Notes: 

HealthNews RoundUp - 3rd Week of May, 2019

5/23/19

 

I’m Dr. Howard Smith, PENTA Medical Network, reporting from NYC with the Health News Roundup for the 3rd week of MAY, 2019.  This is Health News You Should Use, the latest medical discoveries and commonsense advice that you can use in a practical way to keep yourself and your family healthy.  

 

Here are this weeks stories :

Management of Asthma Changing

Button Battery Dangers

TELL ME WHY: Coffee is Good For Your Gut

Bowel Cancer Rising In Over-fed Young Adults

Measles Will Become Epidemic Unless We Compel Immunization

Broccoli Triggers Cancer Immunity

Asthma App Helps Kids Breathe Better

Holistic Approach To IBD

Impact Of Weed Legalization On Colorado Health Care Utilization

Childrens’ Protruding Teeth Are At Risk

Falling Asleep To The TV Robs Kids Of Healthy Sleep

Obsession With Healthy Eating Is Dangerous

Early Onset Heart Failure On The Rise 

The Reproductive Clock Ticks For Men Too

TRY A LITTLE KINDNESS:  Big Pharma Can Have A Big Heart

 

For more information, you’ll find all the references for the stories and a copy of show notes on my website at: https://www.drhowardsmith.com/may-2019-3rd-week-health-news

 

#Asthma #albuterol #budesonide #bronchodilators #Ingestions #buttonbatteries #coinbatteries #parenting #Coffee #gimotility #bowelcontraction #microbiome #Bowelcancer #colorectal cancer #fecaltestkits #colonoscopy #fat #fiber #Measles #MMR #vaccination #antivaxx #Broccoli #cancer #cauliflower #cabbage collard greens #Brussel sprouts #kale #WWPI #PTEN #indole3carbinol #smartphoneapp #asthma #peakflow #AppStore #IBS #holisticmedicine #TVtime #sleep #screentime #parenting #hypnotherapy #Cannabis #pain #motorvehicleaccidents #drugoverdose #drugabuse #Dentalprotrusion #buckteeth #dentalfracture #orthodontia #mouthguard #dentalimplant  #Orthorexia #ocs #healthyeating #vegan #vegetarian #Heartfailure #obesity #diabetes #cholesterol #lipids #fastfood #alcohol #Paternity #agingsperm #prematurity #birthdefects #spermbanking #PrEP #HIV #AIDS #corporatephilantrophy

 

 

Here is the news:

Management of Asthma Changing

A study just published online by the New England Journal of Medicine is challenging the way we manage asthma.  

 

For decades, inhalation of the short-acting bronchodilator albuterol, sold as Proventil and Ventolin, has been the recommended

treatment for attacks with the addition of an inhaled steroid for maintenance of easy breathing. A collaborative group from New Zealand, Australia, and Britain now demonstrates that the inhaled steroid+long acting bronchodilator combo budesonide-formoterol, marketed as Symbicort, and only used when needed not only works effectively to stop asthma attacks but also prevents them with less steroid exposure for the patient.

 

The study included 688 adult asthma patients in 3 treatment groups who randomly received either as-needed albuterol, as-needed budesonide-formoterol, or daily budesonide with the addition of albuterol as needed.  The results showed that as-needed steroid+long-acting bronchodilator reduced the incidence of severe asthma attacks by 40% when compared with as-needed short-acting bronchodilator and 44% when compared with daily steroid.  Also important was the finding that only using the steroid when needed versus daily reduced the amount of steroid exposure by by more than half.

 

The take away: as-needed steroid+long-acting bronchodilator, budesonide-formoterol is more effective and safer for asthma treatment and prevention than as-needed short-acting albuterol or daily steroid budesonide with added albuterol when necessary.  

 

If you or your child is asthma, speak with your doctors about this newer strategy.

 

Richard Beasley, D.Sc., Mark Holliday, B.Sc., Helen K. Reddel, Ph.D., etal. Controlled Trial of Budesonide–Formoterol as Needed for Mild Asthma.  NEJM Online: May 19, 2019

DOI: 10.1056/NEJMoa1901963

 

Asthma, albuterol, budesonide, bronchodilators

#Asthma #albuterol #budesonide #bronchodilators

 

 

Button Battery Dangers

If a child swallows a button battery that has passed into the stomach, a study to be presented to the Digestive Disease Week annual meeting concludes that the ingested object must be removed quickly to prevent damage to the gastrointestinal tract linings.  Current recommendations suggest wait and see to allow the battery to pass through the gastrointestinal system. 

