GILEAD TO DONATE TRUVADA FOR PrEP

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This means up to 2.4 million bottles/year which will treat, so this makes 120 patients treated for free which is not that many considering how many who need financial help to prevent HIV. Activists want to bring down the price since it can cost up to $20K/year.

HEPATITIS A OUTBREAKS

Are happening in many major US cites.  Those at risk who are men who have sex with men, are homeless, have been incarcerated recently, and those who use street drugs. If you have one of these risks, please consider asking your health care provider for a blood test to see if you are protected. If not, then the vaccine is needed.

BEWARE OF KRATOM

The FDA has sent warning letters to multiple companies not to claim that Kratom is a helpful chemical, which the companies claim can treat opioid addiction, withdrawal, and a host of other problems including depression, anxiety, and cancer.  This marketing strategy is old and effective: find a disease or symptom that people have trouble correcting and market your product targeting these without proof.  The main side effects are: 1-the patient is avoiding better ways of treating the problem, and 2-the patient pays good money for something that might harm them or do nothing for them.

VAPE PEN EXPLOSION

A 17-year-old Utah boy had a vape pen suddenly explode in his face. I imagine the battery is the cause. This reminds me of hoverboard and laptop explosions. I think vapes are possibly less dangerous than cigarettes but an explosion happened to only 1 out of thousands of vape pens.

PARKINSONS AND HEPATITIS C

Parkinson Disease is more common in those with Hepatitis C. Parkinsons causes a tremor, stiff muscles, and dementia. Multiple studies show a link, so it is important to get cured. Tremors are caused by many conditions so see your provider if you have them.

COLLEGE PREVENTS LIVER CANCER DEATHS?

Death from liver cancer is rising. A study found that, especially in men, those with education stopping at high school or lower, had an increased risk for liver cancer. What to do? Avoid the risks: The risk factors for HCV-unrelated liver cancers include obesity, diabetes, smoking, and excessive alcohol consumption. Also, becoming informed about your health is a big help.

ARE YOU GETTING UP TO PEE TOO OFTEN AT NIGHT

Here is an update on this symptom.

Diabetes can cause you to eat too much, drink too much fluids, and pee too much. This is easy to diagnose at your provider’s office.

Urinary tract infections can cause burning, blood in the urine, fever, chills, sweats, poor appetite, and energy. Again see your provider.

Prostate enlargement is a chronic condition that rarely causes symptoms before age 40, the occurrence and symptoms increase with age. Benign prostatic hyperplasia (BPH) affects about 50 percent of men between the ages of 51 and 60 and up to 90 percent of men older than 80. The symptoms are:

Urinary frequency

Urinary urgency

Nocturia- Needing to get up frequently at night to urinate

Hesitancy – Difficulty initiating the urinary stream; interrupted, weak stream

Incomplete bladder emptying – The feeling of persistent residual urine, regardless of the frequency of urination

Straining – The need strain or push (Valsalva maneuver) to initiate and maintain urination in order to more fully empty the bladder

Decreased force of stream – The subjective loss of force of the urinary stream over time

Dribbling – The loss of small amounts of urine due to a poor urinary stream as well as weak urinary stream

The provider will check for diabetes, infection, and prostate cancer–I would do a rectal/prostate exam with a glove if not done in the last year.

The main symptom is losing sleep by getting up many times at night. Most patients feel 2 times a night is tolerable but more gets to be a hassle.

The first step is to limit fluids 3-5 hours before bedtime. The ageing body processes fluids slower so that is why the long time.

There are 3 categories of medications in addition to surgery to treat BPH:

Alpha blocker blood pressure meds. The blood pressure must be monitored to make sure you aren’t at risk to faint when standing up fast. We start at low doses and increase until the problem is better and there isn’t significant dizziness.

Alpha Reductase inhibitors: These shrink or stop the prostate from growing. Some have sexual performance problems with these drugs so we would change them for another.

Viagra® types: These also work but may cause erections when not desired, e.g. when you have sexual thoughts but you don’t want others to know this.

Combinations of the above at lower doses to minimize side effects and maximize the desired effect.

Surgery is also an option like when I was doing a urology rotation in the Seventies but is quite uncommon now that we have these medications.

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®

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