Mayo Clinic Health Matters

The COVID-19 pandemic has led people to delay testing and treatments for a variety of diseases and conditions. This includes HIV testing.During the pandemic, the number HIV diagnosis decline, but that decline is most attributed to declines in testing, according to the Centers for Disease Control and Prevention. Experts attribute this decline to less frequent visits to health centers, reduced outreach services, and shifting of public health staff to COVID-19 response activities. June 27 is National HIV Testing Day, a day to encourage people to get tested for HIV, know their status, and get linked to care and treatment.But who should be tested?"The CDC recommends that everyone over the age of 13 be tested for HIV at least once in their lifetime," says Dr. Stacey Rizza, an infectious diseases specialist at Mayo Clinic. "This is endorsed by the Center for Medicare & Medicaid Services and paid for by all private insurance companies. So no matter what your background is, if you've never been tested for HIV, you should get tested. And that's because many people with HIV have no idea they have it. They can be completely asymptomatic for a very long time and not only have the virus causing ill effects on themselves, but they're at risk of potentially transmitting it to others. We need to do a better job in the U.S., particularly as health care providers, to follow that recommendation, and to make sure that every adult has had an HIV test at least once in a lifetime." If HIV is not treated, it can lead to AIDS. But effective therapies can control HIV, which is why getting tested and seeking treatment is so important."We know now that if somebody is on effective HIV therapy, and the virus in their body is suppressed, it's not gone. But it's suppressed. Their risk of transmitting it to somebody else is close to zero," explains Dr. Rizza. "So if you just pause for a minute and think about that implication. That means if every human on planet Earth who had HIV were diagnosed, linked with health care, and on effective therapy, then HIV would be gone from the human race in one generation."Like many other areas of health care, health disparities play a significant role when it comes to testing, diagnosis and treatment of HIV. Those disparities have been exacerbated by the COVID-19 pandemic. Improving awareness and community outreach can help combat these disparities."It's the same old thing that works for every disease state," says Dr. Rizza. "Its education, engagement and role-modeling within the communities. That education is essential. And it needs to be done in the community. We can't wait for people to come to us, and then we'll teach them, we need to get into those worlds, with people who are leaders in those communities, and have ways to bring diagnosis, treatment and preventive measures to them." Dr. Rizza says disparities in diagnosing HIV face an additional challenge that some other diseases do not: stigma."It is just heartbreaking," says Dr. Rizza. "And the stigma that had been around HIV for a very long time is part of what prevents people from coming forward, from taking the initiatives to prevent the disease, to prevent the infection — and also to be diagnosed — out of fear of the answer. And, so, we also need those community leaders to help break down the stigma issue in addition to educating and bringing diagnosis and treatment closer to home."On the Mayo Clinic Q&A podcast, Dr. Rizza discusses the importance of HIV testing and improvements in therapies to treat HIV. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. But it can occur in people of all gender identities.Nearly 13% of women in the U.S. will be diagnosed with breast cancer at some point, according to the National Cancer Institute. Fortunately, thanks to earlier detection and advances in diagnosis and treatment, most people diagnosed with breast cancer will survive. Understanding what to expect can make the cancer journey smoother."It's important for people to know the road map," explains Dr. Daniela Stan, an internist with the Mayo Clinic Breast Diagnostic Clinic. "What treatments are they expected to have and what's the timeline? What will the side effects be? How can they prepare?" People who survive breast cancer can have unique needs depending on their cancer type and stage, but there are some experiences many breast cancer survivors will share after treatment."Survivors on a daily basis learn how to deal with their cancer, how to pace themselves, how to get help from family and friends, and how to go forward during and after the treatment is completed," says Dr. Stan. "Luckily, there are many, many resources available to deal with the physical and psychological issues of cancer survivorship."Dr. Stan encourages cancer survivors to talk with their health care team about how nutrition, exercise and controlling stress can help with the long-term effects of cancer treatment and even help prevent cancer recurrence.On this Mayo Clinic Q&A podcast, Dr. Stan discusses what people can expect after completing breast cancer treatment and how to achieve the best quality of life. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