 

These tiny coin-shaped batteries are found in small electronic devices including toys, key fobs, talking greeting cards, watches, and hearing aids.

 

A study by the Children’s Hospital Colorado that presents data from 68 kids treated at children’s hospitals in that state, Florida, and Ohio.  The findings indicate that acid released by these ingested batteries leads to corrosive stomach lining injuries 60% of the time.

 

Because of this damage, the authors’ recommendation for immediate removal of the coin battery is far more aggressive and proactive than the current wait and see guidelines issued by the North American Society of Pediatric Gastroenterology and the National Capital Poison Center.  These authorities have suggested allowing passage through the gastrointestinal tract for those batteries that have traversed through the esophagus into the stomach.  In contrast, most guidelines from a variety of panels do recommend immediate endoscopic removal if the battery has lodged in the esophagus.

 

One problem is that parents and other caregivers are not always certain about the type of coin-shaped object that a child has swallowed.  While coins can usually pass safely through the gastrointestinal tract, we can’t always be certain that the circular foreign body seen on x-ray is not a battery. 

 

The safe money is on immediate removal of all circular ingested foreign bodies detected in the esophagus or stomach.

 

Digestive Disease Week. "Button batteries can rapidly damage stomach lining before symptoms appear: Experts recommend changing current practice of watchful waiting." ScienceDaily. ScienceDaily, 18 May 2019. www.sciencedaily.com/releases/2019/05/190518172524.htm.

 

Ingestions, buttonbatteries, coinbatteries, parenting

#Ingestions #buttonbatteries #coinbatteries #parenting

 

 

TELL ME WHY: Coffee is Good For Your Gut

We’ve known for years that coffee can be good for your digestion as it helps keep you regular,  reduces risk of gallstones, and keeps your liver humming along.  A new study from the University of Texas at Galveston explores that reasons for this conclusion.  Their studies were carried out in a rat model.

 

These investigators found that, when exposed to coffee for three successive days, the small and large intestines of the tests animals showed more forceful muscular activity than seen in animals on a coffee-free diet..  In addition, the bacteria within the guts of the experimental animals showed slower growth in the coffee-fed animals.  Most interesting was the observation that gut contractions increased and bacterial proliferation decreased whether or not the coffee was caffeinated or decaf.

 

Healthline.com summarizes the known benefits of coffee:

• Boost energy.

• Burns fat.

• Improves physical performance.

• Contains essential B vitamins and minerals.

• May lower diabetes risk.

• May protect against dementia.

• May lower Parkinson’s risk

• May protect the liver.

• Fight depression

• Fights cancer with antioxidants.

• May lower stroke risk.

• May extend your life.

 

Added to this list is a better functioning gastrointestinal tract, and now you know the reasons why.

 

Digestive Disease Week. "Researchers document impact of coffee on bowels: Rat study shows coffee changes gut microbiome and improves ability of intestines to contract." ScienceDaily. ScienceDaily, 19 May 2019. <www.sciencedaily.com/releases/2019/05/190519123556.htm>.

 

https://www.healthline.com/nutrition/top-13-evidence-based-health-benefits-of-coffee#section1

 

Coffee, gimotility, bowelcontraction, microbiome

#Coffee #gimotility #bowelcontraction #microbiome

 

 

Bowel Cancer Rising In Well-fed Young Adults

While the incidence of bowel cancer dropped in middle-aged adults 50+ over the decade ending in 2014, colon and rectal cancer is on the rise for younger adults.  This result is now reported in the journal The Lancet Gastroenterology & Hepatology, and it is derived from a tabulation of cancer registry data from the westernized countries Australia, New Zealand, Canada, Britain, Ireland, Denmark, and Norway.

 

The numbers are small but significant.  While the bowel cancer incidence was dropping by 2% on average in older persons, it was rising 2.5% in the younger adults.  The rise is particularly significant for rectal cancer.

 

The study authors speculate that better screening for young adults should be considered, since most surveillance doesn’t begin before the ages of 45-50 except in those with a strong family history of bowel disease.  With the advent of cheap at-home fecal immune test or FIT kits, it may be prudent to begin that type of screening on a periodic basis in the 20s.

