Sometimes inadvertently, children and adults ingestforeign objects. So,
what to do? If
an adult or child swallowing foreign objects, which can be done is to see a
doctor as soon as possible.
If foreign objects that cause choking, and must be helped
as soon as possible before they can contact a doctor, the American Red Cross
recommends the procedure "five-and-five" as first aid. What
can be done to these as suggested Mayoclinic.com are:
1.Give 5 blows / a pat on the back. First,
give five blows between the shoulder blades choking person by using the heel of
the hand.
2.Give 5 times poke /
stomach encouragement. Perform
five belly poke movement (also known as the Heimlich maneuver).
3.Perform the
procedure as an alternative until the blockage is gone.
If you're just alone, do back blows and abdominal poke
before calling the local emergency assistance. If
there are other people with you, ask the person to call emergency medical
assistance while you perform first aid.
The American Heart Association does not recommend the
technique back blows, abdominal impulse procedure only. You
do not need to perform back blows technique if you have not studied the
technique.
How
the time to do the Heimlich maneuver on someone else? Do the following:
1.Stand behind the person. Wrap
your arms around his waist, and push the person forward slightly.
2.Make a fist with
one hand. Position
fist above your navel choking person.
3.Grasp the fist with
the other hand. Press
hard into the abdomen with a quick push towards the top - as if you're trying
to lift someone up.
4.Perform a total of
5 poke stomach if necessary. If
the obstruction (choke) still occurs, repeat the cycle of five-and-five.
A modified version of this technique are sometimes taught
to be used in pregnant and obese people. Rescuer
will put his hand in the middle of the chest to squeeze (compress), rather than
on the abdomen of pregnant / obesity.
Perform the Heimlich maneuver on yourself can be done
even though you might find it difficult to hit the back of his own. Do
a belly poke technique to dislodge objects that cause choking:
1.Place a fist slightly above the navel.
2.Grasp your fist
with your other hand while bending on a hard surface (table or chair).
Findings Have Clinical Implications on How We Treat
and Follow Survivors
Most people assume strokes only happen to octogenarians, but recent evidence
suggests that survivors of childhood cancer have a high risk of suffering a
stroke at a surprisingly young age.
Sabine Mueller, MD, PhD
A new study from UC San Francisco's Pediatric Brain Center
shows that childhood cancer survivors suffering one stroke have double the risk
of suffering a second stroke, when compared with non-cancer stroke survivors.
The study found that the main predictors of recurrent stroke were cranial
radiation therapy, hypertension and older age at first stroke – factors that could
help physicians identify high-risk patients.
The findings provide strong evidence for adjusting secondary stroke
prevention strategies in these patients, and to aggressively detect and treat
modifiable stroke risk factors, such as hypertension.
Findings appear in the Aug. 26 online issue of Neurology, the medical journal of the American
Academy of Neurology.
“We are at a point where more children are surviving cancer because of
life-saving interventions,” said Sabine Mueller,
MD, PhD, director of the UCSF Pediatric Brain Tumor Center in UCSF Benioff
Children’s Hospital San Francisco and co-author of the study.
“Now, we are facing long-term problems associated with these interventions.”
Effects
of Cranial Radiation Therapy
The Pediatric Brain Center (PBC) is a collaboration between two UCSF centers
– the Pediatric Brain Tumor Center and Pediatric Stroke and Cerebrovascular Disease Center
– that brings specialists together to provide coordinated care for patients,
while conducting research to better understand how to care for children.
An image of a diseased artery in a childhood cancer patient overlaid
with their radiation therapy concentrations. While the exact mechanisms
are unknown, scientists think that high doses of radiation cause the
blood vessels to constrict.
The researchers analyzed retrospective data from the Childhood Cancer Survivor Study
(CCSS), which has followed 14,358 survivors diagnosed between 1970 and 1986 in
the United States and Canada to track long-term outcomes of cancer treatment.
All of the recruits were diagnosed with cancer before age 21. To assess stroke
recurrence rates, the researchers sent a second survey to participants who had
reported a first stroke, asking them to confirm their first stroke and report
if and when they had had another. The researchers analyzed the respondent
demographics and cancer treatments to identify any potential predictors of
recurrent strokes.
An image of the brain’s blood vessels of a childhood cancer patient
before and after cranial radiation therapy. Post-radiation, two arteries
show signs of narrowing, which may encourage brain clots to form and
eventually cause a stroke.
