236 2021 u9 prevention immunization VOC

 Preventive medicine = ProphylaxisPreventative healthcare  Levels of prevention: Primary Avoid occurrence of disease either through eliminating disease agents or increasing resistance

PREVENTION &

IMMUNIZATION

UNIT 9 – READING & VOCABULARY (2 hours)

ENGLISH IN MEDICINE 2 – GENERAL PRACTITIONER Y2

Editor: Nguyen Hoang Quynh Mai Email: nguyenhquynhmai@duytan.edu.vn

 Preventive medicine = Prophylaxis

Preventative healthcare

 Levels of prevention:

Primary Avoid occurrence of disease either through eliminating

disease agents or increasing resistance to disease

Secondary Detect and address an existing disease prior to the

appearance of symptoms

Tertiary Reduce the harm of symptomatic disease, such as

disability or death, through rehabilitation and treatment

Quaternary Mitigate or avoid results of unnecessary or excessive

interventions in the health system

https://en.wikipedia.org/wiki/Preventive_healthcare

1 PREVENTION

A rehabilitation for syphilitic patients

B breast cancer screenings C do exercise daily

D maintain a healthy diet E avoiding smoking

F sewage treatment G develop personal hygienic routines

H treatment of hypertension I water purification

J immunization against disease

K screening and treatment of infants born by syphilitic mothers

L prevention of diabetes complications

1 PREVENTION

WHICH LEVEL OF PREVENTION ARE THESE ACTIONS AT?

Preventive Medicine is a medical specialty that promotes health and prevents illness In the late 20th century this specialty gained importance as United States public health officials became concerned about the increasing cost of health care Preventive medicine strategies can focus on the population or on individuals.

Population-based Programs

Historically, the first preventive strategies were based on the

awareness that disease transmission can be stopped by public hygiene measures such as quarantining people who are ill, removing

the dead, and providing sewage systems A major advance was the

discovery that immunization can protect people against many

infectious diseases.

1 PREVENTION

Preventive medicine is also concerned with chronic disease and

has developed such measures as screening programs to identify

individuals with high blood pressure and those who have breast or cervical cancer Unfortunately, screening for lung cancer has not been

as successful.

Governments have attempted to prevent disease by requiring

greater purity of air and water and by prohibiting the use of food

additives that cause cancer in animals Federal regulations in the

United States also promote safety in the workplace, for example, by requiring the removal of accident hazards and by limiting employees' exposure to chemicals and radiation.

1 PREVENTION

Individual Actions

Researchers in human health problems also uncover actions that people can take individually to improve their health Primary among these are maintaining a nutritious and balanced diet with a low fat content, getting sufficient sleep and regular exercise, and having periodic medical and dental examinations Many physicians

recommend reducing the intake of cholesterol in the diet to cut

down heart disease Dentists have introduced the application of

fluoride to children's teeth to prevent tooth decay.

1 PREVENTION

Public health officials also stress the use of automobile seat belts, especially for children Physicians and health officials encourage people

to stop smoking as the most effective way to combat the increasing occurrence of lung cancer People are also encouraged to wear sunscreens and avoid prolonged exposure to sunlight in an effort to prevent skin cancers, although these measures have been found to be

ineffective against melanoma, the most deadly form of skin cancer Some

scientists advocate the massive use of vitamin C to prevent colds and the use of vitamins A and E to prevent some cancers, but these measures remain controversial.

1 PREVENTION

PREVENTABLE CAUSES OF DEATH

1 Smoking

2 High blood pressure 3 Overweight-obesity

4 Inadequate physical activity and inactivity

5 High blood sugar 6 High LDL cholesterol

7 High dietary salt

8 Low dietary omega-3 fatty acids (seafood)

9 High dietary trans fatty acids

10 Alcohol use

11 Low intake of fruits and vegetables

12 Low dietary poly-unsaturated fatty acids

1 PREVENTION

available, diagnostic, disorder, fulfilled, form identification, prevalence, problem, remedy, risk

Screening is the (1) , among apparently healthy individuals, of thosewho are sufficiently at (2) _ from a specific (3) to justify asubsequent (4) test or procedure, or, in certain cases, intervention.Screening tests may take the (5) _ of inquiry or may take the form of aspecial test Before screening can provide an effective means of diseaseprevention, certain criteria need to be (6) A knowledge of thedisorder being screened for, including its (7) and natural history, isneeded to ensure that the disease is sufficiently common and serious torepresent an important medical (8) The screening test must besimple, cheap, acceptable and safe, and facilities must be (9) _ to providethe screening service and the consequent (10) _

