INFOGRAPHIC: ‘STOP THE SUPERSPREADING TO STOP THE COVID-19 PANDEMIC’
Category Archives: Men’s Health
THE DOCTORS 101 CHRONIC SYMPTOMS & CONDITIONS #18: SKIN INFECTIONS
The skin is the protective barrier between the inside of our bodies and the outside world of microorganisms, parasites and toxins. It is often the site of inflammation and infections.
In past times, before the advent of cleanliness and antibiotics, mankind was plagued by erysipelas, boils, carbuncles, and other severe infections of the skin, which are rarely seen now. The beta hemolytic streptococcus and Staphylococcus aureus were ubiquitous in the past, and mostly are contained today.
Severe Infections presently require some skin abnormality, immune deficiency, neglect, animal bite or other breach of skin integrity to be a problem. Antibiotic resistance, however, is allowing some organisms like MERSA to make a comeback.
ECZEMA. or Atopic Dermatitis, was common in my medical practice. This condition weakens the skin barrier, allowing Staphylococcal infection to gain a foothold. In my day, If there were a flare of eczema severity, antibiotics would often help. Leg edema and swelling. such as from heart failure, especially coupled with diabetes and blood vessel disease is also an invitation to infection, such as cellulitis.
Redness, swelling, warmth and pain- the classic rubor, tumor, calor and dolor- as well as swollen local lymph nodes and fever often betray infection of the skin. Please see the recently posted infographic on celulitis.
IMMUNE DEFICIENCY raises the likelihood and risk of severe skin infections. Infection from “flesh-eating bacteria”, often beta hemolytic streptococci in deep tissue planes , is a medical emergency. Immediate surgery is often needed.
Disproportionate PAIN after injury or surgery is often a clue. Certain age groups have characteristic skin infections, such as the scalded skin syndrome of infants, and the acne of adolescents. Viruses, molds, and arthropods can also infect the skin.
Viruses, such as herpes in particular can simulate bacterial infection. Ringworm from fungi is easy to distinguish, but arthropod bites, and especially bee sting can look very much like bacterial infection. Scabies and mite infestation are so itchy as to be distinct.
Topical antibiotics applied on skin breaks like cuts or breaks are useful in preventing infection. These ointments and creams are like “artificial skin”. Once again, prevention is key.
–Dr. C.
INFOGRAPHICS: ‘CELLULITIS’ – ITS CAUSE & TREATMENT
CDC INFOGRAPHICS: ‘HEAT STROKE & HEAT EXHAUSTION’
COMMENTARY:
THERMOREGULATION, preservation of the normal body temperature, is well developed in humans, and monitoring the body temperature has been useful since the development of thermometers.
Indirect measurement by Infrared detectors is being widely used today to detect FEVER as a sign of Covid in gatherings such as schools. Reactive increase of body temperature in a cool environment is a body defense mechanism that I have discussed earlier. Contrary to general practice, Fever, in my opinion, should be left untreated unless excessive, such as above 103 degrees F., or even 104 degrees.
Excessive environmental temperature, such as in a closed car, Jacuzzi, or heat wave can defeat the body’s ability to defend the normal temperature. Children, with their high body surface to mass ratio, are particularly at risk, as periodic newspaper articles testify. HEAT STROKE is the most serious of heat-related illnesses, leading to high and increasing body temperature, mental symptoms, even convulsions, and is a MEDICAL EMERGENCY.
The treatment is to call 911, and to lower the body temperature by removing insulating clothing, and immersing in cold water. There are a variety of other conditions based on excessive exertion, water or salt loss.
These include HEAT EXHAUSTION. Older Workers are particularly susceptible, and medical clinic attention may be needed for fluid and electrolyte replacement. MUSCLE CRAMPS and even damage( Rhabdomyolysis), FAINTING (this has been discussed before) and Heat Rash can result from too hot an environment. Furry Animals Pant instinctively to get their highly vascular Tongue to “air condition” their bodies. Humans should dress and exercise appropriately when the environment requires it.
–Dr. C.
INFOGRAPHICS: ‘THE BURDEN OF FLU & BENEFITS OF FLU VACCINATION’ (2019-2020)
MEDICINE: ‘THE FUTURE OF NEUROSURGERY’ (VIDEO)
NYU Langone’s Kimmel Pavilion is home to the region’s newest and most technologically sophisticated neurosurgery suite. Designed to optimize patient care, our facilities are just one reason U.S. News & World Report’s “Best Hospitals” ranks NYU Langone among the top 10 hospitals in the country for neurology and neurosurgery.
Learn more about neurosurgery at NYU Langone and meet our renowned surgeons: https://nyulangone.org/locations/neur…
HEALTH VIDEO: ‘SURGEON GENERAL HYPERTENSION REPORT’ (JAMA NETWORK)
The US Surgeon General’s office has released a report emphasizing the importance of making hypertension control a national public health priority. Vice Admiral Jerome Adams, MD, MPH, the 20th US Surgeon General, discusses the report’s background and recommendations.
Recorded October 7, 2020.
THE DOCTORS 101 CHRONIC SYMPTOMS & CONDITIONS #18: ACTINIC KERATOSES
Red hair and freckles are associated with MCR-1 gene variants, and large areas of skin with lowered melanin protection against the adverse effects of the sun. I have red hair and freckles, for which I was teased. My response was that I had a lot of Iron in my blood, and that the freckles were Rust. This is ironic (no pun intended).