Of the 271 respondents who reported having had a stroke, 70 also reported a
second one. Overall, the rate of recurrence within the first 10 years after an
initial stroke was 21 percent, which is double the rate of the general
population of stroke survivors. The rate was even higher – 33 percent – for
patients who had received cranial radiation therapy.
Previous research has shown that radiation therapy targeting the head is a
strong predictor of a first stroke. In an earlier study, the authors found that
children treated for brain tumors were 30 times more likely to suffer a stroke
compared to their siblings. While the exact mechanisms are unclear, the
scientists think high-dose radiation causes the blood vessels to constrict and
encourage blockage.
“If they have one stroke, it’s not actually surprising that they have a high
risk of getting another stroke,” said Heather
Fullerton, MD, professor of Neurology, founder of the UCSF Pediatric Stroke
and Cerebrovascular Disease Center, and first author of the study. “You might
use aspirin after the first stroke to try to reduce blood clots, but you’re not
making those diseased blood vessels go away.”
UCSF
Updating Patient Monitoring Protocols
The findings have significant implications for medical follow-up in
childhood cancer patients. The authors said that current survivor screening
guidelines do not recommend checking for diseased blood vessels, even though
the signs are visible in standard MRIs.
Heather Fullerton, MD
“The radiologists are so focused on looking in the brain area where the
tumor used to be that they’re not looking at the blood vessels,” Fullerton
said.
Based on the findings, UCSF has updated protocols for monitoring patients to
include screening for both blood vessel injury and modifiable stroke risk
factors, but it is not required on a national level.
“If we could identify high-risk patients, we could recommend they be
followed by a pediatric stroke specialist,” said Mueller. “That will be huge in
providing effective follow-up care for these children.”
Other collaborators on the study are Robert R.
Goldsby, MD, professor of Pediatrics and director of the UCSF Survivors of
Childhood Cancer Program; Kayla Stratton, MS, and Wendy Leisenring, ScD, of the
Fred Hutchinson Cancer Research Center; Gregory Armstrong, MD, Leslie Robinson,
PhD, and Kevin Krull, PhD, of St. Jude’s Children’s Research Hospital; Marilyn
Stovall, PhD, and RE Weathers, MS, of the University of Texas, and Charles
Sklar, PhD, of Memorial Sloan-Kettering Cancer Center.
This work was supported by the National Cancer Institute (U24 CA 55727), the
Cancer Center Support (CORE), the American Lebanese-Syrian Associated
Charities, the National Center for Advancing Translational Sciences, the Frank
A. Campini Foundation and a private donation from the LaRoche family.
UCSF Benioff Children’s Hospital San Francisco is the only California
state-designated children’s medical center in San Francisco. The hospital is
one of the leading children's hospitals in the nation, according to U.S. News
& World Report. Its expertise covers virtually all pediatric conditions,
including cancer, heart disease, neurological disorders, organ transplants and
orthopedics as well as the care of critically ill newborns.
UC San Francisco (UCSF) is a leading university dedicated to promoting
health worldwide through advanced biomedical research, graduate-level education
in the life sciences and health professions, and excellence in patient care. It
includes top-ranked graduate schools of dentistry, medicine, nursing and
pharmacy, a graduate division with nationally renowned programs in basic,
biomedical, translational and population sciences, as well as a preeminent
biomedical research enterprise and two top-ranked hospitals, UCSF Medical
Center and UCSF Benioff Children’s Hospital San Francisco.
A large-scale national study suggests low to moderate use of marijuana is less harmful to users’ lungs than exposure to tobacco, even though the two substances contain many of the same components.
Smoking cigarettes can cause significant lung damage, including respiratory symptoms, chronic obstructive pulmonary disease and lung cancer. It accounts for an estimated 443,000 deaths, or nearly one in every five deaths, each year in the United States, according to the U.S. Centers for Disease Control and Prevention (CDC). Data for the long-term effects of marijuana use on the pulmonary system has been scarce until now.
Mark Pletcher, MD, MPH
“We found exactly what we thought we would find in relation to tobacco exposure: a consistent loss of lung function with increasing exposure,” said the paper’s lead author, Mark Pletcher, MD, MPH, associate professor in the Division of Clinical Epidemiology at UCSF. “We were, however, surprised that we found such a different pattern of association with marijuana exposure.”
