22% of providers (including non-prescribing providers such as case managers) in the Midwest USA felt uncomfortable telling their patients not to be concerned about HIV transmission when their viral loads were less than 200. I tell them and also make clear that they can catch gonorrhea, chlamydia, syphilis and other STDs if they are not monogamous and step out of their relationship to have sex with others. More education needs to be done to help providers understand that U=U.
VAPING KILLING AND MAIMING
Many, many reports are now coming in regarding lung effects of vaping and the death count is shooting up. Some states are banning the sale of vaping products.
STD EXPRESS CLINICS
London has a clinic where you can be notified by text whether you have gonorrhea or chlamydia within a day. Chicago is rolling out two of these clinics. These procedures save money and suffering by catching and then treating these bacteria quickly. Since England has a national healthcare system, the records are easily seen by each provider. In the US this will take some extra steps and delays for your primary provider to know your results and treatment details.
ZANTAC® AND –SARTAN DRUGS HAVE CONTAMINANT
Over-the-counter Zantac®, ranitidine for stomach acid, ulcers, reflux has been recalled since it has a chemical which may cause cancer, NDMA, or N-Nitrosodimethylamine. If your Zantac® is prescribed, then this recall does not affect you.
Blood and heart failure drugs ending in –sartan have the same problem. These are only available by prescription.
Call your pharmacist if you have questions and to make sure if you are on the contaminated medicine and how to fix this.
BABY TEETH CONTAMINANTS ARE ASSOCIATED WITH AUTISM AND ADHD
A new paper describes that when they analyze baby teeth, there is a certain signature of the metals that is associated with Autism or ADHD. This is not a diagnostic tool but does push researchers in the direction of investigating the nutrition of the mother as far as metals, to see if there is an association there and then see if they can prevent these conditions.
THE BIGGER YOU ARE, THE MORE DIARRHEA
A large study of a health information database found that the more obesity and more diarrhea went together. I.e. there was an association: the higher the weight the more episodes of diarrhea there was. This is not a study that proves that one causes the other but sees only an association. They even found the same association when they removed laxatives, diabetes, diet factors, psychological factors, and lifestyle factors by statistical methods.
ASSISTED SUICIDE OR AID IN DYING
The family practitioner group has decided to not speak for or against Aid in Dying—their preferred term. Another authority feels Medical Aid in Dying is better and more specific. There are strong words and feelings on whether providers should aid the death process, even in those who are terminally ill and suffering pain or sedation from pain medicines.
WASH AFTER TOUCHING ANIMALS OR DRY PET FOOD
Any contact with any animal can cause disease transmission; outbreaks have happened with an animal being the primary source. The safest practice is to wash hands after each contact. Dry pet food and frozen or live feeder rodents have also been associated with outbreaks.
Those most at risk are less than 5 or more than 65 years of age. You can touch a pet and then touch them and they get infected and are less able to fight it off. Kids wash their hands less and poorly and put things in their mouth more. Pregnant women are at higher risk also for salmonella, bird viruses, a rodent meningitis virus, and a livestock virus (petting zoo or farm).
WHO SAYS WHICH ARE YOUR MOST IMPORTANT MEDICAL PROBLEMS
There was a survey having the patient list their medical problems in order of most concerning. Their physicians did the same. There wasn’t much agreement on the priority. In reading this summary it looks like the patient listed those which might cause the most suffering now and the physicians listed those which were most dangerous if not handled well. E.g. patients listed runny noses higher than physicians, who listed low thyroid condition higher (which is easily treated with a pill with only rare side effects).
TEENS WITH ANXIETY HAVE MORE ASTHMA EMERGENCIES
A study showed that children and teens who are anxious or depressed have more attacks and then seek emergency care. We–providers and patients–should pay attention to helping their mental health to avoid (sometimes fatal) asthma attacks. The inhalers and shortness of breath also cause jitteriness and palpitations, also anxiety causes an asthma episode, so it may be hard for a provider to separate the causes.
OTHER MARKERS OF SUICIDE
A county death investigator found the following factors associated with suicide although they do not accurately predict imminent suicide: recent foreclosure or eviction, turning a pet into the shelter, and a recent medical visit. Keep an eye on your friends and if a major stress hits them, consider referring them to the National Suicide Prevention Lifeline and giving it to them. 800-273-8255.
SAVING $843 MILLION
The administrative agency overseeing MediCare and MediCaid/MediCal has a budget of 1 trillion dollars. They are starting an effort to reduce paperwork and requirements that seem burdensome. These mainly apply to hospitals. Those savings will be a big chunk.
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