November 5th, 2011 by Paul Auerbach, M.D. in Health Tips, News
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Most of us are familiar with the need to achieve immunization against tetanus (“lockjaw”) and diphtheria. Fewer are familiar with the need to immunize against pertussis (“whooping cough”). Boostrix is a vaccine used to achieve immunity against all three. Until recently, there had not been a vaccine approved by the Food and Drug Administration (FDA) against pertussis intended for use in elders (ages 65 years and older). On July 8, 2011, the FDA approved Boostrix for use in this population of seniors.
The link to the FDA announcement is http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm262390.htm
Whooping cough is not a trivial disease. It is a highly communicable infectious disease caused by the bacterium Bordetella pertussis. It is transmitted by respiratory secretions or large droplets from the respiratory tract of an infected person. In children, whooping cough is typified by Read more »
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October 21st, 2011 by Paul Auerbach, M.D. in Research
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Dehydration is a common phenomenon in those suffering from infectious diseases, particularly if the diseases cause vomiting and/or diarrhea. We are all familiar with having the “stomach flu,” “traveler’s diarrhea,” or food poisoning. However, severe infections of all sorts can cause profound illness, debilitation, and fluid losses. In many developing countries, very large numbers of small children are afflicted with non-gastrointestinal infectious diseases that rapidly cause relatively large fluid losses, and therefore profound, life-threatening dehydration, which is manifested in part by dangerously low blood pressure and subsequent failure to deliver precious liquid, nutrients and oxygen to the tissues of the body. This is called “shock.”
The following discussion is cutting edge information, but not simplistic or necessarily easy to understand or apply. However, I have learned that my readers are often volunteers in settings where intensive care medicine must be applied, and want to read more than simple approaches to therapy. So, I am going to do my best to interpret for you what has recently been published in the New England Journal of Medicine in an article entitled “Mortality after Fluid Bolus in African Children with Severe Infection” (N Engl J Med 2011; 364:2483-95) written by Kathryn Maitland and her colleagues.
The focus of their investigation was Read more »
This post, Study Investigates The Role Of Fluid Resuscitation In Treatment Of Life-Threatening Infections, was originally published on
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October 13th, 2011 by Paul Auerbach, M.D. in Health Tips, Opinion
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Dr. Robert “Brownie” Schoene, an enormously talented, accomplished, and insightful physician who resides within the bedrock of wilderness medicine, gave a wonderful presentation about the concept of risk at the 2010 annual summer meeting of the Wilderness Medical Society. Risk is inherent in outdoor activities, whether it is part of exploration, adventure, science, or industry. I am going to summarize his approach to the topic, which is among the most important general concepts in the field, and editorialize with some of my thoughts.
When one thinks of risk related to outdoor health, it is about the possibility of suffering harm, damage, or loss. When a person is aware of the possibility of a specific risk, he or she usually weighs the risk against the possible benefits. When you hike on a slippery, snowy trail in early spring, where the trail winds over patches of ice near ledges from which a fall would cause a severe injury, is the experience worth the risk? When you ride a wave on your surfboard when the waves are intimidating and you are outside your comfort zone, is the improvement in performance worth the possibility of a tumble and possible muscle tear or broken bone? Sometimes the answer is easy. When I travel to a third world country, I always run the risk of acquiring infectious diarrhea. The benefits of the mission supersede the discomfort, and I both anticipate the risk and prepare for treatment by carrying oral rehydration supplies and appropriate antibiotics.
I love the quote from Winston Churchill that Dr. Schoene used to illustrate a risk-taker’s approach: Read more »
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October 12th, 2011 by Paul Auerbach, M.D. in Health Tips, Research
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There were no real surprises for me in the article entitled “Television Viewing and Risk of Type 2 Diabetes, Cardiovascular Disease, and All-Cause Mortality” by Anders Grøntved and Frank B. Hu that appeared in the Journal of the American Medical Association (JAMA 2011;305(23):2448-2455). As stated in the abstract: “Prolonged television (TV) viewing is the most prevalent and pervasive sedentary behavior in industrialized countries and has been associated with morbidity and mortality. However, a systematic and quantitative assessment of published studies is not available.”
The authors performed an analysis of eight previously published studies to determine the association between TV viewing and risk of type 2 diabetes, fatal or nonfatal cardiovascular disease, and all-cause mortality.
The risk of all-cause mortality appeared to increase with TV viewing duration of greater than Read more »
This post, Risk Of Type 2 Diabetes And Cardiovascular Disease: Don’t Be A Couch Potato, was originally published on
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October 7th, 2011 by Paul Auerbach, M.D. in News
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Isolated environments combined with austere circumstances sometimes call for extraordinary measures, and in particular call for planning in advance for situations of multi-casualty incidents. Many, if not most, austere settings are in outdoor or frankly wilderness settings. Anyone who spends considerable time in the outdoors is going to sooner or later encounter a group of individuals in need of assistance in a setting of limited resources. This could be a scout troop suffering sunburn, multiple persons stung by a swarm of bees, a group of people struck by lightning, or a carful of people in a vehicle swamped and trapped in a flood. A winter camping expedition might be overcome by an unanticipated storm that generates victims of hypothermia. At the ends of the earth, the risks may be greater and multiplied by the very difficult logistics of rescue and evacuation.
Christopher Mills, MD and colleagues recently published a very interesting article entitled “Mass Casualty Incident Response and Aeromedical Evacuation in Antarctica” (Western Journal of Medicine 2011;12(1):37-42). This excellent review addresses the complications of multiple environmental and operational challenges, and highlights that Read more »
This post, Complications Associated With The Rescue Of Injured Persons In Isolated Environments, was originally published on
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