FEATURE ARTICLESHEALTH

Medical Update

By: Dr Pearce

TAILOR SEXUAL HEALTH EDUCATION TO HISPANICS
Latinx individuals are at high risk of pregnancy and STIs. Researchers looked at several studies that promoted safe sex to Hispanics and found the most success was achieved when the interventions were coached by members of their community.  Understanding the dynamics and importance of family made a difference in the messages.

FAT OR CARBS?
More evidence is accumulating that for losing weight, it is the calories that count, whether from fats or carbs.  For heart health and postponing diabetes, low carbs and higher good (saturated) fats are the keys.
I tried the keto diet for 4 months and I didn’t lose much weight and in fact, got to a new maximum weight. I am now on a healthy carb diet with a little extra oil added and losing weight again, but only for about 3 weeks so far.

COMPANION ANIMALS HELP MENTAL HEALTH?
There are studies of companion animals which show depression worsens and other studies show depression improves with an animal. Some studies show animals promote more physical activity, combat loneliness by promoting more social interaction with others, and that the animal offers direct social support. A problem with some of these studies is that they didn’t compare the animal owners to those who don’t own an animal. This new study shows that having a loss (death or divorce of spouse) and grieving can be helped by having a companion animal.  This study was performed in middle age and older adults and did not specify the type of animal or how many they had.

HIGH DEDUCTIBLES POSTPONE CARE
Some private insurances have high deductibles: $3,000, and $5,000 for a family. This causes people to postpone care and not be as healthy.  The US government has gutted the Affordable Care Act so it is not affordable to many who live here.  As I wrote before, since insurance is so available, hospitals are not waiving or reducing fees, but are being very strict about debt payments.

ARE YOU HAPPY WITH THE GOVERNMENT?
Please register to vote so you can help elect quality government officials. Otherwise you can’t complain when bad things come down from the government.  I am actively working for improvement in our government since I am so unhappy with what our government is doing.

RECREATIONAL MARIJUANA CAN LEAD TO MENTAL ILLNESS
Many young people start cannabis when their friends or family are using it and then with chronic use can have depression, anxiety, and even psychosis (thinking is disconnected from reality) and then use more of it to treat these conditions.  As a reminder, young peoples’ minds are not fully formed till they hit 24 years old or so and cannabis can permanently damage the brain while it is forming/maturing.

CYTOKINE STORM AND COVID 19
When there is inflammation, such as in a pneumonia, the white cells rush to the area to fight the viruses or bacteria. They send out chemical signals (like humans do with sweat, perfume; like ants do with chemical trail markers) to bring in more white cells. These are cytokines. Certain conditions cause the immune system to overdo the cytokines and the result is an over-reaction and hyper-inflammation so that the membranes in the lungs fill with fluid which lowers the ability to grab oxygen from the air.
One way to try to reduce the over-reaction is to give immune modulators, such as the medicines for severe psoriasis and rheumatoid arthritis. But so far these are not proving as helpful as desired.
Another way to dampen the storm is to give a steroid like cortisone and this has been helpful in some cases. This is not to be confused with sex steroids like estrogen and progesterone (female) and testosterone (male) hormones. Dexamethasone has been used in Covid 19 successfully as it has been used in other conditions to blunt the body’s immune response. E.g. when there is brain swelling from a tumor, trauma or, a stroke, the swelling can crush the brain inside the hard skull. Steroids have been very helpful for these conditions.
These steroids can cause many side effects though, such as weight gain, hypertension, psychosis, and make you more susceptible to some infections like fungus and tuberculosis.  They also can bring out or worsen diabetes.

COVID 19 HERD IMMUNITY NOT ACHIEVED IN SWEDEN
The public health officials in Sweden are disappointed that only around 6 % of their population have developed immunity to the Corona virus.  They did not order strict isolation as did most countries. They had some restrictions on vulnerable populations like nursing homes.  They wanted to slow the virus down so that their hospitals and ICU beds would not be over-filled.  This has worked.  However, they have had 5,000 deaths from Covid 19 and this is higher than their Scandinavian neighbors on a per-person basis, but less than Spain, Italy, and the United Kingdom which had stricter isolation rules. They thought that if enough of stronger of the herd had become immune by letting them get infected, then the rest of the herd would be protected.

BLOOD CLOTS AND STROKES MORE COMMON IN COVID 19
The authorities are calling it Covid Coagulopathy.  The blood seems to more easily clot when a person has Covid 19. These blood clots can block flow to the legs, brain, and lungs.  Many providers are treating those with severe symptoms with blood thinners and that seems helpful in avoiding these clots.

HEADACHE AND LACK OF SMELL MAY BE A GOOD SIGN IN COVID 19
Those with these symptoms had shorter hospitalization times. But the headache can persist for many days after recovery.
Lack of smell may first be noticed as lack of taste since smelling is a big part of tasting.

Keep those questions coming, Be safe!

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

REFERENCES: Medscape®