Posted in Entertainment, movies, news

Avengers 4 Arrives May 2019 and Has Some “Splain’n” to Do!

Marvel will release the 4th Avengers installment on May 3rd, 2019.  Although its title has not been released, fans are hoping it’s along the lines of “Our Bad!”, apologizing for the 3rd’s horrendous ending.

The previous film, Avengers: Infinity War left viewers with dropped jaws, and multiple cliff hangers that no one could talk about for weeks.

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Marvel Studios President Kevin Feige promises, however, that the 4th installment will have a definitive conclusion as “the best stories have a definitive ending to a storyline. That’s certainly what’s going to happen next year with Avengers 4.”  He continues, “The Universe, the world, many of the characters we’ve introduced will continue onward in unexpected ways, some of which I don’t even know yet.

“But bringing a definitive conclusion at the 22-film mark, and just over 10 years, seemed like the right thing to do.”

Ya think?  For 21 movies we fall in love with multiple characters and in one fell swoop they’re annihilated??? But there’s hope.  This summer’s Ant-Man and the Wasp spewed out lots of science with “Quantum Realm” being discussed half a dozen times.  Then Emergency Awesome posted an interview, reported by ScreenRant, in which Tom Holland (Spider-Man) appeared to spill the beans when discussing his and Benedict Cumberbatch’s (Dr. Strange) lines, saying “He has the most difficult lines though. He has to talk about so much Quantum Realm stuff. I just have to talk about, ‘Yeah, man, that’s awesome!’ So mine is easy but his is so difficult!”

But hold the shield….Dr. Strange dies at the end of Infinity War, as does SpiderMan…or do they?  All we see are dark ashes wisping around the air after they pseudodisintegrate.  Maybe they become Quantum molecules that need to be webbed together…..I got it.  They meet up with Ant Man who is stuck in the Quantum sphere and hit the button thingy to become large again.

Too easy.

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

 

 

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Posted in allergies, food, Health, news

Death By Cookie: How Common are Food Allergies?

A 15 year-old girl with known peanut allergies has died after eating a Chips Ahoy cookie that she mistakenly thought was peanut-free.

Alexi Ryann Stafford, of Weston, Florida, was at a friend’s house when she reached for a cookie in the red Chips Ahoy packaging, famous for being the “Chewy” type. However, she did not read the package delineating it was the “Chewy Reeses Peanut Butter cups/chips” brand.

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Both packages are similar in color, and Alexi immediately began to feel symptoms. She went home, was given two Epi-Pens while waiting for paramedics, but unfortunately went into anaphylactic shock and died within 90 minutes of consuming the cookie.

Her mother, Kellie Travers-Stafford, is now calling for more warning labels on the packaging.

If one is allergic to an insect or food, a severe allergic reaction may ensue upon exposure, in which the immune system releases a flood of chemicals that can cause throat tightness, hives, lip and facial swelling, difficulty breathing, nausea, vomiting, low blood pressure, rapid heart rate, cardiac arrest and possibly death.  This anaphylaxis needs to be treated immediately while maintaining airway support and minimizing the allergic response.

The EpiPen® auto-injector contains epinephrine, a drug of choice in these situations.

Epinephrine stimulates the heart to increase cardiac muscle contractility, cardiac output, subsequently raising the blood pressure. Additionally it relaxes the muscles surrounding the airways, allowing one to breathe easier and take in more oxygen. Moreover it helps to stop the release of additional immune chemicals.

The EpiPen® is manufactured by Mylan.  Its cost made headlines when the EpiPen two-pack recently stickered for close to $600. Now generic forms are available costing anywhere from $109-$300 for a dual pack.

The disposable auto-injector, for an adult, delivers 0.3 mg of epinephrine, while the EpiPen Jr., used in pediatric populations, delivers 0.15mg of the medication.  It can be self-administered, through clothing if necessary, into the thigh muscle in one smooth movement once the safety release is removed.

