Happy New Year 2023!

Dear readers, listeners and fellow bloggers:

Good morning. The Laplume family wishes our loyal readers and listeners a Very Happy and Prosperous 2023 in the company of our loved ones, the most precious gift God Almighty has endowed us with. Let’s raise our glasses for a toast.

Note. This picture was taken after Christmas Sunday’s mass in the fabulous Saint Patrick’s church of Miami Beach

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.

With the very best friend God Almighty has given us in our whole lifetime!

Merry Christmas to all our readers, listeners and fellow bloggers:

Good afternoon and Happy Holidays to all of you. Just a few minutes ago, we took this selfie with our son Gian Luca, the very best friend we could possibly ask for.

We hope you are similarly spending these festivities in the company of your loved ones, the Godsent blessing for us.

We would like to warmly greet the brave Ukrainian people in this most sacred week as they are daily battling Evil. Moreover, they are engaged in the biggest cultural battle if our times. The faceoff of the Modern Democratic nations ruled by laws with Russia’s abject Authoritarianism that harks back to the Middle Ages. We firmly support you as our children’s world will be marked by that outcome.

No compromise with Fascism. Long live Ukraine. Hasta la victoria, siempre.

Stay distant. Stay safe. Stay beautiful.

Perception of Time

“We turned into the deep bed of a narrow street that ran between two sidewalks built high up off the ground. It had suddenly got dark; I heard quick, almost secret footsteps above me—I raised my eyes and saw a boy running along the narrow, broken sidewalk high above, as though running along the top of a narrow, broken wall. I recall the short, baggy trousers—like a gaucho’s—that he wore, the straw-soled cotton slippers, the cigarette in the hard visage, all stark against the now limitless storm cloud, Unexpectedly, Bernardo shouted out to him—What’s the time Irineo? Without consulting the sky, without a second’s pause, the boy replied, Four minutes till eight, young Bernardo Juan Francisco. The voice was shrill and mocking.”

Funes, el Memorioso. Jorge Luis Borges, Collected Fictions, translated by Andrew Hurley, Penguin Classics.

This image of Jorge Luis orges was located  at Wikimedia Commos,

Did you ever feel so bored that time slowed down to almost a standstill?

Did you ever feel so happy that time was flying away almost in a rush?

Of course, you did. The possibility of selectively perceiving time is wired in humans.

Interoceptive perception of time is a critical bodily function that processes a myriad of sensorial inputs from our immediate environment, our physiological functions, our memories of experiences and even our emotional baggage attached to those instances of living, all synchronized and fully integrated in our Central Nervous System to illuminate our path in the world, and even predicting the future.

Human awareness is inextricable tied to our perception of time. In an excellent article, Danielle di Lerma et al., researchers at the Department of Psychology from the Università Cattolica del Sacro Cuore of Milano, said: “Our consciousness, our ability to perceive the world around us, and, ultimately, our very sense of self are shaped upon our perception in loop connecting of memories from the past, present sensations and expectations of the future… Scalar Expectancy Theory (Gibbon et. al 1984) is one of the most accepted frameworks of time perception (Church, 1984; Treisman et al., 1990) A core tenet of SET is an internal clock with a pacemaker-accumulator component. Pulses emitted by the pacemaker are stored in the accumulator. and the amount of units stored in a finite span influences sample frequency and our time perception. A high pulse rate will store more units in the accumulator, therefore leading to overestimation in subjective perception, whereas a low pulse rate will produce opposite effects. Recent developments of SET included memory and decision-making components along with the pacemaker-accumulator unit, providing a more efficient neurocognitive framework for time awareness (Gibbon et al., 1984; Lui et al., 2011)”

This image of Aiale Carracis’ Allegory of Truth ad Time was located at Wikimedia Commos.

