Finally the cost of HPV vaccine
Medicine is foremost a business and nothing is free. A single dose of Gardasil costs $120-$140. Each individual requires three doses over a 6-month period. Further, many physicians are also charging for a consultation fee, cost of syringe and office time. Thus, the average cost for the entire series of HPV vaccine amounts to about $500-$600 plus.
Not all health insurance plans cover Gardasil. Moreover, some insurance plans only cover the vaccine for females in-between the ages of 9-26, the age where the vaccine has been FDA approved. At present, there is no legislation mandating that insurance plans cover the cost of the vaccine.
The pharmaceutical giant, Merck now has released data that the vaccine is also useful in women up to the age of 45. If there is FDA approval for the vaccine for this older group of individuals, perhaps some insurance companies may cover the cost.
At the moment, Gardasil is covered under a federal program for those who have no insurance and to Medicaid eligible children under the age of 18. For those individuals who lack medical insurance, one can check with the physician or the local health clinic to determine if there is program to get the vaccine free.
Thursday, June 11, 2009
HPV vaccine: Part 2
The one reason why Gardasil is not recommended for women over the age of 25 is that by this time it appears many women have already been exposed to HPV. However, there are studies that have documented safety of this vaccine in the older age group. At present, Gardasil is believed to be effective for at least 5 years after injection. Current research is trying to determine if a booster shot at the end of 5 years will extent protection from the vaccine.
All consumers should understand that getting the HPV vaccine does not eliminate the need for future doctor visits. Pap smears are highly recommended in all females when they become sexually active.
As far as side effects are concerned, both vaccines have proven to be quite safe. From the recent clinical trials, the most common side effects observed were redness and pain at the injection site. These transient side effects last for a few days.
Neither Gardasil nor Cervarix is recommended for pregnant women. Once injected with the HPV vaccine, more than 95-98 percent of women are protected from developing cervical cancer
All consumers should understand that getting the HPV vaccine does not eliminate the need for future doctor visits. Pap smears are highly recommended in all females when they become sexually active.
As far as side effects are concerned, both vaccines have proven to be quite safe. From the recent clinical trials, the most common side effects observed were redness and pain at the injection site. These transient side effects last for a few days.
Neither Gardasil nor Cervarix is recommended for pregnant women. Once injected with the HPV vaccine, more than 95-98 percent of women are protected from developing cervical cancer
What is all the fuss about the human papillomavirus (HPV) vaccine?
Cervical cancer is quite common all over the world. The tragedy of cervical cancer is that it affects young females. Current estimates indicate that in America, approximately 11,000 women develop cervical cancer and there are about 3,000 deaths each year. Over the years, a strong link between the human papilloma virus (HPV) and cervical cancer has been established. Furthermore, HPV has also been linked to cancers of the mouth, vulva, anus, and penis. With more people engaging in sexual activities at an earlier age, a vaccine would be a great way to prevent these cancers associated with HPV.
At present two vaccines have been developed to prevent infection from HPV. Both vaccines are administered by an injection in three divided doses. The current injection guidelines recommend that the first injection be followed by the 2nd and 3rd dose, two and six months, apart.
So far, only one vaccine is currently available in North America. Gardasil is currently available and recommended for all girls and young women between the ages of 9 and 26. In different countries, the age of vaccination is slightly variable. For example in Australia, cervarix is recommended for all females between the ages of 10-45 and for boys in-between the ages of 9-15. Cervarix is currently in the clinical trials stage in North America but data indicate that it is just as effective and safe as Gardasil.
The most important factor with both vaccines is that one gets vaccinated prior to becoming sexually active. Current data indicate that if the vaccine is injected in sexually active individuals, it does not get rid of HPV infection and thus protection against cervical cancer is not a guarantee.
At present two vaccines have been developed to prevent infection from HPV. Both vaccines are administered by an injection in three divided doses. The current injection guidelines recommend that the first injection be followed by the 2nd and 3rd dose, two and six months, apart.
So far, only one vaccine is currently available in North America. Gardasil is currently available and recommended for all girls and young women between the ages of 9 and 26. In different countries, the age of vaccination is slightly variable. For example in Australia, cervarix is recommended for all females between the ages of 10-45 and for boys in-between the ages of 9-15. Cervarix is currently in the clinical trials stage in North America but data indicate that it is just as effective and safe as Gardasil.
The most important factor with both vaccines is that one gets vaccinated prior to becoming sexually active. Current data indicate that if the vaccine is injected in sexually active individuals, it does not get rid of HPV infection and thus protection against cervical cancer is not a guarantee.
Monday, June 8, 2009
Blood in urine: Part 4
Treatment
When hematuria occurs, the doctor has to treat the underling cause.
Urinary tract infections are treated with antibiotics and within a few days both the symptoms and hematuria will disappear. In rare cases, one may need long-term treatment with antibiotics
Kidney stones generally pass spontaneously through the ureter when one drinks a lot of water and remains active. If this method fails, then there are several other options to reveal kidney stones. One is non-invasive use of ultrasonic shock waves to break up the stone. Other more invasive methods include Cystoscopy or surgery.
