Posted in Health, news, sex

WHO Declares Sex Addiction a Mental Health Disorder

This month, the World Health Organization, WHO, declared compulsive sexual behavior disorder, or sex addition, a mental health condition. Here are your questions answered.

What is sex addiction?

Sex addiction is defined as an inability to control sexual urges or impulses leading to repetitive sexual behavior that disrupts health, home or work life, most of which does not yield enjoyment or intimacy.

How common is sex addiction?

Approximately 3-6% of US adults qualify as having a compulsive sexual disorder, which equates to 7-14 million adults.

How is sex addiction diagnosed?

Criteria for diagnosis, according to Psychology Today, include:

  • Symptoms must occur for at least 6 months
  • An individual experiences recurrent and intense sexual fantasies, sexual urges, or sexual behaviors
  • The time spent engaging in sexual fantasies, urges, or behaviors consistently interferes with other important activities and obligations
  • Sexual fantasies, urges, or behaviors occur in response to dysphoric mood states (anxiety, depression, boredom, irritability) or stressful life events
  • An individual engages in consistent but unsuccessful efforts to control or reduce their sexual fantasies, urges, or behaviors
  • An individual engages in sexual behaviors while disregarding the potential for physical or emotional harm to self or others
  • The frequency or intensity of sexual fantasies, urges, or behaviors cause significant personal distress or impairment

Can sex addiction lead to other mental health illness?

Sexual addiction may often coexist with other struggles such as depression, anxiety, bipolar disorder, alcoholism or drug use.  The compulsive sexual behavior may precede, follow, or be a symptom of a current mental illness.

How is sex addiction treated?

Treatment of sexual addiction may include group therapy, behavioral and cognitive therapy, treatment of underlying issues and other behavior modification techniques.

 

Who suffers from sex addiction?

Anyone can suffer from sex addiction.  It knows no boundaries when it comes to gender, age, race or occupation.

Stars who have opened up about their sex addition include:

  • Jada Pinkett Smith
  • Russell Brand
  • Kanye West
  • Michael Douglas
  • Lindsey Lohan
  • Rob Lowe
  • Tiger Woods
  • David Duchovney
  • Colin Farell
  • Charlie Sheen

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Does watching porn lead to sex addiction?

Although some sex addicts frequently view porn, watching porn does not constitute a sexual addiction.  However, the number of those addicted to porn is rising, and those individuals need treatment for a porn addiction.

How does watching pornography affect health?

Although we do not have any definitive studies telling us porn is good or bad for our health, there are many opinions on the matter.

One concern is inactivity and time spent in front of a screen.  Sitting in front of a computer, tablet, or hand-held device watching hours of porn could increase risk of a blood clot, heart disease and (prolonged sitting) has been linked to colon cancer.  However, according to PornHub, the average time spent viewing porn only ranges from 9-13 minutes.

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What about lack of sleep? Are people secretly watching porn at night, and not getting their 7-9 hours of uninterrupted rest?

According to PornHub the most common time during the day to watch porn was between 10 pm and 1 am.  If one is only online for 10 minutes and falls asleep afterwards, they may still receive a good amount of sleep.

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What about the risks of frequent masturbation?

In 2009 a study found frequent masturbation in young males could increase their risk of prostate cancer, but in older men (>50 years), reduced their risk.  Other studies have suggested reduced risk of prostate cancer that occurs in older men but not aggressive cancer in younger men.

Excessive masturbation could affect one’s refractory period, or time it takes to form an erection again after sex.  For some this could last 15 minutes, for others a week.  So if a date night is planned for later that evening, one with a long refractory period could have issues.

Chafing and inflammation can also occur but are usually rectified with a change in modality.

For more on sex addiction see here.

For more on porn addiction see here.

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

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Posted in food, Health, news

Parasite Outbreak Linked to Veggie Trays Causing “Explosive Diarrhea”

Del Monte Fresh Produce has had to initiate a vegetable tray recall when over 200 people fell ill to an intestinal parasite.  According to the CDC, as of July 5, 2018, 212 cases of Cyclospora occurred in individuals who consumed broccoli, cauliflower, carrots and dill dip in their Del Monte Fresh Produce Vegetable Tray.  Thus far the states involved include Wisconsin, Michigan, Iowa and Minnesota.  Indiana and Illinois consumers are also being warned of the recall.

The parasite involved is called Cyclospora cayetanensis, causing an intestinal infection called cyclosporiasis.

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Cyclosporiasis may occur when one consumes contaminated food and water and symptoms include abdominal pain, bloating, nausea, vomiting, fever, loss of appetite, weight loss, headache, and watery diarrhea.

Explosive diarrhea has been reported in severe cases and occurs when the loose stools are passed very quickly and abruptly and may even make loud sounds.

