The War on Zika

Chelsea Kwong, senior

Recently, the CDC issued travel advisories for several regions affected by the spreading Zika virus. The increasing concern about this virus has even impacted Duquesne nursing students, as the annual spring break trip to Nicaragua led by Duquesne faculty has been cancelled. As international health authorities and impacted countries work to minimize the impact of this deadly illness, little information about its effects are actually known. The virus shows no signs of stopping at this time, and is expected to result in approximately 3-4 million cases within the next year1.

According to the World Health Organization, Zika is “an emerging mosquito-borne Flavivirus related to dengue, yellow fever, Japanese encephalitis, and West Nile viruses, and is transmitted by Aedes spp. Mosquitoes” (2015).  Symptoms include fever, myalgia, conjunctivitis, and other unpleasant conditions2. However, its most striking effects have been neurological and autoimmune in nature. The virus has been linked to an increased incidence of conditions including Guillain-Barre syndrome, thrombocytopenic purpura, leucopenia, and meningoencephalitis1.

Its most devastating effects, however, have been observed in newborns whose mothers contracted the virus during pregnancy. Specifically in Brazil, an alarming amount of cases of microcephaly (a condition in which the infant’s head appears shrunken. The smaller head capacity affects the brain, which cannot properly develop as a result of the condition) have arisen within the past year. Much of the travel advisories and warnings have been targeted toward pregnant women, whose fetuses are at risk for birth defects2.

The virus was first discovered in Uganda in 1947, but has not been of concern to humans until 2007, when the virus surfaced in Micronesia. Several years later, in May of 2015, the World Health Organization reported occurrence in the Americas, particularly in Brazil. It is said that Brazil had upwards of 1.3 million occurrences of Zika in 2015. The virus has since spread to several countries in South and Central America, even reaching Puerto Rico.3

Attention has been directed toward Brazil, a country that has been most impacted by the virus, as it is to host the Olympic Games this summer in Rio de Janiero. Already suffering political and financial hardships, the government remains optimistic about the situation, saying that “Zika will pose no risk to Olympic visitors unless they’re pregnant”, and that because the games are occurring during Brazil’s winter, the mosquitoes should not be as active. Despite the outward optimism, athletes and prospective spectators of the international event have raised concerns, and airlines have begun to give refunds to those canceling trips to Zika affected areas, particularly Brazil.4

The U.S. Department of Health states that “although local transmission of Zika virus has not been documented in the continental United States, Zika virus infections have been reported in returning travelers”. Currently, there are no publically available tests for the disease. People within the affected regions observe for onset of symptoms such as the dengue infection, fever, conjunctivitis, etc. There is also no vaccine for the disease, and it has become especially important for those inhabiting these regions (or those who must travel to these regions) to engage in standard mosquito precautions. It is critical that pregnant women avoid travel to these areas, and should be assessed by a doctor immediately if exhibiting the various symptoms of the disease within two weeks of travel.3 Though the United States is at low risk for a widespread outbreak of Zika, it is important to be aware of the condition and its devastating effects.

1Trinfol, M. & Udani, S. (2016). Concern over Zika virus grips the world. The Lancet. doi. 10.1016/S0140-6736(16)00257-9

2World Health Organization. Zika virus outbreaks in the Americas. Weekly Epidemiological Record, 45(90), 609-616. Retrieved from http://www.who.int/wer

3Hennessey, M., Fischer, M., & Staples, J.E. (2016). Zika virus spreads to new areas- Region of the Americas, May 2015-January 2016. U.S. Department of Health and Human Services/Centers for Disease Control and Prevention: Morbidity and Mortality Weekly Report, 65(3), 55-57.

4Walsh, B., Sifferlin, A., Worland, J. & Sandy, M. (2016). Zika’s toll. Time, 187(5), 42-47.

 

The Reality of the Dangers of a Broken Heart

Holly Storm, freshman

You have just broken up with your significant other and feel like you could die from a broken heart. Even though it sounds silly to say you could die of a broken heart there is actually a chance you could. Broken heart syndrome is a stress-cardiomyopathy which means the heart muscle is abnormal that can be misdiagnosed as a heart attack. And even though these two things are similar in some aspects, Broken Heart Syndrome actually is very different from a normal heart attack.

In Broken Heart Syndrome, your body reacts to a sudden increase of stress hormones and a part of your heart will enlarge and start pumping badly while the rest of your heart will be functioning fine. Even though the effects of Broken Heart Syndrome can be very severe and threatening like short-term heart failure, the good news is that more than likely you can be back to normal within a week or two. Some things to look out for when experiencing Broken Heart Syndrome are severe chest pain, shortness of breath, and irregular heartbeats.  The reason that Broken Heart Syndrome is not the same as a heart attack is for several clear reasons. Heart attacks are a result of plaque building up in the arteries over long periods of time which then puts pressure on the junctions of the arteries. So heart attacks are the result of a poor health whereas to experience Broken Heart Syndrome, you do not need to be in bad health. It can happen in healthy people, even though what happens during the attacks are very different.

So when you are extremely upset over something such as a breakup or a death, do not push aside what is happening to you, as that could become life threatening.  Though it sounds ridiculous to say that you experienced Broken Heart Syndrome, it is something that should be taken seriously and your heart will thank you.

Is Broken Heart Syndrome Real? (n.d.). Retrieved February 17, 2016, from http://www.heart.org/HEARTORG/Conditions/More/Cardiomyopathy/Is-Broken-Heart-Syndrome-Real_UCM_448547_Article.jsp#.VsTaADY0tlI

 

The Ins and Outs of Diabetes

Briana Gavin, freshman

The month of November is diabetes awareness month so why not take a moment and learn more about diabetes? Diabetes mellitus comes in two main forms, type 1 and type 2 and is characterized by high blood glucose levels1. Type 1 is defined as a condition where the pancreas produces little to no insulin. Type 2, the more common form of diabetes, is where the amount of insulin produced does not meet the amount needed to perform the necessary functions; also referred to as insulin resistance.

Insulin is a hormone produced by the pancreas that controls the amount of glucose the liver produces and how much is released into the blood stream. Insulins main job is to help the cells in the body take the glucose out of blood to be stored and used in cellular respiration2. After eating you begin to digest your food and sugar is introduced into the blood stream therefore insulin is released to signal cells to absorb the sugar. Insulin levels are lower between meals because the amount of sugar in the blood stream is low1. With diabetes, insulin is not produce or effective to control the body’s blood sugar level. Running high sugars can have dangerous repercussions overtime such as vision problems and kidney problems because of weak or damaged blood vessels3.

Managing diabetes consists of keeping a balanced diet, exercising, watching blood sugar levels and taking needed insulin. Diabetics inject insulin, mainly synthetic, into their blood stream between or after meals to make up for the insulin they do not produce3. The amount of insulin needed is dependent on the individual and how resistant they are to insulin. Most diabetics carry around a blood glucose meter, this is a machine that can check blood glucose levels by testing a drop of blood and displays a number illustrating the amount of sugar in the blood. Usually blood sugar levels should be between 70-130 and less than 180, 2 hours after eating2.

The production of insulin is lifesaving medicine but misuse of insulin can have dangerous repercussions. When diabetics do not have enough insulin their blood sugar will spike and be high, if the blood sugar drops below 70 it means they have too much insulin and need sugar. Both can be dangerous if it happens too often or for too long. Diabetes is a chronic condition and affects about 347 million people worldwide, the more awareness about diabetes there is, the more efforts there can be towards curing it.

 

  1. http://www.news-medical.net/health/What-is-Insulin.aspx
  2. https://blog.myfitnesspal.com/25-things-you-should-know-about-diabetes/
  3. http://www.medicalnewstoday.com/info/diabetes/

Image from intel.org

 

Peppermint, Seasonal and Beneficial

Ashley Altieri, senior

It is unmistakable when the Winter break and Christmas season arrive.  Commercials of holiday sales bombard televisions and jaunty Christmas music adorns the malls and stores.  Candy Canes are placed on the shelves and peppermint flavored coffees- like the Peppermint Mocha Frappuccino- are available at Starbucks.  Besides being a traditional winter treat, peppermint has many therapeutic uses.

The main ingredient of the peppermint plant is known to scientists as menthol, and is used in chest rubs, topical lotions, and throat sprays2.  Peppermint is popularly used in aromatherapy or essential oil blends with the purpose of providing a calming and soothing atmosphere.  Multiple studies were conducted by nurses in comparing the use of peppermint aromatherapy to antiemetic medications.  Nurses in a study wanted to find a way to reduce postoperative nausea and vomiting in C-section patients without the adverse side effects that can occur with medications1.  The results of the study explained that peppermint aromatherapy is a useful adjunct therapy to treat postoperative nausea, and encouraged others to replicate the study in a variety of postoperative environments for more detailed results1.