In a paper published today in the Journal of American Medical Association (JAMA), researchers analyzed the relationship between current and lifetime exposure to marijuana and pulmonary function. The Coronary Artery Risk Development in Young Adults (CARDIA) study collected medical data from 5,115 men and women in four U.S. cities from 1985 to 2006.
They measured air flow rate – the speed in which a person can blow out air – and lung volume, which is the amount of air a person is capable of holding, typically about six liters of air for an adult male. Lung function was measured using a common medical device called a spirometer that measures air flow when the participant breathes in and out.
The same was not true with marijuana use. Air flow rate increased rather than decreased with increased exposure to marijuana up to a certain level.
“An important factor that helps explain the difference in effects from these two substances is the amount of each that is typically smoked,” Pletcher said. “Tobacco users typically smoke ten to 20 cigarettes/day, and some smoke much more than that. Marijuana users, on average, smoke only two to three times a month, so the typical exposure to marijuana is much lower than for tobacco.”
“And marijuana is one where a lot of people dabble with it in their late teens and 20s, and some people continue with relatively low levels for a long period of time,” Kertesz added.
Heavy Marijuana Use May Take Toll
Although there was a suggestion that very heavy use of marijuana might be taking a toll on the lungs, the researchers could not get reliable estimates of the effects of very heavy marijuana exposure, as such smokers were relatively rare in the study population.
All participants in the study began as young, healthy adults 18 to 30 years old from four communities: Oakland, Chicago, Minneapolis and Birmingham. They volunteered to be part of this long-term medical research study, agreeing that their data could be used to explore questions, including about tobacco and marijuana use.
Researchers believe the results can supplement the growing body of
knowledge about beneficial aspects of low to moderate marijuana use in
controlling pain, stimulating appetite, elevating mood and managing
other chronic symptoms.
“Our findings suggest that occasional use of marijuana for these or
other purposes may not be associated with adverse consequences on
pulmonary function,” Pletcher said. “On the other hand, our findings do
suggest an accelerated decline in pulmonary function with heavier use –
either very frequent use or frequent use over many years – and a
resulting need for caution and moderation when marijuana use is
considered.”
Pletcher is the lead author of the paper; co-authors are Eric
Vittinghoff, PhD, and Feng Lin, MS; of the UCSF Department of
Epidemiology and Biostatistics; Ravi Kalhan, MD, MS, of the Divison of
Pulmonary and Critical Care Medicine at Northwestern University Feinberg
School of Medicine; Stephen Sidney, MD, MPH, of Kaiser Permanente of
Northern California, Oakland; Joshua Richman, MD, PhD, Monika Safford,
MD, and Stefan Kertesz, MD, of the University of Alabama at Birmingham
and Veterans Affairs Medical Center.
The study was supported by funds from the National Heart Lung Blood Institute.
UCSF is a leading university dedicated to promoting health worldwide
through advanced biomedical research, graduate-level education in the
life sciences and health professions, and excellence in patient care.
Open the condom packet at one corner being careful not to tear the condom with your fingernails, your teeth, or through being too rough. Make sure the packet and condom appear to be in good condition, and check that the expiry date has not passed.
Place the rolled condom over the tip of the hard penis, whilst pinching the tip of the condom enough to leave a half inch space for semen to collect. Never unroll the condom before putting it onto the penis. If the penis is not circumcised, pull back the foreskin before rolling on the condom.
Roll the condom all the way down to the base of the penis, and smooth out any air bubbles. (Air bubbles can cause a condom to break.)
howtowear a condom
If you want to use some extra lubrication, put it on the outside of the condom. Always use a water-based lubricant (such as KY Jelly or Liquid Silk) with latex condoms, as an oil-based lubricant will cause the latex to break. The man wearing the condom doesn't always have to be the one putting it on - it can be quite a nice thing for his partner to do. If you decide to have anal intercourse after vaginal intercourse, or vaginal intercourse after anal intercourse, you should consider changing the condom. When you have ejaculated or finished having sex, withdraw the penis before it softens. Make sure you hold the condom against the base of the penis while you withdraw, so that the semen doesn't spill.
What condoms should you use for anal intercourse? With anal intercourse more strain is placed on the condom. You can use stronger condoms (which are thicker) but standard condoms are just as effective as long as they are used correctly with plenty of lubricant. Condoms with a lubricant containing nonoxynol-9 should NOT be used for anal sex as nonoxynol-9 damages the lining of the rectum increasing the risk of HIV and STI transmission.
