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Diverticulitis Expected To Become More Prevalent In An Aging Population

Diverticula are small outpouchings that develop at weak points along the wall of the colon (large bowel), probably because of high pressures associated with muscle contractions during the passage of stool. When these sacs become obstructed and/or inflamed (most frequently in middle-aged or elderly individuals), they enlarge and create pain and fever. Usually, the left lower quadrant is involved, because diverticula tend to form in the left-side portion of the colon (descending colon) more frequently than in the right-side portion (ascending colon) or horizontal connecting section (transverse colon). A ruptured diverticulum can cause a clinical picture much like that of a ruptured appendix, with pain in the left side of the abdomen instead of the right side. The victim should seek medical attention, and his diet be limited to clear fluids. Antibiotics (metronidazole, metronidazole combined with doxycycline, amoxicillin-clavulanate, trimethoprim-sulfamethoxazole, cefixime, ciprofloxacin, or cefpodoxime) should be administered if help is more than 24 hours away.

As the population ages, diverticulitis is expected to become more prevalent. In a recent article Read more »

This post, Diverticulitis Expected To Become More Prevalent In An Aging Population, was originally published on Healthine.com by Paul Auerbach, M.D..

Handling One’s Emotions In A Survival Situation

Perhaps the greatest thrill in attending a summer meeting of the Wilderness Medical Society (WMS) is listening to new, enthusiastic and exciting speakers. They bring new insights and opinions to numerous topics and discussions, which is an essential part of the educational process. This past summer, at the 2010 Annual Meeting of the WMS held in Snowmass, Colorado, Dr. Drew Watters from the Indiana University School of Medicine approached the audience with his observations about neurobiology and survival. It was an innovative approach to a very common topic within wilderness medicine. How does one account for and handle emotions in a time of stress, including the most stressful situation of all—namely, a survival situation? When is it better to think, rather than to react? The objectives of his presentation were to understand to a certain extent survival, the anatomy of thought and perception, the neurobiology of emotions, behavior, emotive and cognitive decisions, and implementation of interventions in situations dominated by emotion.

Anyone who has practiced wilderness medicine knows that bad things happen, sometimes despite the best preparations and intentions. People make bad decisions that can too often be characterized as dumb. If they follow with more bad decisions, the situation Read more »

This post, Handling One’s Emotions In A Survival Situation, was originally published on Healthine.com by Paul Auerbach, M.D..

Article Compares Hemostatic Agents: Are There Any Differences?

Once of the major recent advances in trauma care has been the evolution of topical substances that can be applied to wounds in order to limit or stop hemorrhage (bleeding). This is very important in wilderness medicine, because uncontrolled bleeding is a leading cause of death from injuries. When the bleeding site can be approached in such a manner as to stop the bleeding, then something very valuable may possibly be done for the patient.

In article entitled “Comparison of Celox-A, ChitoFlex, WoundStat, and Combat Gauze Hemostatic Agents Versus Standard Gauze Dressing in Control of Hemorrhage in a Swine Model of Penetrating Trauma,” Lanny Littlejohn, MD and colleagues used an animal model of a complex groin injury with a small penetrating wound, followed by completely cutting the femoral artery and vein, to determine whether there was any benefit to one or another hemostatic (stops bleeding) agent in comparison to each other and to standard gauze dressing. To cut to the chase (no pun intended), the results showed that no difference was found among the agents with respect to initial cessation of bleeding, rebleeding, and survival. In this study, WoundStat was inferior with respect to initial cessation of bleeding and survival when compared to Celox-A.

The authors point out how important it is to Read more »

This post, Article Compares Hemostatic Agents: Are There Any Differences?, was originally published on Healthine.com by Paul Auerbach, M.D..

Article Recommends Herpes Zoster Vaccine For Adults Over 60

shingles.I am often asked by elder persons whether or not they should take the herpes zoster (“shingles”) vaccine. Up until this point, I have been answering “yes” based on my own experience, but now there is some data to support this recommendation.

In the article, “Herpes Zoster Vaccine in Older Adults and the Risk of Subsequent Herpes Zoster Disease,” Hung Fu Tseng and his colleagues reported their findings in the Journal of the American Medical Association (JAMA 2011;305[2]:160-161). They evaluated the risk of herpes zoster after persons received the vaccine in a general practice setting.

In a retrospective (looking back at a cohort of patients from medical records) study, the researchers compared Read more »

This post, Article Recommends Herpes Zoster Vaccine For Adults Over 60, was originally published on Healthine.com by Paul Auerbach, M.D..

The Importance Of Physicals For Young Athletes

Injured football player.Increasing numbers of young people participate in outdoor activities, including strenuous competitive athletics. In so doing, they subject their bodies to stresses that are more intense and prolonged than those presented by a largely sedentary life. Every story of a sudden death in a young person is a tragedy, and usually accompanied by commentary pondering the role and utility of pre-activity screening. Could the death have been prevented? What was the physiological condition of the deceased? Could the collapse, often attributed to a heart problem, have been predicted? Was there an examination or evaluation that might have indicated that the deceased was at greater risk, or should have been held out of the activity? These are all important questions, with no simple answers.

Sudden collapse and cardiac arrest in a young person seems wrong. It shouldn’t happen. It is a parent’s worst nightmare. Similar horrors occur on the freeway when a teenage driver is killed, or at the beach when a surfer is tossed in a monster wave and drowned. We know a great deal about injury prevention; much of our teaching and experience points to errors in judgment. But the situation is different when the seemingly healthy slumps to the ground without a pulse. That person has been taken by surprise in a cruel act of fate.

Sometimes we learn that the victim had Read more »

This post, The Importance Of Physicals For Young Athletes, was originally published on Healthine.com by Paul Auerbach, M.D..

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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