Friday, January 30, 2015

From the Archives: MRSA

MRSA: The Myth and Truth Behind the So-Called “Newest Gay Plague” 

Article originally published in Out IN Jersey Magazine

In June 1981 Los Angeles doctors found a strange type of pneumonia, called Pneumocystis carinii pneumonia, in five young gay men. PCP is a type of pneumonia caused by a microorganism that occurs naturally in the lungs of people and animals. Although the medical professionals knew that PCP was associated with a weakened immune system, the cause of this impaired immunity was a mystery. The patients died within days. That same summer, a New York Times article announced the appearance of a rapidly fatal form of a rare cancer that doctors had found in 41homosexual men. A CBS newscaster also reported that this mysterious cancer seemed to be spreading only in the gay community. In 1985, the Center of Disease Control announced that it wasn’t a “gay cancer” after all causing all the disease and death, but rather a virus called Human Immunodeficiency Virus, or HIV. The CDC also called the multitude of strange diseases the virus caused Acquired Immune Deficiency Syndrome, or AIDS. It wasn’t until the disease claimed the life of a Hollywood celebrity that the threat of the virus was brought home to many Americans.  
Ripples. Photo by Alina Oswald. All Rights Reserved.
Ripples. Photo by Alina Oswald. All Rights Reserved.

Fast forward to 2008. Researchers at the University of California, San Francisco, called attention to a multi-drug resistant staph infection, called MRSA, prevalent among men who have sex with men (MSM). The epicenter of this infection seemed to be San Francisco’s Castro district, and also Boston. Not long afterwards, reports started to surface, alarming individuals that the multi-drug infection, also referred to as  “the newest gay plague,” could take over the general population.

Reaction to the super-infection news is two-fold. Those who’ve lived through the early years of AIDS consider some media treatment of “the newest gay plague” news a “deja-vue” of the eighties. Those who’ve always considered AIDS a plague sent by God to punish sinners, use the “newest gay plague” news the same way they used the “gay cancer” and AIDS news to fuel homophobia and anti-gay hate crimes, to alarm and misinform individuals, thus, potentially, to put them at risk of getting infected with MRSA.

So, is MRSA a deadly threat? And why should we be aware of it, if at all? 

MRSA (pronounced MER-SUH), or Methicillin-resistant Staphylococcus aureus (staph for short) is an infection caused by bacteria present on the human body, for example, on the skin and in the nose also armpit, groin or genital area. Initially present only in hospitals and nursing homes, a strain of MRSA has extended to the general population. This new strain, called CA-MRSA, or Community-Associated MRSA, appears mainly in gyms. Depending on the type of sport they practice, athletes can get infected from rubbing against the gym equipment that, in turn, can cause broken skin on the hands, knees, elbows, buttocks or sides of their legs.

MRSA is easily spread through skin-to-skin contact, be that skin contact with people who are infected (including sexual contact) or touching contaminated surfaces. MRSA can appear as sores, blisters filled with fluid (called impetigo when they appear on the face), red painful bumps under the skin called boils or abscesses, or as cuts that become swollen and filled with pus. Some 25-50 percent Americans have staph in their nose, but they are unaware of it. In healthy individuals, MRSA infection may cause pimples. In individuals with a compromised or weakened immune system (such as those with HIV/AIDS) staph can cause deep skin infections, pneumonia, blood or joint infections.

Although MRSA is resistant to most of the antibiotics usually used to treat this kind of infection, doctors have not run out of options to treat this kind of staph infection. Experts make it clear that MRSA is not an “AIDS all over again” plague, it’s not a gay plague, but rather it can happen to anybody who comes in contact with the bacteria.

Practicing common sense when coming in contact with infected surfaces makes a huge difference in preventing infection. Experts advise taking a shower with soap and water. Unscented soaps like Ivory and Dove are less likely to cause skin allergies. Fact is—soap and water can kill 99.9 percent of the staph.

Monday, January 26, 2015

Winter Storm Juno in and around New York City

Severe Weather: Snow Storm Juno. January 26, 2015

Finally, finally, winter is finally here. And the first blizzard or the year, too. That's right. It's called winter storm Juno.

So, I had to check it out, if only for a few moments. I got my camera ready, placed it in the waterproof special plastic bag, to keep it from getting wet, dressed warmly, and did not forget my special photographer gloves, the ones that allow you to pull out your thumb and index finger in order to be able to use the camera. One word of caution, here. Do not pull our your fingertips before it's the right time, because they will freeze and become numb, and you won't be able to use them to...operate the camera. In addition, keep in mind that the camera is in a plastic bag, which makes it even more difficult to photograph.

Did I mention that I've been battling a nasty cold for a few days now, and that today, before my contact with the snow, I wasn't feeling too bad, but I can't say the same thing now, that I'm back inside? But it's all for a very good reason.

Anyway, when I stepped outside, it was, well, it was cold, and windy. The wind started picking up by the time I reached the waterfront. Two joggers passed by me, only to do it again, only a few moments later, in the opposite direction.

As I reached the boardwalk, I realized why the two joggers had changed their minds so quickly--snow, frozen snow, and, mostly, wind, the kind that slashes and slaps the skin. I walked around only for a few moments, enough to take a couple of snapshots of an invisible Manhattan, and ferry silhouettes, resembling the ghost ship from Pirates of the Caribbean.

NYC Ferry on the Hudson during winter storm Juno. January 26, 2015. Photo by Alina Oswald. All Rights Reserved.
NYC Ferry on the Hudson during winter storm Juno. January 26, 2015. Photo by Alina Oswald. All Rights Reserved.
 I walked a few more steps, squinting, only to notice a shadow of a skyline, and also city lights. It was the city line of Lower Manhattan. From outside the island, when you cannot see Manhattan, it feels like you're in the middle of nowhere. Lost in space and darkness. It's the weirdest feeling, uneasy and somewhat unpleasant.... 


Lower Manhattan buildings as seen from across the Hudson River, during winter storm Juno, January 26, 2015. Photo by Alina Oswald. All Rights Reserved.
Lower Manhattan buildings as seen from across the Hudson River, during winter storm Juno, January 26, 2015. Photo by Alina Oswald. All Rights Reserved.

Needless to say, I didn't hang out for too long. On my way back home, I noticed tiny snow tornadoes forming from the ground up, in the air. They wouldn't last long, only as long as the wind was gusting through them.

And in all that storm, there were a few people, finding their way home. Maybe they were coming from grocery shopping, a bag in their hands.


An individual faces winter storm Juno, carrying in hand a bag with a few groceries. Photo by Alina Oswald. All Rights Reserved.
A woman stops for a few moments, facing the snow, carrying a bag with groceries. Behind her, an invisible Manhattan Island. Photo by Alina Oswald. All Rights Reserved.

 What I found most fascinating was the patterns created by the snowflakes in the wind, illuminated by garden lights. They would changed direction flawlessly, slicing the air, zigzagging as they were about to weave it an icy coat


Lights, camera, action on winter storm Juno, January 26, 2015. Photo by Alina Oswald. All Rights Reserved.
Snow storm Juno captured in garden headlights. Photo by Alina Oswald. All Rights Reserved.
I could see the snowflakes up close and personal, forming tiny, illuminated, storms. A mesmerizing sight.

Snowflakes. Photo by Alina Oswald. All Rights Reserved.
Snowflakes, looking more like out of space particles. Photo by Alina Oswald. All Rights Reserved.

This lip of ice hanging from this outdoor garden light in the image, below, somehow reminded me of lava, spilling out of the volcano crater. Similar shape. Different materials. Different temperatures.

Ice brimms the outdoors garden light. Photo by Alina Oswald. All Rights Reserved.
Ice spill. Photo by Alina Oswald. All Rights Reserved.

Also, here's a very short video:

video



It's quiet outside now. Cold. Windy. It doesn't seem to be snowing anymore, not for now, anyway. Until when, I wonder?

Thanks for stopping by! Stay safe and warm.

Alina Oswald
Writer/Photographer/Author

PS: Morning updates

Snow plows are out, cleaning the streets. It's windy. Cold. A few snowflakes in the air, thick ones. But there's nowhere new a hundred percent chance of snow, as announced. But it's picking up.

Friday, January 23, 2015

From the Archives: HIV/AIDS Updates--The Missing Link

From the Archives: HIV/AIDS Updates - The Missing Link

Article originally published in Out IN Jersey Magazine


AIDS turned twenty-eight this year! Sometimes it’s hard to believe that it all started with one genetic transformation from a monkey virus to a human one, with (possibly) a hunter in the jungles of Central Africa sometime in the late 1930s. That one mutation led to the first HIV infection, which medical professionals officially recorded in 1959. The infected hunter, the world’s AIDS patient zero, left his village for the large cities of Africa and the opportunities they provided. The crowds and busy city nightlife attracted both the hunter and his virus in different ways. Soon, HIV started to spread from person to person, taking over communities, cities, countries and continents, becoming what we know today as the global AIDS pandemic.

Fence seen through purple baloon
Missing Link. Photo by Alina Oswald. All Rights Reserved.


While most HIV/AIDS experts agree today that HIV, the Human Immunodeficiency Virus, has mutated from SIV, or Simian Immunodeficiency Virus, scientists have also been interested to find out why SIV doesn’t destroy its hosts, while HIV has decimated those it infected?

This year AIDS experts may be closer to an answer thanks to a nine-year research study on chimpanzees at the Gombe National Park in Tanzania. The study results show that chimps are the only other primates, besides humans, that are not immune to the immunodeficiency virus. The virus in question is a new strain of SIV, one that is as deadly to chimpanzees as HIV is to humans.

The discovery is significant because it connects the strain of non-deadly SIV in monkeys and apes to the deadly strains of HIV that have killed tens of millions of people. Researchers call it “the missing link” in the history of the AIDS pandemic.

There are a few similarities between the deadly strain of SIV and HIV: chimps and humans have contracted the respected viruses in similar ways—by eating contaminated monkey meat; both species have spread the viruses in similar ways—through sexual encounters. Experts believe that the other primates have remained healthy despite contracting SIV because, in time, they have adapted to the virus. Chimpanzees started getting infected with SIV only recently; therefore, they did not have enough time to adapt to the virus.

There is the school of thought suggesting that, in time, HIV itself becomes weaker. Past years studies have shown that the HIV of the early eighties was more damaging than the HIV of today. Another aspect that needs to be considered is the HIV/AIDS treatment (HAART medications) available today, treatment that was almost non-existent in the early days of the pandemic.

Experts hope that studying the new strain of SIV will help them learn more about HIV. While this brings new hope to those in the continuous fight against the AIDS pandemic, the newly discovered strain of SIV represents an immediate death sentence for the chimps that are already placed on the list of endangered species because of diseases, hunting and loss of habitat. Unlike humans, chimpanzees don’t have the necessary (anti-SIV) medications to keep them alive. For them, the clock is ticking… 


As always, thanks for stopping by!

Alina Oswald
Writer/Photographer
Author of JOURNEYS THROUGH DARKNESS: A BIOGRAPHY of AIDS



Friday, January 16, 2015

From the Archives: HIV/AIDS and Oral Care

From the Archives: HIV/AIDS and Oral Care

HIV/AIDS Updates: HIV and Oral Care
Oral Issues Specific to HIV/AIDS Patients

[Article originally published in Out IN Jersey Magazine]


Biting the Apple. Fans appear from within the sunrise, biting the Big Apple. Photo by Alina Oswald. All Rights Reserved.
Teeth: Biting the Apple. Photo by Alina Oswald. All Rights Reserved.
The eyes may be windows to the soul, but the mouth is an open door to a person's overall health. Rigorous oral maintenance and regular checkups can play a vital role in one's oral--and overall--health. This is of special significance to HIV/AIDS patients whose already weakened immune systems make them more prone to infections.



Many health issues start in the mouth. For HIV/AIDS patients, issues like decaying teeth, dry mouth, cavities or mouth sores may signal the existence of more serious health problems. For example, dry mouth can be related to certain HAART [Highly Active Anti-Retroviral Therapy] regimens, while untreated or late detected cavities can be hosting infections that later on may spread throughout the entire body, causing significant damage; mouth sores or lesions, if cancerous, can be manifestations of HIV/AIDS-related cancers.

While a lot of information is available on a wide range of HIV/AIDS medical topics--HAART regimens, for example--information on HIV/AIDS-related oral care and oral conditions is not as abundant or easily available. In addition to the general dental problems, HIV/AIDS patients should be in particular aware of a series of issues that can affect their oral health, be that because of their compromised immune systems, HIV itself or side-effects to their medications.

Studies have shown that the cases of oral lesions and periodontal disease in people living with HIV/AIDS have significantly decreased after the advent of HAART regimens. This is because the new medications have improved patients' immune systems beyond the levels triggering certain infections, including certain oral conditions. In the same time, the new medications, especially a certain class called protease inhibitors (PIs), may be the cause of an increased number of oral warts in HIV/AIDS patients.

A 2004 study conducted by the U.S. Department of Health and Human Services has shown that eighty percent of people living with HIV/AIDS will develop at least one oral condition during the course of the disease. Over thirty oral conditions have been reported in HIV/AIDS patients since the beginning of the epidemic. Most frequent conditions include oral candidiasis (thrush), oral hairy leukoplakia (OHL), HIV-related cancers like [oral] Kaposi's sarcoma (KS) and lymphoma, also HIV-related gingivitis and periodontitis that affect the gums and teeth, xerostomia (dry mouth), caries and human papillomavirus (HPV).

Among these conditions, thrush is maybe the most common and one of the earliest signs of the disease. Thrush and/or OHL are conditions that should prompt individuals to take an HIV test. Also, HPV and xerostomia (and related issues) are most frequently met, today, in HIV/AIDS patients.

Candidiasis, or thrush, is a fungal infection occurring when the T cell count falls below 400 (measured per unit of blood). Although thrush is the most common in people living with HIV/AIDS and one of the earliest signs of the disease, it can also be caused by dry mouth, extended periods of stress, depression or use of antibiotics. The infection usually occurs inside the mouth but it can also extend to the throat and corners of the lips. When painful, thrush can cause loss of appetite, loss or distortion of taste, and discomfort. Treatment includes antifungal medication administered in the entire body (systemic) if the infection is extended, or as local application (topical).

Oral hairy leukoplakia (OHL) is a viral infection and one of the most common oral conditions found in people living with HIV/AIDS. Believed to be caused by Epstein-Barr virus--that causes mononucleosis (mono, a.k.a. kissing disease), OHL appears as white patches with a hair-like appearance (hence the name) on the walls of the mouth or on the sides of the tongue. OHL occurs when the T cell count is very low, thus it's less probable in patients who are on HAART regimens. Treatment includes ganciclovir (a medication also used to treat CMV, or cytomegalovirus, that can attack the retina and the digestive system, including the oral cavity). Also, propolis tincture (from bees) has proven to be a helpful alternative therapy.     

Nowadays, human papillomavirus (HPV)--that usually causes genital and anal warts--is more common in HIV/AIDS patients. HIV makes the HPV lesions more serious and more difficult to treat. HPV lesions can occur on the skin and in the mouth. Although lesions can be removed surgically or with laser, they can also reoccur. Infection with HPV, including infections with (HPV-16) type of HPV, can increase the risk of cervical and anal cancer. In the mouth, it can increase the risk of oral (mouth or throat) cancer. Prevention includes safe oral sexual practices.

Another very common oral condition found in HIV/AIDS patients is dry mouth, or xerostomia. One cause can be the virus itself--HIV can cause salivary disease, which can lead to swollen salivary glands and, therefore, a reduced amount of saliva in the mouth. Another cause can be the antiretroviral medications--especially certain classes of HAART regimens, for example protease inhibitors (PIs) like indinavir (Crixivan) and nucleoside analog transcriptase inhibitor (NRTI or nuke) like ddI (didanosine, Videx). Antihistamines, antihypertensives, antipsychotics and antidepressants can also cause dry mouth. Other factors include allergies and infections.

Why saliva is important? And why a dry mouth can be a serious health problem?

A dry mouth may enable food particles to remain in the mouth and build up between the teeth and the gum, thus causing tooth decay, periodontal disease, and candidiasis. A dry mouth can also cause high acid levels to persist in the mouth after eating, thus allowing the appearance of cavities, which, in turn, can further lead to infections that can spread throughout the entire body.

In HIV/AIDS patients, cavities develop at the cervical region of the tooth, that is where the crown meets the root of the tooth and where the surface consists of cementum (not enamel). Cementum is a bony substance with a faster decaying speed. The process can lead to infections of the tooth pulp (the soft tissue inside the tooth) and abscesses (infections, pus). Oral care is vital in discovering these kinds of issues in early stages. Treatment includes a technique called "scoop and fill." Using hand instruments and usually no anesthetic, dentists scoop out the damaged part of the tooth and fill it in with a temporary fluoride-based filling that prevents further decay. For abscesses, treatment options include antibiotics, in particular penicillin.

Dry mouth treatment options vary from prescription drugs and artificial saliva to therapies that stimulate the salivary glands (for instance, pilocarpine therapy) and certain herbs like demulcents, chickenweed and slippery elm. Also chewing sugarless gum or sucking on sugarless candy can stimulate more saliva.

Bacterial infections are a result of overgrowth bacteria. In HIV/AIDS patients, bacterial infections that occur in the mouth signal the virus' presence in the rest of the body. They are easier to treat but, if left untreated, undetected, or if they are detected late, they can lead to serious health problems.

Among the bacterial infections frequently met in people living with HIV/AIDS are gingivitis, also called HIV-gingivitis or linear gingival erythema (LGE), and periodontal disease, also called HIV-pertiodontitis or necrotizing ulcerative periodontitis (NUP).

Gingivitis is a chronic inflammation of the gums and it can happen to anybody. Symptoms include bad breath and bleeding. In HIV/AIDS patients, gingivitis is more severe and appears as red band-like lesions along the gumline (where teeth meet the gum). If left untreated, LGE can lead to HIV-periodontitis (NUP), which is an extremely serious condition. NUP attacks the gums, teeth and surrounding bone structure. It can cause tooth loss, bleeding and severe pain. Treatment includes antibiotics, surgical procedures and local debridement (getting rid of dead tissue).

Abnormal tissue growths, or neoplastic lesions, can be benign or cancerous. If cancerous, in the case of HIV patients, they can be manifestations of HIV-related cancers like Kaposi's sarcoma or lymphoma.

Kaposi's sarcoma (KS) is a cancer that affects a patient's skin and/or organs. It appears as purple lesions on the skin. In the mouth, KS can appear as patches or swellings on the gums, tongue, on the roof of the mouth or at the back of the mouth. KS is usually not painful but it can become painful when it interferes with other infections. When painful, oral KS lesions can affect chewing and talking, and also increase the risk of wasting associated with HIV/AIDS or affect treatment, because some medications have to be taken with food. KS usually goes away when the immune system recovers due, for example, to a HAART regimen that works for the patient. KS can be treated locally, using local administered chemotherapy or surgically removing the lesion, or in the entire body, using intravenous chemotherapy.

Lymphoma is more rare than KS and more serious. Lymphoma appears as a small lump in the mouth or near the tonsils. Only a biopsy can determine if a lesion is indeed lymphoma. Treatment includes chemotherapy.

When it comes to dental care, the first question that may occur to HIV/AIDS patients is the disclosure issue. Patients are advised to find a dentist they can trust, be that through referrals or through an AIDS Service Organization (ASO) they work with. It's always best to find a dentist that has experience working with HIV/AIDS patients and knows to look for oral signs of HIV-related illnesses, in order to monitor the progression of the disease and possibly prevent certain oral conditions from occurring. In order to do that, though, dentists have to first be aware of their patients' HIV status. Also, while living with HIV commands certain rules when it comes to dental care, the virus should not exclude patients from dental work or dental maintenance. Quite the contrary. 







Tuesday, January 6, 2015

Thoughts on Product Photography


How to Make Product Photography More Interesting (if you are not into it)

"Fancy" is not what comes to mind when describing product photography, but product photography can become fancy, and help pay the bills, too, if done correctly, and also if done with passion. Problem is, not many are passionate about product photography. After all, who would choose spending the day stuck in a room (studio) with a bunch of products (small electronics, jewelry, toys, etc) rather than photographing fabulous models?

I seldom shoot products, but I found that when having to do so, it does help to connect the product I'm about to photograph to something I'm passionate about. If that's not possible, try to find something--it can be the product itself or the light in which it's photograph--that may make it interesting.

For example, over one year or so ago I attended the (re)Presenting AIDS event taking place in Manhattan, and covered it for A&U Magazine--America's AIDS Magazine. At the event, I picked up these AIDS ON GOING GOING ON cloth bags. Once at home, I photographed the bags hanging on my door, to submit, together with the article and other photos taken at the event. (and, yes, I did use scotch tape to get the bags to stay in place on the door, as shown in the picture below)


AIDS on going going on cloth bags on white door, photographed by Alina Oswald.
AIDS ON GOING GOING ON bags photographed by Alina Oswald originally for A&U Magazine.

For images similar to the above image, especially when shooting in a white room with white doors, either bounce the flash or put it on a stand and attach an umbrella, use a reflector for fill. In the above image there was a window facing the door, and also white walls on each side of the door.

 A few months ago I stopped by Washington Square Park to check out the Rise Up to HIV event. See the table full of bracelets below, photographed with my iPhone. (I tried to hold my iPhone as parallel to the table as possible, horizontal, so to speak). For a cleaner look, I could have clone out the white threads in post.

I also bought an ACT UP bracelet for myself.

ACT UP bracelet. Photo by Alina Oswald. All Rights Reserved.
ACT UP bracelet. Photo by Alina Oswald. All Rights Reserved.
This past spring, I had the unique opportunity to become part of a collective, later on called the Undetectable Flash Collective. To keep this short (but I may write about it at a later time), I still have to pinch myself, to remind myself that it's true. Words cannot express the honor and pride, and also...humbleness, too, of being part of something like this.

Read more about the Undetectable Collective in an article published in A&U Magazine. Also follow the collective on Tumblr, too.

Here are a few images I took of the Undetectable cards. I rotated the image, for an easier read.

The Undetectable Flash Collective cards, photo by Alina Oswald.
The Undetectable Flash Collective cards, photo by Alina Oswald.



Then, of course, there are the holiday cards, e-cards, I should say. This past year, I wanted to design an e-card that would also bring HIV/AIDS to the minds of those who do connect the dots. And while it doesn't spell it [HIV/AIDS] out, red is the color of the AIDS Ribbon. So, I decided to use red in the image, too.

Red tree deco and Happy Holidays card. Photo and Design by Alina Oswald. All Rights Reserved.
Red tree deco and Happy Holidays card. Photo and Design by Alina Oswald. All Rights Reserved.


And while I'm here, and as this is my first blog post of 2015, and also the first post in a very long time, I'd like to take the opportunity and wish everybody a very Happy New Year!

Thank you for visiting!

Alina Oswald
Writer/Photographer
Author of JOURNEYS THROUGH DARKNESS: A BIOGRAPHY of AIDS