American Doctor's Popular Posts

Tuesday, July 30, 2013

Arkansas girl battles brain-eating amoeba

Arkansas girl battles brain-eating amoeba

By Jacque Wilson and Jen Christensen


Doctors say there may be a glimmer of hope for a 12-year-old girl in Arkansas who is infected with a rare but deadly brain-eating parasite. Not a single person is known to have survived such an infection in the past decade, but Kali Hardig is hanging on in critical condition, according to doctors at Arkansas Children's Hospital.

Hardig's mother took her to the hospital nine days ago. Hardig had a fever and a headache, but something else didn't seem right. Doctors checked her spinal fluid, and that's where they found a microscopic amoeba called Naegleria fowleri.

The amoeba enters the body through the nose and travels to the brain. It's usually found in people who have been swimming in warm, fresh water. You cannot be infected with the organism by drinking contaminated water, the CDC says.


Brain eating parasite
"This infection is one of the most severe infections that we know of," Dr. Dirk Haselow of the Arkansas Department of Health told CNN affiliate WMC. "Ninety-nine percent of people who get it die."

Dr. Sanjiv Pasala, one of Hardig's attending physicians, says they immediately started treating Hardig with an anti-fungal medicine, antibiotics and a new experimental anti-amoeba drug doctors got directly from the CDC. They have also reduced the girl's temperature to 93 degrees. Doctors have used that technique in some brain injury cases as a way to preserve undamaged brain tissue.

Today, doctors checked the girl's cerebral spinal fluid and could not find any presence of the amoeba.

Pasala said that while other cases have not met with such favorable results, what may have made a real difference is that the girl's mother got her to the hospital so quickly.

Willow Springs Water Park in Little Rock is the most likely source of Hardig's infection, according to a news release from the Arkansas Department of Health. Another case of the same parasite, also called primary amoebic meningoencephalitis, was reported in 2010 and was possibly linked to Willow Springs.

"Based on the occurrence of two cases of this rare infection in association with the same body of water and the unique features of the park, the ADH has asked the owner of Willow Springs to voluntarily close the water park to ensure the health and safety of the public," the news release said.

The first symptoms of primary amoebic meningoencephalitis appear one to seven days after infection, including headache, fever, nausea, vomiting and a stiff neck, according to the CDC.
"Later symptoms include confusion, lack of attention to people and surroundings, loss of balance, seizures and hallucinations," the government agency's website states. "After the start of symptoms, the disease progresses rapidly and usually causes death within one to 12 days."

Getting this amoeba is extremely rare. Between 2001 and 2010, there were 32 reported cases in the United States, the CDC says. Most of the cases occurred in the Southeast.
Here are some tips from the CDC to help lower your risk of infection:

• Avoid swimming in freshwater when the water temperature is high and the water level is low.
• Hold your nose shut or use nose clips.
• Avoid stirring up the sediment while wading in shallow, warm freshwater areas.
• If you are irrigating, flushing or rinsing your sinuses (for example, by using a neti pot), use water that has been distilled or sterilized.


Doctors say it is still too early to know whether Hardig can survive or to know how much of an impact the amoeba has had on the girl's brain.

Wednesday, July 24, 2013

Belly-flops can cause injuries

Belly-flops can cause injuries

By Dr. Sonu Ahluwalia


Q: Can belly-flops be dangerous?

A: A belly-flop, for the uninitiated, is when you land flat on your belly and face in the water -- intentionally or unintentionally.

Believe it or not, some people have made a profession out of this.

Darren Taylor, aka "Professor Splash," professionally jumps from high ledges, landing belly-down in a small pool of water. Even reality shows have caught on to the entertainment value of a well-executed belly-flop; ABC's "Splash" features celebrities executing dives poorly.

For those of us who may not be the best divers, there is good news: Belly-flops rarely cause serious injuries. That said, let's talk about what can happen, other than a bruised ego.

The higher you jump or dive from, the faster you will hit the water. Some experts believe that you can reach speeds of up to 40 mph diving from a 10-meter board (almost 33 feet). And as nice as the water feels when you are in it, it does not act that way when you enter it at a high speed.

The most common injuries seen with belly-flops are contusions or bruising of the skin. Rarely do these bruises go deeper and affect your internal organs, but they can.

Deeper abdominal injury from belly flops is known as blunt abdominal trauma. It is similar to being hit on the belly really hard. It can affect organs such as the liver, kidney, pancreas and the bowels. Not only is the abdomen taking the brunt of the landing into the water at a high velocity, there is also sudden deceleration, both of which can cause trauma to the organs. Children are more vulnerable than adults because they have less abdominal fat and a relatively larger abdominal cavity.

After a belly-flop, it is normal for the skin to sting for a while. If the pain is persistent, or if you see blood in your urine or stool, you should see a doctor right away.

Helpful hint: If you find yourself turning from swan to hippo in mid-air, try to lessen the blow by breaking the water with your fingers or feet. When you fall flat, the larger surface area causes a bigger impact.

The biggest danger for daredevils comes when they leap from high ledges without knowing how deep the water is below. Hitting the bottom of the pool, lake or river headfirst could cause a spinal injury, which could lead to paralysis or death.

Always make sure the pool is deep enough before you dive or intentionally belly-flop. When in doubt, always jump feet first. A pool with a 1-meter springboard must be a minimum of 11.5 feet deep at the point directly under the edge of the diving board. For a 3-meter board, the water must be 12.5 feet deep. For a 10-meter platform, the water should be 16 feet deep.

Also, be sure to dive off the tip of the diving board. Never dive from the side, as there is a risk of hitting the side of the pool or landing painfully on a sloped bottom near the wall.

Bottom line: Swimming is a great activity, and kids are unlikely to injure themselves by just being kids. Follow these simple safety rules and provide supervision -- even for good swimmers -- to have a fun, injury-free summer!

Thursday, July 18, 2013

Blacks die earlier from homicide, heart disease

Americans are living longer than ever before. But if you are an African-American in the United States, a new report shows your life, on average, will not be as long as your white neighbors’.
The report comes from the Centers for Disease Control and Prevention’s National Center for Health Statistics.  Lead author Ken Kochanek says his agency has always run these kinds of numbers internally. The results, though, get a little lost in the larger report on overall mortality rates that goes out annually to the public. This year the agency wanted to highlight some of the important racial disparities in the data.
This particular report shows a deeply troubling trend, Kochanek said: Too many black men are the victims of homicides, and that is one of the main reasons black men, on average, don’t live as long as white men do.
The report
The study looked at life expectancy at birth between 1970 and 2010.  The National Center for Health Statistics collects this data directly from death certificates. By law, a death certificate is filed with every person who dies.  The certificates note cause of death and race.
This particular analysis compared life expectancy rates by race and gender. It also looked at the causes of death and how these causes influenced the difference in life expectancy between the black and white populations. It then sliced the numbers even further by comparing the causes of death and their influence on life expectancy between black and white males born in 2010, and black and white females born in 2010. The researchers did not look at socioeconomic status.
The results
Research shows that life expectancy at birth increased from 70.8 years in 1970 to 78.7 years in 2010 for the population overall – that’s an 11% increase.  Life expectancy in the United States has been gradually improving since 1900.  The 78.7 average was a new high.  In 2010 however, the life expectancy for the African-American population still fell short of the white population’s by 3.8 years. Studies have shown that white Americans have always lived longer on average than black Americans - at least for as long as the U.S. government has collected this data. 
Black men did fare the worst of all the groups they compared – with their life expectancy at 4.7 years lower than white men, who live on average to the age of 76.5.
The statisticians found that black men don’t live as long as white men primarily because of higher incidence rates of death from heart disease, homicide and cancer. It is the homicide issue that stands out most for Kochanek.
“The causes of death that account for these differences between the populations haven’t changed all that much,” Kochanek said. “Heart disease, diabetes, stroke – these differences always seem to be there. But what’s interesting in this particular report is just what a difference homicide plays ...  The difference between homicides for black and white men in particular is gigantic.”
“From a public health standpoint I’m sure the experts would say it’s especially worrying,” he said. “You would hope the (racial disparities) would be accounted for by natural causes. You can try and do prevention work to keep heart disease down or diabetes for instance. But when you see homicide as having such a big impact it’s like, ‘Wow, this is a much more complicated issue to fix.'”
White women still have the longest life expectancy at birth - 81 .3 years - followed by black women at 78 years.
This report is the first in a series that will take a closer look at causes of death. The CDC will continue to study other life expectancy issues with ethnic and racial populations in the United States.