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Saturday, December 25, 2010
Date: Jan. 6th, 2011 (First Thursday of the Month Free Lecture Series)
Time: 6:15 PM
Pure Compounding Pharmacy
3072 Dick Pond Road
Myrtle Beach, SC 29588
Thursday, December 23, 2010
Timothy Ray Brown, also known as the "Berlin Patient," received the transplant in 2007 as part of a lengthy treatment course for leukemia. His doctors recently published a report in the journal Blood affirming that the results of extensive testing "strongly suggest that cure of HIV infection has been achieved."
Brown's case paves a path for constructing a permanent cure for HIV through genetically-engineered stem cells.
Last week, Time named another AIDS-related discovery to its list of the Top 10 Medical Breakthroughs of 2010. Recent studies show that healthy individuals who take antiretrovirals, medicine commonly prescribed for treating HIV, can reduce their risk of contracting the disease by up to 73 percent.
While these developments by no means prove a cure for the virus has been found, they can certainly provide hope for the more than 33 million people living with HIV worldwide. Alongside such findings, global efforts to combat the epidemic have accelerated as of late, with new initiatives emerging in the Philippines and South Africa this week.
Saturday, December 18, 2010
Please convince me that I shouldn’t be bothered by this. The other day I was at the hospital paying a visit to a friend. As usual this trip to the hospital - like every other - involved a significant amount of waiting and doing nothing. I killed the time by doing some people watching, specifically doctor watching.
One doctor in particular did something that caught my attention.
Leaving a patient in their room the sat down at the computer and started typing away. However as I looked closer I noticed that this dcotor was looking something up [pause for dramatic effect] on Wikipedia. Now for those of you who don’t know, Wikipedia is an on-line encyclopedia of just about anything, from the truly important to the totally random. What makes Wikipedia unique is that the content is user-created. That is, any dude sitting in his mom’s basement can jump on and help write the definition regardless of whether or not they have an idea of what they’re talking about. And while these same people can help ensure the accuracy of the content it is nonetheless the equivalent of selling dictionaries with an eraser and pen attached.
Now, please understand. I like Wikipedia. I use Wikipedia. But I don’t wholeheartedly trust Wikipedia. And I don’t think I want my doctor coming to a diagnoses with the help of Wikipedia. Aren’t there large, dusty books that they are supposed to be pulling off shelves or top-secret doctor only web-sites that they are supposed to be accessing when they leave the examination room? Is a 100K education supposed to hinge on what one can “google?”
Granted, I’m making an assumption that this doctor was doing something associated with a patient when she surfed to, read through, and wrote down several things in her chart from the site. But it sure looked like it.
I just don’t what the day that a doctor looks up my illness to be the very same day that some over-zealous pharmacy rep listed their experimental drug (that just so happens to lower your sperm count and make your hair fall out) as the “proven” cure all. But hey, maybe I’m making a big deal out of nothing. I tend to do that. Besides my doctor is awesome.
6 Responses to “Wiki-Medicine. Scary.”
September 27th, 2008 at 2:16 pm
Geez…someone needs to tell that Doc about WebMD! That I trust!
2.Carrie LaMay Burgan Says:
September 28th, 2008 at 1:10 pm
I admit to using Wikipedia to identify muscle groups when I’m studying anatomy, but I’m but a lowly massage therapy student. General Wiki research is fine, but I would be scared, too. Is the doc to cheap to subscribe to the online reference DBs for docs? They exist in spades. Or yeah, use WebMD? Sadly, Google, Dictionary.com and Wikipedia are the top three free web “research” vehicles out there. When I was pursuing my Master’s in Library Science, we were inundated with information about students using these (non-reliable) sources as all primary sources in their undergrad-to-DOCTORATE papers. *slaps forehead* Heaven forbid someone actually pick up a dusty “Journal of the American Medical Association” (”JAMA”) and look something up.
October 8th, 2008 at 9:19 am
Wow, that is really scarey. I am constantly telling people the truth about that website. Hopefully whoever wrote the page she looked at was another doctor.
January 8th, 2009 at 9:57 pm
Wikipedia is said to be more accurate in a lot more subjects than the Encyclopedia Brittanica.
