The use of new computer technologies (Internet) in the treatment of diarrhea in the field
A knitted hat, a guitar, a beard and a romantic glow in the eyes - by these signs, we will precisely identify a tourist from the sample of the 60s and 80s of the last century. The Soviet tourist was considered by the State as a creature, first of all spiritual with reduced needs for solid food. Canned food was considered the classic food of a wanderer - the "tourist breakfast", which had taste characteristics so depressing that its use outside camp conditions meant an extreme degree of material and moral decline and responded naturally to dyspepsia.
The described image of a tourist is now quite rarely seen in post-Soviet space. The term itself, referring to those who left civilization in search of risky adventures of people, has given way to the most popular extreme. However, the change in social background did not significantly affect the urgency of the problem of impaired function of the gastrointestinal tract in people traveling, which is associated with inevitable eating disorders and the inability to comply strictly the rules of hygiene.
“Traveller's diarrhea” (the term is also medical), taking a mountain or rafting in a turbulent river, can deprive him of enthusiasm and upset the idyll of communication with the nature. Instead of admiring the splendor of the vast expanses of the gaze, the discouraged gaze of the poor traveler wanders in the roughness of the relief in the hope of finding an isolated place. The problem quickly ceases to be personal and can jeopardize the whole event. Therefore, medications that can cope with diarrhea must be present in each first aid kit. The english-speaking Internet gives its recommendations on its compilation.
Coal is always priced, it is not in vain that they say "black gold". Especially if activated carbon. You must take it on a "flawless" trip and "in large quantities - packs of 8-10" recommend the "Traveler's first aid kit" section of the "Lita-beauty" site. , and in this case "throw in a few" pills. "No, without shamanism and not with the aim of developing precision, but" for the disinfection of water ". This is a very spiritual, logical and at the same time simple recommendation, in which the author, based on widely known data on the adsorbing effect of activated carbon, overcomes the highly specialized approach of medical guides and widens the range of traditional indications for the use of the drug. I wonder if there have been any trials confirming The effectiveness of this rationalization proposal? Well, let's not quibble, in any case, it is one of the few recommendations of a preventive nature. The rest mainly concerns treatment.
And there again, the article "A Traveller's First Aid Kit" admires, trying to instill a cautious attitude to antibiotics. "As for antibiotics, they should not be taken for any reason", rightly point out the authors of the article. "It makes sense to take LEVOMYCETIN with you," they advised with caution. Prudence lies here, presumably, not in the advice itself, but in its formulation, because "to take" does not mean to accept.
It should be noted that such caution with regard to chloramphenicol is not uncommon. So, for example, the compilers of the "first aid kit" on the site Wanderer - a server for tourists and travelers" write the following on the chloramphenicol "Put it in the kit first aid for the "most extreme case", that is to say in the case of a serious intestinal infection which cannot be treated otherwise "(article" Antibiotics in camp conditions ").
Among the "other methods", it is proposed to use phthalazole for diarrhea, on which it is written "that it is effective in many infections". Thus, such an algorithm to control diarrhea is recommended: first, phthalazole, and if it does not help, chloramphenicol. These are the two drugs that appear in the first aid kit for travelers on the website of the same name in the article "Camping First Aid Kit - Version 1.1", where the well-reasoned warning on chloramphenicol reappears: "N ' remember: chloramphenicol causes severe dysbiosis, so you shouldn't drink it in vain. ”Yes, if only dysbiosis...
The attitude towards chloramphenicol in RuNet is respectful. It's nothing that the preparation fights bacteria like erythrocytes with less success, sometimes causing aplastic anemia - the air is fresh in the mountains! Neuritis of the optic nerve with the prospect of never seeing the surrounding beauties again is not frightening. "See Paris and die!".
On the same site, in the article "Camping First Aid Kit. Medication Information", you will find a detailed description of the antimicrobial drugs recommended for a camping first aid kit. In addition to the information previously mentioned about the impressive properties of phthalazole, he talks about the possibility of using this drug for "intestinal surgery (to prevent purulent complications)". Interesting detail for tourists, right?
Are you used to gargling furacilin with a sore throat ?! Well, take it on a hike, it will help with diarrhea - skitalets.ru recommend taking FURACILIN "indoors for the treatment of bacterial dysentery". The drug, unfortunately, is not without side effects, but whatever - "side effects are eliminated or reduced by the appointment of antihistamines (DIMEDROL and others)" - recalls skitalets.ru. And from the drowsiness that appears, take something else, and so on! Be more reliable in the mountains.
By the way, this is what is written on furatsilin in the manual "Clinical Pharmacology", published in 2004 under the supervision of Academician RAMS prof. V. G. Kukesa: "... Apply only topically... When taken orally, it can cause severe peripheral polyneuropathies and acute hemolysis of red blood cells" (p. 627).
Mr. Yu. Bogolyubsky offers his answer to diarrhea in the basic work "Our First Aid Kit". According to the author, the best result in "intestinal infections with diarrhea" will be obtained "after gastric lavage and subsequent weekly use of FURAZOLIDONE or SULGIN".
Furazolidone, apparently, has seduced the compiler as a drug, which helps maintain a strong culture of tourist behavior, making it difficult for them to drink alcoholic beverages. So, of all possible restrictions on the use of the drug, the author noted for himself the only thing - "do not take with alcohol"!
"What is written with a pen...", as you know, is difficult to modify. But on electronic Internet pages, corrections are possible and necessary.
I think the following table can serve as an incentive to make adjustments to their treatment recommendations for authors of online medicine kits. It is based on the data contained in the most comprehensive modern guidelines for antimicrobial therapy: "Practical guide to anti-infective chemotherapy" edited by a corresponding member of RAMS, prof. L.S. Strachunsky, corresponding member of RAMS, prof. Yu.B. Belousova and MD S.N. Kozlova, and the book "Rational Antimicrobial Pharmacotherapy" edited by prof. V.P. Yakovleva and prof. S.V. Yakovleva, 2002 and 2003 publications, respectively.
Both books contain chapters on the use of antimicrobials to fight diarrhea. In the "Practical Guide..." on pages 237-238 (section "Infections of the gastrointestinal tract"), and in "Rational antimicrobial pharmacotherapy" on pages 477-478, a list of drugs is recommended in this case. A total of 9 drugs are indicated. And among them not a single of the first aid kits mentioned by the compilers. But what about the drugs on the Internet.
We accept as an axiom a high professionalism and a responsible attitude towards the work of specialists who give recommendations on the Internet. Is it possible to assume the opposite when it comes to advice on the use of medicines intended for a large mass of people without medical knowledge; people without criticism, on faith accepting what the doctor tells them ?! In this case, how can we understand the fact that among more than two hundred antimicrobial agents registered in the United States, the medical doctors selected the 5 least effective and the most toxic? How to joke ?!
Or, perhaps, the compilers of the first aid kits have put on tourists the function of a sort of "medicinal jungle" prescriptions. According to their plan, travelers who do not know their humanitarian mission should buy all ineffective and dangerous medicines from pharmacies, remove them from civilization, risk their lives, use them and bury them in their own excrement. What is not extreme !?
Really, tourism in USA is more than tourism!