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
Healthine.com by Paul Auerbach, M.D..
October 5th, 2011 by Toni Brayer, M.D. in News
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If you have watched any news over the past week you know there is a listeria outbreak from contaminated cantaloupes that has been traced to Jensen Farms in Colorado. The CDC has confirmed 72 illnesses, including 13 deaths linked to the melons and three other deaths may be involved. By now most of the cantaloupes should be gone as they usually last only a couple of weeks. The recalled cantaloupes were shipped between July 29 and Sept 10.
Listeriosis is a serious infection caused by eating food contaminated with the bacterium Listeria monocytogenes. It causes fever, muscle aching and sometimes diarrhea. It feels like a bad flu with headache, stiff neck, confusion, loss of balance and in severe cases, convulsions. As with many infections; babies, pregnant women, people with weakened immune systems and older adults are more likely to have severe illness. There are about Read more »
*This blog post was originally published at EverythingHealth*
September 8th, 2011 by Michael Kirsch, M.D. in Opinion
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A good friend of mine and Whistleblower reader contracted the sniffles and received a prescription for antibiotics at a local urgent care center. Nothing newsworthy here. So far this quotidian event sounds like a ‘dog bites man’ story. Had antibiotics been denied, this would have been ‘man bites dog’, as this denial would be a radical departure of standard medical practice, particularly in the urgent care universe.
No doubt, my friend was not assigned the dismissive diagnosis of ‘the sniffles’, but was likely given a more ominous diagnosis of ‘acute upper respiratory infection’, a term that sounds so serious that he might have feared that a 911 call had already been made.
Why are antibiotics prescribed so casually and so frequently? Read more »
*This blog post was originally published at MD Whistleblower*
August 29th, 2011 by Harriet Hall, M.D. in Opinion, Research
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During the early days of the 2009 H1N1 influenza A pandemic, the popular herbal formula maxingshigan–yinqiaosan was used widely by TCM practitioners to reduce symptoms. (It’s hard to pronounce and spell, so I’ll refer to it as M-Y.) A new study was done to test whether M-Y worked and to compare it to the prescription drug oseltamivir. It showed that M-Y did not work for the purpose it was being used for: it did not reduce symptoms, although it did reduce the duration of one sign, fever, allowing researchers to claim they had proved that it works as well as oseltamivir.
“Oseltamivir Compared With the Chinese Traditional Therapy: Maxingshigan–Yinqiaosan in the Treatment of H1N1 Influenza” by Wang et al. was published in the Annals of Internal Medicine earlier this month. The study was done in China, which is notorious for only publishing positive studies. Even if it were an impeccable study, we would have to wonder if other studies with unfavorable results had been “file-drawered.” It’s not impeccable; it’s seriously peccable.
It was randomized, prospective, and controlled; but not placebo controlled, because they couldn’t figure out how to prepare an adequate placebo control. They considered that including Read more »
*This blog post was originally published at Science-Based Medicine*
May 17th, 2011 by DrCharles in Health Tips
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A fever in an infant can be the first sign of an illness. While a rise in body temperature above 100.4 degrees Fahrenheit is part of a healthy immune system response, it does signal potential danger and need for further evaluation. Since a reading may lead to a call or visit to the child’s doctor or emergency room, accuracy is key. What is the best type of infant thermometer?
A digital rectal thermometer.
This is according to such authorities as the American Academy of Pediatrics, Consumer Reports, and the American Academy of Family Physicians.
The definition of a fever is important as well. According to the AAFP:
A normal temperature is about 98.6°F (37°C) when taken orally (in your child’s mouth) and 99.6°F (37.5°C) when taken rectally (in your child’s bottom). Many doctors define a fever as an oral temperature above 99.5°F (37.5°C) or a rectal temperature above 100.4°F (38°C). Read more »
*This blog post was originally published at The Examining Room of Dr. Charles*