Treatment of cyclosporiasis includes fluids, rest and antibiotics such as trimethoprim-sulfamethoxazole, Bactrim.

The CDC posted the following on the recent outbreak:

    • On June 15, 2018, Del Monte Fresh Produce recalled 6 oz., 12 oz., and 28 oz. vegetable trays containing fresh broccoli, cauliflower, celery sticks, carrots, and dill dip. Recalled products were sold in clear, plastic clamshell containers.
        • Recalled products were distributed to the following stores: Kwik Trip, Kwik Star, Demond’s, Sentry, Potash, Meehan’s, Country Market, FoodMax Supermarket, and Peapod.
        • Recalled products have a “Best If Enjoyed By” date of June 17, 2018.
        • The recalled 6 oz. Del Monte Fresh Produce vegetable tray has a UPC code of 7 1752472715 2 found on the package label.
      • The recalled 12 oz. Del Monte Fresh Produce vegetable tray has a UPC code of 7 1752472518 9 found on the package label.
      • The recalled 28 oz. Del Monte Fresh Produce small vegetable tray has a UPC code of 7 1752478604 3 found on the package label.
    • Do not eat or sell recalled vegetable trays. Throw them away.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

Posted in fashion, Health, news

Ties May Disrupt Brain Circulation

A study out of Germany finds men who wear neck ties may have less blood flow going to the brain.

Published in the Journal Neuroradiology, the study led by Dr. Robin Luddecke of the University Hospital Schleswig-Holstein in Kiel, Germany found blood flow to diminish in those donning the professional look.

30 men were recruited, 15 wearing a neck tie and 15 with an open collar shirt. All had successive MRI scans and those in the first group were scanned wearing the tightened tie, loosening the tie but buttoning the collar, and loosening the tie and unbuttoning the collar.

The specific knot tested in this study was the popular Windsor knot, asked to be tightened to the point of slight discomfort.

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Inquisitr reported:  Based on the researchers’ findings, those who wore ties saw their blood circulation to the brain drop by about 4.33 mL/min/100 g, or about 7.5 percent, between the baseline scan and the second MRI, where the tie was tightened. The difference jumped to 12.8 percent from baseline during the final scan, right after the test subjects loosened their ties. Cerebral blood flow figures were similar across all three scans for those in the control group.  Interestingly, the researchers did not notice any statistically significant changes when it came to blood flow in the jugular vein.

That is interesting as the jugular vein, which transports blood from the brain, is more superficial than the carotid artery, which lies deeper, transporting blood to the brain.

 

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However this study was very small, only 30 subjects and I’m not convinced that its a compression on the arterial circulation that we’re seeing.  It could be the fact that a tightened tie causes discomfort around the windpipe which may affect blood flow, or affects the jugular vein causing back pressure to the brain, thereby sending a signal that decreases blood flow to the brain.

In 2010, a study by Rafferty et al found tight neck ties to increase intracranial pressure due to decrease of venous return.

In 2004 a case of “Tight Necktie Syndrome” was discussed by Dr. Gifford Jones in a businessman who began to experience headaches, blurry vision and right ear tingling from his tight shirts and collars.

In 2003 a study suggested intraocular pressure could rise with the wearing of tight ties, worsening glaucoma, a leading cause of blindness.

The moral? Ties should never be worn too tight. That’s why my favorite work uniform is…scrubs.

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Health, news, Politics

Hillary Clinton Rumored to be Running Again for President in 2020

One of the most bitter and exhausting elections may have a rematch if Hillary Clinton, postulated to make a third attempt at the Presidency, runs in 2020.

According to a piece in the NY Post, emails were sent by Clinton five times, touting how Onward Together, her Super PAC is poised to help defeat Trump, if he seeks reelection.

According to author Michael Goodwin:

Most seized on headline events, such as the family-separation issue at the southern border.
Under the message line, “horrific,” she wrote June 18: “This is a moral and humanitarian crisis. Everyone of us who has ever held a child in their arms, and every human being with a sense of compassion and decency should be outraged.” She said she warned about Trump’s immigration policies during the 2016 campaign.
Three days later, she was back again, saying that her group, Onward Together, raised $1 million and would split it among organizations working to change border policy, including the American Civil Liberties Union and a gaggle of immigrant, refugee, Latino and women’s groups.
And the day after Supreme Court Justice Anthony Kennedy announced his retirement, Clinton introduced a newly minted resistance partner. Called Demand Justice, it promises to protect “reproductive rights, voting rights and access to health care” by keeping Senate Democrats united in opposing any conservative Trump nominee.

Many times, rumors get circulated not by the opposing party but by the affected one in an attempt to test the waters to see how the nation would react prior to millions of dollars being raised.

So would another run by Hillary Clinton be viable, and more importantly, successful?

