Tag Archives: tetanus

Straight, No Chaser: Step on a Nail? What Happens Next?

June 4, 2018General Health and Wellness, Infectious Disease, Orthopedics/Bones844-SMA-TALK, Behind the Curtain, Cellulitis, osteomyelitis, puncture wound, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, tetanus, There are 72 Hours in a DayJeffrey Sterling, MD

What would you do if you stepped on a nail? What if the nail was rusty? Does it make a difference if you were wearing shoes? Is stepping on a nail dangerous? Why does everyone pronounce tetanus “teknus?” For the answers to these questions (well maybe not the last one) and more, read the rest of this Straight, No Chaser!
It’s an interesting thing that so many nails are allowed to stay on the ground until they become rusty. One would think either they’d be picked up or that you wouldn’t be walking around barefooted in unknown areas. We’ve discussed puncture wounds previously, and stepping on a nail is an example of a puncture wound. However, there are some important considerations that make it worthwhile to discuss.

What should you do if you step on a nail?
Assuming the nail isn’t stuck in your feet, clean your foot vigorously. If the nail is superficially struck in your foot, it’s likely you will have reflexively yanked it out. That’s ok as long as the wound isn’t significantly bleeding at the time.
It’s prudent that you call your physician for next instructions, but in most cases you’ll be directed to come to the emergency room.

What’s the issue?
There is no one issue. There are several potentially significant consequences of stepping on a nail.

If the skin was sliced instead of punctured, that’s a laceration, which will need to be addressed.
It makes a huge difference if you were wearing shoes or not, and not in the way you might think. Stepping on a rusty nail is a much more dangerous proposition if you did so while wearing rubber soles. One of the more dangerous bacteria we have to deal with (named Pseudomonas) thrives in rubber. The puncture from grass or ground through the sole of a rubber shoe into your foot may plant this bacteria superficially or deeply into your foot, causing one (or several) of many different types of infections.
Rusty nails can produce tetanus, which is almost always fatal. This is why you get immunized at least every decade for this disease. You wouldn’t want your worse enemy to suffer a death from tetanus (at least I’d hope not).

What kind of infections can you get from this?
Skin infections are common after puncture wounds involving nails, and can include the following:

Cellulitis – a straightforward infection of the skin
Abscesses – those walled-off “pus pockets” that sometimes require incision and drainage to make it go away
Osteomyelitis – the bones deeper into the foot can actually become chipped and/or infected as well

These are significant wounds, especially if rubber soles are involved, and they may even require surgery to clean the area. In some instances (especially when you have certain risk factors) skin ulcerations (breakdown of the skin) can occur, making severe infection more likely. In some of these instances, foot amputation is necessary.
In addition to wearing rubber-soled shoes at the time of the injury, these other conditions place you at risk for a worse outcome.

Cancer
Diabetes
Malnutrition
Reduced immunity
Smoking history

The infections associated with nail-induced puncture wounds are potentially serious and hard to treat. Patients sometimes end up hospitalized with weeks and sometimes months of treatment with antibiotics.
In case you think the take home message is it’s better not to wear shoes or sandals when walking through the house, grass or sand, you’re partially correct. My best advice to you is look before you weep.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Public Health Has Saved More Lives Than Medical Care

April 9, 2018General Health and Wellness, Public Health844-SMA-TALK, asbestosis, Behind the Curtain, black lung disease, Centers for Disease Control and Prevention, Conditions and Diseases, coronary heart disease, diphtheria, family planning, goiters, homophiles, immunizations, infant mortality, Influenza, measles, motor vehicle collision, pellagra, polio, rickets, rubella, Sexually transmitted disease, silicosis, smallpox, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Stroke, tetanus, There are 72 Hours in a Day, vaccinationsJeffrey Sterling, MD

When I tell most people I have a degree in public health, the typical response involves an assumption that public health involves caring exclusively for the indigent. I guess if you watched the news you could get that impression as well. Public health is the discipline dedicated to optimizing care for populations. Over the course of my career, I’ve cared for a lot of patients as a physician, and I’ve actually saved a few lives. However, the work I’ve done as a public health professional has affected millions. The opportunity to work in public health is extremely gratifying.