1 PREVENTION

1 Cervical cancer A Low-dose helical computed tomography

2 Breast cancer B CA-125 test

3 Lung cancer C Colonoscopy, sigmoidoscopy

4 Prostate cancer D Pap test

5 Liver cancer E Mammography

6 Colorectal cancer F Alpha-fetoprotein blood test

7 Ovarian cancer G PSA test

SCREENING TESTS - MATCHING

1 PREVENTION

Immunization, also called vaccination or inoculation, is a

method of stimulating resistance in the human body to specific diseases using microorganisms - bacteria or viruses - that have been modified or killed These treated

microorganisms do not cause the disease, but rather trigger

the body's immune system to build a defense mechanism that continuously guards against the disease If a person immunized against a particular disease later comes into contact with the disease-causing agent, the immune system is immediately able to respond defensively.

2 IMMUNIZATION

Immunization has dramatically reduced the incidence of a

number of deadly diseases For example, a worldwide vaccination

program resulted in the global eradication of smallpox in 1980, and

in most developed countries immunization has essentially eliminated

diphtheria, poliomyelitis, and neonatal tetanus The number of cases of Hemophilus influenzae type B meningitis in the United

States has dropped 95% among infants and children since 1988, when the vaccine for that disease was first introduced In the United States, more than 97% of children are immunized by the time they reach school age In an attempt to continue these global successes, the World Health Organization (WHO) has set the year 2000 as a target date for the immunization of all children.

2 IMMUNIZATION

Active and Passive Immunization

Active immunization involves injection of all or part of a disease-causingmicroorganism or a modified product of that microorganism into the body tomake the immune system respond defensively The activating components of

the vaccination are antigens, substances that the immune system recognizes as

foreign In response to the antigen, the immune system develops either

antibodies or white blood cells called T lymphocytes, which are special attacker

cells Immunization mimics real infection but presents little or no risk to therecipient Some immunizing agents provide complete protection against adisease for life Other agents provide partial protection, meaning that the

immunized person can contract the disease, but in a less severe form Some immunizing agents require repeated inoculations - or booster shots - at specific

intervals Tetanus shots, for example, are recommended every ten yearsthroughout life

2 IMMUNIZATION

A person can be actively immunized by receiving an injection of deadorganisms that are no longer capable of causing disease but that still containantigens This type of vaccination is used to protect against bacterial

diseases such as typhoid fever, whooping cough, and diphtheria Active

immunization can also be carried out using bacterial toxins that have beentreated with chemicals so that they are no longer toxic, even though theirantigens are still intact This procedure uses the toxins produced by thebacteria rather than the organism itself and is used in vaccinating against

tetanus, botulism, and similar toxic diseases Finally, a person can be

injected with live organisms that have been attenuated - that is, changed sothat they do not cause disease This procedure is used to protect againstpoliomyelitis, yellow fever, measles, smallpox, and many other viraldiseases

2 IMMUNIZATION

While active immunization confers long-lasting immunity, passive immunization

provides temporary immunity and is performed without injecting any antigen Passive immunization is accomplished by injecting antibodies obtained from the blood of an actively immunized human being or animal The antibodies last for two to three weeks, and during that time the person is protected against the disease Although short-lived, passive immunization provides immediate protection, unlike active immunization, which can take weeks to develop Consequently, passive immunization can be life-saving when a person has been infected with a deadly organism.

Occasionally there are complications associated with passive immunization.

Diseases such as botulism and rabies once posed a particular problem Immune

globulin (antibody-containing plasma for these diseases) was once derived from the

blood serum of horses Although this animal material was specially treated before

administration to humans, serious allergic reactions were common Today,

human-derived immune globulin is more widely available and the risk of side effects is reduced.