 

How can you prevent colon cancer? One giant step is to cut out those fast food meals with red meat, low fiber, and high fat. 

Marzieh Araghi, Isabelle Soerjomataram, Aude Bardot, etal. Changes in colorectal cancer incidence in seven high-income countries: a population-based study. The Lancet Gastroenterology & Hepatology, 2019; DOI: 10.1016/S2468-1253(19)30147-5

 

Bowelcancer, colorectal cancer, fecaltestkits, colonoscopy, fat, fiber

#Bowelcancer #colorectal cancer #fecaltestkits #colonoscopy #fat #fiber

 

 

Measles Will Become Epidemic Unless We Compel Immunization

This is a wake up call for the US, Britain, Ireland, Italy, and Australia that comes from Italy’s Bocconi University and Bruno Kessler Foundation.  Researchers there crunched the numbers using a computer model and simulated the characteristics of measles immunity between 2018 and 2050 in these countries as well as in South Korea and Singapore.

 

The study projections show that by 2050, only South Korea and Singapore would have the required 7.5% of their populations immune to measles and thereby escape a string of measles epidemics.  At the current rates of vaccination in the other countries, none of them would reach the 7.5% target.

 

The CDC is webcasting a seminar this week for clinicians to help them cope with this year’s measles outbreak.  Although 95% of Americans have immunity to measles either by having had the disease or by vaccination, 1 in every 12 children in the US fail to receive their first dose of MMR vaccine on time.  Most of the cases of measles that enter the US occur in unvaccinated Americans who have been traveling abroad.

 

Public health officials and practicing clinicians know the answer to this problem.  It is time to develop some political courage and make measles vaccinations mandatory.   Those who oppose vaccination have only pseudo-science and discredited research to back up their position.

 

Let’s move to protect our children and ourselves by demanding that our local, state, and federal politicians act to insure 100% immunity in the USA to measles and other dread diseases.

 

 

Filippo Trentini, Piero Poletti, Alessia Melegaro, Stefano Merler. The introduction of ‘No jab, No school’ policy and the refinement of measles immunisation strategies in high-income countries. BMC Medicine, 2019; 17 (1) DOI: 10.1186/s12916-019-1318-5

 

https://content.govdelivery.com/accounts/USCDC/bulletins/2452548

 

Measles, MMR, vaccination, antivaxx

#Measles #MMR #vaccination #antivaxx

 

 

Broccoli Triggers Cancer Immunity

Broccoli and its cruciferous vegetable cousins can inactivate a gene that cancers use to overwhelm our immune systems and our bodies.  This latest finding comes from Boston’s Beth Israel Deaconness Medical Center’s Cancer Research Institute.

 

We know that eating broccoli, cauliflower, cabbage, collard greens, Brussel sprouts, and kale seems to reduce the risk of cancer.  The Harvard researchers report that a tiny molecule in these vegetables, indole 3 carbinol or I3C, blocks one gene, WWP1, and releases a second gene, PTEN that is a potent human cancer cell suppressor.  By this round about mechanism, these veggies metabolically disable tumor cells.

 

So all we have so do is eat some broccoli, cauliflower, or cabbage to cure cancer.  No so fast.  Only tiny amounts of the magic I3C are in the usual servings of these vegetables, so you’d have to consume whopping quantities to consistently have an effect.  

 

Nonetheless, eating them regularly is beneficial while researchers find a way to produce or extract larger quantities of this cancer Achille’s heel.

 

Yu-Ru Lee, Ming Chen, Jonathan D. Lee, etal. Reactivation of PTEN tumor suppressor for cancer treatment through inhibition of a MYC-WWP1 inhibitory pathway. Science, 2019; 364 (6441): eaau0159 DOI: 10.1126/science.aau0159

 

Broccoli, cancer, cauliflower, cabbage collard greens, Brussel sprouts, kale, WWPI, PTEN, indole3carbinol

 

#Broccoli #cancer #cauliflower #cabbage collard greens #Brussel sprouts #kale #WWPI #PTEN #indole3carbinol

 

 

Asthma App Helps Kids Breathe Better

Electronically monitoring a child’s day-to-day breathing patterns and their responses to medicine improves asthma management.  Pediatricians at the University of Utah developed a smartphone app they call eAsthmaTracker and tested it with more than 300 children receiving care at 11 clinics statewide.