What's the difference between male and female condoms?
A female condom (left) and a male condom (right)
There are two main types of condom. What is generally called a condom is the 'male' condom, a sheath or covering which fits over a man's penis, and which is closed at one end. There is also now a female condom, or vaginal sheath, which is used by a woman and fits inside the vagina. There is only one female condom approved by the U.S. Food and Drug Administration - the FC2 female condom, although a number of others are sold across the world. This page discusses the male condom, but you can find out more about female condoms and how to use them in our female condoms page.
What are condoms made of? Condoms are usually made of latex or polyurethane. If possible you should use a latex condom, as they are slightly more reliable and in most countries they are most readily available. Latex condoms can only be used with water based lubricants, not oil based lubricants such as Vaseline or cold cream as they break down the latex. Polyurethane condoms are made from a type of plastic. They are suitable for the small number of people who are allergic to latex. Polyurethane condoms are thinner than latex condoms, and so can increase sensitivity. However, they are more expensive than latex condoms and slightly less flexible so more lubrication may be needed. Both oil and water based lubricants can be used with them. It's not clear whether latex or polyurethane condoms are stronger. However, with both types the likelihood of breakages is very small if used correctly.
Where can I get condoms? Family planning and sexual health clinics provide condoms free of charge. Condoms are available to buy from supermarkets, convenience stores and petrol/gas stations. Vending machines selling condoms are found in toilets at many locations. You can also order them online from different manufacturers and distributors. There are no age limits for buying condoms. Buying a condom no matter how old you are shows that you are taking responsibility for your actions.
What are lubricants and spermicides? The lubrication on condoms varies. Some condoms are not lubricated at all, some are lubricated with a silicone substance, and some condoms have a water-based lubricant. The lubrication on condoms aims to make the condom easier to put on and more comfortable to use, it can also help prevent condom breakage. Lube is also available separately.
Some condoms and lubricants contain spermicide. Spermicides are chemical products that inactivate or kill sperm to prevent pregnancy. Condoms containing the spermicide nonoxynol-9 were previously thought to help prevent the transmission of HIV and other STIs. However, nonoxynol-9 sometimes causes adverse effects, which can facilitate the transmission of HIV. Therefore you should only use condoms and lubricants containing nonoxynol-9 if you are HIV negative and know your partner is too. However, using a condom (even if it contains nonoxynol-9) is much safer than having unprotected sex.
What about the condom size? Condoms are made in different lengths and widths. Different manufacturers produce varying sizes. There is no standard length for condoms, they are increasingly made in a range of sizes. The width of a condom also varies. Some condoms have a slightly smaller width to give a 'closer' fit, whereas others will be slightly larger. Whilst condoms are produced in a range of sizes, both length and width, some may not be available in certain countries. However, condoms made from natural rubber will always stretch if necessary to fit the length of the man's erect penis. The brand names will be different in each country, so you will need to do your own investigation of different names.
What shapes are there and which should I choose? What about flavoured condoms?
different shapes, sizes
Condoms come in a variety of shapes. Most have a reservoir tip although some have a plain tip. Condoms may be regular shaped (with straight sides), form fit (indented below the head of the penis), or they may be flared (wider over the head of the penis). Ribbed condoms are textured with ribs or bumps, which can increase sensation for both partners. It's up to you which shape you choose. All of the differences in shape are designed to suit different personal preferences and enhance pleasure. It is important to communicate with your partner to be sure that you are using condoms that satisfy both of you. Condoms also come in a variety of colours. Some are flavoured to make oral sex more enjoyable. They are also safe to use for penetrative sex as long as they have been tested and approved.
What do you do if the condom won't unroll? The condom should unroll smoothly and easily from the rim on the outside. If you have to struggle or if it takes more than a few seconds, it probably means you are trying to put the condom on upside down. To take off the condom, don't try to roll it back up. Hold it near the rim and slide it off. Then start again with a new condom, as using the same one turned over could cause pregnancy, or transmit STIs.
