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Claire Panosian Dunavan is a professor of medicine and infectious diseases at the David Geffen School of Medicine at UCLA and a past-president of the American Society of Tropical Medicine and Hygiene. A few weeks back, shock and awe gripped the media after a report in Emerging Infectious Diseases (EID) described a 3-inch nematode removed from the brain of a

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The arrival of long-acting injectable antiretroviral therapy (ART) has ushered in a new option for providers and patients with HIV, though limits on its use may present new challenges. "Ultimately, this is about choice based on an individual's preference," said Samir Gupta, MD, of Indiana University in Indianapolis. "Some people with HIV may not want to carry around pill bottles,

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A convicted felon who hopscotched his way into high-paying health executive positions all over the country despite a federal prison term has once again landed in a top position -- albeit briefly -- this time at Penn Medicine in Philadelphia, according to news reports. In an investigative story last spring, MedPage Today detailed the long saga of how Larry D.

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Oktoberfest Doctor: Not the Wurst Job You Could Have

Welcome to "Medical Mavericks," a new series from MedPage Today featuring interviews with healthcare professionals working in unconventional fields of health and medicine. To kick off the series, we spoke with Philip Kampmann, MD, head emergency physician at Oktoberfest. First held in Munich, Germany in 1810, Oktoberfest has since evolved into an annual event celebrated around the world. The festival lasts 16 to 18 days and honors Bavarian culture with beer steins and wine, festival rides, traditional music, bratwursts, and more. While gathering millions of people for beer and good cheer sounds like an excellent time, accidents do happen. That's where Kampmann and his team, who are in the midst of their fourth year running the medical station at the festival, become essential to keeping the tradition alive. From tracking down a runaway patient with a brain bleed to relieving the burden on Munich's healthcare system, read on for insights into Kampmann's work at the world's largest beer festival. This interview has been edited for brevity and clarity. What is your medical background and how did you get involved with Oktoberfest? Kampmann: I studied in Munich, and now work as a general practitioner. We have a big practice: It's three places in the suburbs of Munich, where we have 70 people working together. There are 20 doctors, and we offer care for family medicine, general medicine, and all that. When I studied, I worked as a paramedic for an ambulance service called Aicher Ambulance, and later became the chief medical officer, helping with medication and making training programs. For Oktoberfest 2018, the government of Munich had to make ausschreibung , where they ask a lot of companies to make angebot to provide medical services. So, the government of Munich chose us to do that for the first time; I was suddenly the head officer for the Oktoberfest. Due to the Coronavirus we had to pause the Oktoberfest in 2020 and 2021, so now it's the fourth time for us. For 130 years, it was the German Red Cross, the Bavarian Red Cross. But due to the international programs, the city of Munich had to choose the cheapest provider. We made a good offer in 2018 and got the job. But we don't know if we're getting it next time. They repeat the "ausschreibung," and at the moment it's a mixture of price and quality. If the politicians choose just based on price, maybe we have no chance, but if they also combine it with quality, then we may get lucky. Can you tell me about your role at Oktoberfest? Kampmann: I have the role of a chief medical officer; I coordinate all the other doctors working here. On the weekend is when we expect a lot of patients. We are 12 doctors at the moment here, together with 110 paramedics at the most busy times. And I have to coordinate the doctors. I have to see if there are problems. I have to react if there are a lot of patients, if we have to dismiss this one and send them to the hospital. When the Oktoberfest is in Munich, we have nearly twice as many people as normal living in Munich, but we don't have twice the hospitals or twice the rescue system. So, we try to keep the patients here and treat them here so they can go home and don't have to visit the hospital. Since last year, we have a CT scanner here to do a scan of the brain and the skull and the spine. We even have a study in the New England Journal of Medicine. It's due to a special situation, since we are now forced to try to keep the number of patients going to the hospital very low. This is because, I don't know how it is in the States, but in Germany we have a problem with getting enough nurses, doctors, paramedics, and all that stuff. So especially at a time like the Oktoberfest, they are working more than ever and we have to relieve the burden for the hospitals and the paramedic system. And that's what we do. Can you tell me about patient volume and the typical patients you're seeing? Kampmann: If it's a nice day on the weekend, we have about 500,000 visitors at the Oktoberfest. So, it's the city of Nuremberg who is in Munich. And that's a lot of people. Of course, most people come happy to the Oktoberfest and leave happy. But some people they have injuries, and of course there is a lot of alcohol, but they also have cardiac failure or cerebral problems. On our first weekend, on the Saturday, we had 650 patients altogether. On a normal weekend day, it's typically more than 500 people a day. And over the whole Oktoberfest, we think we will treat more than 7,000 people -- and that's a lot of work. If you think about it for the whole system, if the 7,000 people couldn't be treated here at the Oktoberfest, we would have to send them to the hospitals. And that would be a real problem and maybe a game stopper for the Oktoberfest. But I think all of us, the police and the fire brigades, they are important to keep this running. Because if there weren't any people like us, the Oktoberfest couldn't work. What percentage of patients end up having to be sent to a hospital? Kampmann: This year we are really great. We have less than 3% of the patients sent to the hospital. So that's really perfect. And if they have a problem that has to be treated in the hospital, of course everybody gets hospital treatment who needs it. But if you think 3% of 7,000 people, that's not very much and that's great work for us. Have you had any unusual patient cases at the festival this year? Kampmann: Just in the beginning, on the first Saturday, we had a nice old man who had too

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The combined effects of immunotherapy and targeted therapy have revolutionized treatment for non-small cell lung cancer (NSCLC). Clinical guidelines recommend some form of immunotherapy as frontline treatment for most cases

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