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What Foods Cause Anaphylaxis?

Any food could theoretically cause an allergic reaction, mild or severe, but the most common culprits include:

  • Nuts (peanut, tree nuts, pistachio, etc.)
  • Milk
  • Shellfish
  • Fish
  • Soy
  • Wheat
  • Fruits

 

Food Allergies are Rising

According to FARE – Food Allergy Research and Education, 15 million adults have food allergies, including approx. 6 million children, or 1 in 13 kids.

On their website they report:

  • The Centers for Disease Control & Prevention reports that the prevalence of food allergy in children increased by 50 percent between 1997 and 2011.
  • Between 1997 and 2008, the prevalence of peanut or tree nut allergy appears to have more than tripled in U.S. children.

Why are food allergies rising?

Multiple theories have been suggested.  Some include:

  1. The hormones in our food alter our immune system, making it more sensitive
  2. The preservatives in our food may have the same effect, sensitizing our immune system
  3. We may be “too clean”…over sanitizing or not exposing our children to the outdoors as we did as children, thus preventing their immune system to mature
  4. Our gut microbiome may be changing as we eat more of a fatty, junk food diet, having some effect on our ability to manage food allergens.
  5. Vitamin D deficiency, caused by lack of sunlight and playing outdoors, might be a risk factor for severe allergies
  6. Obesity has been linked to allergies and asthma, and the average weight of an American has risen over the past few decades

Researchers are desperately working on desensitization treatments for those with severe food allergies.  In the meantime, however,  those who are vulnerable need to be extremely cautious about what they eat, stock EpiPens®, have a plan for alerting the Emergency Medical System, and wear medical alert bracelets for others to be aware in time of an emergency.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Education, Entertainment, Health, news

The Science of Swearing

Having gotten in trouble my whole life for doing so, I thought it was about time I investigated what is “swearing”, why it comes so fluently and why we frequently choose to do it. So lets break down the science of swearing…..

What is the definition of a curse word?

Most dictionaries define a curse word as a “profane or obscene word.”  But I disagree with this definition.  “Profane” comes from the latin root “profanus”, or “unholy”, and Oxford Dictionary defines “profane” as not relating to that which is sacred or religious; secular, (of a person or their behaviour) not respectful of religious practice.  

But many of us who use these words when you say “I just stepped in dog $%&t” aren’t referring to religion in any way, shape or form.

“Obscene”, when defined by multiple dictionaries, alludes to terms of a sexual nature.  Again, complaining that you just stepped in dog $%&t has nothing to do with sex.

So I define a swear/curse word as one that society deems to be off-color and not appropriate in public and professional settings….a word that has plenty of other socially acceptable alternatives used during anger, excitement, or awe.

When was the first curse word spoken?

According to historians, the first curse words originated in the 15th century.  I’m sure horses were just as messy as our dogs.  But as you can see by my definition, curse words must have had their origin in caveman days as humans developed language.  Rocks were dropped, people slipped and fell, and some burned themselves on early fire so I seriously doubt that only grammatically acceptable words and phrases were used in times of accidents.

Where did specific curse words originate?

Although a good old-fashioned four letter word seems as American as they come, most originate from foreign sources.

The “S” Word

According to Business Insider, the noun nods to Old English scitte, meaning “purging, diarrhea.” And just the basic form of excrement stems from Old English scytel. The action, however, has a much more widespread history — Dutch schijten and German scheissen. The Proto-Indo-European base skie conveys the idea of separation, in this case, from the body.

The “F” Word.

 According to the Huffington Post, the f-word is of Germanic origin, related to Dutch, German, and Swedish words for “to strike” and “to move back and forth.” It first appears, though, only in the 16th century, in a manuscript of the Latin orator Cicero. An anonymous monk was reading through the monastery copy of De Officiis (a guide to moral conduct) when he felt compelled to express his anger at his abbot. 

“Ass”

Comes from the word “arse” and used as early as the 11th century when referring to an animal’s anatomy, and then later to humans.

