Flu Season is Here

Flu Season is Here

https://phartm01.wordpress.com/2022/10/31/flu-season-is-here/
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The CDC reports rising cases of the flu in the Southeast and South-Central U. S. They estimate about 880,000 cases so far, which is the most in this amount of time since the 2010-2011 season.

They recommend everyone age 6 months and older get vaccinated. The flu vaccine and the COVID vaccine can be administered at the same time.

If you get the flu, there are now 4 different medications that can be prescribed to reduce the severity of illness. They must be given as soon as possible after infection.

The flu is likely to cause disruptions in many businesses. Encouraging employees to get vaccinated is a good idea. If they develop a fever with a cough or sore throat, they should stay home until well. It would be prudent for them to contact their doctor to find out if taking one of the anti-flu medicines would be appropriate.

To learn more, go to my blog on WordPress.

Peter M. Hartmann, MD

Flu Season is Here

Each year we expect an outbreak of influenza. Flu has been less frequent in the last couple of years due to measures begun to deal with the COVID-19 pandemic. Now that those measures are declining, flu is making a comeback.

The CDC estimates that 880,000 people have gotten a flu-like illness so far; 6,900 people have been hospitalized; and 360 people have died from it. This rate of infection and hospitalization is the highest since the 2010-2011 flu season.

The majority of flu cases this year are due to influenza A (H3N2). Very few have been due to influenza B. The greatest number of cases are from the Southeast and South-Central parts of the country. However, it is rapidly spreading North.

The CDC recommends that people age 6 months or more receive the flu vaccine. The vaccine can be given at the same time as a COVID-19 vaccine. Getting vaccinated is the best protection against getting a severe case of the flu.

In addition, using protective measures such as frequent hand washing, everyone covering their nose and mouth when coughing or sneezing by use of a handkerchief or coughing/ sneezing into their elbow, and wearing a mask when around others who may be carrying the flu virus.

If you do catch the flu, there are 4 different medications that a doctor can prescribe to shorten the course of the illness These medicines must be started as soon as possible after onset of the flu.

Stay safe and be well.

Peter M. Hartmann, MD

Family Medicine & Psychiatry

End of Anonymous Sperm and Egg Donors in Colorado

Colorado will outlaw anonymous sperm and egg donors in the near future. Donors will have to provide personal information including a detailed medical history. Information will have to be updated every 3 years.

Children of donors will have the legal right to learn the identity of their donor parent at age 18. It is already possible in some cases to find a donor parent by means of genetic testing companies that have test subjects all over the country.

Colorado’s new law prohibits the use of sperm and egg donors from other states that allow donors to remain anonymous. It is unclear if this violates interstate commerce laws.

It is understandable that children born of a donor sperm or egg might want to know about the donor and may want to reach out to them. In Colorado, potential donors will have to decide if they are willing to donate without anonymity.

If you live in a different state, how would you advise your legislators about this topic?

Peter M. Hartmann, MD

Family Medicine & Psychiatry

ADHD Medication Shortage

People with Attention Deficit Hyperactivity Disorder (ADHD) are often treated with a stimulant medication. The most common ones are methylphenidate (Ritalin) and dextroamphetamine/amphetamine (Adderall).

These medications are usually beneficial and enables patients to function much better. Ideally, treatment also includes psychotherapy that teaches the patient methods to compensate for their difficulty with impaired attention, impulsivity, and hyperactivity. The therapy also helps them correct unhelpful thinking such as a belief that will-power alone is all that is needed. In addition, there are other medications that can be used when these stimulants do not work well enough or are not tolerated.

For those patients treated with an amphetamine they may face a new challenge. This category of medications is now in short supply, so it may be difficult to get the medication at doses and amounts needed.

This shortage appears to be due to a major manufacturer having difficulty producing it. Hopefully, this will only be temporary.

If you are taking an amphetamine for ADHD, you may want to speak with your doctor about what you should do if you cannot obtain the medication in doses and amounts you usually take.

Peter M. Hartmann, MD

Family Medicine and Psychiatry

Nuclear War and Acute Radiation Sickness

Nuclear War and Acute Radiation Sickness

https://phartm01.wordpress.com/2022/10/07/nuclear-war-and-acute-radiation-sickness/
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Putin has threatened to use nuclear weapons against Ukraine. Not long ago, Russia threatened to use them against the U.S. to bring Alaska under Russian control.