As immunity wanes for many vaccinated adults and omicron and its subvariants continue to circulate, it seems that just about everyone knows someone with a case of COVID-19. The steady increase in COVID-19 infections is due to changing, highly contagious variants, explains Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. Dr. Poland says it’s still important to take the precaution of mask-wearing in public areas, even if you have been vaccinated and have received your boosters. "I can’t say it enough. This is so hypercontagious that, regardless of having had three or four doses of vaccine or of having previous COVID-19, you still run an appreciable chance of getting COVID," explains Dr. Poland. "The risk in that case is not of death or hospitalization, but of the complications and long-haul symptoms of COVID-19. And that’s what we’re trying to prevent in people."  For parents, there is positive news this week, as the Food and Drug Administration (FDA) advisory panel voted unanimously to authorize emergency use of the Pfizer and Moderna COVID-19 vaccines for children under 5. For this age group, the Pfizer vaccine will be given in three doses while the Moderna vaccine will be given in two doses. The FDA panel's recommendation now goes to the Advisory Committee on Immunization Practices (ACIP) at the Centers for Disease Control and Prevention for approval before shots can be administered, possibly beginning as early as next week. On the Mayo Clinic Q&A podcast, Dr. Poland shares the latest COVID-19 news, answers listener questions, and discusses another infectious disease outbreak: monkeypox. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

LGBTQ people can face specific health concerns related to their gender incongruence, sexual orientation, practices and social stigma. People in the LGBTQ community often experience barriers to accessing health care and preventive services, which can result in disparities in both cancer risk and treatment. "Many of those disparities are rooted in stigma and discrimination that have really historically been an issue for this population," says Dr. Jewel Kling, chair of the Women's Health Center at the Mayo Clinic in Arizona.Dr. Kling encourages people who identify as LGBTQ to find a health care professional they trust, as open and honest communication is important."Once they find a provider they trust, then hopefully they feel that they can disclose everything about themselves, including their health behaviors, their challenges, the things that are impacting their social determinants of health," says Dr. Kling.On the Mayo Clinic Q&A podcast, Dr. Kling discusses cancer screening, prevention and treatment for people who identify as LGBTQ, and the importance of finding a trusted health care team. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

An ear infection is an infection of the middle ear, the air-filled space behind the eardrum that contains the tiny vibrating bones of the ear. Children are more likely than adults to get ear infections.Because ear infections often clear up on their own, treatment may begin with managing pain and monitoring the problem. Sometimes, antibiotics are used to clear the infection. Some people are prone to having multiple ear infections. This can cause hearing problems and other serious complications.If your child has repeated, long-term ear infections or continuous fluid buildup in the ear after an infection has cleared up, your child's doctor may suggest ear tubes.On the Mayo Clinic Q&A podcast, a special edition of "Ask the Mayo Mom," pediatrician and host Dr. Angela Mattke is joined by Dr. Shelagh Cofer, a Mayo Clinic otolaryngologist, to discuss when ear tubes may be necessary, their traditional surgical placement, and outline a newer procedure that might be an option for some patients. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Palliative care is offered alongside cancer treatment to help people with cancer manage symptoms and improve the quality of life for them and their families. Palliative care is specialized medical care that focuses on relieving patients' pain and other symptoms of serious illness no matter the diagnosis or stage of disease. "The palliative care team really focuses on addressing symptoms and needs so that we can help people feel as comfortable as they can as they go through their treatment for cancer," says Dr. Deirdre Pachman, a palliative medicine expert at Mayo Clinic. "We do this by focusing and talking about some different interventions. They might be medications, or they might be other procedures for pain that some of our colleagues do. Palliative care is a very team-based approach, so we may involve our nurses, our physical therapists, our social workers really to all be there to help support the patient and make sure that we're addressing their symptoms and their needs." Palliative care is designed to fit the life and needs of each individual patient. It may include symptom management, support and advice, care techniques that improve comfort and well-being, referrals to other specialists, and advance care planning. Palliative care also offers support for families and those caring for people with cancer."The goal of palliative care, along with helping patients manage their symptoms and improving quality of life, is really providing that support to their loved ones or their caregivers, so that they have time to care for themselves and feel well-supported so that they can continue to give to others," says Dr. Pachman.Research indicates that early use of palliative care services can improve quality of life for people with serious illness, decrease depression and anxiety, increase patient and family satisfaction with care, and in some cases even extend survival.On this Mayo Clinic Q&A podcast, Dr. Pachman discusses how palliative care can improve quality of life for people with cancer. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