Perception of time is solidly rooted in our physiological matrix as not only bodily functions and emotions alter it, but also a state of physiological arousal can increase the pulse frequency of the pacemaker, creating overestimation of subjective time perception. The movements of our bodies and its sensory-motor integration in our cerebral cortex can distort our awareness of time, producing different outcomes. Recent neurophysiological studies have identified an interoceptive matrix located in the anterior cingular cortex (AIC) that receives input from small diameter sensory fibers from the Lamina I spinothalamocortical pathway, which receives sensory information form multiple organs and systems of our body to maintain homeostasis.

Friston et al. studied the interoceptive buffer, which processes and compares the actual information with previous ones to make rational predictions about the system’s functioning and thus optimize its efficiency, just like a “little internal chip” Considering that this buffer has small dimensions and can be easily filled up to saturation levels by incoming stimuli, Craig et al. proposed that: “ high rate of salient stimuli can saturate the finite dimension of the buffer, speeding up the sampling frequency, effectively slowing (Tse et al., 2004; Campbell and Bryant, 2007; van Wassenhove et al., 2008; Wittmann and Paulus, 2008; DroitVolet et al., 2011) the perception of time, which will appear to ‘stand still to the subjective observer’ (Craig, 2009). Contrary, when the interoceptive buffer is not filled up ‘large intervals of time in the objective world can appear to pass quickly’ (Craig, 2009)”

Recent studies of the AIC showed that in paradoxical situations where high rates of high salience stimuli can produce opposite effects, there is an asymmetric activation of the buffer. The parasympathetic impulses are processed by the left and mid insula of the AIC and the sympathetic impulses are in its right side. “According to Craig’s emotional asymmetry perspective, when we experience a dominant sympathetic arousal, stimuli processed in the right AIC speed up the sample rate frequency, accumulating pulses in the internal clock, leading therefore to overestimation of subjective time perception. Conversely, when we are engaged in a parasympathetic (e.g., affiliative) activation, stimuli are preferentially processed by the left AIC, leading to underestimation of time due to a lack of sympathetic activity.” There is ongoing research about the functioning of this interoceptive buffer, especially when it is overloaded with parasympathetic stimuli that foster a distorted time perception.

It has critical importance in pathological situations where there might be interference with the perception in time according to the person’s load of sympathetic or parasympathetic stimuli. Daniele di Lermia et al studied the following: “we hypothesized that depressive symptoms (Dunn et al., 2007, 2010; Pollatos et al., 2009; Paulus and Stein, 2010; Wiebking et al., 2015) and eating disorder tendencies (Pollatos et al., 2008), will interfere in a negative direction, while anxiety symptoms (Whyman and Moos, 1967; Pollatos et al., 2009, 2014; Dunn et al., 2010; Paulus and Stein, 2010; Yoo and Lee, 2015) and other sympathetic stimuli (Ogden et al., 2015a) in a positive one.”

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.

Loneliness is the worst world pandemic

– “I moved to X.  because of the war and I am lonely here, can you help me cope with loneliness?”

This incredible message was sent to us a few days ago by a knockout-blue-eyed- blonde professional lady from the Ukraine that we had met online in a chat space. How is it possible that she could not find a romantic partner anywhere she chose to settle? And if I were to tell you that she cooks. And she knits too

Loneliness is a major scourge of all nations that crosses all the socioeconomic, ethnic, age and cultural segments of our modern societies, significantly worsened after two years of social isolation and profound anxiety due to the Covid pandemic. The social and economic consequences have been progressively subsiding, but the mental and psychosomatic sequelae are not only resiliently persisting but for many individuals have even worsened. There are new triggers of anxiety and depression.

As we have repeatedly said in our previous articles and recent book, despite having the most advanced means of communication that mankind has ever known, we are more isolated and lonelier than ever in the history of societal communities. The terms loneliness and social isolation are related but not interchangeable. Social isolation is usually defined by objective measures like the number and depth of family relationships, social networking, participation in social institutions, etc. Loneliness is usually defined by subjective measures like personal perceptions of emotional deprivation and absence of inclusiveness plus the void of personal rapports.

