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Vaccine Success Has Long History

In September 2008, a group of researchers at the University of Pennsylvania modified messenger RNA (mRNA) in a way that stabilized the molecule and made mRNA a promising tool for both gene replacement and vaccination. This relatively new technology was used in 2020 to rapidly develop and manufacture a COVID-19 vaccine. This represents the latest in a series of breakthroughs in the realm of viral vaccines, each building on the last and each with a compelling record of disease prevention. The first major vaccine-related advance occurred in 1796 when Edward Jenner, a physician who had a laboratory...

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SBP

Ascites is an abnormal collection of fluid within the abdominal cavity. It may be caused by a number of diseases but is most commonly seen in people who have advanced liver disease that includes cirrhosis. Cirrhosis, a condition in which the liver is scarred and dysfunctional, may be caused by alcohol abuse, viral hepatitis, and many other diseases. People who have ascites may also have an impaired immune system, which puts them at increased risk of developing a life-threatening condition called spontaneous bacterial peritonitis (SBP). Peritonitis is an infection of the lining (peritoneum) and...

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TIAs and STROKES

Stroke is the fifth leading cause of death in the U.S., with annual costs related to stroke care exceeding $70 billion. Nearly 800,000 patients experience a stroke per year in the U.S., of which nearly 700,000 are acute ischemic strokes (AIS). The word ischemia refers to tissue damage caused by a lack of blood flow. AIS is a stroke caused by blood clot in an artery and, in most cases, that clot is embolic, meaning it originated elsewhere in the body. A hemorrhagic stroke, caused by the rupture of an artery and subsequent bleeding, is the opposite of an AIS. In many cases of stroke, there are...

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Nose Bleeds

Epistaxis, commonly called a nosebleed, is a frequently encountered condition that is responsible for about one in 200 emergency department visits here in the U.S. It has an estimated lifetime prevalence of 60%, and about 6% of those who have nosebleeds seek treatment. Management is usually straightforward but can be complicated by several factors, primarily the use of anticoagulant medication. In most cases, bleeding starts spontaneously without any obvious precipitant. The underlying causes of and risk factors for epistaxis may be classified into local (e.g., lack of humidification, trauma,...

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Hair Today

Alopecia (hair loss) of the scalp is a common complaint in primary care medicine. Once the areas of hair loss are found to be non-scarring (scarring refers to scaling, crusting, and obliteration of the hair follicles), the next step is to determine whether the distribution of hair loss is patterned, diffuse, or focal as the distribution guides the possible causes and approaches to treatment. If scarring is present, a scalp biopsy is usually necessary so referral to a specialist is recommended. In patterned hair loss, the thinning occurs symmetrically and most notably at the front, top, and sides...

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The Way It Was

Literary classics, for example works by authors like Mark Twain and Robert Louis Stevenson, often give us a glimpse of medical care as it was many years ago. Take Robert Frost’s 1916 poem “Out, Out- .” It describes the traumatic death of a young boy in a farming accident. It is based on a real-life tragedy; an article from the Littleton New Hampshire Courier published in March 1910 provides the background: Raymond Tracy Fitzgerald…died…as a result of an accident by which one of his hands was badly hurt in a sawing machine. The young man…accidently hit a loose pulley, causing the saw to descend...

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Sights On Glaucoma

Glaucoma is a chronic, progressive optic neuropathy characterized by damage to the optic nerve head and retinal nerve fiber layer, both located at the back of the eye. But glaucoma is a disease of the front of the eye, or anterior chamber. The lens separates the eye into the anterior and posterior chambers. In glaucoma, aqueous humor, fluid that is found in the anterior chamber, is unable to drain from the anterior chamber, causing an elevation in intraocular pressure (IOP). Prolonged elevation of IOP causes damage to the optic nerve and retina, and if left untreated, glaucoma can lead to irreversible...

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Prolactin

Benign, or noncancerous, tumors come in all shapes and sizes. For example, adenomas are benign tumors that grow in glands, often in glands that control the human endocrine system. When adenomas form in endocrine glands, they often cause a hormonal imbalance which can have negative effects on the body’s hormonal functions. In addition, when adenomas grow in the brain, they displace brain tissue proving the old adage that there is no such thing as a benign brain tumor because the brain is within a hard shell with no room for expansion. Let’s look at pituitary adenomas, specifically prolactinomas. Prolactin...

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Leery On Lockdowns

We all remember watching Gov. Cuomo and Mayor de Blasio in the early days of the COVID epidemic when they proposed temporary lockdowns to “flatten the curve.” They claimed to be “following the science.” Well, here we are, more than a year later, and we still have partial lockdowns. So, did they really follow scientific recommendations and did the lockdowns prevent COVID deaths? Growing research tells us that the answer is no. The lockdowns destroyed a booming economy, forced many small businesses to close, and put many people out of work and into a financial nightmare. Locking healthy people...

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