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Avoiding Wild Animal Attacks

Photo of a brown bear (grizzly) in the wild.By now, most everyone is familiar with the tragic circumstances in which a visitor on a trail in Yellowstone National Park on July 6, 2011 surprised a brown (grizzly) bear with cubs, provoking a fatal attack. Fortunately, events like this are rare. At the same time, they are also predictable by virtue of our understanding of bear behavior, particularly in the wildland-urban interface. It was not the victim’s fault, and our hearts go out to his family and friends. For the benefit of others who will backpack and explore in bear country here is an excerpt about avoidance of hazardous animals, in particular bears, adapted from the book Medicine for the Outdoors:

Avoidance of Hazardous Animals

Most wild animal encounters can be avoided with caution and a little common sense. Follow these rules: Read more »

This post, Avoiding Wild Animal Attacks, was originally published on Healthine.com by Paul Auerbach, M.D..

One Of The Most Common Infections Of Childhood: Otitis Media

A doctor examining the inside of a young girl's ear while her mother looks on.Ear infections are the bane of childhood and can spoil many outdoor adventures. One of the most common infections of childhood, they provoke long nights of miserable children, sleepless parents, and unhappiness all around. They may be recurrent, and can also progress (rarely) to more serious medical problems, such as meningitis.

What Are Ear Infections?

Acute otitis (inflammation of the ear) media (“middle”) infection is caused by bacteria or viruses. When it occurs, there is redness and inflammation of the eardrum, frequently with a collection of  blood, serum, or pus behind the drum. To know whether or not this has occurred, and to precisely determine the anatomic diagnosis and severity, one needs to see the eardrum, which is what the healthcare provider does with an otoscope.

With otitis media (middle ear infection), there is no drainage from the external ear canal (unless the eardrum ruptures, which is unusual in an adult and more common in a child) and the victim has a fever, sometimes with an accompanying sore throat. In many cases, the victim has a history of prior similar ear infections. Most often, otitis media occurs in children; when it occurs in an adult, it may be associated with a sinus infection or functional obstruction of the eustachian tube (the pressure-release mechanism from the middle ear into the throat).

It is interesting to note that children who chew Read more »

This post, One Of The Most Common Infections Of Childhood: Otitis Media, was originally published on Healthine.com by Paul Auerbach, M.D..

Dengue Fever: Mosquito Born Illness Now Found In Texas, Florida, And Hawaii

Asian tiger mosquito, Aedes albopictsDengue fever is a viral (flavivrus) disease transmitted by Aedes albopictus and female A. aegypti mosquitoes. It is estimated that 50 to 100 million people in more than 100 countries are infected each year with dengue viruses.

There are four different types of dengue virus, and there is no cross-immunity, so a person may be stricken with dengue fever four times in his life. The most active feeding times for dengue vector mosquitoes is for a few hours after daybreak and in the afternoon for a few hours just after dark (dusk).

As opposed to the night-feeding mosquitoes that transmit malaria, these species tend to be “urban,” may also feed during daylight hours (also indoors, in the shade, and during overcast weather), and are known to bite below the waist. Dengue fever is seen chiefly in the Caribbean and South America, as well as other tropical and semitropical areas, such as Southeast Asia, Africa, and Mexico. In the United States, cases have been noted in Texas, Hawaii and Florida. The larvae flourish in artificial water containers (e.g., vases, tires), often in a domestic environment.

The incubation period following a mosquito bite is two to eight days. The disease is self-limited (five to seven days) and characterized in older children and adults by a sudden onset of symptoms, including: Read more »

This post, Dengue Fever: Mosquito Born Illness Now Found In Texas, Florida, And Hawaii, was originally published on Healthine.com by Paul Auerbach, M.D..

Everything You Wanted To Know About Nasal Irrigation

A neti pot.Nasal irrigation is sometimes recommended to thin or remove mucous from the nose. The two most common conditions that produce mucous are upper respiratory infections (e.g., the “common cold”) and allergies. Irrigation may also be beneficial to clear out dust, dirt, and allergens, and to allow the cilia within the nose to function more efficiently. Cilia are organelles that work to move mucous and debris in the nose (among other parts of the body) to a location where they can be expelled more easily. Another benefit of nasal irrigation is that it moisturizes the mucous membranes inside the nose.

Methods of Nasal Irrigation

Irrigation can be pulsatile or non-pulsatile (sometimes called “laminar flow”). Each type has its advocates. It is generally felt to be a safe practice so long as Read more »

This post, Everything You Wanted To Know About Nasal Irrigation, was originally published on Healthine.com by Paul Auerbach, M.D..

Osteoporosis Treatment With Bisphosphonates: Is Exercise Good Or Dangerous?

X-ray of a fractured femur boneMy 86 year-old mother, who is generally in good health, slipped and fell recently and suffered a fractured femur. She was unfortunate to have suffered the accident, but had the good fortune to be discovered quickly, treated promptly and well by the paramedics who responded to her, and then to have a swift and skillful operation by an orthopedic surgeon to repair the fracture. Almost miraculously, she was standing upright (with a considerable amount of pain) the next day and had begun the rehabilitation process.

At her age—indeed at any age—a fractured femur is a very significant injury. This past year, I have learned of friends and others who have suffered falls and broken their legs, ankles, or backs, as well as others who suffered “pathological fractures.” The latter group had the bones break from normal daily stresses, without a traumatic incident, because the bones were weak and/or osteoporotic. More than a few of these injuries occurred outdoors, associated with stumbles on the trail or falls.

All of this highlights features of an excellent review article that was published this past year in the New England Journal of Medicine. Authored by Murray Favus, MD, it is entitled “Biphosphonates for Osteoporosis” (New England Journal of Medicine 2010;363:2027-35). Anyone who is contemplating taking or administering this therapy would benefit from reading this article. Read more »

This post, Osteoporosis Treatment With Bisphosphonates: Is Exercise Good Or Dangerous?, 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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