In fact, according to the Centers for Disease Control and Prevention (CDC), the field of public health has been responsible for adding 25 years to the life expectancy of U.S. citizens over the 20^th century. In this post I’d like to review the “Ten Great Public Health Achievements in the 20^th Century.” Hopefully, this will cause you to reflect on how these discoveries, innovations and habit promotion affect your life and provide you opportunities to live a healthier life. These are being presented in no particular order.

Control of infectious diseases: The combination of hand washing, improved sanitation and appropriate use of antibiotics has saved untold millions. Examples of once prominent diseases being much better controlled include cholera, tuberculosis and even sexually transmitted infections.
Decrease in deaths from heart disease and stroke: The combination of risk modification, symptoms recognition and early treatment has contributed to a reduction in death rates by over 50% in the last four decades.
Family planning and contraceptive services: Innovations include barrier contraception to prevent pregnancy and transmission of HIV and other STDs, pre-pregnancy screening and counseling, promotion of smaller family size, longer intervals between children and the development of prenatal assessment.
Food safety and healthier food production: Food safety has involved reduction in contaminated food sources, better portion control, improvement of nutrition and appropriate components of meals. Fortification of foods has nearly eliminated once prominent diseases such as rickets, goiters and pellagra.
Fluoridation of drinking water: Multiple benefits exists including better infectious control and prevention of tooth decay. It’s estimated to have reduced tooth decay and loss by 40-70% since its inception in the 1940s.
Healthy mothers and babies: It is astounding that infant mortality rates dropped 90% and maternal mortality rates dropped 99% during the last century. The combination of better prenatal care, technological advances and better hygiene and nutrition all have played an important role.
Motor vehicle safety: Seat belts, child safety seats, motorcycle helmets, speed limits, air bags, safer highways and reduction in drinking and driving have all led to substantial reductions in deaths from motor vehicle crashes.
Recognition of tobacco as a health hazard: Today there are more former smokers than current smokers and untold million of lives have been saved since the 1964 Surgeon General’s report on the health risks of smoking.
Vaccinations: It wasn’t long ago in history when epidemics of measles, polio and influenza were killing tens of thousands of people annually. Rubella, tetanus, diphtheria, Hemophilus and other diseases have been brought under control. Smallpox has been eradicated as a disease due to immunizations.
Workplace safety: Elimination of workplace health hazards such as black lung (coal workers’ pneumoconiosis), silicosis, asbestos poisoning and reductions in injuries related to occupational hazards have reduced fatal occupational injuries by approximately 40% in the last 30 years.

These efforts don’t occur by accident and shouldn’t be taken for granted. Public health is a clear example of important, appropriate and effective societal collaboration for the betterment of us all. Next time you see a public health professional, give her or him a pat on the back. More importantly, take the time to review the above listing and be sure you’ve incorporated the items into your life.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Tetanus (Lockjaw)

October 27, 2017General Health and Wellness, Infectious Disease, Neurology, Skin/Dermatology844-SMA-TALK, Behind the Curtain, clostridium tetani, Conditions and Diseases, lockjaw, rictus sardonicus, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, tetanusJeffrey Sterling, MD

If there could possibly be anything cool about tetanus, it’s that the overwhelming majority of us have never seen it and never will. At first thought, that could seem odd because if you ever end up in an emergency room with a cut or scratch, you’re sure to hear about it. Those two facts are reconciled by knowing there is an incredibly effective vaccine for tetanus, necessary because tetanus is an incredibly dangerous disease. As a result of vaccination, tetanus just doesn’t happen much anymore. Over approximately the last 20 years, less than 30 cases a year have been reported in the United States – nearly all in those either never vaccinated or those not up to date with their tetanus booster shots.
Here are some questions about tetanus to help you understand while this mostly invisible disease is still a major concern.

What causes tetanus?
Tetanus is an infection caused by bacteria named Clostridium tetani. These bacteria are virtually everywhere in the environment, most notably in soil, dust and manure.

How do I catch tetanus?
Tetanus is contracted through your skin, usually via cuts or punctures by contaminated objects. Burns and crush wounds also are prone to delivering tetanus. You catch it primarily if you’re not immunized, and you receive a tetanus-prone wound.
Is tetanus contagious?
Tetanus doesn’t spread between individuals.

What are the symptoms of tetanus?
If you’re old enough, you’ve probably heard of lockjaw, which is a nickname for tetanus and describes the muscle spasms of the jaw that occur and prevent opening of the mouth. Other symptoms include muscle stiffness and spasms, jaw cramping and trouble swallowing. Seizures, headaches, fever, sweating, high blood pressure and a fast heart rate are other common symptoms.
Severe cases of tetanus can produce devastating complications, including fractures, pneumonia, blood clots, involuntary contractions of the vocal cords and breathing difficulties. Up to 20% of cases cause death.

If I got immunized as a child, am I safe?
Full tetanus immunization requires lifelong booster shots every ten years after having received the primary immunization series as a child.

How will I know if I get tetanus?
Your physician will have to make the diagnosis based on your clinical signs and symptoms. There is no quick test available to confirm the disease.
What will happen if I get diagnosed with tetanus?
Regarding treatment, it’s aggressive and includes hospitalization, further immunization, antibiotics and addressing the wound and developing symptoms. Treating tetanus is a race against the clock, and the disease is life threatening.

What’s with the picture of the Joker?
The grimace on his face was modeled after the symptom of tetanus known as rictus sardonicus (roughly translated as scornful laughter), as illustrated in the pictures above of those infected. It’s not a grin or a cry. In tetanus, the sufferer’s face is locked in a painful and often sinister pose that resembles a smile. It results from the spasms causing lockjaw.

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Public Health Has Saved More Lives Than Medical Care

April 5, 2017General Health and Wellness, Public Health844-SMA-TALK, asbestosis, Behind the Curtain, black lung disease, Centers for Disease Control and Prevention, Conditions and Diseases, coronary heart disease, diphtheria, family planning, goiters, homophiles, immunizations, infant mortality, Influenza, measles, motor vehicle collision, pellagra, polio, rickets, rubella, Sexually transmitted disease, silicosis, smallpox, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Stroke, tetanus, vaccinationsJeffrey Sterling, MD

When I tell most people I have a degree in public health, the typical response involves an assumption that public health involves caring exclusively for the indigent. I guess if you watched the news you could get that impression as well. Public health is the discipline dedicated to optimizing care for populations. Over the course of my career, I’ve cared for a lot of patients as a physicians, and I’ve actually saved a few lives. However, the work I’ve done as a public health professional has affected millions. The opportunity to work in public health is extremely gratifying.

In fact, according to the Centers for Disease Control and Prevention (CDC), the field of public health has been responsible for adding 25 years to the life expectancy of U.S. citizens over the 20^th century. In this post I’d like to review the “Ten Great Public Health Achievements in the 20^th Century.” Hopefully, this will cause you to reflect on how these discoveries, innovations and habit promotion affect your life and provide you opportunities to live a healthier life. These are being presented in no particular order.

Control of infectious diseases: The combination of hand washing, improved sanitation and appropriate use of antibiotics has saved untold millions. Examples of once prominent diseases being much better controlled include cholera, tuberculosis and even sexually transmitted infections.
Decrease in deaths from heart disease and stroke: The combination of risk modification, symptoms recognition and early treatment has contributed to a reduction in death rates by over 50% in the last four decades.
Family planning and contraceptive services: Innovations include barrier contraception to prevent pregnancy and transmission of HIV and other STDs, pre-pregnancy screening and counseling, promotion of smaller family size, longer intervals between children and the development of prenatal assessment.
Food safety and healthier food production: Food safety has involved reduction in contaminated food sources, better portion control, improvement of nutrition and appropriate components of meals. Fortification of foods has nearly eliminated once prominent diseases such as rickets, goiters and pellagra.
Fluoridation of drinking water: Multiple benefits exists including better infectious control and prevention of tooth decay. It’s estimated to have reduced tooth decay and loss by 40-70% since its inception in the 1940s.
Healthy mothers and babies: It is astounding that infant mortality rates dropped 90% and maternal mortality rates dropped 99% during the last century. The combination of better prenatal care, technological advances and better hygiene and nutrition all have played an important role.
Motor vehicle safety: Seat belts, child safety seats, motorcycle helmets, speed limits, air bags, safer highways and reduction in drinking and driving have all led to substantial reductions in deaths from motor vehicle crashes.
Recognition of tobacco as a health hazard: Today there are more former smokers than current smokers and untold million of lives have been saved since the 1964 Surgeon General’s report on the health risks of smoking.
Vaccinations: It wasn’t long ago in history when epidemics of measles, polio and influenza were killing tens of thousands of people annually. Rubella, tetanus, diphtheria, Hemophilus and other diseases have been brought under control. Smallpox has been eradicated as a disease due to immunizations.
Workplace safety: Elimination of workplace health hazards such as black lung (coal workers’ pneumoconiosis), silicosis, asbestos poisoning and reductions in injuries related to occupational hazards have reduced fatal occupational injuries by approximately 40% in the last 30 years.