Dr. Neil Charness, Director of the Institute of Successful Longevity, said: “Important risk factors for loneliness and social isolation are age (older people are more likely to report being lonely), physical and mental health (greater disability is associated with greater loneliness), lack of access to mobility options (driving, public transportation), lower income levels and living arrangements (living alone).  Taking on the role of full-time caregiver for a loved one can also led to social isolation.”

Note. This reproduction of Le Penseur by Auguste Rodin was taken from Wikimedia Commons.

Recognizing the deleterious effects on the mental and physical health of patients of modern nations, the United Kingdom, the very first Western nation to institute a National Health Service after World War II, took the initiative by creating a new Ministry of Loneliness with Baroness Barran as its first designated functionary.

In June 2021, inaugurating the Loneliness Awareness Week, Baroness Barran said: “Although life is beginning to feel closer to normal for many people, we are still in a critical stage when it comes to tackling loneliness. There is a large number of people who felt lonely before the pandemic and will continue to do so as lockdown restrictions ease.”  There is generous funding to set initiatives to foster the following.

a) Check in with a neighbor, recognizing that some people will be keen to get together in person once possible, while others might be more cautious.

b) Keep in touch with friends, family, and neighbors – for example calling someone or writing a letter, asking how they feel about getting out and about again, and considering whether going together would help both of you feel more confident.

c) Contact organizations – there’s a list of organizations on the Let’s Talk Loneliness website, which can offer support.

d) Set a routine with online activities, regular tasks or by volunteering. Rejoin groups that might not have met for some time, and think about how you can welcome others back, especially people not feeling very confident.

An online survey of 950 Americans carried out in October 2020 showed that: “36% of all Americans—including 61% of young adults and 51% of mothers with young children—feel ‘serious loneliness.’ Not surprisingly, loneliness appears to have increased substantially since the outbreak of the global pandemic.” However, the loneliness epidemic in the USA not only concerns the elderly, but also younger generations like the Baby Boomers, who have started to retire in droves since the begging of the 21st century, and the still employed Gen X.

In a November 27, 2022, New York Times article Dana Goldstein and Robert Gebeloff said: “in 1960, just 13 percent of American households had a single occupant. But that figure has risen steadily, and today it is approaching 60 percent. For households headed by someone 50 or older, that figure is 36 percent. Nearly 26 million Americans 50 or older now live alone, up from 15 million in 2000. Older people have always been more likely than others to live by themselves, and now that age group—baby boomers and Gen Xers—makes up a bigger share of the population than at any time in the nation’s history.”

However, there are encouraging signs that older people are positively reacting to their loneliness at home by reaching out for civic institutions in society to do voluntary services and even opt to become partially employed as caregivers. In our book Emotional Frustration—the Hushed Plague, we discuss it extensively.

Stay distant. Stay safe. Stay beautiful.

 What do you think? Please tell us.

Don’t leave me alone.

Happy Day of the Physician

Dear readers, listeners, fellow bloggers and podcasters;

Today, December 3rd, we celebrate the Day of the Physician the Americas in honor of all the dedicated and hard-working professionals tending to the health care needs of people from Alaska in the extreme North to Ushuaia in the extreme South.

The Panamerican Health Organization, or Organización Panamericana de la Salud in Spanish, designated this day in honor of Carlos Juan Finlay Barres, a Cuban physician and researcher who had discovered in 1881 that the Yellow Fever was transmitted through an insect vector like Aedes aegypti; he was born on December 3, 1833 in Puerto Principe, Cuba, and studied Medicine at Jefferson Medical College in Philadelphia.

Note. This image of Dr. Carlos Finlay was taken form Wikimedia Commons.

Dr. Finlay, dubbed as “the mosquito doctor” by his detractors, had a hard time to prove his hypothesis but he finally collected enough clinical data to submit to the “Yellow Fever panel” headed by Dr. Walter Reed that finally accepted his findings in 1901. That medical breakthrough prodded the Panama Canal authorities to set up the proper sanitary conditions in the workers’ camps in order to finish the humongous project. In 1902 Dr. Finlay headed the precursor office of the present day PHO.  Dr. Remo Bergoglio, an Argentine physician acting on behalf of the “Sociedad Médica de Cordoba”, submitted a proposal to celebrate this day on the floor of the PHO congress in Dallas in 1953.

To my dear colleagues of the Americas, thank you for your devoted daily work.

A mes collègues de l’Amérique, felicitations pour votre travail dévouée de tous les jours. Salut!

A mis queridos colegas de las Américas, gracias por su trabajo abnegado de todos los días. Salud!

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Do not leave me alone.

Fox Sisters: pioneers of American Feminism

Spiritualism was a religious reaction to the “crisis in faith” that the Civil War produced across the United States of America, with millions of citizens seeking to reconnect with loved ones who died in that extremely bloody confrontation. It did not have a formal structure nor supervising hierarchy, for which women welcomed it as a spontaneous way to express their feeling, fears and hopes, without the castrating influence of the Patriarchate that dominated civic and religious entities.

In an era where women were excluded to the back of religious congregations and were prohibited from speaking loud and clear, let alone address the worshippers, it offered an uncensored and unsupervised channel for them to address critical social issues like abolition, labor reform, education of children, health reform, temperance. Spiritualism gave oppressed women a venue to express their opinions without the censoring gaze of the State or the Official churches; it gave them a human presence.

Spirituals affirmed that God gave the gift of talking to every human being, which enabled women to express their personal opinions and fight for a progressive agenda. Acting as inspired “mediums” and “trance speakers” they slowly but steadily gained confidence in talking before the public at large and they forever left the anonymity of their kitchens where they had been perfidiously relegated for many generations. They immediately clashed with the male-dominated healthcare institutions as they were branded of “quacks” and “illegitimate healers” by the envious professionals.

The religious movement, which was born before the Civil War and thrived during the conflict and its very traumatic aftermath, was paradoxically born in the Fingers Lake region of Upstate New York, where Mormonism and Millerism also started. Two young girls named Margareta “Maggie” Fox, 14 years old, and Kate, her 11 years old sister, were living in a farm in Hydesville, New York. In March 1848, they confided to a lady that lived next door, that they had been hearing a series of raps on the walls and the furniture lately. They invited her to witness the experience and under the guidance of Margaret, their mother, they huddled in the girls’ bedroom.

– “Count five,” said Margaret. Then the room shook five times.

– “Count fifteen,” ordered Margaret. The mysterious presence obeyed her command.

– “What’s our neighbor’s age?” she asked. There were thirty-three clear raps.

– “If you are an injured spirit,” she finally asked, “manifest it with three raps. It did.

Note. This image of the Fox Sisters was taken from Wikimedia Commons.

An excellent review article in the Smithsonian Magazine explained what happened afterwards with the Foxx sisters. “The Fox family deserted the house and sent Maggie and Kate to live with their older sister, Leah Fox Fish, in Rochester. The story might have died there were it not for the fact that Rochester was a hotbed for reform and religious activity; the same vicinity, the Finger Lakes region of New York State, gave birth to both Mormonism and Millerism, the precursor to Seventh Day Adventism. Community leaders Isaac and Amy Post were intrigued by the Fox sisters’ story, and by the subsequent rumor that the spirit likely belonged to a peddler who had been murdered in the farmhouse five years beforehand. A group of Rochester residents examined the cellar of the Fox’s home, uncovering strands of hair and what appeared to be bone fragments.

The Posts invited the girls to a gathering at their home, anxious to see if they could communicate with spirits in another locale. “I suppose I went with as much unbelief as Thomas felt when he was introduced to Jesus after he had ascended,” Isaac Post wrote, but he was swayed by “very distinct thumps under the floor… and several apparent answers.” He was further convinced when Leah Fox also proved to be a medium, communicating with the Posts’ recently deceased daughter. The Posts rented the largest hall in Rochester, and four hundred people came to hear the mysterious noises. Afterward Amy Post accompanied the sisters to a private chamber, where they disrobed and were examined by a committee of skeptics, who found no evidence of a hoax.”

