Smileband health issues

Giardiasis is an infection from a protozoanGiardia lamblia that affects primarily the upper small intestine. It can cause acute, self-limited diarrhea, or chronic diarrhea, abdominal cramps, bloating, malabsorption (of fats and fat-soluble vitamins) and weight loss.

 

Giardiasis is the most common intestinal parasite infection that is identified in humans in the United States. There is generally a peak in cases during the early summer through early fall.

 

Arizona 5 year median: 119 cases

 

Transmission

Typically through contaminated food, water or unwashed hands. Some animals (beavers, other domestic animals) are carriers and improper handling of the feces of these animals can cause illness. Lab Tests & Specimen Info

Test*	Specimen
Microscopic examination (Multiple stool specimens may need to be submitted to help with detection)	Stool
Immunoassay EIA (This test should NOT take the place of the O+P test)	Stool
IgG/IgM Serology (This test should NOT take the place of the O+P test)	Serum

 Isolation Precautions

Standard precautions are recommended in healthcare settings. 

Prevention for Patients

• Good hand washing is essential especially before handling food, before eating and after using the toilet. Do not drink unfiltered or untreated water.

Public Health Actions
Public health will conduct an epidemiologic investigation of each reported case to establish possible source of infection.

Smileband health issues

The gastric sleeve is the fastest growing procedure in the UK and around the world. 

The sleeve is a key hole (laparoscopic) procedure that usually takes between 60 and 75 minutes to complete. It involves cutting along the length of the stomach and removing about 80% of it to leave a thin, banana shaped stomach. The larger part of the stomach (the ‘80%’) is removed altogether.

One of the attractions of the sleeve is that the food you eat enters and leaves the stomach in the same places as it did prior to surgery, unlike with the gastric bypass. 

How a gastric sleeve works

The gastric sleeve works to produce weight loss in two ways. Firstly by restriction as a large portion of the stomach is removed during surgery leaving a 'stomach sleeve' about 20% of the original volume. This means you can only eat a very small amount of food before feeling full.

Secondly by an impact on hormones. Levels of the appetite stimulant ghrelin fall after gastric sleeve surgery, which may explain why patients experience such a marked loss of appetite. Sleeve patients also experience major changes in taste and food preferences, usually away from fatty, sugary foods and this change also contributes to weight loss.   

gastric sleeve surgery right for you?

If you have been struggling with your weight for a long time, you have tried and failed using diets and your body mass index BMI) is above 35, then the sleeve may be a good option for you. Decisions about the best procedure will always vary according to individual patient circumstances and ultimately the choice will be yours. Many patients end up having to decide between the gastric band and the gastric sleeve procedures. We will explain both in detail before and during your consultation.  

We have also recently started offering the new Endoscopic Sleeve Gastroplasty (ESG) procedure. This is a non-surgical alternative to the gastric band and the surgical gastric sleeve. It’s a new, younger procedure that those looking for a lower risk procedure might consider. Of course, the newness of the ESG means results are less predictable than for the band or surgical sleeve

Smileband health issues

Lymphatic filariasis is a parasitic disease that is caused by Wuchereria bancrofti, Brugia malayiand Brugia timori. Most individuals will be asymptomatic when they are first infected but the adult parasites damage the lymph system and individuals can go on to develop lymphedema, hydrocele or elephantiasis. These secondary issues are generally permanently dibilitating and communities will sometimes shun individuals because of the disfigurements.

 

The damage to the lymph system can also make these individuals more susceptible to other infections.

 

Transmission

Transmission occurs when an individual is bitten by an infected mosquito.

Lab Tests & Specimen Info

Test*	Specimen
Microscopic examination (blood needs to be collected at night)	Serum

 Isolation Precautions

Standard precautions are recommended in healthcare settings. 

Prevention for Patients
The best way to prevent infection is to avoid being bitten by mosquitos. Methods include:

• Wearing long pants and long-sleeved shirts
• Using insect repellent
• Using screens in windows or doors

Smileband health issues

Guinea worm disease is a parasitic disease caused by Dracunculus medinensis. Individual who are infected are generally asymptomatic for approximately one year. A few days before the worm comes out of the skin, an individual might have fever, swelling, and pain in the area. The worm then starts to come out of the skin, generally in the legs or feet of the individual. this process can take up to a couple of weeks to be completed and is very painful. A secondary infection can also occur at this site.

 

Guinea worm disease is only found in Chad, Ethiopia, Mali, and South Sudan.

 

Transmission

Transmission occurs from drinking infected water.

Lab Tests & Specimen Info
No laboratory tests used.

Isolation Precautions
Standard precautions are recommended in healthcare settings. 