If your child is a picky eater, the battle over healthy foods can be a challenge. Being fussy about food is common in toddlers and small children, but parents can try some tips and tricks to introduce new foods. One approach to improving eating habits is to get kids involved in the kitchen. Involving children in meal planning and teaching kids to cook can have multiple benefits. Not only is cooking a necessary life skill, learning how to cook teaches math, science and creativity. Using fresh fruits and vegetables encourages healthy eating and children are more likely to eat food they've helped prepare. Other tips include: Let your child pick which fruits and vegetables to make for dinner or during visits to the grocery store or farmers market.  Read kid-friendly cookbooks together and let your child pick out new recipes to try. Toddlers and children can help with some cooking tasks — with supervision — including sifting, stirring, counting ingredients, picking fresh herbs from a garden or windowsill, and “painting” on cooking oil with a pastry brush. On the Mayo Clinic Q&A podcast, a special edition of "Ask the Mayo Mom" pediatrician and host Dr. Angela Mattke is joined by Kate Zeratsky, a Mayo Clinic registered dietitian nutritionist, and Jen Welper, Mayo Clinic executive chef, for a discussion on teaching children how to nourish their bodies with healthy foods, encouraging kids to try new foods, and getting kids involved in cooking. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Pectus excavatum is a condition where a person's breastbone is sunken into the chest. While the sunken breastbone is often noticeable shortly after birth, the severity of pectus excavatum typically worsens during the adolescent growth spurt."The initial diagnosis is often based on appearance," explains Dr. Denise Klinkner, a pediatric surgeon at Mayo Clinic Children’s Center and practice chair of the Division of Pediatric Surgery at Mayo Clinic. "Then when we try to grade the severity, using what's called the Haller index."The Haller index is calculated by measuring the width of the chest and dividing that width by the distance between the sternum and the vertebral column. This calculation can be performed using a chest X-ray or chest CT scan.In severe cases of pectus excavatum, the breastbone may compress the lungs and heart. Signs and symptoms can include: Decreased exercise tolerance. Rapid heartbeat or heart palpitations. Recurrent respiratory infections. Wheezing or coughing. Chest pain. Heart murmur. Fatigue. Dizziness. Surgery can correct the deformity. The two most common surgical procedures to repair pectus excavatum are known by the names of the surgeons who first developed them: Nuss procedure This minimally invasive procedure uses small incisions placed on each side of the chest. Long-handled tools and a narrow fiber-optic camera are inserted through the incisions. A curved metal bar is threaded under the depressed breastbone, to raise it into a more normal position. In some cases, more than one bar is used. The bars are removed after two or three years. Ravitch technique This older procedure involves a much larger incision down the center of the chest. The surgeon removes the deformed cartilage attaching the ribs to the lower breastbone and then fixes the breastbone into a more normal position with surgical hardware, such as a metal strut or mesh supports. These supports are removed after 12 months. Many pain control options are available after surgery to improve recovery. Cryoablation temporarily freezes the nerves to block pain after surgery, and can help with recovery and decrease postoperative pain for four to six weeks."With the addition of cryotherapy, patients need less narcotic pain medicine and have been able to go home the next day after surgery," says Dr. Klinkner. On the Mayo Clinic Q&A podcast, a special edition of "Ask the Mayo Mom" focuses on minimally invasive pectus repair in children. Dr. Angela Mattke, a Mayo Clinic pediatrician and host, is joined by Dr. Klinkner to discuss options for pectus excavatum repair and what patients can expect after surgery. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

