INFOGRAPHIC: ‘PFIZER’S VACCINE INGREDIENTS & TREATMENT INFORMATION’
THE DOCTORS 101 CHRONIC SYMPTOMS & CONDITIONS #31: COLD SORES
“Fever Blisters”, or “Cold sores” are caused by infection, almost always, with the Herpes Simplex 1 virus. Herpesvirus infestations are present in 50% of the population, usually causing little disturbance. The symptoms on first exposure depend on the Age the virus is first acquired.
NEONATAL Herpes can be extremely serious, due to the immaturity of the infant immune system. Herpes acquired in CHILDHOOD, or Primary herpetic Gingivostomatitis, can cause very dramatic FEVER, with blisters in the mouth, that lasts for a week to 10 days, causing lots of misery and hand-wringing but having a good outcome.
I had one such case early in my pediatric residency at Walter Reed Army Hospital, a young French boy named Didier Dupont. He screamed with pain, and wouldn’t eat or drink. His parents thought that he was going to die, and that I saved his life, neither of which was true. My roommate and I lived in the same housing complex as the Duponts, and enjoyed many fine french meals with them, one of the few positive events to result from an encounter with Herpes Viruses.
The first acquaintance with Herpes in ADULTHOOD produces outcomes ranging from no symptoms at all, to a flu like syndrome with mouth blisters. Many people have positive blood tests for herpes, but cannot recall any mucosal burning, blisters or pain, so Herpes can enter the body without producing memorable symptoms.
The Herpes 1 Virus gains entrance to the body through the lining of the lips, mouth or nose(or through broken skin), and travels up the local nerves to the cell body in the local Trigeminal ganglion. There it remains quietly, until some STRESS reduces the resistance, allowing it to awaken and travel back down the nerves to the “mucocutaneous junction”, where the skin thins out into the lining of the nose, mouth, or occasionally the eyes.
There it multiplies and forms painful blisters, or “cold sores”. Sunburning of the lips, a “cold”, or psychological strain are examples of the stresses that can trigger cold sores. Reduced resistance is the common factor.
The Acyclovir family of drugs is usually effective in treatment, and works by inhibiting DNA Polymerase. These oral medications can be given to curtail each episode, if cold sores are infrequent, or continuously to reduce the number of outbreaks.
Herpes 1 is a double stranded DNA Virus in a family that includes Herpes 2, Chickenpox, the EB virus of mononucleosis fame, and Cytomegalovirus, which is the bane of organ transplant recipients. A nasty Clan indeed, and very successful in evolutionary terms.
–Dr. C.
HEALTH: VALUE OF A HEALTHY ‘SKIN MICROBIOME’ (VIDEO)
Our skin is home to billions of microorganisms, the vast majority of which are bacteria. Much like the microbiome in our gut, these microbes play a crucial part in keeping us healthy. They are part of a finely balanced ecosystem of friendly or ‘commensal’ bacteria, which protect our skin by creating an inhospitable environment for would-be invaders, bolstering the physical integrity of the skin, and training the immune system to distinguish commensal inhabitants from pathogens. A number of skin conditions are now understood to be influenced by a breakdown of this microbial ecosystem. Researchers are working out whether restoring the balance can treat these conditions. Understanding the ecology of this rich community is likely to be an important part of both dermatology and the study of the microbiome. Read more in https://www.nature.com/collections/sk…
THE DOCTORS 101 CHRONIC SYMPTOMS & CONDITIONS #30: ACNE (Vulgaris)
ACNE is almost a rite of passage in adolescents, although it is not totally restricted to the teen years; women may experience acne during pregnancy, or at the time of menopause. It afflicts about 90% of kids during their PUBERTAL growth spurt, though is moderate or severe in only 15%.
Acne is caused by PLUGGING of the sebaceous glands of the skin. Infection by certain skin BACTERIA follows. Check the accompanying video for a description of the battle between the “Good guys”, Staph epidermidis and Cutibacterium acnes, vs. the bad guy, Proprionibactrium
acnes.