In 2016, she did have a successful campaign securing the popular vote of 65,845,063 to Trump’s 62,980,160.  One reason for her failure to secure the electoral college was her sideline battle with Bernie Sanders, 76, who will most likely not run again.

In fact, besides the media frenzy that surrounded Oprah’s presidential aspiration rumors, there has not seemed to be any media chatter regarding the next Democratic stand out.

Funding won’t be an issue as Clinton’s super PAC appears to have an easy time raising money for the already wealthy candidate.

However, her success will be based on a multitude of factors going right this time.

Her health will be at the center of discussion as footage of stumbles, dizzy spells, braces, and secret service agents donning syringes were previously captured and used to illustrate a medical record with a poor political prognosis.

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Democrats may frown upon Clinton’s age, who would be 72 during the next election, suggesting a two-term presidency would carry her into her 80’s.  And as presidents need to frequently stump for their Congressmen in tumultuous smaller elections, some may worry about her resilience and stamina.

Trump is gaining popularity.  With a stronger economy and lower unemployment rate democratic voters may find themselves doing better that they were a few years back making them less likely to “hate” the incumbent, despite disagreeing with some of his policies.

So do I think she’ll run?  Maybe.  Despite the Clintons hating to lose, they’ll seize an opportunity if no one else does.  As Ben Stein called roll in Ferris Bueller’s Day Off, we may hear the Democrats saying, “Anyone…..anyone……..?”

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in food, Health, news

Banana Survival Threatened by Deadly Fungus

Scientists are going bananas over the possibility of the fruit becoming extinct due to a widely spreading fungal disease.  Panama disease is an infection that has already ravaged banana farms in Africa, Australia, Central America, the Middle East and Asia.  If it spreads to South America, the most widely consumed banana, the Cavendish banana, may fall victim.

For those of us who tire of constantly throwing away the easily bruised and mushy fruit, we may not care and reach for an apple instead.

 

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But scientists are concerned that the fall of the Cavendish banana may be the end of the fruit’s species.

Panama disease (Fusarium Wilt) is caused by the fungus Fusarium oxysporum and is resistant to most fungicides.  Back in the 1950’s, the tropical disease nearly wiped out banana farms in South America but today’s strain appears more resilient and deadly.

 

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Image from ResearchGate

Scientists may have one recourse to save the species.  There are 5 rare trees in Madagascar that grow a wild banana and are resistant to the fungus.  Researchers are hoping they could hybrid the resistant properties of the rare Madagascar trees to the current bananas the world seems to enjoy in their banana splits.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

Posted in Health, news

Johns Hopkins TB Incident Caused by Broken Latch

Two buildings were evacuated Thursday when frozen tuberculosis was “spilled” at Johns Hopkins Cancer Research Building.

The spill occurred on the bridge between two buildings, not directly exposing patients.  Spokesman Ken Willis assured reporters this was an isolated incident stating, “Although we believe that this was a one-time event with no risk to anyone on campus, we take this event seriously and will conduct a thorough review of existing procedures, retrain staff and make any other needed improvements.”

According to the Baltimore Sun, pressure from a secondary interior container with dry ice pushed the frozen specimen out when the latch failed on the transport container.

The specimen was being used for research.

Dr. Karen Duus, Associate Professor of Basic Sciences, Microbiology & Immunology at Touro University Nevada states, “One of the basic safety rules when transporting a biohazardous substance is to place it in a primary and then a secondary non- breakable container. So the TB sample should have been encased in at least one additional container. The failure of the latch should have resulted in the sample in that additional container landing on the floor, but still contained when it slipped out. Result: no spill, even if the tube or vial broke upon impact.”

Tuberculosis (TB), once called “Consumption”, has been one of the deadliest lung infections in history.  With recent advances death rates have drastically dropped, but currently 1/3 of the world’s population is infected with TB and worldwide it ranks in the top 3 causes of death.

What is Tuberculosis?

TB was first discovered in 1882 by Robert Koch. It  is caused by the bacteria, Mycobacterium tuberculosis.  It’s an acid-fast staining bacteria (significant for diagnosis purposes) and it needs oxygen to survive, hence the lungs offer the perfect environment for this pathogen to grow.

How is Tuberculosis passed?

TB is passed by aerosol/droplet transmission so when someone coughs, sneezes, or passes respiratory fluid they could transmit TB.  It may also grow on contaminated surfaces.

What are symptoms of Tuberculosis infection?

Symptoms may include the following:

  • Coughing > 3 weeks
  • Coughing up blood (hemoptysis)
  • Pain with coughing and/or breathing
  • Weight loss
  • Fatigue
  • Fever
  • Night sweats
  • Chills
  • Loss of appetite

How is Tuberculosis diagnosed?

If a patient has any of the above symptoms the first test needed is a Chest Xray.  The chest xray may show an effusion (fluid), consolidation (area of the lung obscured with fluid/infection infiltrate), and lymphadenopathy (lymph node swelling). Ghon’s lesions (a necrotic, calcified focus of infection) and a Ghon’s complex (a Ghon’s lesion with lymph node involvement) may be seen as well.

Cultures of the sputum/mucous can be done but they take 4-6 weeks.  Acid-fast staining can be done on the sputum which will give a quicker diagnosis.

Can Tuberculosis spread?

Yes.  15-20% of the cases can be extrapulmonary.  Meaning “beyond the lung”, one could have extrapulmonary TB, with infections affecting the gastrointestinal tract, genitourinary tract, lymph nodes and lining of the brain.

Sometimes TB may disseminate throughout the lungs and body, this is called Miliary TB.  Miliary TB can spread to the above areas as well as heart, brain, and bone.

TB may also become “latent” and reactivate at a later date.

How is Tuberculosis treated?

Active TB needs to be treated for 6-9 months. The following medications include:

Isoniazid (INH)

Rifampin (Rifadin, Rimactane) (RIF)

Ethambutol (Myambutol) (EMB)

Pyrazinamide (PZA)

Initially we prescribe a 2 month “intensive phase” treatment of the above four drugs.  Then its followed by a “continuation phase” of only INH and RIF.

For latent TB cases we prescribe a 9 month regimen of INH.

Health care providers watch for liver toxicity and, especially with INH, vitamin B 6 deficiency.

 

Is there a vaccine for Tuberculosis?

Yes.  The BCG Vaccine was created in the 1920’s and it is the most common vaccine given outside of the US. Due to cost and its lack of efficacy (only 50% effective) its not given during routine vaccination here in the US. Moreover, it may interfere with PPD skin tests used for screening, as one vaccinated will show a positive result.

How do we screen for Tuberculosis?

The Mantoux, purified protein derivative (PPD) skin tests are given subcutaneously in the arm and read 48-72 hours later, looking for a red marking.

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Two steps are done a week apart to ensure against false negatives.

IGRA – Interferon Gamma Release Assay blood tests, such as QuantiFERON®, can be done and provides results within 24 hours.  It is beginning to replace the PPD test for screening in many healthcare settings.

Who is at risk for acquiring TB?

High risk populations include the following:

  • Healthcare workers
  • Prisoners
  • Homeless shelters
  • Nursing homes
  • Alcoholics
  • Chronically debilitated
  • Those with HIV

Where is TB the most common?

Countries with the highest TB rates include:

  • India
  • Indonesia
  • China
  • Nigeria
  • South Africa
  • Philippines
  • Pakistan
  • Bangladesh

50% of all cases in the US are immigrants coming from any of the above countries.

How does one prevent TB?

In addition to vaccination, and treating household/close contacts of those infected with TB, prevention includes the following:

  • Education
  • Homes with good ventilation
  • Avoidance of sick household contacts
  • Avoid close quarters with large amounts of people

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Health, news

Doctor’s Tattoos and Piercings Don’t Turn Off Patients

Image above from AllPhysiciansJobs.com

A study finds patients don’t mind their ER doc’s body art.

Researchers from St. Luke’s University Health Network in Bethlehem, Pennsylvania surveyed emergency room patients who rated the providers on a five point Likert scale on their perception of competence, professionalism, caring, approachability, trustworthiness, and reliability in their doctor.  Their findings found patients had “no perceived difference” in the above metrics, “and assigned top box performance in all domains >75% of the time, regardless of physician appearance.”

So Can Medical Students Break out the Nose Ring?

No, not so fast.  Although body art is beautiful, and accessorizing with piercings can make our dreary scrubs pop, the average physician is fighting more and more these days to capture the faith of the patient who keeps turning to the web for medical advice.

The above study surveyed patients in emergency rooms….a setting in which patients are desperate to receive care in an emergency and are grateful, on most occasions. What about the oncologist who needs to give somber news about a patient’s cancer?  Would patients appreciate the skull and crossbones tattoo on his neck? Probably not.

 

 

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Piercings and tattoos make a statement, tell a story, or add character to the body on which they adorn.   And the attention they command is why I’m such a fan.  So I agree that it has no bearing on one’s “competence, professionalism, caring, approachability, trustworthiness, and reliability.”  However, in many medical scenarios the patient needs to feel he is the main focus.  Patients want to believe we providers wake up, eat, exercise to maintain our health, dress, and wash our hands for them.  And they’re right…we do.  So our personal style, statements and stories are kept to a minimum at work.

It’s unfortunate because I was really hoping to get the following Lord of the Rings tattoo of Aragorn when hubby wasn’t looking….

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For more on the study see here.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada