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July 30, 2013

Death From a Severe Nosebleed

Image by RIs from Wikipedia Attila the Hun was one of the most feared enemies of the Roman Empire. Ruler of the Huns from the year 434 until his death in 452, his empire stretched from Ural River to the Rhine River and from the Danube River to the Baltic Sea. Although there are numerous theories as to how he died, the conventional account is that he died from a severe nosebleed on his wedding night. Some may scoff that only people in historical times die from nosebleeds ... but it …
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July 27, 2013

Vocal Cord Tear Silences R&B Singer Frank Ocean

Image by Fred von Lohmann from Wikipedia On July 25, 2013, R&B singer Frank Ocean was forced to cancel his entire Australian concert tour due to a small vocal cord tear. After singing his opening night with a sore throat during which he reportedly sounded "noticeably off-key," he seeked medical attention and was informed of the unfortunate condition of his vocal cord. Listening to his voice on this YouTube video recorded during this fateful concert, his voice actually doe…
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July 23, 2013

Popular Nasal Decongestants Associated with Birth Defects

Researchers have discovered that there is a very small, but significant association between birth defects and use of nasal decongestants in the first trimester of pregnancy. Unfortunately, decongestants  (ie sudafed, afrin, etc) are also one of the most popular medications purchased over-the-counter to treat symptoms of nasal congestion , runny nose, and allergies . In particular, three strong associations were found: • Phenylephrine and endocardial cushion defects • Phenylpropanolam…
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July 19, 2013

Swimming Pools, Poop, and Ear Infections

So here's an interesting statistic... The average person has 0.14 grams of feces on their rear end. If a person does not shower prior to swimming, that 0.14 grams of stool gets washed off into the swimming pool. Kids tend to have a bit more stool on their rear end (up to 10 grams). See references below. That means if 100 individuals enter the swimming pool in any given day without showering beforehand, anywhere from 14 grams to 1 kilogram of stool enter the swimming pool water (0.03 - 2…
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Vaccine to Prevent Throat Cancer

Spread through oral sex, it is well established that human papilloma virus (HPV) types 16 and 18 cause the vast majority of throat cancer especially in men... even more than smoking and drinking alcohol. What was not known, but suspected, was whether in BOTH men and women the HPV vaccine Cervarix (made by GSK) or Gardasil (made by Merck) would help prevent throat cancer as effectively as cervical cancer for which it is FDA approved for. At least for the vaccine Cervarix, a randomized, co…
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July 16, 2013

Maggots in the Ear After Trip to Peru

Image from Wikipedia Adventurous international travelers have to worry about malaria and safe drinking water, but for one 27 years old British woman, she also had to contend with a maggot infestation in the ear after a trip to Peru. It was not quite the 57 maggots found in one Illinois woman, but apparently this traveler recalled walking thru a fly swarm in Peru and that one fly did briefly enter her ear canal. However, it was enough for the fly ( New World Screwworm fly ) to lay its e…
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Rapid Saliva Test to Look for Laryngopharyngeal Reflux

When you compare a spit test to the current way of how throat level reflux  (LPR) is determined via  barium swallow , upper endoscopy (EGD), and  24 hour ph/impedance testing , it sounds quite attractive. How does such a test work? It basically looks for a stomach protein called pepsin. Given reflux is when stomach contents moves up towards the mouth and pepsin is a protein ONLY produced in the stomach... pepsin should NOT be found in the throat/mouth.  As such, the test can state &qu…
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July 13, 2013

Treatment for Vocal Tremor

Vocal tremor is characterized by a rhythmic undulating vocal quality whenever talking, much akin to vibrato that can not be turned off. In the past, it was felt that use of botulinum toxin type A ( botox ) to treat vocal tremor was not possible nor realistic given the multiple muscle groups involved. This is in contrast to dystonias of the voice (i.e., spasmodic dysphonia ) where only one muscle group is involved and is readily and easily treated with botox injections to the affected vocal co…
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July 12, 2013

Singer Carnie Phillips Suffered from Bell's Palsy

Image by InSapphoWeTrust from Wikipedia In March 2013, singer Carnie Phillips (of the Wilson Phillips ) revealed that she suffered from a sudden left facial paralysis due to a condition known as Bell's Palsy . Through a series of tweets , it was apparent that it came fast and started improving within a week. Thought to be due to a viral infection of the facial nerve, it is commonly treated with prednisone with or without an anti-viral antibiotic (ie, valtrex). For most patients, …
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PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus)

Only in kids, there is a VERY rare (and controversial) disorder where strep throat infections can rapidly lead to involuntary tics including chronic throat clearing , cough , head/neck movements, sneeze, etc as well as OCD behavior. Known as PANDAS  ( P ediatric A utoimmune N europsychiatric D isorder A ssociated with S treptococcus), it is felt to be an autoimmune reaction triggered by antibodies produced by the body when fighting a strep infection. With this disorder, an evaluation with a p…
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July 11, 2013

What Reflux Meds are Best in Infants and Children?

Once a decision is made to start medications beyond the conservative ways of dealing with reflux, the most common reflux medications used to treat adults are also used to treat reflux in infants and children. They are the same exact medications, albeit at lower dosages. Although the effectiveness of such drugs are clear in adults suffering from acid reflux, it is less so in children. As is true with so much of medicine, there's no clear answer to the question of what the best reflux …
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July 09, 2013

Medications that (Might) Help Tinnitus?

The blunt answer is that there is no drug or supplement that has been consistently found to help with tinnitus (ringing of the ears). Here's a partial table showing all the research that has been done either proving or disproving effectiveness to treat tinnitus (info collected from this review paper ). For a more comprehensive list going over 17 drugs, click here . Drug Research That Supports Research That Disputes …
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July 08, 2013

What Caused Beethoven's Hearing Loss?

Image from Wikipedia When Beethoven composed his 9th Symphony, it was an amazing accomplishment especially when considering he did so totally deaf. It has been a medical mystery as to what caused his slowly progressive hearing loss to the point of deafness, but a recent publication suggests it was due to chronic low-level lead exposure consumed from wine tainted with lead. FACT: High levels of lead were found deep in the bone suggesting chronic lead exposure over a long period of tim…
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July 07, 2013

Does Drinking Alkaline Water Help With Reflux?

Image by WJ Pilsak from Wikipedia Treatment in some reflux-sufferers may require addressing not just the acid in reflux, but also the pepsin. In one tantalizing  research paper,  alkaline water (pH 8.8) was found to instantly and permanently inactivate pepsin in vitro (ie, in a test tube). Pepsin is a stomach enzyme that can cause inflammation and mucosal damage when in the throat area. This peptic enzyme can be deposited outside the stomach due to laryngopharyngeal reflux (LPR) and ca…
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Can Melatonin Stop Ringing in the Ears (Tinnitus)?

In a rigorous study, researchers have found that taking melatonin 3mg nightly for 1 month did significantly help with patients suffering from chronic tinnitus (ringing in the ears). Of course, the caveats are that melatonin significantly helped in patients with these specific characteristics: • Male • No history of depression • Tinnitus has been present for a long time • History of loud noise exposure • Tinnitus is severe and on both sides Given melatonin is a relatively benign sup…
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July 03, 2013

Video of How Nasal Cauterization for Nosebleeds Is Performed (Silver Nitrate and Electric)

I made a nosebleed  video a few years ago that was roundly criticized for being poorly made. The biggest complaint was the loud background music. As such, I have made a new video that I feel addresses many of the shortcomings levied on the original video. I also added additional footage of what different types of nosebleeds look like as well as adding bipolar cauterization as another method of cautery other than silver nitrate . Check the new (upgraded) video ! There is another video …
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Men's Ability to Taste Linked to Fertility?

Image by  צביה   from Wikipedia Researchers found that two proteins that govern the ability to taste sweet and savory profoundly influenced sperm development. This surprising connection between taste and male fertility occurred when the gene encoding the taste receptor proteins TAS1R3 (part of savory taste receptor) and GNAT3 (converts oral taste signal to a nerve signal) were modified in mice allowing for selective knockout with the drug clofibrate. When these genetically modified mic…
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July 01, 2013

New Video on Tongue Tie Release Procedure

Tongue tie is a common problem whereby a flap of tissue anchors the tongue tip to the bottom of the mouth. With tongue tie , it is impossible for a patient to stick the tongue straight out (licking an ice cream is impossible) and may potentially lead to problems with feeding in a newborn baby, speech articulation in a young school-age child, and french kissing in teenagers and older. Due to the frequency at which tongue tie release is performed and the questions parents often have about h…
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