There are many references in The Bible about human beings talking with spirits, angels, demons, etc., for which Modern Spiritualism found a fertile ground in the fervently religious, mostly rural communities of the New World. By the mid-1800s the preaching of Franz Anton Mesmer, an Australian healer, had spread all over the young nation. He claimed that everything in the Universe, including the bodies of all living beings, is ruled by a “magnetic fluid” that produces sickness when it is out of balance. He waved his hands over the body of the sick patient and supposedly induce a hypnotic state to restore the homeostasis and get rid of the pathogens. Thus, the verb “to mesmerize” came into being as it referred to a person that can hypnotize another person with a rather uncommon, even supernatural, mode.

The American population of the mid-nineteenth century was also influenced by the teachings of Emanuel Swedenborg, a Swedish philosopher and mystic, that described. After Life as a collection of three heavens, three hells and an intermediate staging ground where everybody went right after their death. Selfish beliefs and deeds pushed you closer to one of the hells while generous ones push you closer to one of the heavens. He claimed to have interacted with spirits in all levels. Seventy-five years later, Andrew Jackson Davis, an American seer nicknamed the “John Baptist of Modern Spiritualism”, claimed that Swedenborg had spoken to him in a trance and urged him to combine the philosophical tenets of Mesmer and his own to create a novel current that would better serve the needs of the American people.

The Fox Sisters had peripatetic lives, full of public demonstrations and excitement. Being national celebrities, Maggie, Kate, and Leah Fox embarked on a tour across the country, even presenting their act before the most rancid New York society. They carried their act in the parlor of the Barnum Hotel with 10 AM, 5 PM and 8 PM sessions that could accommodate up to 30 attendees who had to pay one dollar each. Leah set up a cabinet in the Big Apple where she set up regular office hours for her clientele, while the two sisters went on a national tour in major Eastern cities.

The Smithsonian article added: “On October 21, 1888, the New York World published an interview with Maggie Fox in anticipation of her appearance that evening at the New York Academy of Music, where she would publicly denounce Spiritualism. She was paid $1,500 for the exclusive. Her main motivation, however, was rage at her sister Leah and other leading Spiritualists, who had publicly chastised Kate for her drinking and accused her of being unable to care for her two young children. Kate planned to be in the audience when Maggie gave her speech, lending her tacit support.” Maggie confessed that together with her sister Kate they tied an apple with a string and manipulated it to resemble the clapping that supposedly spirits might make.

Notwithstanding this confession, which she would later recant, Spiritualism became an extremely popular religion, with as many as 10,00,000 adherents in its heyday. And it opened the doors of public discourse and civic engagement to many smart and committed ladies that wanted to voice their opinions about social issues dear to them.

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.

 

Uruguay’s Number One football fan in Miami, Florida, USA

Dear readers, listeners, fellow bloggers and podcasters:

Good morning. Today the Uruguayan football team is playing Ghana in the qualifying rounds of the Quatar World Cup. We are winning 2 to 0 in the beginning of the second half.

As the character played by Guillermmo Francella, in the 2009 Oscar award-winning film “The Secret in their Eyes“, explained with the most famous movie phrase about football:

¿Te das cuenta, Benjamín? El tipo puede cambiar de todo: de cara, de casa, de familia, de novia, de religión, de Dios. Pero hay una cosa que no puede cambiar, Benjamín, no puede cambiar de pasión

(Do you realize, Benjamin? The guy can change everything: his house, his family, his girlfriend, his religion, his God. But there is one thing that he cannot change, Benjamin, he cannot change his passion)

He was referring to a fugitive from the law that had changed identity and hid away from his family, after assassinating a young housewife that he had known since childhood.

VAMO’ ARRIBA LA CELESTE!!!

What do you think? Please tell us.

Don’t leave me alone.

Hasta la Victoria, siempre!!!

