geoffrey modest medical blogs

  A recent article reviewed the clinical presentations and epidemiology of monkeypox infections worldwide ( see  monkeypox clinical presentation NEJM2022 in  dropbox, or DOI: 10.1056/NEJMoa2207323 )      Details :  -- 528 infections (confirmed by PCR) diagnosed between April 27 and June 24, 2022 at 43 sites in 16 countries (90% from    Europe and 6% from North America, but also from Argentina and Israel)  -- those infected: 98% gay or bisexual men, 75% white, median age 38, 41% had HIV infection (controlled: in 97% with HIV VL <200, CD4 680)  -- concomitant sexually transmitted infection: 109/377 (29%): 33 with syphilis (9%), 32 gonorrhea (8%), chlamydia 20 (5%), others 1% each)  -- positive hepatitis C antibody: 30 (6%)  -- history of smallpox vaccination: 49 (9%)  -- transmission: 95% through sexual activity       -- median number of sex partners in prior 3 months: 5  -- clinical features: 95% had a rash (64% had 10 or fewer lesions): 73% had anogenital lesions; 55% trunk, arms or

A recent article evaluated metformin, finding it has a wide array of potential benefits independent o f those  for diabetes (s ee  dm metformin drug for all diseases metab2022  in dropbox, or doi.org/10.1016/j.metabol.2022.155223); this article is replete with references (474 of them) to back all of the following findings    Review:  -- metformin is a synthetic biguanide, first used to treat type II diabetes in the late 1950s and has for years been the first choice drug for approximately 150 million diabetic patients      -- it was developed as an antidiabetic med based on  information   going  back to the 17 th  century  when  extracts of French Lilac (Galega officinalis, also called goat’s rue, Italian fitch, and, in the US, Professor Weed)  were  used to treat people with ‘sweet urine’      -- French Lilac extracts have the toxic alkaloid galegine, which was synthesized in the late 19 th  century to guanidine and biguanides (found to decrease blood sugar in rabbits) and subsequently