Infographic: HPV from Oral Sex Causes Throat Cancer

I have blogged in the past regarding how HPV transmitted through oral sex (and potentially even French kissing) has now become the number 1 cause of throat cancer in individuals under the age of 50, even more than smoking and drinking alcohol [link]. Of course, smoking and alcohol further exacerbates this risk.

Indeed, A 2007 study in the New England Journal of Medicine found that younger people with head and neck cancers who tested positive for oral HPV infection were more likely to have had multiple vaginal and oral sex partners in their lifetime. Having six or more oral sex partners over a lifetime was associated with a 3.4 times higher risk for oropharyngeal cancer; cancers of the base of the tongue, back of the throat, or tonsils. Having 26 or more vaginal-sex partners tripled the risk. The association continued to increase as the number of partners in either category increased. Of greater concern is that "French" kissing may also potentially be a mode of transmission.

In any case, Mt. Sinai Hospital published a great infographic to further educate the risks of oral sex. Needless to say, if you find/see an abnormal bump in the mouth, talk to your doctor about it!

References:
Human papillomavirus and oropharyngeal cancer. N Engl J Med. 2007 Sep 13;357(11):1157; author reply 1157-8

Human papillomaviruses in head and neck carcinomas. N Engl J Med. 2007 May 10;356(19):1993-5.

Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med. 2007 May 10;356(19):1944-56.

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Sinus Surgery Lawsuit Ruled Against ENT

A patient who had undergone endoscopic sinus surgery suffered detachment of the extraocular muscle resulting in double vision that required further surgical intervention.

A jury found against the ENT and ambulatory surgery center rewarding $2.5 million dollars to not only the patient, but also the wife "for loss of consortium".

Damage to the eye and vision is part of the normal consent process for endoscopic sinus surgery when considering the geographic proximity of the eye and sinus cavities.

Eye muscle injury as in this case is particularly relevant when surgery is performed on the ethmoid sinus cavity which is located between the eyes (purple in illustration). Risk of injury is even higher when powered instruments are used like a diego sinus shaver.

Although informed consent appears to have been present, the jury still found for the patient:

- $1.5 million to Mr. Dias for pain and suffering
- $0.5 million for loss of service
- $0.5 million to his wife for loss of consortium.

This case appears to suggest that informed consent does not really provide any legal protection. A bad outcome regardless of consent implies sufficient cause for lawsuit... and winning.

This case also suggests that any bad outcome can affect a patient's ability to have intimate relations with a spouse which is sufficient cause for lawsuit and winning.

I wonder if I now have to add to the informed consent (which may not afford me any legal protection) the possibility of "loss of consortium" with a spouse.

Source:
Patient Awarded $2.5 Million After Suffering Endoscopic Sinus Errors. Outpatient Surgery Magazine 9/5/12

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Child's Allergy Risk Higher If Same Sex Parent Has It

British researchers reported this month their findings that a child is at higher risk of allergies if the same sex parent has allergies. In other words, if a father has bad allergies, his sons are at higher risk for them and if a mother has bad allergies, than her daughters are at higher risk for allergy problems.

They based their findings following 1456 children examined at 1, 2, 4, 10, and 18 years of age. History of asthma, eczema, rhinitis, and environmental factors was obtained and skin prick tests were carried out at ages 4, 10, and 18 years, and total IgE measurement was carried out at 10 and 18 years. Parental history of allergic disease was assessed soon after the birth of the child, when maternal IgE levels were also measured.

Keep in mind that the appearance of allergy in a child is not wholly based on genetics but does have some environmental basis as well.

However, the association of gender is a new twist on whether a child will develop allergies or not.

Reference:
The effect of parental allergy on childhood allergic diseases depends on the sex of the child. The Journal of Allergy and Clinical Immunology Volume 130, Issue 2 , Pages 427-434.e6, August 2012

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