 

The app tracks a child’s respiratory symptoms and peak flow rates and their impact on everyday activities permitting parents and clinicians to detect impending acute asthma attacks and use proactive medication adjustments to prevent or at least moderate such episodes.  Use of the app improved asthma control, reduced ED visits by 60%, diminished the need for rescue steroids by 35%, led to 60% fewer missed school days, and drove an improved quality of life.

 

The Utah app is not yet ready for prime time, but the good news is that there are several free asthma tracking apps already available on the iOS and Android App stores.  These apps appear to provide some of the same tracking and predictive benefits as the eAsthmaTracker.  I’ll provide links to these apps in the references.

 

If your child or you have asthma, I would urge you to try one of these apps.  They will keep the asthma under better control and hopefully reduce the need for excessive medication.

 

Flory L. Nkoy, Bernhard A. Fassl, Victoria L. Wilkins, Joseph Johnson, Eun Hea Unsicker, Karmella J. Koopmeiners, Andrea Jensen, Michelle Frazier, Jordan Gaddis, Lis Malmgren, Stacey Williams, Heather Oldroyd, Tom Greene, Xiaoming Sheng, Derek A. Uchida, Christopher G. Maloney, Bryan L. Stone. Ambulatory Management of Childhood Asthma Using a Novel Self-management Application. Pediatrics, 2019; e20181711 DOI: 10.1542/peds.2018-1711

 

https://asthma-app.com

https://www.asthmamd.org/

 

smartphoneapp, asthma, peakflow, AppStore

#smartphoneapp #asthma #peakflow #AppStore

 

 

Holistic Approach To IBD

Inflammatory bowel disease is best treated by simultaneously applying therapies that focus both on the gut and the brain.  A study from Sweden’s University of Gothenberg just published in journal Gastroenterology emphasizes the need a comprehensive, holistic approach to the disease.

 

The researchers studied 400 patients with IBD and matched controls using quantitative measures of intestinal sensitivity and motility as well as a questionnaire to explore the subjects neurological and psychological issues.  Their studies were particularly focused on the so call gut-brain axis which is the link between these components of IBD.

 

The study concludes that the most severe forms of IBD were accompanied by multiple problems in the gastrointestinal tract and in the psyche.  Effective treatment was only possible when each component of the disease was recognized and managed holistically with not only pharmaceuticals such as anti-depressants but also cognitive behavioral therapy and hypnotherapy.

 

Magnus Simrén, Hans Törnblom, Olafur S. Palsson, Lukas Van Oudenhove, William E. Whitehead, Jan Tack. Cumulative Effects of Psychologic Distress, Visceral Hypersensitivity, and Abnormal Transit on Patient-reported Outcomes in Irritable Bowel Syndrome. Gastroenterology, 2019; DOI: 10.1053/j.gastro.2019.04.019

 

IBS, holisticmedicine, hypnotherapy

#IBS #holisticmedicine #hypnotherapy

 

 

Impact Of Weed Legalization On Colorado Health Care Utilization

The ready availability of marijuana had both positive and negative impacts on the use of hospital services in the state of Colorado.  Cardiologists and epidemiologists at UC-San Francisco studied some hospital records from Colorado comparing utilization before and after pot legalization.

 

 On the positive side, there were fewer hospitalizations for chronic pain.  This statistic is a tribute to the effectiveness of cannabis and its components THC and CBD as agents for pain management.  On the negative side, hospital admissions rose due to marijuana-driven motor vehicle accidents, alcohol abuse, and cannabis overdosing.  The net effect on hospital utilization was zero.

 

The lesson learned is that mind-altering drugs can have health benefits.  Their ready availability dictates the need for public education about responsible, moderate use.   This is particularly true in the context of heavy machinery operation.

 

Francesca N Delling, Eric Vittinghoff, Thomas A Dewland, etal. Does cannabis legalisation change healthcare utilisation? A population-based study using the healthcare cost and utilisation project in Colorado, USA. BMJ Open, 2019; 9 (5): e027432 DOI: 10.1136/bmjopen-2018-027432

 

Cannabis, pain, motorvehicleaccidents, drugoverdose, drugabuse

#Cannabis #pain #motorvehicleaccidents #drugoverdose #drugabuse

 

 

Childrens’ Protruding Teeth Are At Risk

Kids with teeth that protrude are at significant risk for a lifetime of dental problems.  An Australian study of more than 50,000 children and adolescents was just published in the journal Dental Traumatology.