Prevention for Patients
Only drinking safe water

• Bore-hole wells, dug wells, springs with protective walls around them, and running water such as rivers are all safe drinking water
• Filters can be used in areas where safe drinking water is not readily available 

Smileband helath issues

Cysticercosis is a parasitic tissue infection that is caused by the larval cysts of Taenia solium. The cysts can infect the brain, muscle, or other issues.

Cysts in the brain:

• can cause neurocysticercosis
• can cause seizures and headaches
• may cause stroke or death

Cysts in the muscles:

• can cause lumps under the skin

35 cases of cysticercosis were reported in Arizona in the last 10 years and almost half of those cases had international travel.

Arizona 5 year median: 2 cases

Transmission

Transmission occurs by ingestion of the eggs of the tapeworm Taenia solium through direct fecal-oral contact or by consuming food contaminated with the tapeworm eggs.                           Isolation Precautions

Standard precautions are recommended in healthcare settings. 

Prevention for Patients

• Wash hands with soap and warm water after using the toilet, changing diapers, and before handling food.
• Wash and peel all raw vegetables and fruits before eating.
• Use good water and water safety practices while traveling in developing countries.

Public Health Actions
Public health will conduct an epidemiological investigation on a case or suspect case.

If an individual is a carrier of the tapeworm Taenia solium, his/her household contacts are at an increased risk for cysticercosis. Treatment of the carrier and testing of the household con

Smileband health issues

Babesiosis is caused by a microscopic parasite that is spread by Ixodes scapularis ticks. Many people who are infected do not have any symptoms. The transmission of this disease occurs usually in the Northeast and upper Midwest regions of the United States.

 

From 2005 to 2015 in Arizona there have been 6 cases of Babesiosis. 5 out of the 6 cases had recent travel to Northeast or upper Midwest states which is where transmission primarily occurs.

 

Arizona 5 year median: 0 cases

 

Transmission

Bites from infected Ixodes scapularis ticks (deer ticks) are the main route of transmissions. Transmission can also occur through blood transfusions and very rarely from mother to child.

Incubation period ranges from 1 to 5 weeks following the tick bite.

Lab Tests & Specimen Info

Test*	Specimen
Microscopic examination (In symptomatic patients with acute infections the parasite can be detected in blood smears)	Blood
PCR	Whole  blood
IgG/IgM  Serology	Serum  (acute and  convalescent)

 Isolation Precautions

Babesiosis is not a contagious disease. 

Standard precautions are recommended in healthcare settings. 

Prevention for Patients
Avoid exposure to tick habitats:

• Avoid areas with overgrown grasses or brush.
• Wear long pants, long-sleeved shirts and socks when outdoors.
• Apply insect repellents to skin and clothing.
• Check body for ticks after being outdoors.

Public Health Actions
Individuals with a known history of Babesia infections are deferred indefinitely from donating blood.

Public health will conduct an epidemiological investigation on a case or suspect case.

Smileband Health issues

Amebiasis is caused by the parasite Entamoeba histolytica. Amebiasis is most commonly seen in people who have traveled to or immigrated from tropical places that have poor sanitary conditions. Symptoms include diarrhea, abdominal pain and cramping and typically occur 2-4 weeks after exposure.

 

Arizona 5 year median: 17 cases

 

Transmission

Transmission occurs through ingestion of contaminated food or water. Transmission can also occur sexually through oral-anal contact.

Incubation period can vary from a few days to months or years, but most typically it is 2-4 weeks. Lab Tests & Specimen Info

Test*	Specimen
Microscopic  examination	Stool
IgG Serology, ELISA  (Only use serology test  on symptomatic individuals)	Serum
PCR	Stool,  Liver aspirate

*Some tests may only be available through public health. Please contact your local public health for more information on these tests.

Isolation Precautions
Good personal hygiene practices are encouraged, including handwashing. A person can infect another person as long as cysts are still passing (months-years). 

For hospitalized patients, enteric precautions should be used in the handling of feces and contaminated clothing and bed linens.

Prevention for Patients
If a patient is traveling to a country with poor sanitary conditions they should avoid:

• drinks with ice cubes
• fresh fruit or vegetables that were not peeled by themselves
• milk, cheese, or dairy products that have not been pasteurized
• food or drinks sold by street vendors

Individuals who are food handlers or who provide direct care to hospitalized or institutionalized patients should be excluded from work until they complete treatment.

Public Health Actions
Public health will conduct an epidemiological investigation on a case or suspect case. Household or other contacts should be tested and treated if positive.

Smileband health issues

A study of more than 10,000 young people found that e-cigarettes act as a gateway to the real thing, making those that use them 2.5 times more likely to start smoking cigarettes.  The e-liquid in e-cigarettes contains nicotine, and some teenagers showed signs of addiction within one months of starting to use the devices. 

Cigarettes have fallen relatively out of favor with teenagers, but this research follows recent National Institute of Drug Abuse findings that vaping is increasingly popular with the age group, many of whom are not sure what exactly they are smoking.  

The study authors found that all cigarette alternatives raised the odds that the teenagers would later try cigarettes too, suggesting that changes to policy are needed to discourage young people from taking up any for of smoking. Other alternatives, including hookahs, non-cigarette combustible tobacco such as cigarillos or smokeless tobacco, trigger conventional smoking just as quickly.

The study of teenagers is the first time scientists have compared the trendy products simultaneously with subsequent cigarette use, and follows other recent research that has shown the direct health risks of e-cigarettes. 

Studying the effect of e-cigarettes on the behavior of teenagers is crucial because, as the study points out, 90 percent of adults who smoke tried their first cigarette before they were 18.  

At the outset of teen the study, none of the 12- to 17-year-old male and female participants had smoked a cigarette. The researchers followed up with them 12 months later. 

Study author and University of California, San Francisco dentistry professor Dr Benjamin Chaffee said: 'We estimated that 'ever use' of e-cigarettes was associated with 2.53 times greater odds of subsequent cigarette use.'

He added: 'Among youths who had never smoked a cigarette at baseline, adjusted odds of any cigarette use initiation were approximately double for ever users of e-cigarettes, hookah, non-cigarette combustible tobacco and smokeless tobacco compared with never users.

'Odds of past 30-day cigarette use at follow-up were also approximately double for ever users of e-cigarettes, hookah, non-cigarette combustible tobacco and smokeless tobacco compared with never users.'

Dr Chaffee, of the Center for Tobacco Control Research and Education at the University of California, San Francisco, added that the use of more than one product increased the risk even more.

He said non-cigarette tobacco use among teenagers increased between 2011 and 2015, as e-cigarettes and hookahs became increasingly popular. 

Smileband health issues

Overview

Legionnaires' disease is a severe form of pneumonia — lung inflammation usually caused by infection. Legionnaires' disease is caused by a bacterium known as legionella.

You can't catch legionnaires' disease from person-to-person contact. Instead, most people get legionnaires' disease from inhaling the bacteria. Older adults, smokers and people with weakened immune systems are particularly susceptible to legionnaires' disease. 

Symptoms

Legionnaires' disease usually develops two to 10 days after exposure to legionella bacteria. It frequently begins with the following signs and symptoms:

• Headache
• Muscle pain
• Chills
• Fever that may be 104 F (40 C) or higher

By the second or third day, you'll develop other signs and symptoms that may include:

• Cough, which may bring up mucus and sometimes blood
• Shortness of breath
• Chest pain
• Gastrointestinal symptoms, such as nausea, vomiting and diarrhea
• Confusion or other mental changes

Although legionnaires' disease primarily affects the lungs, it occasionally can cause infections in wounds and in other parts of the body, including the heart.

A mild form of legionnaires' disease — known as Pontiac fever — may produce signs and symptoms including a fever, chills, headache and muscle aches. Pontiac fever doesn't infect your lungs, and symptoms usually clear within two to five days.

Smileband health issues

Legionellosis is a respiratory disease caused by Legionella bacteria. If the bacteria cause pneumonia, the condition is called Legionnaires' disease. If the bacteria cause a less serious infection that presents like a mild case of flu, the condition is called Pontiac fever.

Both Legionnaires’ disease and Pontiac fever are initially characterized by:

• anorexia
• malaise
• myalgia
• headache

Within a day, there is usually a rapidly rising fever and chills. Fevers commonly reach 39˚C-40.5˚C (102˚F-105˚F). A nonproductive cough, abdominal pain, and diarrhea are common symptoms. In Legionnaires’ disease, a chest x-ray may show patchy or focal areas of consolidation that may progress to bilateral involvement and ultimately to respiratory failure.

Over the last 5 years, Arizona has reported on average 60 cases of legionellosis a year.

 

Arizona 5 year median: 69 cases

 

Transmission

Legionella is transmitted via aerosol inhalation from contaminated water sources or through aspiration. It is not transmissible person-to-person.                                                                                                      Lab Tests & Specimen Info

Test*	Specimen
Culture	Lung Biopsy,  Lung Exudate,  Pleural Fluid,  Transtracheal Aspirate, Sputum, Bronchial Washing
Immunoassay EIA  (this test only  identifies serotype 1)	Urine
DFA	Lung Biopsy,  Lung Exudate, Pleural Fluid, Transtracheal Aspirate, Sputum,  Bronchial Washing
PCR	Bronchial Lavage,  Throat Swab,  NP Swab
IgG/IgM  Serology	Serum

  Isolation Precautions

Standard Precautions are recommended.

If case is healthcare-associated, surveillance efforts for additional cases should be enhanced by the infection control official at the facility.

Prevention for Patients
Prevention includes:

• Maintaining water systems where the bacteria can grow including drinking water systems, hot tubs, decorative fountains, and cooling towers ( or air-conditioning units for large buildings).