The American Heart Association and the American Stroke Association have updated primary guidelines to help people to prevent a first stroke. Every 40 seconds, an American has a stroke, and, every three minutes, an American dies from a stroke. Over 600,000 Americans will have their first stroke this year, a preventable event if underlying risk factors are controlled or eliminated.

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Walking pneumonia rates are higher than the past 7 years, rising since early spring and peaking in August. The Centers for Disease Control and Prevention (CDC) has warned that many of the recent ER visits and hospitalization stays for pneumonia have a diagnosis of walking pneumonia, which is uncommon.

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Liver cancer or hepatocellular cancer is the 6th most common cause of cancer and the 3rd leading cause of cancer deaths worldwide. In the US, liver cancer is the 6th leading cause of death.

Common risk factors of liver cancer:

•Cirrhosis or liver scarring and it’s underlying risk factors (20% of cases of liver cancer form without cirrhosis present, yet in the presence of or more of the below conditions)

•Metabolic Dysfunction-Associated Steatotic Liver Disease (formerly, non-alcoholic fatty liver disease) of which obesity, diabetes and high cholesterol are risk factors

•Hepatitis B and Hepatitis C (transmitted via body fluids, commonly during sex, childbirth (mother to fetus) or with IV drug use)

•Alcohol

•Smoking

•Aflatoxin (a fungus that may grow on grains and nuts improperly store in hot and humid environments)

Common symptoms of liver cancer:

•None

•Abdominal discomfort

•Abdominal swelling

•Nausea or vomiting

•Gastrointestinal bleeding

•Weight loss

•Loss of appetite

•Jaundice (yellowing of the skin and whites of the eyes)

•Easy bruising or bleeding

•Persistent itching

•Fatigue

•Fever

Populations at increased risk for liver cancer:

Nationally, the highest rates are seen in Asian/Pacific Islanders and American Indian/Alaskan Natives. Rising rates have been noted in the Latinx population.

Globally, rates are actually highest outside the US, in sub-Saharan Africa and Southeast Asia.

Liver cancer prevention:

•Eat whole food, plant-forward nutrition (fruits, vegetables, lean proteins, whole grains, minimal saturated fat)

•Reduce alcohol intake or abstain https://www.cdc.gov/alcohol/about-alcohol-use/index.html

•Get screened for and vaccinated against hepatitis B (infants, children and adults) https://www.cdc.gov/hepatitis-b/index.html

*Get screened and treated for hepatitis C (no vaccine currently exists and many patients are without symptoms, which often only occur with advanced disease.) https://www.cdc.gov/hepatitis-c/index.html

•Practice safer sex with regular condom use (including same gender couples)

•Get screened for STDs annually or with every new partner

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