Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

4 Sivan 5762 - May 15, 2002 | Mordecai Plaut, director Published Weekly









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Shema Yisrael Torah Network
Shema Yisrael Torah Network











Home and Family
Your Medical Questions Answered!
by Joseph B. Leibman, MD

Diplomate, Board Certification of Emergency Medicine

Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua Hospital

I wanted to continue on my series concerning what occurs in an emergency, but the mail is piling up and I must answer it. Also, some important news items must be discussed. From Jerusalem, we are asked two separate questions. First, what can you tell us about the winter scourges: influenza, URI, bronchitis, strep and pneumonia. Influenza, URI and bronchitis can be indistinguishable, and are caused by viruses. They commonly have a low grade or no fever and are over within a few days, although influenza may persist up to 2 weeks. A flu shot at the beginning of the season is recommended, but expensive antivirals do exist that will shorten the disease's course. Antibiotics are never indicated for bronchitis, URI or influenza, and these all present with a normal x-ray and normal lung exam. Strep must present with a sore throat, although carriers are common where the bug is in the throat and can be spread, although it isn't causing disease at the present. It is extremely hard to eradicate. Strep rarely presents with congestion or cough. A rapid strep test is a good screen. Mouthwashes may help. Tonsillectomy is done less and less these days, but frequent strep throat may dictate this painful surgery.

Pneumonia is much more serious and, while less serious cases exist, they commonly do well even without antibiotics. Two exceptions to the rule. One is that the army agent Anthrax can look like the flu early on and once it is obvious that it isn't the flu, it is too late. Persistent cough is a feature of viruses as well as recovering pneumonia, and usually no treatment is required, but whooping cough is making a comeback in adults. A blood test can help.

Fungi are plants that live off dead material, and love wet, warm places, meaning they are strong in the summer. Between the toes is a great place to get such diseases and especially in shared showers. Keeping feet as dry as possible will prevent this disease, and this includes absorbent socks and drying the feet off well after bathing.

Toenail fungus seems to plague certain susceptible individuals, and is extremely hard to treat successfully; although inroads are being made, the most novel being a lacquer that is put on the toenail akin to nail polish. Early treatment probably is the best idea, along with the measures mentioned above.

In Israel, 35 percent of the males smoke as well as 15 percent of the females. Why aren't these people reading my column?

Best wishes to my friends and readers in Kiryat Sefer regarding missed heart beats and a father who passed way at 39. You need a stress test and a Holter -- a twenty-four hour test of the heart's rhythm now! Anyone with a family member who died young needs to make sure that the heart is working well, and that other risks are accounted for. Last week I took care of a 19 year old whose mother had a heart attack at a young age. This young man made the wise (?) decision to take up smoking. He will be doing a stress test very soon.

Water parks and mikvaot are common places that adults take young children, and the Journal of the American Medical Association recently published a warning about children with diarrhea that have even the slightest accidents in these places. Crystoporidium and Giardia are two parasites that can infect everyone in the water and are only mildly susceptible to chlorine. Guidelines have been published, but since they are unlikely to be followed, please protect the public and leave sick or diapered children at home. We'll get to more letters next week. Write me in care of the Yated.

A message from Glaxo, sponsor of this column. If you do need antibiotics for strep or pneumonia, a wise choice is Augmentin. Treatment failures are rare, and it is a twice a day medication which is more convenient. A proven safe track record exists -- Augmentin has been around for quite awhile. Children can take this medication in syrup form.


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