What do you do if the condom slips up or breaks? Whilst you are having sex, check the condom from time to time to make sure it hasn't split or slipped up. If it slips up, roll it back down immediately. If it comes off you will have to withdraw and put on a new one. 3 If a condom breaks during sexual intercourse, pull out quickly and replace the condom. If the condom has broken and you feel that semen has come out of the condom during sex, you should consider emergency contraception such as the morning after pill and ensure that you get checked for STIs at a clinic. A major factor that can lead to a condom breaking or slipping off during sex is it's size, as this can affect how easy it is to put on and how likely it is to stay on. Different sizes of condoms are available, and it is important to make sure that the condom being used is the correct fit. 4
How can I check a condom is safe to use? In the UK, condoms that have been properly tested and approved carry the British Standard Kite Mark or the EEC Standard Mark (CE). In the USA, condoms should be FDA approved, and elsewhere in the world, they should be ISO approved. Some countries have their own approval marks. Condoms have an expiration (Exp) or manufacture (MFG) date on the box or individual packet - you should not use the condom if this date has passed. It's important to check this when you use a condom. You should also make sure the packet and the condom appear to be in good condition. Condoms can deteriorate if not stored properly as they are affected by both heat and light. So it's best not to use a condom that has been stored in your back pocket, your wallet, or the glove compartment of your car. If a condom feels sticky or very dry you shouldn't use it as the packaging has probably been damaged.
Is using a condom effective? “The main reason that condoms sometimes fail is incorrect or inconsistent use, not the failure of the condom itself” If used properly, a condom is very effective at reducing the risk of HIV infection during sexual intercourse. Using a condom also provides protection against other sexually transmitted infections, and protection against pregnancy. In the laboratory, latex condoms are very effective at blocking transmission of HIV because the pores in latex condoms are too small to allow the virus to pass through. However, outside of the laboratory condoms are less effective because people do not always use condoms properly. Using oil-based lubricants can weaken the latex, causing the condom to break. Condoms can also be weakened by exposure to heat or sunlight or by age, or they can be torn by teeth or fingernails. The evidence for the effectiveness of condoms is clearest in studies of couples in which one person is infected with HIV and the other not ( discordant couples). In a study of discordant couples in Europe, among 123 couples who reported consistently using condoms, none of the uninfected partners became infected. In contrast, among the 122 couples who used condoms inconsistently, 12 of the uninfected partners became infected. 5
How do you dispose of a used condom? All used condoms should be wrapped in tissue or toilet paper and thrown in the bin. Condoms should not be flushed down the toilet as they may cause blockages in the sewage system. Latex condoms are made mainly from latex with added stabilizers, preservatives and vulcanizing (hardening) agents. Latex is a natural substance made from rubber trees, but because of the added ingredients most latex condoms are not biodegradable. Polyurethane condoms are made from plastic and are not biodegradable. Biodegradable latex condoms are available from some manufacturers. Using oil-based lubricants can weaken the latex, causing the condom to break. Condoms can also be weakened by exposure to heat or sunlight or by age, or they can be torn by teeth or fingernails.
What are the other reasons to use a condom? As well as preventing pregnancy and helping to stop the transmission of STIs, condoms also:
Have none of the medical side-effects that some other birth control methods may have.
Are available in various shapes, colours, flavours, textures and sizes. These can all increase the fun of having sex with condoms.
Are widely available in pharmacies, supermarkets and convenience stores. You don't need to visit a doctor or have a prescription.
Make sex less messy.
Are user friendly. With a little practice, they can also add confidence to the enjoyment of sex.
How can I persuade my partner that we should use a condom? It can be difficult to talk about using condoms. But you shouldn't let embarrassment become a health risk. The person you are thinking about having sex with may not agree at first when you say that you want to use a condom when you have sex. These are some excuses and some answers that you could try.
Confidence tips
Here are also some tips that can help you to feel more confident and relaxed about using condoms.
Keep condoms handy at all times. If things start getting steamy - you'll be ready. It's not a good idea to find yourself having to rush out at the crucial moment to buy condoms - at the height of the passion you may not want to.
When you buy condoms, don't get embarrassed. If anything, be proud. It shows that you are responsible and confident and when the time comes it will all be worthwhile. It can be more fun to go shopping for condoms with your partner or friend. Nowadays, it is also easy to buy condoms discreetly on the internet.
Talk with your partner about using a condom before having sex. It removes anxiety and embarrassment. Knowing where you both stand before the passion starts will make you a lot more confident that you both agree and are happy about using a condom.
If you are new to condoms, the best way to learn how to use them is to practice putting them on by yourself or your partner. It does not take long to become a master.
If you feel that condoms interrupt your passion then try introducing condoms into your lovemaking. It can be really sexy if your partner helps you put it on or you do it together.