These efforts don’t occur by accident and shouldn’t be taken for granted. Public health is a clear example of important, appropriate and effective societal collaboration for the betterment of us all. Next time you see a public health professional, give her or him a pat on the back. More importantly, take the time to review the above listing and be sure you’ve incorporated the items into your life.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Public Health Has Saved More Lives Than Medical Care

April 1, 2016General Health and Wellness, Public Health844-SMA-TALK, asbestosis, Behind the Curtain, black lung disease, Centers for Disease Control and Prevention, Conditions and Diseases, coronary heart disease, diphtheria, family planning, goiters, homophiles, immunizations, infant mortality, Influenza, measles, motor vehicle collision, pellagra, polio, rickets, rubella, Sexually transmitted disease, silicosis, smallpox, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Stroke, tetanus, vaccinationsJeffrey Sterling, MD

When I tell most people I have a degree in public health, the typical response involves an assumption that public health involves caring exclusively for the indigent. I guess if you watched the news you could get that impression as well. Public health is the discipline dedicated to optimizing care for populations. Over the course of my career, I’ve cared for a lot of patients as a physicians, and I’ve actually saved a few lives. However, the work I’ve done as a public health professional has affected millions. The opportunity to work in public health is extremely gratifying.

In fact, according to the Centers for Disease Control and Prevention (CDC), the field of public health has been responsible for adding 25 years to the life expectancy of U.S. citizens over the 20^th century. In this post I’d like to review the “Ten Great Public Health Achievements in the 20^th Century.” Hopefully, this will cause you to reflect on how these discoveries, innovations and habit promotion affect your life and provide you opportunities to live a healthier life. These are being presented in no particular order.

Control of infectious diseases: The combination of hand washing, improved sanitation and appropriate use of antibiotics has saved untold millions. Examples of once prominent diseases being much better controlled include cholera, tuberculosis and even sexually transmitted infections.
Decrease in deaths from heart disease and stroke: The combination of risk modification, symptoms recognition and early treatment has contributed to a reduction in death rates by over 50% in the last four decades.
Family planning and contraceptive services: Innovations include barrier contraception to prevent pregnancy and transmission of HIV and other STDs, pre-pregnancy screening and counseling, promotion of smaller family size, longer intervals between children and the development of prenatal assessment.
Food safety and healthier food production: Food safety has involved reduction in contaminated food sources, better portion control, improvement of nutrition and appropriate components of meals. Fortification of foods has nearly eliminated once prominent diseases such as rickets, goiters and pellagra.
Fluoridation of drinking water: Multiple benefits exists including better infectious control and prevention of tooth decay. It’s estimated to have reduced tooth decay and loss by 40-70% since its inception in the 1940s.
Healthy mothers and babies: It is astounding that infant mortality rates dropped 90% and maternal mortality rates dropped 99% during the last century. The combination of better prenatal care, technological advances and better hygiene and nutrition all have played an important role.
Motor vehicle safety: Seat belts, child safety seats, motorcycle helmets, speed limits, air bags, safer highways and reduction in drinking and driving have all led to substantial reductions in deaths from motor vehicle crashes.
Recognition of tobacco as a health hazard: Today there are more former smokers than current smokers and untold million of lives have been saved since the 1964 Surgeon General’s report on the health risks of smoking.
Vaccinations: It wasn’t long ago in history when epidemics of measles, polio and influenza were killing tens of thousands of people annually. Rubella, tetanus, diphtheria, Hemophilus and other diseases have been brought under control. Smallpox has been eradicated as a disease due to immunizations.
Workplace safety: Elimination of workplace health hazards such as black lung (coal workers’ pneumoconiosis), silicosis, asbestos poisoning and reductions in injuries related to occupational hazards have reduced fatal occupational injuries by approximately 40% in the last 30 years.