2 IMMUNIZATION

There are more than 20 vaccines licensed in the United States The

American Academy of Pediatrics and the U.S Public Health Servicerecommend a series of immunizations beginning at birth The initial series forchildren is completed by the time they reach the age of two, but boostervaccines are required for certain diseases such as diphtheria and tetanus inorder to maintain adequate protection When new vaccines are introduced, it

is uncertain how long full protection will last Recently, for example, it wasdiscovered that a single injection of measles vaccine, first licensed in 1963 andadministered to children at the age of 15 months, did not confer protectionthrough adolescence and young adulthood As a result, in the 1980s a series of

measles epidemics occurred on college campuses throughout the United

States among students who had been vaccinated as infants To forestall futureepidemics, health authorities now recommend that a booster dose of measlesvaccine be administered at 4 to 6 or 11 to 12 years

2 IMMUNIZATION

Although modern immunizing agents generally are considered safe andeffective, risks associated with the use of vaccines can vary from insignificant(fever and soreness at the site of injection) to life threatening The goal invaccine development is to achieve the highest degree of protection with thelowest rate of side effects Today's genetic engineering technology makes itpossible to prepare safer and highly effective genetically altered vaccines.

Not only children but also adults can benefit from immunization Manyadults in the United States are not sufficiently protected against tetanus,

diphtheria, measles, mumps, and German measles Health authorities

recommend that most adults 65 years of age and older, and those with

respiratory illnesses be immunized against influenza (yearly) and

pneumococcus(once), which causes pneumonia.

2 IMMUNIZATION

1/ Immunization = =

 to fight _ by _ the immune system 2/ Vaccines help prevent some diseases such as 3/ Active vs Passive immunization?

4/ Vaccines can be made from

5/ Immunization mimics real infection with

6/ Why do children need vaccination?

2 IMMUNIZATION

3/ Vaccination program help eliminate some diseases.

4/ Active immunization provides temporary immunity.

5/ Passive immunization is achieved by injecting antibodies.

6/ There are some complications of vaccination.

7/ There is no use vaccinating for the adults.

2 IMMUNIZATION

Innate immunity - the first line of defence, non-specific

Adaptive immunity - the second line of defence, specific, antibody response

Immunodeficiency disorders: primary & secondary

Autoimmune diseases: primary & secondary; localized & systemic Allergies: hypersensitivity disorders

Asthma: inhaled particles

Cancer: avoid immune destruction

Transplants: immune system’s recognition

Vaccines: teach the body to recognize & defend itself

2 IMMUNIZATION

TYPES OF VACCINES

• Inactivated vaccines (hepatitis A, flu, polio, rabies): killed germs

• Live-attenuated vaccines (measles, mumps, rubella, smallpox,

chickenpox): weakened germs

• Messenger RNA (mRNA) vaccines (COVID-19): make trigger

proteins

• Subunit, recombinant, polysaccharide, and conjugate vaccines

(hepatitis B, HPV): specific pieces of germs

• Toxoid vaccines (diphtheria, tetanus): toxin made by germs

• Viral vector vaccines (COVID-19): use a different virus as a vector

Ask “Do you smoke?” routinely while taking patient’s vital signs

Assess the patient’s nicotine dependence

Pre-contemplation stage (smoking is not a problem)

Contemplation stage (smoking may be a problem)

Preparation stage (wants to quit smoking)

Action stage (quits smoking) Maintenance stage Relapse

Reinforce their healthy choice

Assess patient’s readiness

to change

3 SMOKING CESSATION

A Begin nicotine replacement and continue bupropion

B Educate the patient about the effects of smoking, introduce ambivalence (inquire

about decision to continue smoking), express concern, and recommend quitting

C Reassess readiness to change and enter at appropriate stage; identify reasons for

relapse and consider how things might be done differently

D Set a quit date, select smoking cessation strategies, determine dosage

of nicotine replacement if indicated, identify triggers, gather social support for

quitting, and begin bupropion if indicated

E Assess the patient’s nicotine dependence

F Assess positive and negative thinking about smoking

G Continue positive reinforcement of the healthy choice

3 SMOKING CESSATION

Today most people agree that smoking is not good for your health What do you think about that?

I am concerned about your health and believe you should stop smoking I am wondering how I can help you with that Your cough will improve when you quit smoking.

Let’s set a date for you to quit smoking and make plans for how you can do it.

Pre-contem.

Contemplation

Preparation

3 SMOKING CESSATION

prophylaxis awareness hygiene quarantine

IMPORTANT CONCEPTS

WRITING PRACTICE

1 What is primary prevention? (3-5 sentences)

2 What is active immunization? (3-5 sentences)

3 The impact of prevention in healthcare (introduction

& good impacts in at least 2 paragraphs).

10 MCQS ON KAHOOT

QUESTIONS