The “B” Word

Having Old English and Germanic roots, the “B” word represented a female dog.  By the 1400’s, however, it became a “term of contempt to women,” according to Business Insider.

 

So why do we curse?

There are various theories as to why people would choose a word that may offend others.  Here’s mine:

  1.   The words are easy to say.  Four letter words seem to be the most popular and can be spewed out with ease when in pain or in anger.
  2. The words inspire an emotion.  When we communicate we need a reaction to what we say, and curse words seem to elicit some of the strongest of reactions, hence reinforcing our belief that we are effectively communicating.
  3. They’re weapons.  When we get mad at someone and want to avoid a physical altercation, we weaponize our words instead, inflicting as much verbal hurt and pain as possible. One rarely finds themselves in jail after launching a full foul word offensive.
  4. They allow us to rebel. If curse words are not allowed in a school, work or professional setting then our use demonstrates our autonomy.
  5. They convey meaning that other words cannot.  The F word, for example, is one of the most notorious and ubiquitous, with movies, books, and speakers having validated its use so many times as a noun, adjective, or verb, that it has its own character and conveys a meaning, no matter how it’s used, that society easily recognizes. In fact, it’s so notorious that the F word is recognized by those who don’t even speak English.

 

What are “fake” curse words?

“Fake” curse words are terms we use to convey a curse without acutally swearing.  Commonly used alteratives to swearing include:

  • Flip
  • Flipp’n
  • Frick
  • Dang
  • Heck
  • Witch
  • Shut the Front Door
  • Son of a Motherless Goat
  • Son of a gun
  • Dagnabbit
  • Beeswax
  • Holy shitake mushroom
  • Wuss
  • Pluck it
  • Yuk fou
  • Fire truck
  • Donald Duck

 

Is cursing/swearing ever considered “good”?

In 2017, a study from Stephens et al, from Keele University in the UK, found swearing to increase strength and power performance when working out.

Previously, in 2009, the same researchers found men who were allowed to swear while immersing their hand in cold water could maintain it twice as long as those who had to keep their language clean.

So if we perform better while cursing, will it ever become acceptable to curse?

Society seems to already accept many curse words, even on prime time television, a barometer we use to determine if a word is OK to say out in public.  However once we take a four letter word and “legalize it”, people will gravitate towards words that aren’t acceptable because of the aforementioned reasons.  We want to be rebellious and demonstrate our feelings in times of pain and anger.

So for those of you who find this unacceptable, I really couldn’t give a flipp’n cluck.…..

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

 

 

 

 

 

Posted in Health, news, travel

Hotel Related Illnesses – Your Guide to Not Getting Sick

Some of us travel to see family, some to hang out with friends…but some of us get some unexpected guests when we go on vacation that make us sick.  Hotel related illnesses result from any of a variety of exposures that can occur on vacation.  Here’s your breakdown:

The Bed

Most hotels do not wash the comforter.  Headboards may also be unclean.  Bedbugs may hide out, looking like dark spots on the sheet. Even though bedbugs should not cause disease from their initial bite, a secondary infection could take place and if one is not vaccinated could be at risk for tetanus.

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The Air

Dust, smoke and allergens can pervade a room, if poor ventilation is in place. Those with asthma or lung disease could have an exacerbation due to allergies or poor air quality.  A rise in complaints of marijuana stench have been noted as well.

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Watch where you put your hands

Remote controls, light switches, glasses, ice containers, door handles, curtain wands do not get routinely cleaned and could harbor dangerous bacteria, viruses and fungi.

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Watch where you eat

Buffets are a travel favorite with all-you-can-eat access to food.  However buffet lines can be risky if patrons serve their own food.  You may be handling spoons and serving utensils others (who didn’t wash their hands after going to the bathroom) touched.  Moreover food may sit out for lengthy periods of time collecting bacteria.

