Browsing: Ask the Doctor

Several studies confirm that exercise is a treatment and prevention for depression and anxiety. One to two hours a week is the minimum. It doesn’t have to be super-intense. My understanding is that you need to get your heart rate up to a level that you are breathing too fast for an easy conversation or that you are sweating when the weather is cool.  Some say level should be maintained for at least 15 minutes a day; no need to push it farther unless you want to. A safe and easy and inexpensive way to do this is speed walking,…

Share.

You can get them at a pharmacy if you have insurance. Otherwise the clinics usually get them by mid-October. Reactions to the flu shot are your body fighting the flu virus pieces in the vaccine. There is no complete virus in the vaccine. Those who don’t get the flu shot put themselves at risk for getting one of the 3 or 4 flus that may be lethal this next flu season. Also, it puts those around you at risk since you may infect them before you know it. MENTAL ILLNESS PROFILES ON GAME OF THRONES Of course, it is impossible…

Share.

A gay sauna house in England found many more got tested with this method than by having someone there to do testing. RISKY ALCOHOL DRINKING INCREASING A very large US study showed that risky drinking is going up, especially among minorities, women, and elderly. Risky drinking is defined as drinking more than the safe daily amount at least once a week. For men this is 3 12oz beers or 3 mixed drinks or 3 shots of spirits. For women the number for each of these is 2. The liver is damaged a little bit each time you go over…

Share.

Based on a Danish study of 70,000 using databases. Of course, this wasn’t a double-blinded, randomized trial—who would agree to drink this amount or less or more each week consistently for many years! So,bar this is not the final word but very interesting. Alcohol has been shown, just as moderate coffee drinking to have bad and good effects. CURING APPENDICITIS WITHOUT SURGERY There was a meta-analysis (a study combining other studies to have large numbers and more firm conclusions) that showed that for those whose appendix had not burst, that antibiotics were not a bad idea. There is no firm…

Share.

A study showed that those with HIV are at higher risk of mental decline if they had poor kidney function (eGFR <50, ask you provider). Less strong association was having no more education than high school, having HIV at least 15 years, and a high spinal fluid protein level. The kidney function is concerning since the risks for that are: diabetes, hypertension, obesity, African-American genes, HIV and one HIV medication–tenofovir which is in many medications. I have many patients on it, but many of us HIV specialists monitor the kidney function at least every 6 months and switch out the…

Share.

Since having HIV increases the risk of heart attack or stroke by factor of 1.5-2 maybe we should test them earlier than HIV negative people. The risks are from having chronic inflammation even if the virus is undetectable, risk factors (the strongest are smoking and diabetes), and a smaller risk from the medications (some of them increase the bad cholesterol or lower the good cholesterol). Some recommend a treadmill test which gets your heart beating fast enough for the cardiologist to see changes in the electrocardiogram or the blood pressure. Other recommend a Cat Scan looking at the calcium in…

Share.

I am at the Loma Linda Hospital in Malawi for a couple of weeks substituting for the regular internist and family medicine physicians who are on vacation in Southern California. So this is my yearly Malawi update. IMPROVEMENTS We still run out of basic medications and lack certain machines–see below. The staff seems better trained and experienced. Instead of one nurse for ~60 beds, there is also a nurse for the High Dependency Unit ( our highest care unit which is lower than an ICU). HEART FAILURE Many do not get their blood pressure treated or run out of medications.…

Share.

Apart from the conference, for a research paper I am writing, I found an article which showed that fisting is associated with transmission of more syphilis and HIV. Maybe there are more tears of the rectum and anus with this practice and then if they have sex after the tears, the HIV and syphilis can more easily enter the broken mucosa (lining). I have no data on how long it takes to heal the lining after a fisting event. PREVENTION OF STIs Prevention of gonorrhea with antibiotics for those who have frequent, unprotected sex has been shown to cause resistance…

Share.

I recently attended the Conference on Retroviruses and Opportunistic Infections with 4000 other HIV specialists and researchers.  Here are some things I learned. LONG ACTING INJECTABLE ANTIVIRALS STILL WORKING Injectable Cabotegravir and Rilpiverine are still proceeding in trials and look promising to get an injection once a month. In fact, a study showed that many patients would prefer an injection once a month to pills. This is especially good for those who want to keep their HIV a secret.  But, many might miss their injection appointments and not put a high priority on it as I saw years ago,…

Share.

GETTING THINGS DONE WITH MUSIC A former intern of mine writes a column on Medscape in which he describes the boost to work that music can give. He states that classical music puts him to sleep and that Rock or Country music distracts him with the lyrics. He and others find that video game music makes him work faster and more accurately. After all, video game music is there to help you focus on the game and not let your mind wander off it to your spouse, kids, parents, pets, food, full bladder, fires, emergencies! MARIJUANA GOOD OR BAD? Be…

Share.
1 2 3 4 5 11