Enlarged prostate does require treatment when the patient has symptoms. There is no ideal treatment for enlarged prostate. Every treatment has some negatives. In general, one is treated with medications and these do work well, but they also have side effects. When medications fail, the other options are use of heat, laser, or ultrasonic waves to shrink the prostate.
Immunological kidney disease does require treatment. The treatment depends on the type of kidney disease.
Cancers of kidney and bladder are generally treated with surgery. These tumors generally do not respond well to radiation or chemotherapy. In most cases, surgery is combined with an assorted variety of chemotherapeutic drugs.
Inherited disorders of the kidney which cause hematuria, do not always require treatment. Some disorders may cause extensive kidney damage and dialysis may be the only alternative.
Prevention of blood in urine
Unfortunately, one cannot not prevent hematuria. Even then, one should lead a healthy life style. Drinking adequate water and urinating right after intercourse does help prevent some urinary tract infections
To decrease the risk of kidney stones drink lots of water, limit salt, excess protein, and foods such as spinach.
To decrease risk of cancer, stop smoking, avoid exposure to heavy metals or chemicals and get regular exams from a physician.
When hematuria occurs, the doctor has to treat the underling cause.
Urinary tract infections are treated with antibiotics and within a few days both the symptoms and hematuria will disappear. In rare cases, one may need long-term treatment with antibiotics
Kidney stones generally pass spontaneously through the ureter when one drinks a lot of water and remains active. If this method fails, then there are several other options to reveal kidney stones. One is non-invasive use of ultrasonic shock waves to break up the stone. Other more invasive methods include Cystoscopy or surgery.
Enlarged prostate does require treatment when the patient has symptoms. There is no ideal treatment for enlarged prostate. Every treatment has some negatives. In general, one is treated with medications and these do work well, but they also have side effects. When medications fail, the other options are use of heat, laser, or ultrasonic waves to shrink the prostate.
Immunological kidney disease does require treatment. The treatment depends on the type of kidney disease.
Cancers of kidney and bladder are generally treated with surgery. These tumors generally do not respond well to radiation or chemotherapy. In most cases, surgery is combined with an assorted variety of chemotherapeutic drugs.
Inherited disorders of the kidney which cause hematuria, do not always require treatment. Some disorders may cause extensive kidney damage and dialysis may be the only alternative.
Prevention of blood in urine
Unfortunately, one cannot not prevent hematuria. Even then, one should lead a healthy life style. Drinking adequate water and urinating right after intercourse does help prevent some urinary tract infections
To decrease the risk of kidney stones drink lots of water, limit salt, excess protein, and foods such as spinach.
To decrease risk of cancer, stop smoking, avoid exposure to heavy metals or chemicals and get regular exams from a physician.
Blood in urine: Part 3
What are risk factors?
Anyone can develop blood in the urine.
Age: Many men in the 5th decade of life develop and enlarged prostate and have blood in urine
Females generally tend to have hematuria in urine from a UTI
Family history may predispose one to kidney stones which may lead to blood in urine.
Medications like aspirin and penicillin can cause blood in the urine.
Athletes who are long distance runners or joggers often develop hematuria.
Diagnosis
After a complete history and physical examination, hematuria work up depends on the suspected cause.
Urine analysis can determine if there is blood, infection, or a stone. Urine analyses is not specific for diagnosis and some type of radiological study is usually required.
Imaging with CT scan, MRI, or ultrasound can help look at the urinary tract.
Sometimes a long flexible camera (cystoscope) is passed from the penis or vagina into the urethra and up the ureter. The camera can help visualize structures and biopsy can be obtained.
In a few cases the diagnosis of hematuria may not be evident. This may occur if one has had a prior exposure to a drug or an environmental toxin.
In elderly individuals, the cause of hematuria is almost always investigated to rule out a cancer.
Anyone can develop blood in the urine.
Age: Many men in the 5th decade of life develop and enlarged prostate and have blood in urine
Females generally tend to have hematuria in urine from a UTI
Family history may predispose one to kidney stones which may lead to blood in urine.
Medications like aspirin and penicillin can cause blood in the urine.
Athletes who are long distance runners or joggers often develop hematuria.
Diagnosis
After a complete history and physical examination, hematuria work up depends on the suspected cause.
Urine analysis can determine if there is blood, infection, or a stone. Urine analyses is not specific for diagnosis and some type of radiological study is usually required.
Imaging with CT scan, MRI, or ultrasound can help look at the urinary tract.
Sometimes a long flexible camera (cystoscope) is passed from the penis or vagina into the urethra and up the ureter. The camera can help visualize structures and biopsy can be obtained.
In a few cases the diagnosis of hematuria may not be evident. This may occur if one has had a prior exposure to a drug or an environmental toxin.
In elderly individuals, the cause of hematuria is almost always investigated to rule out a cancer.
Blood in urine: Part 2
Causes of hematuria
There are a number of structures that make up the urinary tract. Starting with kidney, there are the ureters, bladder and urethra. The kidneys remove waste products and make urine. The urine is then carried by the ureter to the bladder where it is stored. When the bladder is full, the urethra opens and one urinates. blood can originate from any one of these structures.
