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MEDICAL NEWS

 

DOES MILK DO A BODY GOOD?

Swedish researchers found in a large database (their country has this wonderful database from their excellent national health system) that women who were followed for about 20 years had a higher risk of death and fracture if they drank 3 or more glasses of milk a day compared to those who drank less than a glass. The men, followed for only about 11 years, had a slightly higher risk of death for the big drinkers and no fracture risk. The more milk, the more their blood inflammatory chemicals were elevated which may explain some of the bad outcomes. Inflammation causes hardening of the arteries.

Yogurt, kefir, and cheese had no effect like milk in a glass.

Caution please: this is not a randomized, prospective trial.

I was told in medical school that cow’s milk is great for baby cows.  I have seen it help in starving children and it is in the formula for a nutritional supplement along with peanut butter for those affected by famine.  But for us who have enough to eat, maybe moderation is a good idea. I have just ordered some kefir granules from Ebay and will start fermenting my milk for my vege/fruit smoothies!

 

LIVER CANCER AND CIRRHOSIS MORE COMMON IN HISPANICS WITH HEPATITIS C

A Veteran’s study of their huge database showed that over 5 years, of the 149,000 patients with Hepatitis C, 13,000 had liver cirrhosis and 3,500 had liver cancer.  Hispanics had liver cancer more often and cirrhosis compared to Anglos, and African Americans had these less than Anglos. They found this risk even if they took out the other possible contributors such as: obesity, age, HIV, Hepatitis C genotype, diabetes, and if they had previously received treatment for the Hepatitis C.  (After Hepatitis C treatment with the new drugs, the cirrhosis may improve but there is still a risk for cancer, so an ultrasound is recommended every 6 months by some.)

African Americans have a poorer response to previous Hepatitis C treatment but with this disadvantage, they still had less cirrhosis and cancer.  The new drugs seem to be helping eliminate this difference in response to treatment by race.

In other studies, Hispanics with fatty liver also have a faster progression to cirrhosis and cancer.

 

AN ASPIRIN A DAY?

A baby aspirin (81mg, tiny yellow pill) has been recommended for all above 40 at one time to prevent heart attacks or strokes. The FDA feels there is not enough evidence to support this. Others feel there is enough evidence for women 55-79 years old for stroke prevention and men 45-79 for heart attack prevention. Aspirin also seems to have a mild prevention power against prostate, breast, lung, and, colon cancer.

I have nosebleeds if I take aspirin since I am a vegetarian and juice with vegetables and fruits daily. The point of the aspirin is to thin the blood a little so you won’t clot in the arteries going to the golden organs: brain and heart.  If I bleed on aspirin 1 pill a week, then my blood is thin enough with my diet; white fruits seem to do this more, e.g. apples and pears.

Carnivores, what should you do? Eat a healthy diet (5+ servings of fruits and vegetables a day and exercise 30 min daily, avoid substances…  I don’t like giving medications unless really needed so I err on the side of no aspirin unless the person is at risk for these bad outcomes; I give it to those with diabetes, tobacco, hypertension, a strong family history or a personal, past history of a stroke or heart attack.

 

HIV PHARMACISTS REDUCE MEDICATION ERRORS

There was a study showing that when pharmacists who are trained in HIV review the hospital record of HIV patients admitted to the hospital they were able to clean up some medication errors such as drug-drug interactions, dosing, and keeping the patient on their antivirals to avoid resistance. They also corrected incorrect dosing, food restriction issues, and eliminated duplications. Patients admitted for surgeries were a prime target since they were not on the service of a Family medicine or internal medicine physician.  I can see that a patient who looks healthy may not seem to need a consultation by an HIV or Infectious Disease specialist.  I have seen and corrected errors in the same way in my outpatient practices and in the hospital.

 

NEW TEST FOR ACUTE HEPATITIS C

A test has been approved to diagnose acute Hepatitis C. This will be quite helpful in following these patients for either spontaneous cure or preparing them for treatment.  Hepatitis B has been easy todiagnose at this stage for many years.

 

DOES WAITING FOR HEPATITIS C TREATMENT DEPRESS YOU?

With the price of treatment and effectiveness going up and the side effects going down many are considering treatment. There was a study showing that those who are uncertain of how bad their Hepatits C was were at higher risk for moderate to severe depression. This held true even if they had tests that showed that they could safely wait since their stage was an early one.

The opposite emotion is present also.I have noticed that those cured of chronic Hepatitis C are quite relieved and happy now that the dark cloud is removed forever if they avoid risky behaviors (needle sharing, non-monogamous, unsafe anal sex–wear a condom, have only 1 faithful partner).

 

IF OPIOID DEPENDENCE TREATED, HEPATITIS C INFECTIONS LESS OFTEN

A study found that those dependent on opioids (e.g. Oxycontin®, Norco®, Percocet®, etc)are less likely to get Hepatitis C, since they are sharing needles less. Ged treated for your pain!)

 

NORCO® AND VICODIN® NOW UNABLE TO BE FAXED OR CALLED IN

There are new FDA rules, that move these medications containing oxycodone higher in the ladder and are now in the top level for prescribed narcotics. The pharmacy must have a written prescription to show the inspectors.  With the lack of gas money and the large distances patients need to travel to the clinics unless a pharmacy travels to the clinic to pick up the prescriptions–this is a very compassionate way to handle these prescriptions. Don’t expect the large chain pharmacies to work this way.  The HIV specialty pharmacies (with delivery service) we work with have a solution. They have a relationship with us and trust us that we won’t go back on our promise. They allow a fax or a call, but then will trust us to give the prescription to their courier.  I have mailed in these prescriptions to other pharmacies, but they get lost in the mail occasionally.

 

Keep those questions coming. Be Safe!

 

Daniel Pearce, D.O., FACOI, AAHIVS

Clinical Associate Professor of Medicine, Loma Linda University School of MedicineAdjunct Professor of Internal Medicine and HIV, Touro University California College of OsteopathicMedicine and Midwestern University Arizona College of OsteopathicMedicineResearcher,Veterans Administration Hospital, Loma LindaHIV Specialist, Riverside County Public Health DepartmentHepatitis C Specialist and Researcher, Southern California Liver Centers, Riverside

 

REFERENCES: Medscape®

 

Note: please understand that some of this information was written 1-2 months before you read it.

 

 

 

 

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