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Norovirus – notorious for making multiple cruise ships, the S.S. Stinky, norovirus outbreaks can occur in hotels or ships where close quarters expose many to contaminated food, water or surfaces.  Symptoms occur within 12-48 hours of exposure, resulting in nausea, vomiting, diarrhea, abdominal cramps, low fever, and malaise.  Severe symptoms may cause dehydration.  Although symptoms last 1-3 days, those infected could shed the virus for weeks after exposure.

Hotel Shower/Tub

Most should be cleaned daily but use caution.  Some hotels have reported Legionnaires’ disease outbreaks, where the bacteria may spray from the shower head.  Legionella bacteria grow and flourish in water systems, therefore lurking in plumbing, air conditioning, and hot tubs.

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Hotel Pools/Hot Tubs

These get cloudy and messy by the hour.  Hundreds of guests with sun screen, sun tan lotion, body lotion inadvertently lose it when they bathe in the pool exposing others to the chemicals.  Moreover when they drink they may not be inclined to jump out of the pool to go to the restroom.

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The Water Quality & Health Council found one in four adults ADMIT to urinating in the pool, which can affect chlorine strength.

Many choose not to wait in line at public bathrooms or use the wet toilets at public water parks and find it easier to relieve themselves in the pool.  For women worried about sitting on wet toilet seats I recommend using a  large soda cup and in the stall standing and urinating into it. Pour it out into the toilet and flush.  Clean, easy and environmentally sensitive.  Men, there’s no excuse. Towel off and head to the potty.

Hot tub folliculitis caused by Pseudomonas aeruginosa can cause an uncomfortable rash around the hair follicles.

The CDC reports outbreaks associated with “treated recreational water” due to multiple organisms including Cryptosporidium, Pseudomonas, and Legionella.

Looking at the time period between 2000-2014, the CDC reports the following:

Investigations of the 363 outbreaks identified 24,453 cases; 21,766 (89%) were caused by Cryptosporidium, 920 (4%) by Pseudomonas, and 624 (3%) by Legionella. At least six of the eight reported deaths occurred in persons affected by outbreaks caused by Legionella. Hotels were the leading setting, associated with 157 (32%) of the 493 outbreaks

Hotel pools and hot tubs appear to be the biggest culprits.

Pseudomonas has been known to cause skin infections such as “hot-tub folliculitis” and ear infections, otitis externa, known as “swimmer’s ear.”  Legionella is known for causing Legionnaires’ disease, a severe pneumonia as well as a milder illness known as Pontiac Fever.

The largest number of cases, however, were caused by Cryptosporidium.  Known as “Crypto”, this parasite can cause severe gastrointestinal illnesses. Here’s the breakdown:

What is Crypto?

Crytosporidium is a parasite protected by an outer shell.

This shell allows it to live outside the body on surfaces.  The shell also allows it to be chlorine resistant which explains why it can live in swimming pools.

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How common is Crypto?

According to the CDC, Cryptosporidium is a leading cause of waterborne disease among humans in the United States.   Its found in every region of the US and the world.

The CDC reports close to 750,000 cases of cryptosporidiosis occur every year in the US.

How is it spread?

Its spread in drinking water and recreational water, such as swimming pools.  Since it lives in the intestines of humans and animals it becomes spread after one passes stool, or poops.  People coming into contact with an infected individual’s poop could become infected with Crypto.

It is not passed through respiratory transmission or blood.  However if feces comes into contact with one’s mouth, or wound, it can transmit Crypto.

Coming into contact with feces contaminated soil, surfaces, water, food therefore put one at risk.

What are the symptoms?

The parasite can cause any of the following:

Diarrhea

Abdominal Pain and Cramping

Fatigue

Nausea

Vomiting

Dehydration

Lack of appetite

Weight Loss

and sometimes  no symptoms at all.

When do symptoms show and how long do they last?

After one becomes exposed to Cryptosporidium, symptoms could show within 48 hours to 10 days.  Symptoms can last 1-2 weeks.