These efforts don’t occur by accident and shouldn’t be taken for granted. Public health is a clear example of important, appropriate and effective societal collaboration for the betterment of us all. Next time you see a public health professional, give her or him a pat on the back. More importantly, take the time to review the above listing and be sure you’ve incorporated the items into your life.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Tetanus (Lockjaw)

October 20, 2015Infectious Disease, Neurology, Skin/Dermatology844-SMA-TALK, Behind the Curtain, clostridium tetani, Conditions and Diseases, lockjaw, rictus sardonicus, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, tetanusJeffrey Sterling, MD

What causes tetanus?
Tetanus is an infection caused by bacteria named Clostridium tetani. These bacteria are virtually everywhere in the environment, most notably in soil, dust and manure.

How do I catch tetanus?
Tetanus is contracted through your skin, usually via cuts or punctures by contaminated objects. Burns and crush wounds also are prone to delivering tetanus. You catch it primarily if you’re not immunized, and you receive a tetanus-prone wound.
Is tetanus contagious?
Tetanus doesn’t spread between individuals.

What are the symptoms of tetanus?
If you’re old enough, you’ve probably heard of lockjaw, which is a nickname for tetanus and describes the muscle spasms of the jaw that occur and prevent opening of the mouth. Other symptoms include muscle stiffness and spasms, jaw cramping and trouble swallowing. Seizures, headaches, fever, sweating, high blood pressure and a fast heart rate are other common symptoms.
Severe cases of tetanus can produce devastating complications, including fractures, pneumonia, blood clots, involuntary contractions of the vocal cords and breathing difficulties. Up to 20% of cases cause death.

If I got immunized as a child, am I safe?
Full tetanus immunization requires lifelong booster shots every ten years after having received the primary immunization series as a child.

How will I know if I get tetanus?
Your physician will have to make the diagnosis based on your clinical signs and symptoms. There is no quick test available to confirm the disease.
What will happen if I get diagnosed with tetanus?
Regarding treatment, it’s aggressive and includes hospitalization, further immunization, antibiotics and addressing the wound and developing symptoms. Treating tetanus is a race against the clock, and the disease is life threatening.

What’s with the picture of the Joker?
The grimace on his face was modeled after the symptom of tetanus known as rictus sardonicus (roughly translated as scornful laughter), as illustrated in the pictures above of those infected. It’s not a grin or a cry. In tetanus, the sufferer’s face is locked in a painful and often sinister pose that resembles a smile. It results from the spasms causing lockjaw.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Straight, No Chaser: Public Health Has Saved More Lives Than Medical Care

April 13, 2015General Health and Wellness, Public Health, Health Prevention844-SMA-TALK, asbestosis, black lung disease, Centers for Disease Control and Prevention, Conditions and Diseases, coronary heart disease, diphtheria, family planning, goiters, homophiles, immunizations, infant mortality, Influenza, measles, motor vehicle collision, pellagra, polio, rickets, rubella, Sexually transmitted disease, silicosis, smallpox, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Stroke, tetanus, vaccinationsJeffrey Sterling, MD

When I tell most people I have a degree in public health, the typical response involves an assumption that public health involves caring exclusively for the indigent. I guess if you watched the news you could get that impression as well. Public health is the discipline dedicated to optimizing care for populations. Over the course of my career, I’ve cared for a lot of patients as a physicians, and I’ve actually saved a few lives. However, the work I’ve done as a public health professional has affected millions. The opportunity to work in public health is extremely gratifying.