Queridos lectores, blogeros y podcasters:

Buenos dias. La gran batalla cultural de nuestros tiempos no esta desarrollándose en los espacios sociales de USA, Inglaterra, Francia o Alemania. Está transcurriendo ahora mismo en los campos de guerra y muerte en el Este y Sur de Ucrania, donde el aguerrido ejército y la población civil de esa gran nación estan enfrentando la invasiôn rusa.

Enfrentados en una guerra reminiscente de la Segunda Guerra Mundial (donde el ejercito alemán luchó y perdió cruentas batallas en esas mismas llanuras) están dos diametralmente opuestas visiones para nuestro plnaeta, con importantísimas implicancias, sociales, económicas y culturales para nosotros y nuestros hijos. Y hasta nietos.

Por un lado está el AUTORITARISMPO DÉSPOTA que niega las libertades individuales y las garantias jurídicas de las naciones democráticas. Eso es la FEDERACIÓN RUSA.

Por el otro lado está UNA NACIÓN MODERNA que esta empezando a implementar reformas sociales y juridicas para ser una sociedad democrática. Esa es la UCRANIA.

Note. This Army poster from the Spanish Republican Army was taken from Wikimedia Commons. The legend says “Grab the rifles. For the Homeland, Bread and Justice.”

https://commons.wikimedia.org/wiki/File:2_posters_of_the_Spanish_Civil_war.jpg

Ahora no es momento de tener posiciones tibias y confuasas en este conflicto . O se está con la DEMOCRACIA REPUBLICANA o se está con la EDAD MEDIA.

Todos los intelectuales tenemos que apoyar, en la medida de nustra capacidad, el gran esfuerzo de las naciones libres para contener el expansionismo ruso.

Como decíamos en nuestras gloriosas épocas de militante político que luchaba contra la dictadura fascista de los militares uruguayos  en las calles de nuestro querido Montevideo.

HASTA LA VICTORIA, SIEMPRE.

Que les parece? Dénnos su opinión.

No me dejen solo.

 

 

Should we get our vaccines against Pneumonia?

Pneumonia is a parenchymal infection of the lungs that presents with acute or subacute onset of fever, productive cough, pleuritic chest pain, localized râles, and radiological signs of consolidation. There are three categories of this disease:

  1. Community-acquired pneumonia (CAP)
  2. Healthcare- associated pneumonia (HCAP)
  3. Nosocomial pneumonia.

It is a worldwide leading cause of emergency visits, hospitalizations, and death; according to the World Health Organization (WHO) it is the fourth leading cause of death, killing more than 2.6 million lives I 2019. There are two major peaks of incidence:

  1. Children less than 5 years of age.
  2. Adults older than 75 years of age.

The combined mortality for influenza and pneumonia has radically decreased in the USA—from 23.7 per 100,000 inhabitants in 2000 to 15.2 per 100,000 inhabitants in 2019—due to the falling of smoking rates across all socio-economic segments of the American population and the increase of use of the corresponding vaccines. According to the American Public Health authorities, the best strategy to decrease the morbidity and mortality rates of CAP is to vaccinate the target groups:

  1. Age: individuals less than 5 years of age and older than 65 years old.
  2. Smoking history.
  3. Chronic Lung diseases: Chronic Obstructive Pulmonary Disease (COPD) Childhood Pneumonia, Occupational dust exposure.

The best strategy to decrease the morbidity and mortality of HCAP is to:

  1. Maintain critical pulmonary defense mechanisms.
  2. Reduce the incidence of intra-hospital infections and similar care events.

The most common pathogen producing Pneumonia is Staphylococcus Pneumoniae, which has been identified in almost a third of patients that had proper testing and approximately 40-50% of all blood cultures-confirmed cases. Patients with COPD often have tracheobronchial colonization with a mix of S. Pneumoniae, Hemophilus Influenzae and Mycoplasma catarrhalis. Heavy use of alcohol carries the risk of dangerous pathogens like anaerobic bacteria, which predispose to lung abscess and empyema, and the opportunistic emergence of gram-negative bacilli tougher to treat.