 

What is the treatment for Crypto?

The infection many times is self-limiting.  Hydration is imperative and initial treatment is making sure one does not become dehyrated.  Young children, pregnant women, elderly, those with weakened immune systems, AIDS, cancer and immunosuppressed transplant patients are at higher risk  of serious infection.

Some medical providers may use Nitazoxanide. According to the National Foundation for Infections Diseases:

Nitazoxanide (Alinia ®) may be used to treat Crypto in both adults and children 12 months of age and over. Nitazoxanide is available as a tablet for adults and as a liquid suspension. A three-day treatment regimen is recommended.

How do we prevent Crypto?

Always wash your hands with soap and water

Avoid eating off of non clean surfaces

Avoid swimming pools that may have just been soiled

Avoid ingesting  water while swimming

Avoid feces of those individuals infected

Avoid sexual contact where oral – anal contact can occur

Change baby’s diapers away from the pool in case it blows into the water

Do not allow any family members with diarrhea to enter the pool

Inform your medical provider if you have any of the above symptoms so he/she can test the stool.

 

 

 

 

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in food, Health, news

McDonald’s Salads Recalled in Two States Over Parasite Fears

Over 100 people have been sickened in what is believed to have been an exposure to a parasite while eating salad at McDonald’s.  Currently the departments of health in Iowa and Illinois are investigating the cause.

The parasite involved is called Cyclospora cayetanensis, causing an intestinal infection called cyclosporiasis.

The Illinois Department of Health has seen 90 cases of cyclosporiasis recently, 25% of whom admitted to consuming a salad at McDonald’s.

Iowa has identified 15 people who have become ill, having eating a salad at the highly popular fast food franchise.

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Cyclosporiasis may occur when one consumes contaminated food and water and symptoms include abdominal pain, bloating, nausea, vomiting, fever, loss of appetite, weight loss, headache, and watery diarrhea.

Explosive diarrhea has been reported in severe cases and occurs when the loose stools are passed very quickly and abruptly and may even make loud sounds.

Treatment of cyclosporiasis includes fluids, rest and antibiotics such as trimethoprim-sulfamethoxazole, Bactrim.

PEOPLE MAGAZINE reports:

“Anyone who ate these salads since the middle of June and who developed diarrhea, especially watery diarrhea and fatigue, should see their health care provider and get tested for Cyclospora to ensure an accurate diagnosis and appropriate treatment,” Dr. Patricia Quinlisk said in the statement on the IDPH website.

Out of an abundance of caution, we decided to voluntarily stop selling salads at impacted restaurants until we can switch to another lettuce blend supplier,” McDonald’s told PEOPLE in a statement. “We are in the process of removing existing salad blend from identified restaurants and distribution centers – which includes approximately 3,000 of our U.S. restaurants primarily located in the Midwest.”

McDonald’s has tried to re-brand itself, offering healthier options, however this past year we’ve witnessed multiple food-related illnesses involving fresh vegetables.

This week Del Monte Fresh Produce has had to initiate a vegetable tray recall when over 200 people fell ill to an intestinal parasite.  According to the CDC, as of July 5, 2018, 212 cases of Cyclospora occurred in individuals who consumed broccoli, cauliflower, carrots and dill dip in their Del Monte Fresh Produce Vegetable Tray.  Thus far the states involved include Wisconsin, Michigan, Iowa and Minnesota.  Indiana and Illinois consumers are also being warned of the recall.

 

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

Posted in Health, news, sex

Rare STD Evading Doctors and May Become Next Superbug

A sexually transmitted disease (STD) may be gaining strength and increasing resistance to antibiotics.

Mycoplasma genitalium (MG) was first identified in the 1980s.  Many may not realize they have it, having no symptoms at all. However some may report burning with urination, penile discharge, vaginal discharge, or bleeding after sex.  Medical providers may confuse these symptoms with chlamydia, the most commonly reported STD, thereby offering a different antibiotic treatment and not ensuring an MG cure.  And antibiotics given incorrectly breed resistance.

