Pepper based chemical is the new DEET?

A very interesting article, from Medical News Today, reports a new chemical compound to appear more long-lasting than DEET (most commonly used and considered the best insect repellent).

The new compound, developed by researchers at the University of Florida and the USDA (US Department of Agriculture), called “N-acylpiperidines” has an active ingredient related to pepper.

The potential breakthrough involving this chemical has to do with length of protection time. DEET traditionally protects for approximately 17 days, while N-acylpiperidine protects for up to 73 days, as reported by the article. However, the testing still needs to be completed in “real-world” scenarios and involving application directly to human skin. Still, a very exciting idea!

Another good article can be found here:

Check out my page on Malaria for more info on what you are protecting against!

Another post about DEET safety in Pregnancy, from this blog.


Getting Started with Remote, Expedition and Wilderness Medicine

“How do I get started in Wilderness, Remote and Expedition Medicine?”  This is a very good and not-so-unusual comment I seem to be getting.  I thought I would write a post about what I know and try to gather some resources in one, easy page.  The website and this blog have a lot of links and resources, but they can be a bit to sort through.  Here it comes… In no particular order:

Classes/Hands-on Training:



Field Guide to Wilderness Medicine By: P. Auerbach, H. Donner and E. Weiss  ISBN: 0-323-01894-7

The Travel and Tropical Medicine Manual By; E. Jonog and R. McMullen ISBN: 0-7216-4214-4

Manual of Rural Practice By: Hutten-Czapski, Magee and Wootton ISBN: 0-9781620-0-5

Primary Surgery Volumes 1 and 2 Edited By: King, Bewes, Cairns and Thornton ISBN: 0-19-261694-3

US Army Special Forces Medical Handbook ST-31-91B

Primary Anaesthesia Edited By: M. King ISBN: 0-19-261592-0

Medicins Sans Frontieres: Minor Surgical Procedures in Remote Areas

District Laboratory Practice in Tropical Countries Vol. 1 and 2 By: M. Cheesbrough ISBN: 0-521-66546-9 Travel Health Guide

Medicine Sans Frontieres Clinical Guidelines Diagnosis and treatment manual for curative programmes in hospitals and dispensaries

World Health Organization International Travel and Health

Wilderness Medicine Newsletter




 Reuters Alert Net

Medicine for the Outdoors by Paul Auerbach MD (I gotta list mine)

This is just a few sites and information to get learn about travel, expedition, remote and wilderness medicine. My list is, by no means, comprehensive…just good places to start! Anybody that wants to suggest some others sites…let’s hear about them! Thanks!

Hope the information is useful!

Adventure Doc

Survival Scenarios

This last weekend, I attended the AAFP Chief Resident Conference, in Kansas City.

Opening day, we ran a Desert Survival Scenario from Human Synergestics. A blog post about the specific scenario can be found at:

Since I am pretty into this stuff and I actually was raised in the Sonoran Desert, we rocked!

I found the exercise to be very interesting and the company that produces it actually has several other locations and survival type scenarios, too. On a funnier note, I was discussing this with the lady and she had a great comment:
“Who ever has the gun, automatically gets everything else”🙂

Non-operative Treatment of Appendicitis

I was lucky enough to attend a great pediatric grand-rounds, yesterday, that discussed the non-operative management of acute appendicitis, in children. This idea seemed very interesting, to me, as it has obvious applications to healthcare providers in remote areas that may not have easy access to definitive surgical care.

The information presented discussed aggresive antibiotics for 48 hours with serial ultrasound exams every 6 hours, as an alternative to surgical appendectomy. The antibiotics currently advocated are standard “triple therapy” with ampicillin, gentamicin and metronidazole. The presenter also stressed that this antibiotic combination is falling out of favor and Mefoxin (cefoxitine) or Zosyn (piperacillin/tazobactam) or cefuroxime are being considered as better selections, by some surgeons. The switch to oral antibiotics, from IV, was also discussed and a concensus that once the patient is afebrile, oral metronidazole can be used for 7-10 days.

This raises an interesting question about treatment of appendicitis in remote locations, and involving adults. Obviously, if a surgical consult is available, it should be taken advantage of. However, for the remote generalist, this is not always possible. I just wanted to present this new information (to me) as an increasingly viable option.

A few decent references I have found on this matter are below:

Healthy Travel to the 2008 Olympics

The CDC, Centers for Disease Control, has an informative new page for travelers going to China for the Olympics. A very “user friendly” way to get some health information about vaccines, risks and things to know about before going to China, I am especially happy with the page that details the diseases you might be exposed to.

Schistosomiasis, Malaria, Hepatitis, Typhoid, Japanese Encephalitis and Influenza are a few illnesses that are covered, in decent detail as well as preventive measures to be taken.

The Olympics offer unique challenges for the traveler, as either a spectator, worker or athlete. The nature that the games are staged at pre-set times and cannot be missed necessitate pre-planning to avoid missing scheduled events. Basically, if you miss and event, you can never see it, live, again. This means you don’t want to risk being ill on these days.

The CDC 2008 Olympics Travel Page can be found here:



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