Acne tends to run in families. The steroid HORMONES like Testosterone and Cortisone promote Acne. STRESS tends to chronically raise Cortisol and is a factor in Acne, and many chronic illnesses as well.
A person who is having trouble with Acne should avoid sweets and greasy foods, which is a good idea for everybody. Skin cleansers, using salicylic or azelaic acids and benzoyl peroxide may help, and creams containing retinoic acid derivatives may be useful..
The doctor may prescribe an antibiotic like tetracycline in resistant cases. Cystic acne may be scarring, but otherwise “the zits” depart with the pubertal years.
–Dr. C.
PATIENT EDUCATION: THE “2020 WEEKLY CROSSWORD PUZZLE CHALLENGE” (DEC 14)
DR. C’S PODCAST: WEEKLY MEDICAL NEWS (DEC 13)
DR. C REVIEWS MAJOR HEALTH AND TELEMEDICAL NEWS FOR THE WEEK ENDING DECEMBER 13, 2020.
HEALTH: WHAT ARE ‘SALIVA TESTS FOR COVID-19’? (VIDEO)
Screening testing is one tool the University of Pennsylvania is using to help reduce the risk of COVID-19 spread within the University community. That’s why we’re performing saliva-based viral testing for students, faculty, postdocs, and staff who are on campus.
THE DOCTORS 101 CHRONIC SYMPTOMS / CONDITIONS #29 UNEXPLAINED WEIGHT LOSS
Unexplained weight loss is rare in our society, where weight gain is so common. Weight loss usually occurs in the context of a causative illness, like prolonged diarrhea, where it is not the main symptom, but just an associated problem. However, sometimes the loss of 5 or 10% of the body’s weight can occur in a few months without explanation or clues, and a consultation is needed.
Proper Nutrition is critical for Health, including maintenance of “normal” weight. The Gastrointestinal tract extracts nutrients from the food we eat, and illnesses such as COELIAC DISEASE, or REGIONAL ENTERITIS can prevent proper absorption. Our HORMONES regulate energy and chemical balance, and Thyroid, Parathyroid, Pancreas and Adrenal malfunction can disturb weight Homeostasis.
Chronic infection, such as AIDS and TB can sap energy quietly. NEUROLOGICAL PROBLEMS such as Depression, Dementia or Parkinsons can result in an improper diet, and subsequent weight loss. CANCER is the first thing we worry about when we unexpectedly lose weight, but Neoplasms usually betray themselves with other, more dramatic symptoms.
It is a good idea to regularly check your weight at the same time every day. Almost always it will reassure you by staying the same. Sometimes it will warn you to cut your feasting. Occasionally an unexpected drop in weight will direct you to your Doctor to find an explanation.
–Dr. C.
COVID-19 INFOGRAPHIC: ONE-YEAR PROGRESS OF TREATMENTS & VACCINES
THE DOCTORS 101 CHRONIC SYMPTOMS AND CONDITIONS #28: CERVICAL POLYPS
Cervical polyps are fairly common, particularly in young women who have had children. They are rare before periods start, and uncommon after menopause. Polyps are often silent, without symptoms.
Polyps are often silent, without symptoms. Polyps are often associated with INFLAMMATION, and may be discovered because of vaginal DISCHARGE. They may bleed and betray themselves by heavy periods, or BLEEDING between periods.
My Daughter, a Student Health Physician, recently saw a patient who presented with a foul discharge and examination revealed a large polyp. A blood count showed a severe ANEMIA.
Although cancer is rare, the polyp should be biopsied or removed and examined to be sure there is no malignancy. Cervical Polyps are often discovered on a routine Physical Examination. Preventative Physical and Vaginal examinations in young women are important to check for such conditions as Polyps, do PAP smears, and, in sexually active women, screen for STDs.
Doctors Without Waiting Rooms 