April 2024
Effective Alternative to Skin/Hair/Nail Picking and Cheek/Lip Biting
A proof-of-concept study involved individuals exhibiting body-focused repetitive behaviors such as skin picking or hair pulling. In this study, participants were taught an alternative technique, which entailed making small circles on unaffected areas of the skin or tracing figure-8 patterns. The aim was to divert the urge away from problem areas. Participants were instructed to practice this technique daily to embed it into their muscle memory. The results indicated that individuals who adopted the small circular motion technique exhibited better emotional regulation, reduced instances of picking or pulling behaviors, and reported a slight alleviation in feelings of depression. The study reported a 75% satisfaction rate among participants with the new technique.
>> Dr. Neuman says: "Body-focused repetitive behaviors are common, and more so in folks with anxiety, depression, ADD, Autism, and many other conditions). These behaviors are often triggered by emotions; changing them, such as substituting damaging actions like picking scabs with non-harmful actions like tapping or circular motions, can contribute to physical healing and lessen the associated shame. Dr. Neuman suggests that transitioning to alternative techniques may be more effective than attempting to directly suppress the behavior, given that it is often driven by unconscious impulses that are difficult to control consciously. However, Dr. Neuman advises exercising gentleness when suggesting such changes to individuals exhibiting these behaviors, recognizing that they may not be ready or willing to make such adjustments. Practice of the new technique makes perfect. Be gentle if you suggest changing these behaviors to those around you; they may not want or be ready to change them."
Changing Statin Dose in Those with a History of Heart Disease
Statins medicines like Lipitor (atorvastatin) and Crestor (rosuvastatin) in people at high risk of, but never had, a heart attack, heart disease, or stroke lower the risk of these bad things by about 1%. Their efficacy is more pronounced in individuals who have already suffered a heart attack or have heart disease, with the potential to lower the risk of subsequent heart disease and mortality by up to 8% over a period of ten years. We used to use 'high-intensity' (strong dose) statins for everyone who has had a heart attack, stroke, or heart disease. A new study suggests using medium-intensity is just as safe as long as the LDL is below 70 mg/dL.
PrEP for Cisgender Women
Pre-exposure prophylaxis (PrEP) is a preventative strategy involving the use of specific antiviral medications, either as needed or daily, to reduce the risk of HIV transmission. Extensive research has demonstrated the safety and efficacy of PrEP in men and transwomen. However, until recently, there has been a lack of studies focusing on cisgender women.
A large, long-anticipated new study shows that it is safe and effective for cisgender women to take PrEP. Currently, we have three PrEP options. Pills include Truvada and Descovy. An injection option, Apretude, was approved in 2021.
>> Dr. Neuman 0.8% of participants in the study were from the U.S. I'm unsure of how generalizable the results are. It will be interesting to see recommendation statements come out from professional societies and who (all ciswomen with multiple partners? only some who do XYZ?) they suggest consider starting PrEP."