Peppermint is also used to relieve pain from headaches, menstrual cramps, bloating, nausea, skin irritation, anxiety associated with depression, and diarrhea2.  Peppermint has been shown as a first line therapy for treating the symptoms of Irritable Bowel Syndrome (IBS)3.  According to Registered Dietician Nutritionist Kate Scarlata, “Peppermint oil has anti-spasmodic properties which relax the smooth muscle in the intestine, and test tube studies show that it has anti-microbial effects which reduce oral bacteria and fungal pathogens”3.  Scarlata also recommends that people use an enteric coated capsule to reduce the likelihood of heartburn3.  Peppermint might work well for people with IBS, but it is not as therapeutic for those with gastroesophageal reflux disease2.  Since peppermint helps to relax the muscles in the stomach, like the esophageal sphincter, it can worsen the effects of heartburn and indigestion in this population2. As with all herbal or holistic therapies, it is necessary to consult your health care provider before seriously starting a new therapy or supplement.  The next time you eat at Olive Garden and get the after-dinner mint, or you are relaxing with a steamy mug of peppermint tea, consider the ways that peppermint can be used in the clinical setting.

 

1, http://jhn.sagepub.com.authenticate.library.duq.edu/content/30/2/90

2, https://umm.edu/health/medical/altmed/herb/peppermint

3, http://web.b.ebscohost.com.authenticate.library.duq.edu/ehost/pdfviewer/pdfviewer?sid=c11288fa-10d1-4bc5-b8c3-a8bb07530544%40sessionmgr110&vid=10&hid=106

 

 

Want to get involved in December AIDS awareness?

Sarah Dudley, freshman

December 1st was World AIDS Day, as people all over the world unite to show their support for people who are living with HIV, fight back against it, and to commemorate those who have passed away .While the White House adorned a massive red ribbon on its front columns, our very own Gulf Tower illuminated in all red to show support. Pittsburgh was one of hundreds of cities worldwide who came together, dawned in Red, to sponsor World AIDS Day.

In the past, there was free HIV testing on December 1st to promote awareness. However, now the Pittsburgh AIDS Task Force offers free HIV and STD testing on every day except Saturday. For more information such as hours and location, visit http://www.patf.org/get-tested.

Other Pittsburgh locations that offer HIV testing include the Allegheny County Health Department, Adagio Health Network, the Pittsburgh AIDS Center for Treatment, Planned Parenthood of Western Pennsylvania, and the Positive Health Clinic.

The University of Pittsburgh held a World AIDS Day Commemoration service in the Heinz Memorial Chapel on December 1st, at 7:30pm. This service was to remember all those who lost their battle with HIV/AIDS, and to support those who are currently fighting. Following this event, over 200 people held a candle light vigil and march through Oakland.

If you missed out on the awareness festivities, be sure to attend the pep rally for preventive medical measures for individuals at risk of contracting HIV. The event will promote pre-exposure prophylaxis, or PrEP, a combination of strategies such as a daily pill and condom use for those who are at risk of contracting HIV. The rally will be held on December 10, from 7:30-9:30pm, at the Kelly Strayhorn Theater, 5941 Penn Avenue, East Liberty. The event is being sponsored by the Pittsburgh AIDS Task Force, and along with the informational speeches and sessions, there will be a “drag queen cheer squad”.

Are you interested in joining next year’s World AIDS Day celebration in Pittsburgh? Or just in bringing about more attention to HIV/AIDS? There are many volunteer opportunities through the Pittsburgh AIDS Task Force available to you! Some include volunteering at their food pantry, being a “buddy” to an HIV-positive individual, office assistants, or many other positions. For more information, visit http://www.paft.org/community-outreach.

 

Nursing Care of TBIs: Beyond Visible Injuries

Chelsea Kwong, senior

For the past year, I have had the unique opportunity of working as a patient care technician on a brain injury rehabilitation unit. Throughout my time there, I have witnessed the devastating effects of traumatic brain injuries (TBI), which include emotional and/or physical disturbances. However, I have also been a witness to the amazing results of intensive therapy. It is a delight to see a patient walk that was unable to do so three weeks ago. Traumatic brain injuries are among the most complex injuries that the human body can experience, and it take special nursing skills to effectively care for these patients (at every step of the way!).

brainThe most common ways that one acquires a TBI are through falls, motor vehicle crashes, sudden blows to the head, and assaults.1 TBI’s are classified as either mild or severe. Mild TBI’s are classified as such “if confusion and/or disorientation is shorter than 30 minutes”2. These individuals can experience several cognitive effects, such as “headache, difficulty thinking, memory problems, attention deficits, mood swings, and frustrations”. Severe TBI’s are associated with “loss of consciousness for more than 30 minutes and memory loss after the injury…longer than 24 hours”. brain2They can have a very significant on the individual’s ability to function socially.

