HEALTH

GAY SEX IS A RISK FOR RESISTANT SHIGELLA DIARRHEA

By: Daniel Pearce, D.O., FCOI, AAHIVMS

GAY SEX IS A RISK FOR RESISTANT SHIGELLA DIARRHEA
People at increased risk of infections for Shigella diarrhea are young children, people who are homeless, international travelers, people who have weakened immune systems, people living with HIV, and men who have sex with men. Shigella bacteria are resistant to the common antibiotics so their antibiotics need to be changed after they try the first one.
Now we have HIV, warts, gonorrhea, chlamydia, syphilis, herpes, Mpox, and shigella to worry about in our friends who are men who have sex with men.

DAILY MJ USE ASSOCIATED WITH MORE VASCULAR EVENTS
A large study of about 5,000 people asked about marijuana use and then connected this with outcomes of heart attacks or strokes. Those who used cannabis of any type (vape, edibles, smoke) daily had more risk for these vascular events. Multiple studies have shown this. They cannot do a double blind, placebo controlled trial and ask some people to use marijuana and others not to; so this is the best type of data we have to answer this question.

INSOMNIA INCREASES CARDIOVASCULAR EVENTS
Those who sleep 5 or less hours a night are at increased risk for these events. If they are missing sleep because they are busy, then they will pay for it later. If they have trouble falling asleep, it is, in my opinion, better to seek mental health counseling rather than medication since sleep from medications is not of good restorative quality. Do you feel rested and energetic in the AM when you finally complete your wake-up process? If not, you may need to seek help.
We already know that sleep apnea is also associated with vascular events.

KETO RISKY FOR CARDIOVASCULAR EVENTS?
A study of 305 patients who said they were on a Keto diet were at higher risk for cardiovascular events (strokes, heart attacks) compared with at least a thousand others who did not say they were on a keto diet whose records were studied over an average over 11 years—it takes time to have an event. This is not a randomized, placebo controlled trial but this association may be the best we can get. Many of us providers wondered if such a diet had these risks. Keto didn’t work well for me so I am not tempted to take this risk.
Darn. It looks like a whole grain diet with minimal white meat, and many fruits and vegetables is still the way to go. People keep trying to find a quick way around the basic healthy lifestyle.

SITTING MORE THAN 8 HOURS EVEN IF YOU EXERCISE IS A CARDIOVASCULAR EVENT RISK
It looks like you can’t compensate for sitting so long by exercising later. I get up and walk around and do intense exercises on my days off. Try standing at your work if possible. Some have desks that elevate to work standing. Taking a 15 min walk at lunch is good too.

HEALTHY OBESITY?
There are a few people who are obese who don’t have obesity-associated conditions such as diabetes, hypertension, heart failure, cancers. But, of course they may have joint pains from overloading their joints. These are interesting people. I know a few.
To figure out if you are obese, search for a BMI calculator on the web and enter your weight and height.

ANXIETY AND DEPRESSION WORSE AFTER MILD COVID IN THOSE WITH THEM BEFORE
Brain imaging showed a loss of brain tissue in the Limbic system, an area where emotions are processed in those who had anxiety and depression before they got mild Covid. Those without the pre-existing emotional conditions did not show the loss of tissue.
More reason to avoid catching Covid as recommended by health departments. Science helps.

LIVER TRANSPLANT DELAYED BY MARATHON TRAFFIC
There is a case of the Philadelphia marathon blocking the vehicle with the new liver. The surgeon jogged a half mile and through the marathon runners to get the liver. He got a police escort for the way back. The waiting patient has done well and the relatives of the donor are assured that the liver donation worked out well.

HOW CAN A DOCTOR KEEP UP WITH THE EXPLOSION OF INFORMATION
Medical knowledge seems to double every few months. There is so much information out there. Some of us read summaries. My method is to listen to multiple journal podcasts when I am driving. Doing these monthly articles helps me stay ahead. Also I have lead Journal Clubs for 2 residencies: the physicians in training have one of them present an important journal article and I comment on the strength of the evidence and how to put the new knowledge into practice. One great idea I learned is that if you take your blood pressure medication at night, that is as strong as adding another medication to those who take the medication in the morning.

HAVANA SYNDROME NOT CAUSED BY ENEMIES.
1500 staff at numerous embassies of the United States have come down with a set of symptoms around the same time and this pattern caused the investigators to think there was a microbe, or ultrasonic bombardment. Seven intelligence agencies gathered information in 90+ countries and found no credible evidence of any external source causing this.

Keep those questions coming and be safe!

dpearce@western.edu

Daniel Pearce, D.O.,
FACOI, AAHIVMS
Associate Professor of Medicine, Loma Linda University School of Medicine HIV, Hepatitis B,C, Transgender, Suboxone Specialist, Neighborhood Health (Riverside, Hemet), Loma Linda SACH (San Bernardino) Member, Coachella Valley Clinical Research Initiative

REFERENCES: Medscape®