A new paper states that the risk of having a health problem from 1 drink a day is ½% and from 5 drinks a day it rises to 37%. Previous studies showed a beneficial effect of a small amount of alcohol on the heart, but if you look at the benefits and risks, you note that the higher risk of cancer, injuries, and infections offsets the beneficial cardiovascular benefits; we used to say that a glass of wine was good for the heart, but you also need the other organs to be alive and functioning well!
BLOOD CLOTS AND DEPRESSION
A new study showed that those on anti-depressants had a higher risk for clots in their veins, usually the legs. Is this from the medications or the depression increasing the risk? Depressed patients don’t exercise as much and tend to not move around the house or office as much. These blood clots are caused by low activity, e.g. long airplane flights.
SMOG MAKES YOU LESS SMART
A study in China found that long-term exposure to air pollution hurt performance on math and verbal tests, especially in men, older people, and those with less education. I’m confused how education would be a risk; maybe these people can’t afford to stay in filtered air or stay home from work on bad smog days. The main researcher found that he had a hard time concentrating with the headache on the worse smog days in China, so he did this study.
SLEEP APNEA ASSOCIATED WITH GOUT
A new study found that those with sleep apnea have a higher risk of gout. We already know that it increases the risk of heart attacks, strokes, obesity, diabetes, and hypertension. Sleep apnea is a condition that causes you to stop breathing while sleeping. Sometimes there is a choking or gasping. I do have thin patients with this, but most are overweight (tissues are thicker, pinching the airway) and older (tissues sag). They fall asleep during the day if not active since they slept so poorly. See your provider if you have any of these symptoms to consider a sleep study.
ADHD DRUG RISK OF HALLUCINATIONS
Methylphenidate (under many brand names) in a meta-analysis (study of multiple papers) showed that 1-2.5% of those using this medication had hallucinations or other psychotic symptoms. Check your friends and nieces and nephews to see if they are on these medications and have been acting strangely. It is a low number but still we should be alert. The medication has helped many so we shouldn’t stop it if it is helping and is well-tolerated.
RISKS LOWERED IN DIABETES IF COMPONENTS IMPROVED
Those with diabetes who controlled their cholesterol, blood pressure, smoking, diabetes, and protein leak from the kidneys were able to lower their risk for strokes, heart attacks, and death to nearly the level of those who do not have diabetes. It takes some work, but they feel better and will have a longer life.
COFFEE AND CANCER?
There have been recent reports that coffee was associated with drinking coffee and now California has a warning on coffee packages. The controversy is that the chemical in coffee is also found in many foods, so why single out coffee? The FDA argues against the California authorities that eating a healthy diet counteracts the negatives of this chemical.
DEATHS FROM SELF HARM HIGHER THAN FROM DIABETES.
200 people die each day in the US from opioid overdoses, others from other drugs and if you add in the suicides then you get this high figure.
UNDER- AND OVERWEIGHT HIV PATIENTS AT RISK
A long-standing database study which checks patients at least yearly, found that those HIV patients who were overweight had increased risk of having Diabetes compared to HIV negatives. Of course diabetes is associated with stroke and heart attack risk, early dementia, impotence, and loss of kidneys and toes. Underweight HIV patients were at increased risk for dying early, strokes, heart attacks, and cancers.
GREAT ADVANCES IN U.S. IN CONTROLLING HIV
A new paper studies the statistics from 1996, when the new antivirals came out, till 2016. 32% of HIV patients attended clinics then, compared with 86% in 2015 and are controlled well. The risks associated with less control were being young, black, using needles. Those in clinics getting treatment went from 86% to 93%. Also, the new antiviral class, integrase inhibitors, had a greater chance of control.
DIABETES, HIV, CIRRHOSIS
Another risk for having Diabetes in HIV patients is having cirrhosis of any cause. This is a scarring, shrinking, and hardening of the liver which then functions poorly. Causes are chronic Hepatitis B and C, and alcohol misuse. If you drink more than 5 drinks for males, and 4 for females more than once a year, you are at risk for liver damage. A drink is 5oz wine, 1 ½ ounces of spirits, or 12oz beer. Of course chronically drinking more than 3 drinks for females and 4 for males per day is also a risk. Hepatitis C can be cured and Hepatitis B can be controlled. Alcohol misuse can be treated with naltrexone and topirimate (an epilepsy drug).
Daniel Pearce, D.O., FACOI, AAHIVMS
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, Borrego Health (Riverside, San Bernardino, San Jacinto)
Member, Coachella Valley Clinical Research Initiative