If STD’s such as MG evade treatment they can fester causing pelvic inflammatory disease, urethritis, and eventually male and female infertility.

Since many do not realize they have it, or fail to elicit symptoms, prevalence rates are under-reported.  In 2016, Getman et al found the prevalence to be approximately 16.1% for females and 17.2% for males in the 946 test subjects seeking care at an STD clinic. But they reported then that macrolide (azithromycin) resistance of the bacteria was found in 50.8% of females and 42% of males.

The treatment for MG, according to the CDC, is a 1 gram one time dose of azithromycin. However they note increasing resistance and suggest if suspected to take a Zpack (azithromycin- an initial 500-mg dose followed by 250 mg daily for 4 days).  And if resistance is still seen to add Moxifloxacin (400 mg daily x 7, 10 or 14 days) which thus far has shown a 100% cure rate.

The treatment for chlamydia is also a 1 gram one time dose, with use of doxycyline 100mg twice daily for 7 days if not cured.

So how is resistance being bred?

When one believes he/she has an STD, most medical providers will not wait for the cultures to come back to treat as results can take days.  So many will prescribe the 1 time dose of azithromycin empirically.  However if a medical provider is only testing for gonorrhea and chlamydia, they may not know if the patient is cured of MG.  The MG bacteria that withstood the original dose of azithromycin may flourish and become resilient to the antibiotic in the future.

To prevent resistance, providers need to check for cure after the medication is given to ensure the infection is gone.  If not, a second antibiotic needs to be instituted immediately to prevent the resistant bacteria from spreading.

Macrolide resistance has also been  noted when treating gonorrhea, another STD with superbug potential.

What is a Superbug?

A superbug is a pathogen, most commonly bacteria, that can survive antibiotics that most species would buckle under.  It’s resistance could be caused by a variety of factors.  Maybe it has a mutation that makes it stronger.  Maybe its genetic material shields it from the toxic medicine.  Maybe it’s luck.  So shortly after it celebrates surviving the antibiotic assault, it divides to reproduce, making more bacteria.  If this progeny bacteria maintain the same genetic material as its parent, or if included, mutation, they can be now be resistant to the antibiotics as well.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Health, news

Why Do Our Armpits Stink? Scientists Find Answer

When called upon in school we were forced to choose between raising our hand and scaring our classmates off in one whiff, or keeping our arms down and getting an “F” in participation. Since puberty we’ve been plagued with body odor, but chalked it up to sweat.

Well for scientists, that explanation wasn’t good enough and they believe they found why our underarm sweat stinks more than other exuding body parts.

Most sweat is practically odorless, however our armpits are home to zillions of bacteria that like the warmth, moisture, crevices, pores and hair, allowing the microbes to flourish.

According to researchers at the University of York Department of Biology, the bacteria that set up shop in our armpit can convert odorless compounds into stinky ones with the help of nearby protein.  This protein, scientists believe, can be targeted by newly designed deodorants.

How do deodorants work?

Deodorants work by preventing bacterial growth on the skin to which they’re applied. Chemicals such as sodium stearate, stearyl alcohol, triclosan, EDTA, and others alter the local environment such that bacteria have a difficulty time flourishing.   Fragrances are also added to help the product mask smell.

How do antiperspirants work?

Antiperspirants are a subgroup of deodorants that decrease the amount of sweat coming from the sweat gland.  Antiperspirants are commonly made up of aluminum salts which, when mixed with sweat or moisture on the skin surface, dissolve and create a gel that “plugs” up the sweat gland.  The less sweat, the less favorable an environment for the bacteria, hence less smell.

 

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Study co-author Gavin Thomas states, “This study, along with our previous research revealing that only a small number of the bacteria in our armpits are actually responsible for bad smells, could result in the development of more targeted products that aim to inhibit the transport protein and block the production of body odor.”

This study was reported by drugs.com.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada