All posts by Andrea Hernandez

Seafood during pregnancy

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Image from TripAdvisor

Andrea Hernandez

You might have heard warnings that pregnant women ought to avoid eating seafood because it can harm the development of the baby. Uncooked seafood is unsafe because there is a risk of ingesting contaminated foods with coliform bacteria, toxoplasmosis and salmonella. This is also true for uncooked poultry and other meats. Raw seafood can have specific types of parasites. Cooked seafood during pregnancy can be beneficial for fetal development.

Seafood like shrimp and salmon are generally safe and beneficial to eat as long as they are properly cooked. It is beneficial to eat fish because it is a great source of protein, iron and zinc. These nutrients are necessary for a baby’s growth and development. Seafood is also rich in omega-3 DHA which is needed for brain and eye development. 

However, high mercury content in seafood like shark and swordfish are harmful at high levels. High concentrations of mercury can cause brain damage, hearing and vision problems to the baby.

Next time someone you know is told to avoid seafood during pregnancy, you can specify to avoid uncooked foods and high mercury seafood!


Virtual Care

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Image from PYA

Andrea Hernandez

In the past few years, there has been a rise in telehealth, video visits with a remote clinician in particular. The use of virtual care is dependent on a person’s comfort meeting with their primary-care-provided (PCP) or a different provider via phone or video. Virtual care is an attractive option because it is more convenient and less costly than an in-person visit.

Some people are more open to telemedicine than others. A U.S nationwide survey conducted in 2015 found that respondents were more willing to see their own PCP via telemedicine, less willing to use telemedicine to see a different provider from the same healthcare organization, and least willing to use telemedicine to see a different provider from a different healthcare organization.  

A study among patients with acute respiratory infection found that a telehealth visit was less expensive than an in-person visit, but increased collective health care spending because of convenience. Patients were more likely to initiate follow-up virtual visits if they had lingering questions about their diagnostic or symptoms. It seems like effective virtual care should aim to put people at ease.  

Although virtual care is convenient and less costly, people of limited means may be less able to afford the technology (smart phone and data) needed to access virtual care. Further steps are needed to improve accessibility for people of limited means, in order to provide a wider range of people the option to decide what type of health care visit they want.


Routine Use of Sunscreen: Good for all skin types?

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Photo from The Skin Cancer Foundation

Andrea Hernandez

Exposure of the skin to sunlight has both benefits (increased vitamin D) and potential harms (skin cancer). A public health recommendation was made that both light and dark complexioned people should wear sunscreen for any exposure to the sun. This recommendation is used as part of promotional messaging by the companies that make and market sunscreen. This strict approach is open to debate. And it’s also unclear that it applies to all skin types.   

In a New York Times article “Should Black People Wear Sunscreen?” Pierre-Louis tackles the public health recommendation that everyone–regardless of skin variation, age, and gender–needs to wear sun protection. She specifically talks about the recommendation that dark-skinned people should wear sunscreen, pointing out the scarcity of research done on dark-skinned individuals to determine the relative benefits and harms. A randomized clinical study found that the four active ingredients found in sunscreen, avobenzone, ecamsule, octocrylene, and oxybenzone, are absorbed into the blood stream of healthy volunteers that exceeded Food and Drug Administration limit. The potential downsides of absorption of the active ingredients in sunscreen into the circulation are unknown.

It’s not clear that people with lots of natural melanin benefit from routine use of sunscreen in any amount of sun exposure. Melanin is a molecule that works like sunscreen. It absorbs and deflects UV rays. More research is merited before recommending routine use of sunscreen for any amount of sun exposure in people with greater melanin in their skin.