If nuclear weapons are used against Ukraine, is there any treatment for radiation sickness that begins within seconds of whole body exposure? One serious effect is widespread bleeding that can be fatal. Fortunately, there is a medication that can be administered by injection for this problem.

The US. has recently purchased a large supply from the manufacturer, Amgen USA. These would be used to save American lives in the event of whole body radiation exposure from any cause.

I don’t know if the US would provide it to the Ukraine if needed, but I imagine we would. To learn more about this, see my WordPress blog listed adjacent to this message.

Peter M. Hartmann, MD

Family Medicine & Psychiatry

Nuclear War and Acute Radiation Sickness

The Associated Press on September 28, 2022 reported that Russian President Vladimir Putin said that he “won’t hesitate to use nuclear weapons to ward off Ukraine’s attempt to reclaim control of Moscow-occupied areas …”.

Question: Are there treatments for acute radiation sickness? The answer is a qualified, “Yes.”

One effect of an acute full body exposure to radiation is uncontrolled bleeding. There is a medication named romiplastin (Nplate) produced by Amgen USA that can treat the bleeding. It works by increasing platelets, which are necessary to stop bleeding.

A supply of this medication has been purchased by the US Department of Health and Human Services’ Administration for Strategic Preparedness and Response for $290 million. The medication is intended “… to save lives following radiologic and nuclear emergencies.”

Nplate is also used to treat bleeding from immune thrombocytopenia unrelated to radiation exposure. It is administered by injection in both children and adults for this disorder or acute radiation sickness.

You can learn more by going to: medicalcountermeasures.gov

Peter M. Hartmann, MD

Family Medicine & Psychiatry

When You Eat Breakfast Affects Weight Gain

An article published in Cell Metabolism by Vujovic and colleagues on October 4, 2022 described their research comparing weight gain when eating an early breakfast compared to eating a late one. Their article was referenced in the AMA Morning Rounds on October 5, 2022.

The research identified several differences between test subjects who ate breakfast at different times. Eating early was defined as eating at about 9 am; eating late was eating breakfast 250 minutes later. The amount of nutrients were identical, and the amount of sleep, exercise and light exposure were the same.

Eating breakfast around noon resulted in several adverse outcomes for people wanting to limit weight gain. It resulted in more daytime hunger, less 24-hour leptin (hormone that decreases hunger), less energy used, lower core body temperature, and altered fat tissue gene expression that leads to increased fat storage.

The researchers stated, “combined, these changes upon late eating may increase obesity risk in humans.” They attributed these differences to effects related to the “circadian timing system.” This system is involved with a variety of biological differences affected by our 24-hour internal clock.

The bottom line is that eating breakfast closer to noontime likely causes more weight gain than eating the same food around 8-9 am.

Peter M. Hartmann, MD

Family Medicine and Psychiatry

New Medicine for Depression

Major Depressive Disorder (MDD) is one of the more common psychiatric illnesses. Treatments can include psychotherapy, oral antidepressant medications, transcranial magnetic stimulation, ECT, and ketamine (IV or nasal spray). Although these treatments can be effective for some patients with MDD, not all patients respond, some are very expensive, and the current oral antidepressants usually take weeks before being effective, if at all.

There is a new oral antidepressant that shows great promise in providing significant relief beginning in about one week. It is a combination of dextromethorphan and bupropion. The name is Auvelity. It has been approved by the FDA and is expected to be available sometime during the fourth quarter of 2022.

Some of you may recognize dextromethorphan as an ingredient in cough medicine. It attaches to certain chemical receptors in the brain (NMDA and sigma-1 receptors). It has been tested on over 1,000 research subjects with MDD in two different studies.

The dextromethorphan is combined with bupropion, a well-established oral antidepressant. In this case, a low dose of the bupropion is used to increase the blood level of dextromethorphan by blocking the enzyme that breaks down dextromethorphan.

As you would expect, there are possible side-effects. The more common ones are dizziness, headache, diarrhea, sleepiness, dry mouth, sexual dysfunction, and excessive sweating. They occur in a minority of patients and can be mild.

The availability of this new oral treatment is a helpful advance in treatment options for MDD.

Peter M. Hartmann, MD

Family Medicine and Psychiatry