What diseases are spreading through homeless camps?

The population of the homeless is currently over 500,000 in the United States.  It is estimated that there are approximately 400,000 homeless shelter beds available.

Of the homeless, 66% are male.

According to the Substance Abuse and Mental Health Services Administration, 20-25% of homeless suffer from severe mental illness, 38% abuse alcohol and 26% abuse other drugs.

One out of every four homeless individuals experiences violence.

Other medical problems that affect the homeless include malnutrition, parasitic infections, dental disease, liver disease such as hepatitis, and sexually transmitted diseases.

In San Diego this year a Hepatitis A outbreak has sickened 500 homeless individuals and 19 have died.  The Seattle area also suffered a major Hepatitis A outbreak.

There is currently a typhoid fever outbreak in California that has affected 167 people.  Typhoid fever is spread through from infected body lice.  It also sickened a first responder.

Tuberculosis just spread throughout the homeless population in Atlanta, sickening many individuals.

Other diseases such as Shigella, spread by bacteria, and Trench fever, spread by lice, have also swept through homeless communities.

The death rate of homeless individuals is 58% higher than the general population.



Does your brain burn calories?

Does thinking burn calories?

The human brain actually uses a lot of energy. How many calories does it burn?

At rest, the brain only burns about a tenth of a calorie a minute.

But when it is actively thinking, the brain burns up to 90 calories per hour! The brain can use up to 20% of the body’s total calories a day. That means that during a typical day, a person uses about 320 calories just to think!

The brain relies on glucose, a form of sugar, to complete the functions of thinking, learning and memory.

While reading, the average person burns 67 calories per hour!

When taking a test, the brain burns up to 270 calories per hour.

When playing chess, viewed as a sedentary game, the brain can burn up to 6000 calories in a day!


Can you make the diagnosis?

Cheryl is back in the office after taking a few days off with a cold.  She had stayed home with congestion, fever, and cough.  Now she is back at her desk and trying to catch up on her work.  Her cold symptoms have not completely gone away though, and she is keeping a box of Kleenex on her desk for her runny nose.

During the next two days, Cheryl develops a dull headache on her forehead and cheeks.  She starts feeling tired again, like when she had the cold, and notices that her teeth are aching.

What does Cheryl have?

  1.   Sinusitis
  2.   Meningitis
  3.   A migraine
  4.   Pneumonia


If you picked 1.  Sinusitis, you are correct!

Sinusitis can occur after a cold, usually starting with a viral illness.  It can cause thick yellow or green discharge from the nose or down the back of the throat (post nasal drainage).  Sinusitis can cause facial pain or a headache, particularly on the forehead or cheek area.  It can also cause dental pain (from referred nerve pain) and fatigue.

Most people with sinusitis do not need to see a doctor as it will resolve on its own.  However if a patient develops a fever, vision changes, confusion, facial redness, or a stiff neck then they must see a doctor immediately.

Meningitis must always be considered with a headache associated with a viral infection, but in this case Cheryl doesn’t have neck stiffness, vomiting, a rash, or other signs of meningitis.  A migraine is typically associated with a severe headache, visual changes, and vomiting.  Pneumonia symptoms can include a productive cough, shortness of breath, fever, and pain with breathing.


Why do we hiccup?

Hiccups are caused by a reflex, which causes the large muscle that divides our chest and our abdomen to forcefully contract.  This muscle contraction then causes our vocal cords to snap shut, creating the hiccup sound.

What purpose does hiccuping service?  We know that infants hiccup more often then adults.  The theory is that when infants hiccup while nursing, it forces air out of their stomach so that they can ingest more milk!

In adults, hiccuping can be caused by coughing, swallowing air, rapid eating, and even by intense emotions.

Many folk remedies have been tried to cure hiccups, such as headstands, squeezing the ear lobe, frightening the person hiccuping, and drinking water upside down.  None of these are known to be consistently effective.  Breathing into a paper bag may be helpful.  Multiple medications have been tried for patients with long-standing hiccups, with varying success.

The Guinness Book of Records lists Charles Osborne for having the hiccups for 68 years!


Are leeches still used in medicine?

Leeches have been used in the medical field for over 2500 years.  They were very popular in the Middle Ages, when it was believed that many diseases were caused by an  excess of blood.   Up until the 19th century, leeches were used to treat everything from tonsillitis to hemorrhoids.

But did you know leeches are still used in the medical field?

Leeches are now used for patients who have suffered an amputated finger.   After the amputated finger is surgically  re-attached, there can be significant swelling, which can cause the surgery to fail.  In that situation, leeches are applied to the re-attached finger to suck the blood out and to decrease the swelling.

The saliva of leeches secretes about 60 different proteins.  Some of these work as blood thinners, and some appear to act as a natural anesthetic (which may be why leech bites are generally not painful).  Leeches secrete a natural blood thinner, called “hirudin”, which is so powerful that it is being studied for other uses such as for heart attacks and strokes.

The FDA has approved Leech therapy for surgical use to help blood circulation and decrease venous congestion.

Medical leech:


Can you make the diagnosis?

Jon is leaving his health club when he notices that his left ear is itching.  He scratches it and wishes he had a Q-tip, but then forgets about it.

Later at work, his ear is itching more, then starts to become sore.  In the afternoon, it starts to hurt, and seems to even have some discharge.

What does Jon have?

  1.  Swimmer’s ear
  2.  Otitis media
  3.  Cellulitis
  4.  Allergic reaction



If you guessed 1.  Swimmer’s ear, you are right!

Swimmer’s ear is an infection of the outer ear canal. It is caused by a moist environment, which allows bacteria to grow. The medical term for swimmer’s ear is “otitis externa”.

Symptoms include itching, redness, ear discharge, and pain of the ear canal.

Swimmer’s ear is caused by any situation which increases moisture in the ear, such as swimming. Use of ear buds or hearing aids has also been identified as causes of swimmer’s ear.

To help prevent swimmer’s ear, dry your ears thoroughly after swimming or bathing with a soft towel. Tip your head to the side to help water drain.

A home remedy for swimmer’s ear is to mix 1 part vinegar with 1 part rubbing alcohol to gently clean the ear. This should only be done if the eardrum is not punctured.

However swimmer’s ear progresses then it needs to be treated with antibiotic drops.

Otitis media is the term for a typical inner ear infection, which causes ear pain, but does not usually have discharge or itching like swimmer’s ear, which is also called otitis externa.   Cellulitis is an infection of the skin layers, and can occur on the ear, but usually causes redness around the affected area, and does not usually have discharge.  An allergic reaction would be unusual to affect just one ear.

swimmers ear.jpeg

Is cheese good for you or bad for you?

We always feel guilty about eating cheese because it is high in calories, sodium, and fat.  But what does the science show?  Are there any health benefits from eating cheese?

One ounce of cheddar cheese provides 20% of the daily requirement of calcium!  This is important to strengthen our bones and prevent osteoporosis.

Cheese contains protein, magnesium,  zinc, and vitamins A, D, and K.

The calcium in cheese is also important for the strength of our teeth.

Studies have shown that individuals with high body weights typically have low calcium levels.  It is thought that calcium may be important in maintaining normal body weight.

Studies have shown that patients who eat more cheese have lower blood pressure.

Researchers have found that cheese contains an antioxidant, glutathione, that is important for brain health and preventing age-related brain degeneration.

Some types of cheese such as gouda, mozzarella, cheddar and cottage cheese, contain probiotics that are good for intestinal health.