Disease Principles: Onset, Detection, and Symptoms

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Disease PrinciplesOnset, Detection, and
Symptoms

• Curtis W. Thorpe, M.D., M.P.H.
• Medical Consultant
• Office of Family Health Services, VDH

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Disease changes can go undetected Acute
vs. Chronic Disease Flu vs. arthritis vs.
cancer Lengths of incubation periods
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Examples of slow, chronic changes, while we are
sitting in the room Colon Polyp Prostate
enlargement Cervical Dysplasia Arthritis
Hypertension Adult Onset Diabetes Elevated
Cholesterol Arterial Plaques Skin Changes
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Not so classic Chronic Diseases

• Epilepsy
• Sickle Cell Anemia
• Chronic Disabilities
• HIV - AIDS
• Tuberculosis
• Hepatitis B
• Importance of Screening early detection

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Prevention PrinciplesOnset, Detection, and
Symptoms

• Primary Prevention Avoidance, Delay
• Secondary Prevention disease onset,
  asymptomatic, screen and intervene
• Tertiary Prevention Rehabilitation, return to
  normal life, avoiding institutionalization

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Genetics

• Prevention must be tempered with genetic
  pre-disposition.
• Issues with race and gender
• What diseases are present in
• other family members?

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New Born ScreeningSickle Cell Anemia

• Primary Prevention Genetic
  Counseling
• Secondary Prevention Sickle
  Cell Screening
• Tertiary Prevention Preventing
  disability

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Immunizations Haemophilus Influenzae

• Primary Prevention Immunization
• Secondary Prevention
• ? Presence of bacteria
• Tertiary Prevention Treatment as
  needed

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Environmental Hazards Lead Screening

• Primary Prevention Remove Lead based paint
• Secondary Prevention Blood test
• Tertiary Prevention Treatment as needed to
  prevent complications

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Environmental Hazards Asbestos
Exposure

• Primary Prevention Avoid asbestos exposure
• Secondary Prevention Serum Osteopontin Levels
• Tertiary Prevention Treatment of Mesothelioma,
  lung complications

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Early Cell Changes Cervix, Pap Smear

• Primary Prevention Limit number of
• sex partners
• Secondary Prevention Pap Smear
• Tertiary Prevention Treatment as
• needed such as colposcopy

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Fetal DevelopmentNeural Tube Defects

• Primary Prevention Counseling, Folic Acid
  before pregnancy
• Secondary Prevention Maternal serum
  alpha-fetoprotein
• Tertiary Prevention Treatment

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Maternity Care Urinary Tract Infection

• Primary Prevention Diet, Prophylactic
  antibiotics
• Secondary Prevention Urinalysis, Urine Culture
• Tertiary Prevention Antibiotics

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Infectious Disease Prevention Tuberculosis

• Primary Prevention Avoid exposure
• Secondary Prevention Skin testing
• Tertiary Prevention Medications

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Injury and Trauma Automobile Accidents

• Primary Prevention Safe Driving, avoiding
  alcohol
• Secondary Prevention Seat belts, Air
  Bags
• Tertiary Prevention EMS Systems

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Metabolic DiseasesDiabetes Mellitus, Type II

• Primary Prevention Weight control, regular
  exercise
• Secondary Prevention Blood tests
• Tertiary Prevention Controlling hyperglycemia

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Cardiovascular DiseasesHeart Attack, Stroke

• Primary Prevention Nutrition, Exercise
• Secondary Prevention Blood tests, blood
  pressure checks
• Tertiary Prevention Controlling blood pressure
  and cholesterol levels

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Cancer Prevention Breast Cancer

• Primary Prevention avoid estrogen
• Secondary Prevention
• self-breast exam, mammography
• Tertiary Prevention cancer treatment

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Cancer PreventionLung Cancer

• Primary Prevention avoid smoking cigarettes
• Secondary Prevention ? Blood tests,
  ? Chest X-Rays
• Tertiary Prevention Treatment

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Cancer PreventionProstate Cancer

• Primary Prevention ? Part of aging process,
  effects of testosterone
• Secondary Prevention PSA Blood Tests, Digital
  Rectal Exams
• Tertiary Prevention Treatment

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Avoiding DisabilitiesHip Fracture

• Primary Prevention healthy bone density,
  hormones, Depo Provera
• Secondary Prevention Bone Scan
• Tertiary Prevention Hip replacement

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Disease Prevention comes from healthy
lifestylesand regular medical visits
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Remembering chronic diseases

• Healthy lifestyles may not be part of our
  routines, especially with no symptoms
• Remember to keep doctors appointments

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Promote Healthy Behaviors

• Eating low fat, high fiber diets
• Physical activity, regular exercise
• Avoiding physical injury and trauma
• Responsible sexual behaviors

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Early Detection Practices

• Blood Pressure, blood sugar, cholesterol levels
• Cancer Screening

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Promote Healthy Environments

• Smoke-Free Policies in Workplaces and Schools
• Lead free Paint in Homes
• Reduction of Allergens and Air polluntants in
  Schools and Worksites
• School and Work Site exercise programs
• Healthy Menu Selections in Schools
  and Restaurants

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Achieving Healthier Communities

• Promote Health through Faith based organizations
• Professional Education Initiatives
• Work with Community Coalitions and Task Groups
• Work place Health Initiatives

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Major Community Areas

• Virginia Arthritis Project (VAP) and Healthy
  Aging
• Virginia Asthma Control Project (VACP)
• Cardiovascular Health Project (CVHP) - heart
  disease and stroke
• Comprehensive Cancer Prevention and Control
  Project (CPCP)
• Virginia Cancer Registry (VCR)
• Diabetes Prevention and Control Project (DPCP)
• Tobacco Use Control Project (TUCP)
• Health Promotion for People with Disabilities
  Project (HPPDP)

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Collaboration

• Good working relationships between public health,
  private medicine, and community advocates
• Need to have consistent and simple health
  messages for the public that do not conflict
• Continuing professional education

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Money to be Made in Health Promotion and
Prevention

• Over the counter miracle drugs
• Fat burning diet pills
• Exercise equipment
• Advertised prescription drugs

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Our Goals?

• To have a long and healthy life

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Our Goals?

• Time to be happy with those we care about

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Questions?????