Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
General measures to treat the sources of the bacterial infection with antibiotics and
drainage are carried out in the hospital while the
patient is monitored for any signs of compromised breathing muscles. Treatment is directed toward stopping toxin production, neutralizing its effects, and controlling muscle spasms.
Sedation is often given for muscle spasm, which can lead to life-threatening breathing difficulty.
In more severe cases, breathing assistance with an artificial
respirator machine may be needed.
The toxin already circulating in the body is neutralized with
antitoxin drugs. The tetanus toxin causes no permanent damage to the
nervous system after the patient recovers.
After recovery, patients still require active immunization because having the
tetanus disease does not provide natural immunization against a repeat episode.
How is tetanus prevented?
Active
immunization ("tetanus shots") plays an essential role in preventing tetanus.
Preventative measures to protect the skin from being penetrated by the tetanus
bacteria are also important. For instance, precautions should be taken to avoid
stepping on nails by wearing shoes. If a penetrating wound should occur, it
should be thoroughly cleansed with soap and water and medical attention should
be sought. Finally, passive immunization can be administered in
selected cases (with specialized immunoglobulin).
What is the schedule for active immunization (tetanus shots)?
All children should be immunized against tetanus by receiving a series of
five DTaP vaccinations which generally are started at 2 months of age and completed at approximately 5 years of age. Booster vaccination is recommended at 11 years of age with Tdap.
Follow-up booster vaccination is recommended every 10 years thereafter. While a 10-year period of protection exists after the basic childhood series is completed, should a potentially contaminated wound occur, an "early" booster may be given in selected cases and the 10 years "clock" reset.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Muscle spasms are involuntary muscle contractions that come on suddenly and are usually quite painful. Dehydration, doing strenuous exercise in a hot environment, prolonged muscle use, and certain diseases of the nervous system may cause muscle spasms. Symptoms and signs of a muscle spasm include an acute onset of pain and a possible bulge seen or felt beneath the skin where the muscle is located. Gently stretching the muscle usually resolves a muscle spasm.
Whooping cough (pertussis) is highly contagious respiratory infection that is caused by the bacteria Bordetella pertussis. There are an estimated 300,000 plus deaths annually from whooping cough (pertussis). Whopping cough commonly affects infants and young children, but can be prevented with immunization with the vaccine. First stage whooping cough symptoms are a runny nose, sneezing, low-grade fever, a mild cough with the cough gradually becoming more severe. After one to two weeks, the second stage of whooping cough begins.
Rabies is a potentially fatal viral infection. Rabies symptoms include fever, headache, myalgia, and can progress to more serious symptoms such as seizures, coma and death. The rabies vaccine (rabies treatment) should be administered immediately after the person or pet has been bitten.
Burns are categorized by severity as first, second, or third degree. First degree burns are similar to a painful sunburn. The damage is more severe with second degree burns, leading to blistering and more intense pain. The skin turns white and loses sensation with third degree burns. Burn treatment depends upon the location, total burn area, and intensity of the burn.
Cuts, scrapes, and puncture wounds are common, and most people will experience one of these in their lifetime. Evaluating the injury, and thoroughly cleaning the injury is important. Some injuries should be evaluated by a doctor, and a tetanus shot may be necessary. Treatment will depend upon the severity of the injury.
Rickets is caused by a deficiency of vitamin D, calcium or phosphate. Infants and children who are exclusively breastfed, have dark skin, and infants born to mothers who are vitamin D deficient are most at risk for developing rickets. Symptoms and signs of rickets include bone pain, delayed teeth formation, short stature, skeletal deformities (bowlegs, abnormally shaped skull), and decreased muscle strength. Treatment of rickets depends upon the cause, but the first step usually involves correcting any abnormal levels of calcium, phosphate, or vitamin D with supplements.
Natural diasters such as a hurricane can take a toll on family, friends, and neighbors. Both physiological and psychological stresses can be devastating. Learn how to prepare for a hurricane like food storage, safe water, first aid measures, cleaning mold, wearing protective gear, preparing for electrical hazards, avoiding carbon monoxide, avoiding physical injuries and hazardous materials, preventing drowning, reducing the risk of thermal stress, and preventing fatigue related injuries.
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