Nurses will most often encounter these patients in intensive care, emergency, and rehabilitation settings. Much of nursing care goes beyond such measures as maintaining intracranial pressure at a safe level, tending to visible structural injuries, etc. Nurse often find themselves providing education to the patient in families in regards to potential life changes. Particularly, the nurse may be charged with finding support groups and counseling for those affected by the injury. Traumatic brain injuries can be very stressful for spouses of injured individuals, as they now find themselves suddenly becoming a caregiver, and losing their equal partner both physically and cognitively. Patients with TBI’s may find that they cannot work, or aid in taking care of their children. All outcomes can be extremely strenuous for patients and their families, and it is important for the nurse to educate and support at this time.

Traumatic brain injuries can be extremely traumatic and life changing. However, with proper nursing care, the journey from hospitalization to discharge can be much less stressful on those who matter most: the patient and their loved ones.

 

1n.a. (2015). Facts about traumatic brain injury. Centers for Disease Control and Prevention. Retrieved from http://www.brainline.org/content/2008/07/facts-about-traumatic-brain-injury.html.

2 n.a. (2013). What is TBI? Head Injury Association. Retrieved from http://www.lihia.org/tbi.html.

3 Zimlich, Rachael. (2014). Nursing interventions in traumatic brain injury go beyond the patient. Modern Medicine Network. Retrieved from http://healthcaretraveler.modernmedicine.com/healthcare-traveler/news/nursing-interventions-traumatic-brain-injury-go-beyond-patient

Photo from mrswatersenglish.com and pintrest

 

In Our Last Moments, Hospice Nursing

Chelsea Kwong, senior

At some point in everyone’s lives, one will have to face the death of a loved one, and eventually, their own death. During this time, it is critical to have adequate support and guidance in the various phases of the end-of-life stage. Some nurses voluntarily put themselves in this position, caring for those with a terminal diagnosis and their grieving loved ones. These nurses, known as hospice nurses, aim to provide maximum comfort for those whose treatments have ended, and provide support and education for the loved ones that the patient will leave behind.

Hospice care, by definition, is a type of care that “focuses on providing compassionate care while maximizing a person’s quality of life”1. Nurses in this field work to manage pain and assess the patient’s condition, rather than performing aggressive measures to keep them alive. Major duties of the hospice nurse lie within the “Gold Standards Framework”, which is a tool to guide healthcare professionals in the care of the terminally ill. The concepts within this framework (also known as “the 7 C’s”) include: communication, chospiceoordination of care, control of symptoms, continuity of care, continued learning for nurses and other professionals, caregiver support, and care of the dying2.

Hospice nurses not only provide care for their clients, but also for their clients’ families. As a terminal illness diagnosis also takes a toll on loved ones, nurses must prepare to educate the families on expectations during the end-of-life phase, and support them during the grieving process. One way that the nurse may do this is by educating the family on performing comfort measures (such as oral care) and encouraging the family to tell stories or perform family rituals2.

The concept of hospice nursing is relatively new, having been developed within the past 25 years. Care is primarily provided in the client’s home, but can also be provided in an in-patient hospice unit, a nursing home/long term care facility, etc3. Those who wish to become hospice nurses need not have additional certification beyond an RN degree, however, organizations such as the Hospice and Palliative Nurses Association offer various certifications (including providing care for pediatric patients)4. Master’s degrees in hospice and palliative care nursing exist at New York University and Ursaline College (in California)3.

Hospice nursing can require a great deal of vulnerability when providing care. One nurse provided a statement about grieving a patient’s death to Linda Norlander, author of To Comfort Always: A Nurse’s Guide to End-of-Life Care, saying, “I cry with the family. I also try to take some quiet time-sometimes I just sit in my car. But I need the time to remember that patient”2. After providing care to a client and their family for a great deal of time, it can be easy to form a bond, and hard to let the patient go.

During the end-of-life stage, many uncertainties can arise. It is a very emotional and confusing time for the patient and their loved ones. With a hospice nurse, these people will not have to go through this journey alone.

1Crusse, E.P. (2014). Hospice care is comfort care. Nursing Made Incredibly Easy!, 12(3), p. 40-49. DOI-10.1097/01.NME.0000445322.70273.8c

2Norlander, L. (2014). To comfort always: A nurse’s guide to end-of-life care. Indianapolis: Sigma Theta Tau International.

3Nurses for a Healthier Tomorrow. (2015). Hospice/palliative care nurses. Retrieved from http://www.nursesource.org/hospice.html.

4Hospice and Palliative Nurses Association. (2015). Certifications offered. Retrieved from http://hpcc.advancingexpertcare.org/competence/certifications-offered/

Photo from Georgia Mountains Hospice