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Medical concerns discussed while shopping

October 13, 2012
By C. Paul Martin, M.D. , Marshall Independent

A significant part of our daily existence is the aural, visual and vocal interactions with others. Family members, co-workers, service personnel, and friends give us information and create interest by sharing their experiences. So I was not surprised when two men whom I recently encountered in a retail store spontaneously initiated conversations with me about their medical history and nutritional inquiries.

A young man posed a perplexing question - in the "cookie" aisle. He inquired as to the difference among high fructose corn syrup, regular corn syrup, ordinary beet sugar, lactose, and honey.

I wondered if he had a concern related to a diabetic diet or the nutritional effects of these different sources of sugar. Wishing I had more specific knowledge of carbohydrates, I remembered what our local dietitians had taught me - "sugar is sugar, whatever the source."All sugars have the same four calories per gram and the same food value role in our diets. Patients with Diabetes Mellitus need to adjust the amount and proportion of carbohydrate intake in their diet.

The second man, a bit older, was concerned about the impact of his recent facial skin biopsy. He related a typical story that his wife had noticed a spot on his back which subsequently required extensive surgical removal and follow up. I reassured him that regular dermatological consultation would give the optimal chance of survival as I noticed the bandage on his face. Anticipating questions about terminal malignant melanoma and its fearful complications, I listened to his subsequent conversation which culminated in his telling me that the back biopsy occurred 41 years ago! I felt relieved as I complimented him on his present health.

The question I might have been asked at the store regarded the medical news concerning the iatrogenic epidemic of fungal meningitis highlighted in the media. This real and significant epidemic has caused 11 deaths and claimed more than 100 victims thus far with a potential to affect many hundreds more. It is not the contagious and infectious disease associated with little children, military camps, college freshmen, compound skull fractures, and religious pilgrimages.

The present cases of fungal meningitis have been traced to contaminated preparations of a corticosteroid drug manufactured by a small pharmaceutical company in Massachusetts. This medication was administered to patients by medical personnel for inflammation in the spinal areas.

A presumed epidural injection transferred the contaminated drug to the area of the spine, and then it spread to the central nervous system, causing the generalized and diffuse systemic signs and symptoms of headache, nausea, malaise, neck stiffness and other neurological signs. It is a classical case of fomite related infection; in some ways, its spread is similar to the spread of typhoid fever by "Typhoid Mary" into the homes - and intestinal tracts of her employers. In other considerations, her method of transmitting the bacterium is more like the classical transfer of a living organism to the host by an infected host.

Of note! There exists neither relationship nor danger to the untreated general public in this epidemic of fungal meningitis.



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