To address health disparities and reach underserved communities, work is underway at Mayo Clinic to raise up community voices through community engagement. "Community engagement is an ongoing process," explains Dr. Chyke Doubeni, director of Mayo Clinic’s Center for Health Equity and Community Engagement Research. "It's a partnership or collaboration among organizational entities and members of the community. And the sole purpose of this is to solve problems and address priorities that a community sees as being priorities for them."The Center for Health Equity and Community Engagement Research focuses on disparity-related health promotion and disease prevention in areas including cancer, cardiovascular disease and metabolic illness. One initiative Mayo Clinic is taking part in is the National Institutes of Health's (NIH) Community Engagement Alliance Against COVID-19 Disparities (CEAL) research program. This research program focuses on working with communities hardest hit by the pandemic to provide trustworthy information and improve diversity and inclusion in COVID-19 research.Eula Dean is a community leader who leads the Arizona CEAL consortium community engagement work group. She is also a member of Mayo Clinic in Arizona's Community Engagement in Research Advisory Board."I think that one of the things that helped was we identified individuals in the community who have respect and who already worked in the community," says Dean. "Whether they were located in our churches or they have positions of power in terms of their work, it opened some doors for us to really be able to reach our community." By partnering with community leaders, the CEAL program was able to reach those who were otherwise reluctant to use the health care system, sometimes due to past experiences. "We had to honor and listen to those concerns," explains Dean. "We had to explain that we want you to know what's happening with COVID-19, so we are bringing this information to you. And we allowed them to ask their questions. And I think it made a difference. We understand that we still have struggles, but I believe that the manner in which we started with a humble heart to say: 'This is what I've learned. Here's my expertise. I love my family. I want my family to be healthy.' I think those were the things that made a difference."Dr. Doubeni agrees that building trust is key to the successful partnership between researchers and the community."What we want to do as researchers is to be able to build trust and be trustworthy so that people can believe in science and can believe in and trust the health care they need to get," says Dr. Doubeni. "So building that trust through community engagement in research can allow us to be stronger for when the next crisis may come along."On the Mayo Clinic Q&A podcast, Dr. Doubeni and Dean discuss the work of the CEAL program and the importance of engaging underserved communities in research.To learn more, read the Raising Up Community Voices in Research blog series, including Eula Dean's essay. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

On average, someone in the U.S. has a stroke every 40 seconds, according to the Centers for Disease Control and Prevention. A stroke is a medical emergency, and prompt treatment is crucial. Early action can reduce brain damage and other complications. A stroke occurs when the blood supply to part of the brain is interrupted, depriving the brain of oxygen. It's important to recognize the warning signs of stroke, because prompt treatment can minimize brain damage. Every moment is crucial. "Strokes commonly occur in people of all ages," says Dr. Robert D. Brown, Jr., chair of Mayo Clinic's Division of Stroke and Cerebrovascular Diseases. "And, so, it's very important that people know what is a stroke, what are the symptoms, and what are the risk factors for stroke." May is National stroke Awareness Month. In this Mayo Clinic Q&A podcast, Dr. Brown explains the importance of remembering the F.A.S.T. acronym to recognize a stroke:  Face drooping. Arm weakness. Speech difficulty.  Time to call 911. Learn more about recognizing the signs of stroke:  Read Consumer Health: Do you know the warning signs of stroke? Watch Mayo Clinic Minute: Think 'FAST' when recognizing stroke symptoms Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy