ALCOHOL SPIRITS CAUSE AGGRESSION

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A new study showed that spirit alcohols (tequila, gin, whiskey, vodka…) are more likely to cause aggression. The study had nearly 30,000 subjects who were asked about positive and negative emotions and whether they drank spirits, wine, or beer. Red wine was more associated with fatigue. Drinkers who were dependent on alcohol were more likely to be energized from their alcohol. Heavy drinkers had more negative emotions and reported more aggression. Drinkers may be seeking that emotion that alcohol gives them, and therefore drink an unhealthy amount.

DO PEOPLE CARE IF THEIR PROVIDER GETS LUNCHES OR PAYMENTS FROM A DRUG COMPANY?
Large surveys show that it is rare for a patient to try to access the website where your providers may be listed with what payments they have received. The payments may be for meals provided during an educational event, fees for speaking to promote a product, or for meeting with the company to advise them. When patients were surveyed, they were most concerned about the meals. I have participated in the past with all three of these, and now only participate in the meals for educational purposes.

TOO MANY PILLS?
If you think you are on too many pills, put them in a bag or take photos of the labels and show them to your provider or pharmacist. This includes supplements, vitamins, herbs. There are many drug interactions that we know about and some we do not know about, especially with the “health” supplements, vitamins, and herbs. Find out why you are on each pill. Vitamins, calcium, and vitamin D are not needed unless there is a strong reason to take them.
As we age, we will come down with more diseases and these need medications too; the older we are, the more medications we are on in order to postpone suffering and death. HIV positive patients are living longer and their antivirals can interact with medications added as the years go by.

MORE PROBLEM SOLVING AND LESS LECTURES FOR MEDICAL STUDENTS
Many medical schools are moving to clickers to answer problem solving questions during class instead of receiving lectures. They are asked to solve problems in teams to learn from each other. This mimics what physicians do in real life. They read the material ahead of time instead of having someone tell them what the book says. Problem-Based Learning has shown to be superior in teaching/learning. I observed this at the Veterinary school at Western University when I taught there, and heard about it at a meeting where a medical school in Texas was using it. I informed my boss and soon afterward, the medical school changed from lectures to clickers. I wonder if regular college and high schools will turn to this. My son had to do projects and reports with teams in his recent time at Cal Poly Pomona.

NEARLY ONE IN FOUR HIV+ YOUTH DO NOT NOTIFY THEIR PARTNERS
They asked the victims, those who were HIV positive, if they were notified by their young partners and, sadly, many were not and the unsafe sex resulted in a positive HIV test. Many of these partners were strangers, so notifying them after the test was impossible. Smart Phone aps may have been involved in the hookups.

LESS MEDS FOR HIV OK?
A new combination was approved by the FDA recently, Juluca. It has dolutegravir (also in Tivicay and Triumeq) and rilpiverine (also in the new monthly injectable study drug, Edurant, Complera, and Odefsy)—which needs a meal—a sandwich or larger. Stomach acid reducer medications must be approved by your provider. Each of these two medicines in the one pill is quite powerful, so a third medication is not needed. The third medication candidates can be held in reserve in order to avoid the low risk of its side effects or in case of future resistance. Of course, no medication is strong enough to avoid resistance if you don’t take it according to directions!

SHRUNKEN BRAIN FROM UNTREATED HIV, GET TESTED AND TREATED
Scans of HIV positive people show smaller brains, but if they take the antivirals, the shrinkage stops according to a recent study. Up to 40% of those with HIV have some mental impairment thought to be caused by HIV. So get tested regularly, at most every 6 months if you are active with multiple sex or needle partners. If you are ill and wonder if you have HIV, get tested then too. Get treatment if you turn positive. Stop brain shrinkage!

QUARANTINE HIV PATIENTS?
Dr. Betty Price, a republican representative in the Georgia House of representatives, proposed quarantining HIV patients like they did in Cuba. This is like using an ice pick to turn a screw. The solution doesn’t match the problem. This doesn’t make sense since HIV medications work well, this would disrupt our society and cost a huge amount of money to move a few million people around. For those in Georgia, giving better access to health care and testing makes much more sense in a state where these are not high priorities.

Stay Safe!

Daniel Pearce, D.O., FACOI, AAHIVS
Clinical Associate Professor of Medicine, Loma Linda University School of Medicine
Adjunct Professor of Internal Medicine and HIV, Touro University California College of Osteopathic Medicine and Midwestern University Arizona College of Osteopathic Medicine
HIV Specialist, Assistant TB Physician, Riverside University Healthcare System, Public Health (Department) Member, Coachella Valley Clinical Research Initiative.

REFERENCES: Medscape®

 

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