Urinary tract infections (UTI) are common in women then men. Often some women develop microscopic hematuria during a UTI. This usually clears up once the UTI is treated with an antibiotic. No investigations are needed.
Infections of the kidney is known as pyleonephritis and can also result as microscopic hematuria. The condition is associated with significant flank pain, fever, and difficulty passing urine. The condition is typically treated with antibiotics.
Stones are a common cause of blood in urine. Urinary stones are excruciatingly painful and often cause both gross and microscopic hematuria. Identification of stones is easy with a dye study. When the stone has passed, hematuria usually clears up.
Enlarged prostate is a leading cause of hematuria in man over the age of 50. The prostate is located at the base of the bladder. As men age, the prostate gets bigger and compresses the urethra; often this leads to difficulty in urination. Often the condition is associated with both gross and microscopic hematuria. The condition is easily diagnosed with a rectal exam or an ultrasound.
Kidney disorders; There are many kidney disorders that can cause microscopic hematuria. Most of these disorders are either infections or immune mediated. These disorders also have other organ involvement and need to be worked up. Most of these immunological kidney disorders present much early in life.
Cancer: Gross hematuria is often the first sign of cancer of bladder, kidney or prostate. Unfortunately, when gross hematuria occurs the cancer is generally more advanced.
Trauma is a common cause of hematuria. Individuals into contact sports may see blood in urine after trauma.
Medications like aspirin and blood thinners can also cause blood in urine.
Strenuous exercise can cause gross hematuria. This is most probably related to dehydration, trauma to the bladder or breakdown of red cells. The condition usually improves within a few days.
There are a number of structures that make up the urinary tract. Starting with kidney, there are the ureters, bladder and urethra. The kidneys remove waste products and make urine. The urine is then carried by the ureter to the bladder where it is stored. When the bladder is full, the urethra opens and one urinates. blood can originate from any one of these structures.
Urinary tract infections (UTI) are common in women then men. Often some women develop microscopic hematuria during a UTI. This usually clears up once the UTI is treated with an antibiotic. No investigations are needed.
Infections of the kidney is known as pyleonephritis and can also result as microscopic hematuria. The condition is associated with significant flank pain, fever, and difficulty passing urine. The condition is typically treated with antibiotics.
Stones are a common cause of blood in urine. Urinary stones are excruciatingly painful and often cause both gross and microscopic hematuria. Identification of stones is easy with a dye study. When the stone has passed, hematuria usually clears up.
Enlarged prostate is a leading cause of hematuria in man over the age of 50. The prostate is located at the base of the bladder. As men age, the prostate gets bigger and compresses the urethra; often this leads to difficulty in urination. Often the condition is associated with both gross and microscopic hematuria. The condition is easily diagnosed with a rectal exam or an ultrasound.
Kidney disorders; There are many kidney disorders that can cause microscopic hematuria. Most of these disorders are either infections or immune mediated. These disorders also have other organ involvement and need to be worked up. Most of these immunological kidney disorders present much early in life.
Cancer: Gross hematuria is often the first sign of cancer of bladder, kidney or prostate. Unfortunately, when gross hematuria occurs the cancer is generally more advanced.
Trauma is a common cause of hematuria. Individuals into contact sports may see blood in urine after trauma.
Medications like aspirin and blood thinners can also cause blood in urine.
Strenuous exercise can cause gross hematuria. This is most probably related to dehydration, trauma to the bladder or breakdown of red cells. The condition usually improves within a few days.
Why do I have blood in my urine?
Having blood in urine is not normal. Seeing blood in urine can be a frightening experience for most people. When blood occurs in the urine, the condition is medically known as hematuria. In most cases, having blood in urine is not a cause for alarm. Sometimes participating in strenuous sports can cause blood to appear in urine. Some footballers often see traces of blood in urine after being knocked down on the sports field. Other common causes of blood in urine include kidney stones and drugs. However, in the elderly individual blood in urine may signal the appearance of a cancer.
Blood in the urine is classified as gross or microscopic. When the urine is only slightly red and red blood cells are only seen under a microscope, this is known as microscopic hematuria. When there is frank blood in urine, this is known as gross hematuria.
When gross hematuria occurs, one must always rule out a cancer. When there is microscopic hematuria, the cause may be an infection or a stone.
Hematuria that is caused with exercise or sports trauma usually disappears within a few days and does not require any extensive work up
Symptoms
In many individuals, microscopic hematuria may present as red or pink colored urine. It takes only a few red blood cells to make the urine look red. In most cases, there is no pain associated with blood in urine.
Blood in the urine is classified as gross or microscopic. When the urine is only slightly red and red blood cells are only seen under a microscope, this is known as microscopic hematuria. When there is frank blood in urine, this is known as gross hematuria.
When gross hematuria occurs, one must always rule out a cancer. When there is microscopic hematuria, the cause may be an infection or a stone.
Hematuria that is caused with exercise or sports trauma usually disappears within a few days and does not require any extensive work up
Symptoms
In many individuals, microscopic hematuria may present as red or pink colored urine. It takes only a few red blood cells to make the urine look red. In most cases, there is no pain associated with blood in urine.
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