In fact, according to the Centers for Disease Control and Prevention (CDC), the field of public health has been responsible for adding 25 years to the life expectancy of U.S. citizens over the 20^th century. In this post I’d like to review the “Ten Great Public Health Achievements in the 20^th Century.” Hopefully, this will cause you to reflect on how these discoveries, innovations and habit promotion affect your life and provide you opportunities to live a healthier life. These are being presented in no particular order.

Control of infectious diseases: The combination of hand washing, improved sanitation and appropriate use of antibiotics has saved untold millions. Examples of once prominent diseases being much better controlled include cholera, tuberculosis and even sexually transmitted infections.
Decrease in deaths from heart disease and stroke: The combination of risk modification, symptoms recognition and early treatment has contributed to a reduction in death rates by over 50% in the last four decades.
Family planning and contraceptive services: Innovations include barrier contraception to prevent pregnancy and transmission of HIV and other STDs, pre-pregnancy screening and counseling, promotion of smaller family size, longer intervals between children and the development of prenatal assessment.
Food safety and healthier food production: Food safety has involved reduction in contaminated food sources, better portion control, improvement of nutrition and appropriate components of meals. Fortification of foods has nearly eliminated once prominent diseases such as rickets, goiters and pellagra.
Fluoridation of drinking water: Multiple benefits exists including better infectious control and prevention of tooth decay. It’s estimated to have reduced tooth decay and loss by 40-70% since its inception in the 1940s.
Healthy mothers and babies: It is astounding that infant mortality rates dropped 90% and maternal mortality rates dropped 99% during the last century. The combination of better prenatal care, technological advances and better hygiene and nutrition all have played an important role.
Motor vehicle safety: Seat belts, child safety seats, motorcycle helmets, speed limits, air bags, safer highways and reduction in drinking and driving have all led to substantial reductions in deaths from motor vehicle crashes.
Recognition of tobacco as a health hazard: Today there are more former smokers than current smokers and untold million of lives have been saved since the 1964 Surgeon General’s report on the health risks of smoking.
Vaccinations: It wasn’t long ago in history when epidemics of measles, polio and influenza were killing tens of thousands of people annually. Rubella, tetanus, diphtheria, Hemophilus and other diseases have been brought under control. Smallpox has been eradicated as a disease due to immunizations.
Workplace safety: Elimination of workplace health hazards such as black lung (coal workers’ pneumoconiosis), silicosis, asbestos poisoning and reductions in injuries related to occupational hazards have reduced fatal occupational injuries by approximately 40% in the last 30 years.

Straight, No Chaser: Tetanus (Lockjaw)

July 16, 2014Infectious Disease, Neurology844-SMA-TALK, clostridium tetani, Conditions and Diseases, lockjaw, rictus sardonicus, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, tetanusJeffrey Sterling, MD

What causes tetanus?
Tetanus is an infection caused by bacteria named Clostridium tetani. These bacteria are virtually everywhere in the environment, most notably in soil, dust and manure.

If I got immunized as a child, am I safe?
Full tetanus immunization requires lifelong booster shots every ten years after having received the primary immunization series as a child.

What’s with the picture of the Joker?
The grimace on his face was modeled after the symptom of tetanus known as rictus sardonicus (roughly translated as scornful laughter), as illustrated in the pictures above of those infected. It’s not a grin or a cry. In tetanus, the sufferer’s face is locked in a painful and often sinister pose that resembles a smile. It results from the spasms causing lockjaw.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: Step on a Nail? What Happens Next?

June 28, 2014General Health and Wellness, Infectious Disease, Orthopedics/Bones844-SMA-TALK, Cellulitis, osteomyelitis, puncture wound, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, tetanusJeffrey Sterling, MD

What’s the issue?
There is no one issue. There are several potentially significant consequences of stepping on a nail.

If the skin was sliced instead of punctured, that’s a laceration, which will need to be addressed.
It makes a huge difference if you were wearing shoes or not, and not in the way you might think. Stepping on a rusty nail is a much more dangerous proposition if you did so while wearing rubber soles. One of the more dangerous bacteria we have to deal with (named Pseudomonas) thrives in rubber. The puncture from grass or ground through the sole of a rubber shoe into your foot may plant this bacteria superficially or deeply into your foot, causing one (or several) of many different types of infections.
Rusty nails can produce tetanus, which is almost always fatal. This is why you get immunized at least every decade for this disease. You wouldn’t want your worse enemy to suffer a death from tetanus (at least I’d hope not).

What kind of infections can you get from this?
Skin infections are common after puncture wounds involving nails, and can include the following:

Cellulitis – a straightforward infection of the skin
Abscesses – those walled-off “pus pockets” that sometimes require incision and drainage to make it go away
Osteomyelitis – the bones deeper into the foot can actually become chipped and/or infected as well

Cancer
Diabetes
Malnutrition
Reduced immunity
Smoking history

Straight, No Chaser: Public Health Has Saved More Lives Than Medical Care

April 8, 2014General Health and Wellness, Public Health, Health Prevention844-SMA-TALK, asbestosis, black lung disease, Centers for Disease Control and Prevention, Conditions and Diseases, coronary heart disease, diphtheria, family planning, goiters, homophiles, immunizations, infant mortality, Influenza, measles, motor vehicle collision, pellagra, polio, rickets, rubella, Sexually transmitted disease, silicosis, smallpox, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Stroke, tetanus, vaccinationsJeffrey Sterling, MD

When I tell most people I have a degree in public health, the typical response involves an assumption that public health involves caring exclusively for the indigent. I guess if you watched the news you could get that impression as well. Public health is the discipline dedicated to optimizing care for populations. Over the course of my career, I’ve cared for a lot of patients as a physicians, and I’ve actually saved a few lives. However, the work I’ve done as a public health professional has affected millions. The opportunity to work in public health is extremely gratifying.
In fact, according to the Centers for Disease Control and Prevention (CDC), the field of public health has been responsible for adding 25 years to the life expectancy of U.S. citizens over the 20^th century. In this post I’d like to share the “Ten Great Public Health Achievements in the 20^th Century.” Hopefully, this will cause you to reflect on how these discoveries, innovations and habit promotion affect your life and provide you opportunities to live a healthier life. These are being presented in no particular order.

Control of infectious diseases: The combination of hand washing, improved sanitation and appropriate use of antibiotics has saved untold millions. Examples of once prominent diseases being much better controlled include cholera, tuberculosis and even sexually transmitted infections.
Decrease in deaths from heart disease and stroke: The combination of risk modification, symptoms recognition and early treatment has contributed to a reduction in death rates by over 50% in the last four decades.
Family planning and contraceptive services: Innovations include barrier contraception to prevent pregnancy and transmission of HIV and other STDs, pre-pregnancy screening and counseling, promotion of smaller family size, longer intervals between children and the development of prenatal assessment.
Food safety and healthier food production: Food safety has involved reduction in contaminated food sources, better portion control, improvement of nutrition and appropriate components of meals. Fortification of foods has nearly eliminated once prominent diseases such as rickets, goiters and pellagra.
Fluoridation of drinking water: Multiple benefits exists including better infectious control and prevention of tooth decay. It’s estimated to have reduced tooth decay and loss by 40-70% since its inception in the 1940s.
Healthy mothers and babies: It is astounding that infant mortality rates dropped 90% and maternal mortality rates dropped 99% during the last century. The combination of better prenatal care, technological advances and better hygiene and nutrition all have played an important role.
Motor vehicle safety: Seat belts, child safety seats, motorcycle helmets, speed limits, air bags, safer highways and reduction in drinking and driving have all led to substantial reductions in deaths from motor vehicle crashes.
Recognition of tobacco as a health hazard: Today there are more former smokers than current smokers and untold million of lives have been saved since the 1964 Surgeon General’s report on the health risks of smoking.
Vaccinations: It wasn’t long ago in history when epidemics of measles, polio and influenza were killing tens of thousands of people annually. Rubella, tetanus, diphtheria, Hemophilus and other diseases have been brought under control. Smallpox has been eradicated as a disease due to immunizations.
Workplace safety: Elimination of workplace health hazards such as black lung (coal workers’ pneumoconiosis), silicosis, asbestos poisoning and reductions in injuries related to occupational hazards have reduced fatal occupational injuries by approximately 40% in the last 30 years.