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Our own silent medical conditions require recognition

January 18, 2014
By C. Paul Martin, M.D. , Marshall Independent

Medical information and misinformation appearing in our collateral reading is often discarded, but it actually may be valuable to us as participants in our own health. A recent online article in the "Investing Commentary" section of a business publication caught my attention by its headline describing five silent common diseases often unknown and unappreciated by the people who have them.

It was my impression during 40 years in clinical medical care that few patients present to the doctor for screening for common medical illnesses; they usually come because of pain or fear.

Certainly, that attitude toward medical care characterized patient behavior up to the latter part of the 20th century,

The success of screening programs such as tuberculosis screening with skin testing and routine chest X-rays and the serological testing for venereal diseases validated screening in the public eye.

In addition, the dramatic decrease in the prevalence of childhood infectious diseases from vaccination procedures brought the concept of personal and public health to national and international attention.

Concerns discussed in the aforementioned article articulate contemporary medical practice in urging patients to know more about their personal medical situations and methods to recognize and improve their health, i.e. active practices versus passive involvement. Prevent disease rather than treat disease.

The dental profession recognized the most common illness present in the world, dental caries, and began preventive methods and treatments including water fluoridation, routine prophylaxis and dental education with dramatic success.

Unfortunately, the other common illnesses, especially malaria and the common cold, have been more formidable foes.

Cardiovascular Diseases, the most common being high blood pressure (hypertension), are usually associated with existing heart and vascular diseases. Thus, blood pressure screening during visits to health care providers is an excellent screening procedure; a "normal" BP reading should be less than 140-150/80. The prevalence of CV disease has increased due to the increasing longevity of our population, but it has decreased due to the movement to decrease smoking and treat hypertension. However, detection of this "silent killer" is paramount to improvement.

Chronic Lung Disease is often associated with CV disease and heart failure, but it is often the result of smoking, industrial exposures, and the aging process. Resting and exertional breathlessness, fluid retention, and fatigue are signs of pulmonary problems.

Diabetes Mellitus is a very common illness: the U.S. has 26 million cases, 7 million which are undiagnosedand thus untreated. Most of the cases ate Type 2 Diabetes, usually associated with obesity, a significant public health challenge.

Of concern, the CDC and other public health agencies estimate that there are more than 50 million adults who are pre-diabetic. Again, these numbers are increased because of our increasing longevity in the U.S.

Evidence of Tuberculosis infection is present in 2 billion people worldwide, yet only 5-10 percent of those patients showing an immunological response to the tuberculosis antigen will have the clinical disease. We use the Mantoux and Gold tests in our schools and adult situations to screen all patients to determine the presence of the antibody and need for treatment to cure the illness and prevent spread of the disease.

Hepatitis C is an infection related to blood and needle sharing; it is a true "silent killer." Although it usually presents no symptoms, this lifelong infection can result in liver scarring (cirrhosis) and liver cancer. Its continued presence in medical encounters has caused the CDC and other agencies to recommend that all patients born in the years 1945 to 1965 be routinely screened for Hepatitis C.

The development of an effective oral therapy for hepatitis C gives impetus to this recommendation.



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