AskDoc Nov

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Editors: I noticed an incorrect spelling of my name on the email address in the magazine. I prefer you take the emails and pass on the ones you feel need my attention. I am not allowed to correspond with patients by email—a malpractice issue. Thanks.

 

PESTICIDES CAUSE DIABETES?

A large literature review showed that being exposed to pesticides increased the risk of having diabetes by 60%. Much of the exposure may have been when working with pesticides or eating them in food: it is hard to tell. Organic foods do not have pesticides in them. If you work with pesticides stay away from the vapors (use the wind in your favor) and wear protection on your body and over your nose and mouth. Yes, I know it is hot sometimes and this recommendation may be uncomfortable.

 

DIABETES: POOR BLOOD SUGARS SLOW YOU DOWN AT WORK AND INCREASES DEMENTIA RISK

A study showed that high blood sugars after lunch decreased productivity of the diabetic worker. These high sugars also increase the risk for dementia.

 

NARCOTICS FIXED TO PREVENT INJECTION AND SNORTING

New products are coming out that makes a popular narcotic hard to inject by turning it into a gel if you try any funny business. Another innovation deters snorting of another popularly prescribed narcotic.Injections and snorting lead to medication reactions and serious infections.

 

PROVIDERS WORK WHEN SICK, SHOULDN’T YOU?

Many health care providers work when ill but they can’t do as high a quality of job and they may be spreading germs. You should consider not going to work when you have a virus (flu or cold). Usually an infectious disease has a fever and maybe body aches. If I can think well, I go to work but wear a mask over my nose and mouth. Of course I wash or sterilize my hands between patients. You should also do this frequently before touching others when you are ill. Consider an elbow bump instead of a hand shake or fist bump. No kissing!

 

SINUSITIS, TREAT WITHOUT ANTIBIOTICS?

If you have certain symptoms for 2 weeks you may need antibiotics. Most of these symptoms do not need antibiotics and they won’t help. Much of this is caused by viruses or allergies. Saline spray, irrigation (snorting or netipot–look it up), and/or nasal steroid sprays are helpful in these conditions.

 

A.D.D.  AND CHRONIC PAIN

More than a third of patients with chronic pain had attention deficit disorder. ADD frequently has these features: deficiencies in concentration, attention, distractibility, impulsivity, reading and retention, coordination, temper, and short-term memory. Now, is the pain caused bythe  trauma or not taking treatments correctly due to the ADD?  I have a couple of patients who took their casts off their broken bones since they didn’t like the cast and now they have life-long pain and deformity.

 

SOME MEN HIDE THEIR GAYNESS AT THE DOCTOR’S OFFICE

In another study, about ¼ of men do not mention their gay activities when they are tested for HIV. This was in North Carolina. This group was mainly young and African American.  By not mentioning this, the providers cannot offer services that are especially appropriate for gays. If they trust the provider, then people are more likely to be honest.

 

HIGH RISK GAY TEENS GET HIV TESTS INFREQUENTLY (ATTENTION OLDER GAYS: HELP THEM, PLEASE)

Even though at high risk for HIV, gay teens do not get tested very frequently. Only about 20% have been tested. This number should be 100%.

Why? A recent study shows that they may not know where to be tested, and may be fearful of getting tested. Some teens feel invincible (like Superman) and are not realistic about their risk.

 

DELAY HIV THERAPY?

734 HIV specialists answered questions on a survey as to why would they delay treating HIV. The answers fell into 3 categories:

Patient not ready: mental illness, life too chaotic, not enough support, maturity, drug use, missing many appointments already.

Physician issues: not enough counseling available, not enough experience with HIV patients, not a specialist.

System issues: insurance, specialist availability (probably transportation too).

 

HOW MANY HAVE HIV IN THE USA?

Of those 18 to 59 years of age, about 0.4% or nearly ½ a percent have HIV in the US. This has not changed much from 1999. There are still more African Americans than Anglos. Those with more than 10 sexual partners in their lifetime are at higher risk. There are an estimated 1.2 million with HIV and 50,000 new infections a year and 20% don’t know they have HIV.

 

INFANTS STILL BEING BORN WITH HIV

Why? A study in Georgia showed that from 2005 to 2012, 27 infants were born with HIV (USA had 162 in 2010) had barriers to prevention. Some barriers were the mothers’ mental problems, or drug abuse. Many of the mothers knew they were HIV positive but did not take treatment well. Sometimes the mother and baby did not receive the AZT protocol that is needed if the mother’s HIV is not well controlled. African Americans had a greater incidence. More must be done to prevent this tragedy and with identifying the areas of weakness, now steps can be taken to target them.

 

Be Safe! Wear protection. Keep those questions coming.

 

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 County Public Health Department

Hepatitis C Specialist and Researcher, Southern California Liver Centers, Riverside

 

REFERENCES: Medscape®

 

 

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