Corona Virus – Update

I have been receiving multiple calls and inquiries from patients concerned about travelling within the continental United States and exposure to Coronavirus or its new name, Covid-19. To date, there have been NO cases identified in the general population outside the high-risk groups whose exposure came in China or from exposure to sick individuals who caught their illness from someone who had been to China. While the quarantine has slowed the spread of the virus here in the continental United States, there are still many unknowns such as:

  1. What are the different ways it is transmitted?
  2. Can asymptomatic persons transmit the disease before they become ill and how far in advance of symptoms can they be contagious?
  3. How long can the untreated virus live and transmit the disease on a surface such as a tabletop or doorknob?
  4. How aggressive is this virus? What percentage of the patients who contract the illness get minimally ill? What are the unexpected risk factors for severe complications? Why is the illness sparing children – for the most part?

If you have travel plans in the USA, I suggest you go. Given the season, it’s far more likely to contract illnesses such as cold or influenza.

When you travel, as always, wash your hands frequently and keep them away from your face.  Wipe down surfaces with antiviral commercial preparations frequently.

If you still haven’t received your flu shot, get one now!  Consider a second seasonal flu shot if it has been more than 3 months since the original one. However, expect to pay for the second shot since most insurers do not cover it.  Also, most pharmacy technicians will say you don’t need it.

Do not hesitate to call me if you are my patient and have any questions.

Staying Alive and Dog Ownership

A recent article published in the Journal of Circulation and Cardiovascular Outcomes looked at the effect of owning a dog on survival and mortality. The authors looked at research studies published between 1950 and May 2019.  They reviewed studies that evaluated dog ownership with all-cause mortality and cardiovascular related deaths. The studies looked at almost 4 million patients and 515 events.

Dog ownership was associated with a 24% risk reduction for all- cause mortality when compared to non-ownership with six of the studies showing a significant reduction in the risk of death. Those individuals who previously had a cardiovascular event had an even more pronounced reduction in the risk of death of all causes. When they reviewed the issue of cardiovascular death risk in dog owners who had a previous cardiac event, the risk reduction for cardiovascular death was 31%.  They reviewers dog ownership is associated with lower risk of death over the long-term, which is possibly driven by a reduction in cardiovascular mortality.

Two years ago my wife and I lost our treasured Pug of fifteen years, “Pug sly” and his sweet mix breed partner “Chloe.”  Losing these two a year apart was like losing beloved family.  We adopted a rescue Pug and then young pup who had been returned to its breeder.  At our first dog checkup with the new pets and our vet my wife expressed concern that at our age the dogs might out-live us. Our vet told us that if that were to occur, and no family members wanted the dog, he and his family would adopt them and care for them. He said that practice is common in many practices and they encourage senior citizens who can provide a loving and caring home to not worry about that aspect of continued care and adopt a dog.  While there is no data on this topic, I suspect pet ownership of cats and birds and other domestic animals requiring care and love confers similar benefits.

PLCO Data Support Protective Effect of Aspirin in Preventing Deaths

In recent months, the US Preventive Task Force has recommended adults without diabetes or documented coronary artery disease avoid taking baby aspirin to prevent heart attacks and strokes. They believe the risk of bleeding outweighs the benefit derived. They still recommend aspirin prevention in men with known cardiovascular, cerebrovascular disease and diabetes.

The Prostate, Lung, Colorectal and Ovarian Cancer Trial (PLCO) just made the decision-making much more complex. In their study, reported in this month’s JAMA Network Open, they found that taking aspirin as infrequently as 1 to 3 times per month reduced the risk of all-cause and cancer related mortality compared to no aspirin in their study with 146,152 patient participants.

Weekly use of aspirin significantly reduced the risk of mortality from both GI and colorectal cancer and all mortality endpoints irrespective of how heavy you were. When the study looked at 12.5 years of aspirin use 1 to 3 times a month, compared to none, the all-cause mortality was reduced by 16%. The results were even more encouraging when aspirin was taken three or more times per week.

The PLCO Cancer Screening Trial involved participants aged 55-74 who were randomized to a cancer screening group or a control group at 10 United States Medical Centers. This review looked at men and women 65 years or older at baseline. While this study showed a beneficial effect of aspirin in the elderly, other recent studies have been less favorable. The ASPREE study, Aspirin in Reducing Events in the Elderly, found that individuals taking 100 mg of aspirin daily were at increased risk for all-cause mortality compared to those taking a placebo.

The decision to take low dose aspirin, or not, is something you should discuss with your physician so that you can tailor the situation and risks to your personalized needs.