As a public health problem, sepsis is a stubborn and serious problem. It is a leading cause of mortality for hospitalized patients. Deaths from sepsis are increasing, not decreasing, so it is unlike other leading causes of death such as cardiovascular disease. Despite many decades of intense research and clinical […]
Paul E. Pepe came to the our department today to discuss his long history of clinical research in emergency medicine, pre-hospital medicine, and critical care. Dr. Pepe was one of the authors of the influential 1994 Bickell paper in the New England Journal. That paper, which was published when I […]
Cars kill a lot of people. We see the consequences every day in the ER. The two most common sources of accidental deaths in New Mexico – automobile accidents and drug overdoses – can be thought of as resulting from mismatch between human neurobiology and modern environment. Mismatch between the […]
Fat, especially visceral fat, has an important immune function, especially in gastrointestinal infections and in response to GI pathogens in the microbiome. In Podcast #39, Coffee Brown and I discuss Mary Jane West Eberhard’s paper on the evolutionary function of fat and a developmental explanation for the obesity epidemic. Her […]
Paul Young and colleagues recently published a meta-analysis that was designed to answer the question – does any group of patients benefit from fever control? The research question was: Since fever is physiologically costly, do patients “with limited physiologic reserves” benefit from reducing fever? The short answer, even for these […]
If it seems like I have been posting a lot on high altitude, here is the reason. I am taking part in the 2019 Mountain Emergency Medicine Conference taking place this year at Taos Ski Valley. Check out the flyer and registration information here. I will be speaking about Andean […]
In the EvolutionMedicine Podcast #37, Coffee Brown and I discuss whether intermittent fasting improves cognitive capacity. We talk about the recent paper by Mark P. Mattson, “An Evolutionary Perspective on Why Food Overconsumption Impairs Cognition” published in the journal Cell. Does overeating make us dumb as a culture? Can fasting […]
Three main groups of people have lived at high elevation for generations. These are the Andeans in South America, the Tibetans, Sherpas and others living on the Himalayan plateau, and the Ethiopian highlanders living at 3000m elevation and above in north eastern Africa. In the last few blog entries I […]
Pathology at high altitude occurs in part because of gene-environment mismatch. We introduced that idea in the first, second, and third blog entries on the topic of high altitude diseases. So far we focused on other clinical contexts in which hypoxia inducible factor (HIF-1) activation is adaptive during common disorders […]
In Ecuador, one member in our party developed significant swelling of her hands and feet. By itself, edema of the hands is not a problem, and it does not require treatment or descent to lower altitudes. But we have mentioned a few other instances in which edema is a big […]
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