will be somewhere inyour records.

Can I See My Records?

U.S. law gives patients the right to see, get copies of, and sometimes even change their medical records.

If you're younger than 18, your parent or guardian will probably need to ask for copies of medical records on your behalf. However, more states are allowing minors to take charge of their own health services, so ask your doctor, hospital, or health system about what access you have to your records.

Medical records — particularly test results or imaging studies like X-rays — can be confusing for people who aren't trained in reading them. Something that might look scary on an X-ray or MRI might be nothing to worry about. So if you do look at your records on your own, keep that in mind and ask a doctor if you have questions.

How Do I Get Them?

Start by figuring out who has the information you want. If it's dental information you're after, contact your dentist's office. If it's a general health issue, you'll probably want to talk to your family doctor.

When it comes to requesting medical records, different providers have different ways of doing things. Some might ask you to fill out an authorization form. If so, you'll want to be ready with information like this:

· Dates of treatment or service (such as a hospital stay). If it's been a while and you don't remember exact dates, ask for records from a range of dates, such as 2000-2005.

· Which information you want. Do you need the entire record or just part? Specific test results? X-ray films, blood work results, etc.?

· How you want the information. Do you just want to look at your records to find out what's in them? Or do you need to get your own copy, have a copy sent to another physician, or both?

A health care provider's office might charge a fee to cover the cost of having someone make copies. Some offices put test results and imaging studies on a CD-ROM. You'll probably have to pay for mailing the records to you or another doctor (if you won't be picking them up in person).

How Long Does it Take?

The law gives health care providers up to 30 days to provide copies of medical records, but almost all health care organizations supply records a lot faster than that. Most people get their non-critical care records within 5 to 10 business days. If records are needed faster — like when a patient needs medical treatment — the health care provider holding the records usually releases them immediately.

If you need to get records for non-emergency situations (such as switching to a new doctor), it's safest to give plenty of notice. Let the medical provider who has your records know that you'd like copies a few weeks ahead of any appointments with your new health care provider.

Can They Say No?

They can — but it almost never happens. When it does, it's because a doctor's office is trying to protect a patient's privacy or safety. For example, they may withhold medical information if they're not sure the person requesting the records has a right to see them. Or they may not release records if they think it will lead to the patient being harmed.

If health care providers deny access to records, they must give the reasons why in writing within 30 days. If any request for medical information is denied, a patient has the right to ask for the decision to be reviewed again.

What if I Spot a Mistake in My Medical Records?

If you notice something missing or something you think is wrong in your medical records, you have the right to request a correction. Ask your doctor's office to explain how they handle changes to your records and what you need to do to request a change. The law gives health care providers 60 days to make the changes or deny the request.

Who Else Can See My Records?

Your information can be used and shared with the following people or groups, when needed:

· other health care providers as necessary to support your treatment and care

· insurance companies, Medicaid, and other groups responsible for paying doctors and hospitals for your health care

· public health agencies as needed to protect the public's health, such as by reporting when the flu is in your area

· law enforcement agencies, such as reporting a gunshot wound to the police

· parents or guardians if you are younger than 18

· family, relatives, friends, or others in your life — but only if you (or a parent or guardian, while you're under 18) give permission

What About My Parents?

Parents have access to their kids' medical records until the child is 18. However, many states now allow doctors to decide whether or not they disclose certain information to parents — like about sexual health or substance abuse, for example. The law also states that parents no longer have access to their teens' health records if they agree to let them have a confidential relationship with their doctors.

Most hospitals or doctors make every effort to protect patients' privacy when it comes to sensitive information that's in their medical records. Sometimes a health care provider will feel that it's not in the best interest of the patient to release information to parents, even when a child is younger than 18.

For mental health records (such as the notes a therapist takes during counseling sessions) the age when parents no longer have access to a child's medical records is 15 or 16, depending on the state.

After you reach 18, your parents cannot see your records — by law. For some people, that may not be a problem. It may even seem like a good thing! But what if you have a health problem and need your parents to make decisions about your care if something happens? If you want your parents to have access to your records after 18, you'll need to sign a document authorizing them to do so, just as you would with anyone else.

Should I Keep My Own Medical Records?

It's a great idea. Many health care experts recommend that patients keep their own medical summaries or Personal Medical Records (PMRs). That way, they can bring them along on visits to specialists, new doctors, or even an unexpected trip to the emergency room.

Your PMR should include the following information:

· your name, date of birth, blood type, and emergency contact

· date of last physical exam

· dates and results of past tests and screenings

· major illnesses and surgeries, with dates

· any injuries you've had and/or illness for which you've been treated

· any allergies to foods, medications, household items, etc.

· a list of all your medicines, doses and how long you've been taking them

· chronic diseases, if any

· a history of illnesses in your family

· any accommodations you may need to make medical decisions (such as sign language interpreter, information written in large print, picture symbols, etc.)

Once you compile your PMR, you can keep it up to date by requesting test results and other medical records as they come up in the future. If you keep your PMR electronically, you can store a copy of it on a flash drive so it's always with you (if you do this, it's a good idea to password-protect it).