Tag Archives: Infection

HEALTH: “COMPRESSION THERAPY” REDUCES CHRONIC CELLULITIS & LEG EDEMA

New England Journal of Medicine (Aug 13, 2020) – In this small, single-center, nonblinded trial involving patients with chronic edema of the leg and cellulitis, compression therapy resulted in a lower incidence of recurrence of cellulitis than conservative treatment.

The researchers have conducted a single-center, randomized, nonblinded trial that aimed to find out an association between the compression therapy and controlled incidents of chronic edema of the leg and people with cellulitis that can be defined as an infection of the skin that involves subcutaneous tissues or the innermost layer of the skin. Cellulitis can be caused by trauma or scratching of other lesions due to animal or human bites that result in fever, extreme pain, and redness of the skin.

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COMMENTARY

I have been using compression stockings for decades, since the discovery of the difference in color of my feet. An evaluation by a vascular surgeon revealed incompetence in the valve of my left popliteal vein. It wasn’t long before I developed small varicose veins.

Comfortable with PREVENTATIVE MEDICINE after a career in ALLERGY, I started wearing Jobst compression stockings, with 30-40 mm of constrictive force. After a decade or so of daily wearing, my big toes started to overlap my second toes, and I began using toe-spreaders; scissor-toe and hammer-toe were my worry, and I wanted to prevent this discomfort.

After a while, I began to notice that the Jobst stockings tended to bunch my toes together. Also, with the developing arthritis in my fingers, it was increasingly hard to get the 30-40mm stockings on without straining my arthritic hands. I now wear OPEN-TOE 15-20mm compression Medi stockings, which are easier to get on, and don’t bunch up my toes.

I still use the visco-elastic toe spreaders. Now, back to the compression stockings for treatment of cellulitis complicating ankle swelling. Of course it works. Beta Hemolytic Streptococci and Staph aureus like nothing better to feed on than a warm pool of interstitial fluid, which is the juice that comprises the ankle swelling.

And BLOOD CLOTS tend to form in the stagnant pools of blood which aggregates in varicose veins, particularly when you are sitting for a long time, such as during a long airline trip. By all means, use compression stockings if you have ankle edema, or even a condition predisposing to ankle edema like varicose veins. Don’t wait for the complication to develop. Be PROACTIVE, and STAY HEALTHY.

–DR. C

COVID-19: “SUPERSPREADING EVENTS” – HOW THEY LEAD TO 80% OF INFECTED PEOPLE

From Scientific American (June 23, 2020):

Scientific American

In fact, research on actual cases, as well as models of the pandemic, indicate that between 10 and 20 percent of infected people are responsible for 80 percent of the coronavirus’s spread.

Researchers have identified several factors that make it easier for superspreading to happen. Some of them are environmental.

  • Poorly ventilated indoor areas seem especially conducive to the virus’s spread – A preliminary analysis of 110 COVID-19 cases in Japan found that the odds of transmitting the pathogen in a closed environment was more than 18 times greater than in an open-air space.
  • Places where large numbers of people congregate – As a group’s size increases, so does the risk of transmitting the virus to a wider cluster. A large group size also increases the chance that someone present will be infectious.
  • The longer a group stays in contact, the greater the likelihood that the virus will spread among them – The benchmark used for risk assessment in her contact-tracing work is 10 minutes of contact with an infectious person, though the CDC uses 15 minutes as a guideline.
  • Some activities seem to make it easier to spread respiratory gunk – Speech emits more particles than normal breathing. And emissions also increase as people speak louder. Singing emits even more particles, which may partially explain the superspreader event at the Washington State choir practice. Breathing hard during exercise might also help the spread of COVID-19.

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CORONAVIRUS: RESPIRATORY-DROPLET CONTACT IS MAJOR WAY COVID-19 SPREADS

From the Wall Street Journal (June 16, 2020):

Health agencies have so far identified respiratory-droplet contact as the major mode of Covid-19 transmission. These large fluid droplets can transfer virus from one person to another if they land on the eyes, nose or mouth. But they tend to fall to the ground or on other surfaces pretty quickly.

Some researchers say the new coronavirus can also be transmitted through aerosols, or minuscule droplets that float in the air longer than large droplets. These aerosols can be directly inhaled.

Illustration: Erik Brynildsen

Sufficient ventilation in the places people visit and work is very important, said Yuguo Li, one of the authors and an engineering professor at the University of Hong Kong. Proper ventilation—such as forcing air toward the ceiling and pumping it outside, or bringing fresh air into a room—dilutes the amount of virus in a space, lowering the risk of infection.

Another factor is prolonged exposure. That’s generally defined as 15 minutes or more of unprotected contact with someone less than 6 feet away, said John Brooks, the Centers for Disease Control and Prevention’s chief medical officer for the Covid-19 response. But that is only a rule of thumb, he cautioned. It could take much less time with a sneeze in the face or other intimate contact where a lot of respiratory droplets are emitted, he said.

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