The American Thoracic Society (ATS) and the Infectious Diseases Society of America (IDSA) noted in their 2005 guidelines that the three variants of pneumonia associated with healthcare facilities –HAP, VAP and HCAP— “are similar in that they often result from colonization, then infection by resistant gram-negative bacilli and methicillin-resistant Staphylococcus aureus (MRSA) necessitating broader empiric antibiotic therapy than that commonly used for CAP.”  These same ATS/IDSA guidelines do not recommend the routine use of blood cultures in the ambulatory setting, except in the following circumstances:

  1. Symptoms or signs of severe CAP.
  2. Suspicion of drug resistant or rare pathogens.
  3. No response to empiric antibiotic treatment after 72 hours.

The same ATS/IDSA guidelines recommend the pre-treatment use of blood cultures before initiating treatment in hospitalized patients who are classified as severe CAP, are being empirically treated for MRSA or gram-negative bacilli or have one of the following: a) cavitary infiltrates, b) leukopenia, c) chronic alcoholism, d) chronic liver disease, e) COPD, f) pleural effusion, g) no spleen, and h) admission to ICU.

Patients who do not have any life-threatening conditions can be managed at home. Pending the results of any blood cultures that were obtained, the 2019 ATS/IDSA guidelines recommend the following initial treatment for Pneumonia:

  1. Amoxicillin 1 gram three times per day.
  2. Doxycycline 100 mg twice per day.
  3. Or a macrolide monotherapy—azithromycin 500 mg on first day and then 250mg per day or clarithromycin 500 mg twice per day.

The ATS/IDSA guidelines recommend at least five (5) days of antibiotic treatment which should be extended 48 to t72 hours if there were any complications; when gram negative or Staphylococcus bacteria are present, treatment should be longer as these pathogens tend to destroy pulmonary tissue and provoke residual scarring.

Note. This 1802 caricature of the Anti-Vaccination movement by Edward Gillray was taken from Wikimedia Commons.

As it has happened ever since Edward Jenner introduced the life saving vaccines against smallpox, there are detractors of the Pneumococcal vaccination. What does the science say?

Pneumococcal vaccination has significantly improved over the past few years, as more variants are accounted for. A single agent, PPSV23, had been traditionally used for immunocompromised individuals and those older than 65 years; it is effective against 85 to 90% of the pneumococcal serotypes in our communities. Considering that the polysaccharide vaccines are not effective in children less than 2 or 3 years of age, we must use conjugate vaccines. In 2010 a 13-valent conjugate vaccine dubbed as PCV13was introduced in the market and its use has steadily decrease the incidence of the disease in children. In 2013 that vaccine was recommended for immunocompromised individuals and two years later for adults older than 65 years. However, considering the sharp decline of Pneumococcal infections in adults after he introduction of PCV 13 in children, they amended that recommendation already.

The influenza vaccine is a trivalent live vaccine that contains the three virus variants that are expected to be prevalent the year following its manufacture. Combined with the pneumococcal vaccine, it has been effective in reducing flu and pneumonia in the USA. However, their use is still limited due to poorly designed Public Health initiatives and lack of provider effective participation in vaccination campaigns.

A September 2022 communique of the CDC to physicians says: “The 13-valent pneumococcal conjugate (PCV15 from Wyeth Pharmaceuticals) and the 23-valent pneumococcal  polysaccharide vaccine (PPSV23 from Merck, Sharp and Dohme) has been recommended for American children; those recommnendations vary by age group and risk groups.”

We, physicians, are notorious for missing that needed vaccination again and again. We paradoxically scold our patients for not getting their yearly flu shots, but….We never got one ourselves. We solemnly promise to get our flu and pneumococcal shots after we get the bivalent Pfizer Covid booster and the Holidays passed. Why? Because we want to minimize any risk, no matter how small it might be,  of interference with the plentiful food and drinks we are planning to load our bodies with. Hey. give us a break…We’re only human!!!

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.