 

The data reveals that children under the age of six with teeth that protrude more than 3 millimeters are more than 3 times more likely to sustain serious dental trauma.  Children and adolescents older than 6 years with dental protrusions of more than 5 millimeters have double the  risk of injury.  When injuries do occur, they may negatively impact continued dental development, complicate future orthodontia efforts, or necessitate later dental implants.

 

Children with protruding teeth should be fitted with protective mouth guards for use during sports and other vigorous play.  They should be considered prime candidates for aggressive and proactive orthodontia in order to normalize their dental profile and reduce risk of injury.

 

George P Arraj, Giampiero Rossi‐Fedele, Esma J. Doğramacı. The association of overjet size and traumatic dental injuries – a systematic review and meta‐analysis. Dental Traumatology, 2019; DOI: 10.1111/edt.12481

 

Dentalprotrusion, buckteeth, dentalfracture, orthodontia, mouthguard, dentalimplant

#Dentalprotrusion #buckteeth #dentalfracture #orthodontia #mouthguard #dentalimplant

 

 

Inappropriate TV Exposure Robs Young Kids Of Healthy Sleep

The myth that falling asleep to the TV is good for children is now dispelled by a study from the University of ‘Massachusetts-Amherst.  Developmental specialists and neuroscientists there studied some 470 preschoolers and their parents using electronic sleep monitoring and questionnaires for behavioral assessment.

 

Thirty-four percent of the kids had TVs in their bedrooms, and those children slept 17 fewer minutes per 24 hours than those without bedroom TVs.  They tended to require longer daytime naps and spent an average of 12 minutes more asleep during the day.

 

TV viewing during the day also had effects on sleep patterns.  The World Health Organization and the American Academy of Pediatrics both recommend limiting TV viewing for 2 to 4 year olds to one hour of high quality, educational programming a day, and the viewing should occur with a parent if possible.  

 

The study showed that only 46% of kids had viewing habits that met these guidelines. Those children whose daily TV screen time did meet guidelines and amounted to less than one hour a day were found to clock 22 more minutes of nighttime sleep.

 

Like any other children’s activity, screen time should be thoughtfully planned and carefully monitored.  As always, moderation is the best policy.

 

Abigail F. Helm, Rebecca M.C. Spencer. Television use and its effects on sleep in early childhood. Sleep Health, 2019; DOI: 10.1016/j.sleh.2019.02.009

 

TVtime, sleep, screentime, parenting

#TVtime #sleep #screentime #parenting

 

 

Obsession With Healthy Eating Is Dangerous

Orthorexia nervosa is medical jargon for an obsession with healthy eating.  Psychologists from Toronto’s York University explain the drivers and dangers of this condition in a review article just published in the journal Appetite.

 

Orthorexia nervosa tends to develop in those individuals with a history of eating disorders, obsessive-compulsive personalities, a history of repeated dieting, a poor body image, a desire to be thin, and often a history of depression.  Those individuals who adopt restrictive eating practices such as vegetarians, vegans, and especially lacto-vegetarians are at high risk for this disorder.

 

Unlike those who suffer from anorexia nervosa and the drive to restrict calories in the effort to maintain a low body weight, persons with Orthorexia nervosa fixate on obtaining or preparing healthy food.  They spend so many hours of the day, planning, purchasing ingredients, and preparing healthy meals that they have little time left for other pursuits.  This disorder seems to affect men and women in near equal numbers.

 

Orthorexia nervosa, although described in a number of studies, is not officially recognized as an official psychiatric diagnosis.  It’s treatment, though, is similar to many psychiatric disorders and includes: cognitive behavioral therapy, meditative therapy, and psychopharmaceutical therapy with anti-depressives and anti-anxiety medications.

 

If any of this sounds familiar to you as a description of a family member or of yourself, please know that help is available.

 

Sarah E. McComb, Jennifer S. Mills. Orthorexia nervosa: A review of psychosocial risk factors. Appetite, 2019; 140: 50 DOI: 10.1016/j.appet.2019.05.005

 

Orthorexia, ocs, healthyeating, vegan, vegetarian

#Orthorexia #ocs #healthyeating #vegan #vegetarian

 

 

Early Onset Heart Failure On The Rise 

Death due to congestive heart failure has been on the rise over the past 7 years, and the group most affected is surprisingly those under 65.  A new study from Northwestern University cardiologists looks at CDC epidemiologic data for nearly 48 million Americans from 35 to 84 years of age.

 

The study shows that the trend toward declining death rates from heart failure seen over the past 3 decades is now reversing.  Younger individuals are now more likely to develop heart failure, and the reasons appear to be due to our country’s dual interrelated epidemics of obesity and diabetes.  Middle-aged black men are at a particularly high risk.

 

Heart failure is deadly with outcomes similar to metastatic lung cancer.  The best treatment is prevention by maintaining a healthy weight, keeping your blood pressure under control, and monitoring your cholesterol and lipid profiles.  These goals will be far easier to achieve by eliminating fast food and excessive alcohol.

 

Peter Glynn, Donald M. Lloyd-Jones, Matthew J. Feinstein, Mercedes Carnethon, Sadiya S. Khan. Disparities in Cardiovascular Mortality Related to Heart Failure in the United States. Journal of the American College of Cardiology, 2019; 73 (18): 2354 DOI: 10.1016/j.jacc.2019.02.042

 

Heartfailure, obesity, diabetes, cholesterol, lipids, fastfood, alcohol

#Heartfailure #obesity #diabetes #cholesterol #lipids #fastfood #alcohol

 

 

The Reproductive Clock Ticks For Men Too

Women over 30 with an interest in motherhood constantly have an eye on that ticking biological clock.  The latest study from Rutgers University suggests that men also need to pay attention to old Father Time if they want to produce healthy offspring.

 

The study reviewed nearly half a century of research on fertility and healthy reproduction.  Men 45 years or older with decreasing testosterone experience declining fertility and contributed suboptimal sperm that trigger pregnancy complications including gestational diabetes, preeclampsia, premature birth, still births, low birth weight, newborn seizures, and birth defects including cardiac anomalies and cleft palate.  Later, the children of older men had an increased incidence of childhood cancer, psychiatric disorders, and autism.

 

The study’s authors recommend that men as well as women keep an eye on the clock if they have parenthood in their futures.  If fatherhood is to be delayed, they suggest that men consider banking their sperm by age 35 or by 45 at the latest.

 

N. Phillips, L. Taylor, G. Bachmann. Maternal, infant and childhood risks associated with advanced paternal age: The need for comprehensive counseling for men. Maturitas, 2019; 125: 81 DOI: 10.1016/j.maturitas.2019.03.020

 

Paternity, agingsperm, prematurity, birthdefects, spermbanking

#Paternity #agingsperm #prematurity #birthdefects #spermbanking

 

 

TRY A LITTLE KINDNESS:  Big Pharma Can Have A Big Heart

Pharmaceutical companies are the corporations that most of us love to hate for their unabashed greed in raising drug prices to astronomical levels.  Here’s one drug company that deserves sustained applause rather than scorn for its generosity.  The story is told by good news network.org. 

 

Gilead Sciences, a biopharmaceutical company based in Foster City, CA, through its CEO Daniel O’Day has announced the largest ever donation by a pharmaceutical company.  Every year for the next 11 years, the company will be donating 2.4 million bottles of their Truvada PrEP pre-exposure prophylaxis medication to over 200,000 needy and uninsured Americans at risk for contracting infection with the human immunodeficiency virus.

 

This combination reverse transcriptase inhibitor medication prevents the proliferation of HIV in virus infected cells and in so doing prevents the development of AIDS.

 

This generous program is just the latest chapter in Gilead’s phialthrophic contributions to eradicating HIV/AIDS.  In 2017, the company announced the launch of its $100 million COMPASS Initiative.  COMPASS is an acronym for COMmitment to Partnership in Addressing HIV/AIDS in Southern States).  Although home to only38% of the US population, the southern states are the sites of 52% of new HIV infections.  In these states, nearly half a million people are currently living with HIV.

 

Let’s hope that Gilead Sciences will become a model for other companies to give back to the community.  

 

https://www.goodnewsnetwork.org/gilead-gives-free-anti-hiv-medication-to-at-risk-patients/

https://www.gilead.com

 

PrEP, HIV, AIDS, corporatephilantrophy

#PrEP #HIV #AIDS #corporatephilantrophy

 

 

That’s health news you should use.  Thanks for listening and special thanks to my followers on social media. As we he’d into the summer season, I’m Dr. Howard Smith reminding you to drive carefully, use that sunblock, keep a smile on your face, your brain active, and your body in motion....these are the best medicines!