Since becoming an Octogenarian, I have had trouble keeping my Iron levels normal. I live in a beach area, where all the young ladies are sunning themselves to promote the socially desirable “bronze goddess” effect, and all of the older ladies hide their leathery skin and wear broad-brimmed hats.
The sun has a good reputation as a health-giver. Being outside does correlate with a lot of beneficial effects, such as enhancing production of Vitamin D. My recommendation, however biased, is to get your Vitamin D in capsule form, and reduce sun exposure.
SUNSHINE, however salutary, is accompanied by invisible, high energy photons capable of breaking DNA strands, and ultimately causing SKIN CANCER. Not accidentally,Visible light has insufficient energy to break bonds, although the rhodopsin in rods and cones do release electrons if stimulated by light.
Actinic Keratoses are the roughened plaques of skin, often on the face, which have a small but definite risk of turning into Cancer. I have a dermatology check every 6 months for precancerous areas to be frozen and destroyed by CO2 spray.
PREVENTION of UV Skin damage is advisable. I wear a broad brimmed hat and UV-blocking sunglasses (UV can promote cataracts and retinal damage as well) when outside in the sun. When swimming I wear a “rashguard” shirt with UV protection in the fabric.
Also, I try to limit my exposure to the Evening and Morning sun, because the light is warmer, and contains less UV. Even with these precautions, I use Sunscreen creams and lotions. I always wondered how a transparent lotion can block UV light.
The explanation lies in the chemicals contained. Such chemicals as Avobenzone and Homosalicylate actually absorb the energy of UV light. Protect yourself now for later health.
–Dr. C.
MEDICAL: ‘JOHNS HOPKINS MUSCULOSKELETAL CENTER’ – FOR MUSCLES, BONES AND CONNECTIVE TISSUES (VIDEO)
The Johns Hopkins Musculoskeletal Center aims to streamline and improve access for diagnosis and treatment of conditions affecting muscles, bones and connective tissues. Each of the center’s locations feature a diverse group of physicians, therapists, and advanced practitioners who work together to bring you the right treatment at the right time.
VIDEOS: DIAGNOSING AND TREATING COVID-19 (MAYO)
Dr. Stacey Rizza, an Mayo Clinic infectious diseases specialist, discusses the various ways COVID-19 is diagnosed and treated.
COVID-19 can be diagnosed several ways when looking for active infection.
“The most common way that testing is done is with a swab into the nose or into the nasal pharyngeal area,” says Dr. Stacey Rizza, a Mayo Clinic infectious diseases expert.
“This polymerase chain reaction (PCR) test is essentially a test looking for the genetic material of the virus.” If it’s positive, it means that person is infected with SARS-CoV-2, the coronavirus that causes COVID-19.
COMMENTARY:
Dr. Stacey Rizza from Mayo Clinic gave the standard Academic recommendations for Covid Testing and treatment. I will comment on how this differs from the testing recommendations of Dr. Michael Mina from the Chan school at Harvard and the actual treatment given to Donald Trump as we speak.
I agree with the latter recommendations, and route that I would opt for, were I to catch Covid 19. TESTING, if it is to be Epidemiologically effective should offer results that are rapidly available so as to reduce spreading of the virus and treatment delay. One trouble with PCR- based tests is that they are slow. Another trouble, according to Dr. Mina, is that if they run for 40 cycles for maximum sensitivity, they may pick up viral shedding that is too minor to be infective, and may cause unnecessary precautions, such as quarantining. If they run for 35 or even 30 cycles to show only infective, actionable cases, they take several days, and even then labs do not usually report the number of cycles run, but only yes or no, positive or negative.
The RAPID TESTS detect viral protein are available within hours. They are less sensitive, but in Dr. Mina’s view, this can be a virtue, since only definitely infected patients are identified. They are cheaper, and can even be done on site. Frequent testing more than makes up for decreased sensitivity. Most tests currently available use only specimens from nasal swabs, which are uncomfortable.
SALIVA is almost as sensitive, and has one additional virtue, when it comes to testing school children. If school children are organized into learning “pods”, They can all spit into a common collector, and the pod tested preemptively, at least twice weekly. If positive The entire pod is individually tested to find who is positive. Of course if a full 20 kids are in a pod, The sensitivity of the protein test may be insufficient for positive to survive a 20-fold dilution, but this can be empirically worked out. Twice weekly testing vs. every other week is much better for reducing the number of the pod members infected at time of discovery, as the NYT has illustrated.
TREATMENT given to Donald Trump has so far consisted of more than Remdesivir. He is also receiving Corticosteroids, plus an experimental double antibody mixture, derived from both Covid Convalescent serum, and monoclonal antibodies from a “humanized” murine source. The antibodies should theoretically be given early. The corticosteroids are generally not given until a bit later, but with the reported drop in O2 sats, he may be later in the disease than we are led to believe. To my knowledge, he is not receiving his tweeted Hydroxychloroquine- azithromycin combination.
If I were infected, at age 88, I would also like the antibody treatment, but most likely would not be allowed to get it.
Doctors Without Waiting Rooms 