I find that much more terrifying than any point you made.
5.dr who dolls Says: (spam content)
6.JP Saleeby, MD Says:
December 18th, 2010 at 7:33 pm
Well in this era of evidenced based medicine, it is really much different subscribing to an opinion, fact or fiction on wikipedia versus our established peer-reviewed journals? How confusing is it when in JAMA one month’s article in support of a new treatment is to be summarily rejected by another article the following month in NEJM?
Sunday, December 12, 2010
|Dec 10, 2010|
Families who enrolled in these plans initially had higher incomes, but lower-income families are now equally likely to be enrolled in high-deductible plans. Overall, lower-income families were more likely to report that they had delayed or foregone care because of the cost, including care for an adult, care for a child, and operations or procedures.
In addition, lower-income families said they did not find their health plans difficult to understand, nor did they believe their families were not well protected from out-of-pocket healthcare costs. Regardless of income, most participants reported that they would talk with their clinicians about delaying or making different plans in 3 hypothetical situations: a $100 blood test during a check-up, a $1,000 colonoscopy, and a $2,000 magnetic resonance imaging scan for back pain.
The findings suggest that physicians play a central role in helping patients with decision-making in high-deductible health plans.
Friday, November 26, 2010
To open up, I want to make it perfectly clear the intentions of this article by stating a few facts. These are facts back up by loads of peer-reviewed publications. These facts are likewise rational and logical.
- Fact: Antibiotics save lives.
- Fact: Antibiotics reduce morbidity and mortality in severe and life threatening infections.
- Fact: Antibiotics have in the past 20-years been over-prescribed.
- Fact: Antibiotics are necessary in the practice of good medicine and new guidelines need to be followed in light of present day resistance.
It is both intuitive and evidence based that appropriate use of antibiotics in modern medicine have saved thousands of lives. Prior to the discovery of the antibiotics (antimicrobials) infection was a leading cause of death in humans. Today, many life threatening illnesses such as pneumonia, sepsis, flesh-eating bacterial infections (necrotizing fasciitis), or meningitis are so dangerous, that delay in antibiotic therapy can cost a life.
For those pseudo-healthcare practitioners that are blinded by sheer bias and hatred toward contemporary western medicine (and suffer brain squeeze because their craniums are so far up their rectums), spouting the foolish notions that "you don't need antibiotics" or "antibiotics are never good for you", be warned. Those reading this article that are experiencing a grave illness due to a microbe should be aware that those advocating the cockamamie notion that all things antibiotic are evil, should run as fast and far away from those practitioners. Furthermore, they can and should be held culpable for the death of a patient should they intentionally delay people from getting life saving antibiotic therapy. Intuitive practitioners, some chiropractors and those who favor wave eagle feathers and crystals over folks in an attempt to cure a complex septic patient should put their unsubstantiated opinions and bias' aside and refer their patients to a medical doctor for definitive care. No need to stain you hands with blood over an idiotic notion unfounded by any empirical evidence. Enough ranting about unfounded prejudice against antibiotics amongst healers.
While there is no question about the helpfulness of antibiotics, it is also true that since their inception they have been abuse and over prescribed. Now we realize the ills of haphazard and unbridled use as we see resistant organisms appear more often and on the rise.
According to Dr. J. G Bartlett in a Medscape CME published in November of 2010 entitled "Addressing the Rising Tide of Antimicrobial Resistance" he spells out the rise of the top six microbes that are defying our current regiment of antibiotic therapy. They are Enterobacter, Staph. aureus, Klebsiella, Acinetobacter, Pseudomonas aeruginosa and Enterococcus. In the US methicillin-resistant Staphylococcus aureus (MRSA) is on the rise with some 94,360 cases a year and 18,650 deaths annually reported by Kelevens et. al., in JAMA in 2007. Those are some fierce numbers for a bacterium that only 10 years ago was only seen in hospital ICUs and nursing homes. Now greater than 60% of cultures of abscesses in my local region culture positive for MRSA. The whole penicillin class of drugs (Amoxil, Keflex, etc.) is useless against MRSA. Clostridium difficile infections are another example with diagnosed cases on the rise and antibiotic resistance mounting as well. Death by C. difficile infection has taken an exponentially rise since 1999.
Furthering the crisis of antimicrobial resistance and of great concern is that in the last ten-years the development of new antibiotics and antibiotic classes has all but dried up. A 2004 report by the Infectious Disease Society of America (IDSA) stated that there is“antibiotic discovery stagnation” were we are witnessing bad bugs with no new drugs to fight them. An example of how slow we are to develop new antimicrobials is seen in a study published in 2009 in the Clinical Infectious Disease journal by Dr. H.W. Boucher reporting that between 1983 and 1887 sixteen new antibiotics were developed. From 1993 - 97 ten antibiotics were developed and this dropped to only five from 2003 - 07 and from 2008 projected until 2012 only one new antibiotic coming to market. From the 1930's through the 1970's there were eleven new classes of antimicrobials developed by pharmaceutical companies, with only four classes in the 1950, and during the 2000's only two new classes were developed. The 1980s and 1990's saw a dry spell, with no new antibiotic-class development. These are scary numbers considering the rapid rise in microbial resistant organisms just in the past decade.
So while antibiotic use is necessary and critical in the very ill, judicious use is necessary to save our "big guns" for those really bad infections. Most pharangitis infections are viral and despite this fact many GPs would prescribe antibiotics just to appease an anxious patient, and not treat the real root cause. This practice has to stop. No one will argue about utilizing a broad spectrum aggressive antibiotic regiment in a septic patient, but we need to look at the evidence of stopping drugs when cultures are negative and using effective shorter courses. Evidence is mounting that a three day course of antibiotics for community acquired pneumonia (CAP) is as effective as a seven- or ten-day course. On the other side of the continuum, those that don't advocate the use of antibiotics at all will harm the really sick. We must reach a happy medium.
Thursday, November 18, 2010
Tuesday, November 9, 2010
Sunday, November 7, 2010
FDA Patient Safety News: Show #104, November 2010
With the influenza season upon us, the CDC is recommending that everyone aged 6 months and older get vaccinated to protect themselves and others. During the last influenza season, people needed one vaccine to protect against seasonal influenza, and another one for the 2009 H1N1 influenza. But this season's vaccine contains the 2009 H1N1 strain, along with two other strains that are predicted to cause influenza, so there is no need to get two different vaccines. As in earlier years, both inactivated and live attenuated vaccines are available.
There is now a vaccine that is specifically indicated for people 65 and older, called Fluzone High-Dose. People in this age group have the highest risk for seasonal influenza complications because people's immune systems weaken as they grow older. The new vaccine contains a higher dose of influenza virus hemagglutinin, which is intended to induce a stronger immune response and better protect the elderly against seasonal influenza.
People who are hypersensitive to egg proteins or who have had life-threatening reactions after previous influenza vaccinations should not receive the vaccine.
FDA Center for Biologics Evaluation and Research. Influenza Virus Vaccine for the 2010-2011 Season. Updated September 17, 2010.
FDA Press Release: FDA Approves A High Dose Seasonal Influenza Vaccine Specifically Intended for People Ages 65 and Older. December 23, 2009.
CDC MMWR. Prevention and Control of Influenza with Vaccines
FDA Patient Safety News is available at www.fda.gov/psn
Friday, November 5, 2010
Friday, October 29, 2010
By JP Saleeby, MD
As the Flu season approaches, we need to be prepared. The Flu, which is different from the common cold, inflicts significant morbidity and even mortality and should be taken seriously. The Flu is caused by the Influenza virus of which there are three types (A, B & C). Type A is the most common and it is the subtypes of A and B that cause the seasonal outbreaks. The constant mutations of these viruses make it necessary to vaccinate annually. Everyone is affected, from the very young to the older adult. Most outbreaks or epidemics occur in late fall and early winter. It has been reported that as many as 20,000 deaths and over 100,000 hospitalizations occur each year in the USA due to the flu. Those deaths are highest in the elderly (over 65), folks with diabetes, HIV, nursing home residents, pregnant women and those with chronic diseases of the lung, heart and kidneys.
A person is contagious for up to 5 days after onset with symptoms that include high fever, aches in joints, muscles and around the eyes, weakness, headache, dry cough, sore throat and watery discharge from nose and eyes. Annually, there are many that miss considerable time from work in the winter months due to infection with this virus.
You acquire the flu virus through contact with contaminated aerosols or droplets found on surfaces such as doorknobs and telephones. So prevention is crucial. Of course maintaining a health lifestyle (not smoking, eating right, plenty of exercise) is important as is taking care not to come in contact with potential contaminants (good hand washing, not sharing cups with others, etc.) And vaccinations are of critical importance especially to those high-risk individuals. They may even be lifesaving.
The flu vaccine (shot) is unique each year, being made up of inactivated A & B viruses. It is injected into the upper arm and should be taken in early fall (from October to mid-November) because it takes two weeks to confer immunity. But once protected (it is considered 70 – 90% effective), it can protect you from the symptoms of the flu, lost work, hospitalization and even death. Who should get the flu shot? Anyone over 50, those with chronic diseases, those with HIV/AIDS, women over 14 weeks pregnant, residents of nursing homes, health care workers, bank tellers, waitresses, students especially those living in dormitories, and those people interested in reducing risk for the flu. Side effects to the shot are rare but include soreness and mild muscle aches or low-grade fever for only a couple of days. These untoward effects are most often noticed in children. Life threatening allergic reaction and something called Guillain-Barre syndrome are extremely rare reactions to the vaccine. But those allergic to eggs should probably avoid the shot.
Myths about the flu shot such as getting the flu from it are unfounded. Since it contains the killed form of the virus, it is impossible to actually acquire the syndrome. Another myth is that one shot in you life will do, but since the virus mutates from season to season, revaccination with new strains must occur each season.
What happens should you get the flu? Well, there are standard medications that should be started within 24 hours of symptoms such as Amantadine, Rimantadine (Flumadine), Zanamivir (Relenza) and Oseltamivir (Tamiflu). The prescription usually lasts 5 to 7 days and it may cut short the course of infection and prevent serious complications such as pneumonia. Decongestants such as phenylephrin and pseudoephedrin are helpful with symptoms. Antibiotics are not indicated unless there is a secondary bacterial infection. Antibiotics are useless against the flu virus.
Nutritional medicine offers high doses of vitamin C, and Zinc. Herbal remedies include Echinacea (E. purpurea root extract) and Goldenseal (H. candadesis root extract). Other immune boosting compounds are extract of maitake and reishi mushrooms, garlic and transfer factor (an extract of colostrum). A very powerful tool in the early treatment of the flu is something called the Myers’ Cocktail. This is a rapid intravenous infusion of high dose vitamins and minerals given over 10 minutes. It has proven effects in reduction of symptoms, viral spread and getting you back on your feet quickly after being infected. Myers’ cocktails must be administered in the doctor’s office and depending on how severe the illness, one to three treatments during a course may be indicated. If caught early, a Myers’ Cocktail may be the most effective remedy in the treatment of the flu. The Myers’ Cocktail is also useful in many other maladies, but for acute respiratory and viral infections, it stands heads above other treatments.
Another more detailed Article on the Flu by Dr. Saleeby: http://southcarolinawellness.blogspot.com/2010/10/just-in-time-for-flu-season.html
Monday, October 25, 2010
by JP Saleeby, MD
In the past half-decade, the importance of Vitamin D in western medicine has reached a new found echelon. Interest in this vitamin’s effects, not only on bone health, but on immune function and the neurological system have caused the assessment of serum levels to become a standard practice during annual physical exams. It is now routine to have your Vitamin D (25-OH-Vitamin D) level checked by your primary care physician. The interest is in part due to the large body of evidence in the last ten years showing that this once esoteric fat-soluble vitamin is in fact an important player in wellness.
Experiments show that Vitamin D2 absorbs UV-B radiation in fungi, plants and invertebrates and acts as a natural sunscreen against the damage sun’s rays can cause on DNA and cells. While more easily available and less expensive to produce, Vitamin D2 is not as bioactive in humans as is D3. Much of what has been used to fortify cow’s milk and other food products, however, has been Vitamin D2 prior to 2006. As our knowledge of Vitamin D grows and with the current research trends, the food and supplement industry is pushing to utilize better preparations for supplements and fortifying foods. Preparations utilizing the Vitamin D3 are becoming more common, as the use of D2 is falling by the wayside.
Common maladies from a deficiency in Vitamin D are Rickets, osteomalacia, and osteoporosis. The recommended daily allowance (RDA) of Vitamin D will keep you out to trouble with Rickets, but supplementing with higher doses of Vitamin D3 has added health and wellness benefits. Vitamin D3 has been shown to reduce inflammation, influence genes that regulate proliferation, differentiation and apoptosis in cells, thus playing a major role in cancer prevention. There have been studies showing benefit not only in bone health, immune function and cancer prevention, but also the delaying of the onset of dementia, multiple sclerosis and even schizophrenia. A recently published peer-reviewed report demonstrated a reduction by almost 50% in stroke when low Vitamin D levels were corrected in the study population.
Even in history Vitamin D plays a significant roll. For example, Dr. Adolf Windaus won the 1928 Nobel Prize in chemistry for his work with Vitamin D. Dr. Harry Steenbock discovered, in the 1920’s, that irradiated foods produced higher levels of Vitamin D and that fortifying foods in this way would reduce Rickets. By 1945 with Dr. Steenbock’s work recognized, the fortifying of milk and some staple foods was common practice; Rickets was all but eradicated in America.
Along with producing Vitamin D naturally with sun exposure, dietary intake is the only other practical way of receiving this beneficial nutrient. Intake can be measured in terms of micrograms (mcg) or International Units (IU), where 1 mcg of Vitamin D is equivalent to 40 IU. More often times foods and supplements are labeled using IU. The National Academy of Sciences (now know as the National Academies) recommends 200IU for those under the age of 50-years and 400IU for those 50 to 70-years, and 600IU for those over 70-years of age. The typical American diet averages 100 IU/day, but this is not saying much, as the “typical” American diet is rather poor when considering the fast foods we generally eat on the run and the processed foods we buy at market. The combination of this type of dietary intake and average sun exposure may allow us to reach these USDA RDA levels without supplementation. However, longevity and nutritional medicine physicians and organizations recommend quite a higher daily dose for wellness and health.
Foods where higher levels of Vitamin D3 are achieved are found in fatty fish, eggs and lean meat. For example, a 3.5 oz piece of salmon will give you 360 IU, tuna (3.5 oz) will give you 235 IU, catfish is a great source having 425 IU per 3 oz and it should be noted 15cc (a tablespoon) of cod liver oil is worth 1360 IU of Vitamin D3. We witness again the intuitive wisdom of our grandparents as they made us choke down cod liver oil when we were sick. A whole egg by the way gives us 20 IU of the vitamin. Fortified milk (historically containing D2) will give on average only 98 IU per 8 oz glass. Consuming milk as our only source of Vitamin D, a person would have to consume ten glasses of fortified milk daily to get minimum effective levels. It is good to fortify foods do not get me wrong, but don’t believe all the advertising, that milk is the one. The only vegan source; the mushroom will confer about 14 IU (un-irradiated) and 500 IU (irradiated) per 100 grams of edible fungi.
We can practically and efficiently measure our body’s stores of Vitamin D in the clinical setting, as mentioned earlier it is becoming a standard annual reimbursable test for many. Measuring serum levels of 25-OH-Vitamin D is by convention the best way to assess levels, as this metabolite has a longer (15-day) half-life than other forms and assays serum and tissue levels quite well. Levels of > 30 ng/ml are desirable while >200 ng/ml are nearing the toxic (hypercalcemia, hyperphosphatemia) range. Levels below 30 are considered too low for optimum health. While “normal” ranges vary rather considerably from one reference lab to another the widely accepted normal range for 25-OH-Vit. D is between 30.0 and 74.0 ng/ml. A person's fat content (obesity) is linked with lower Vitamin D levels, not that fat blocks UV-B rays from doing their thing, but rather adipose tissue can store Vitamin D and take it our of serum circulation.
How Vitamin D is important to our immune system is theorized as conversion occurs of pre- (inactive) Vitamin D to active 25-OH-Vitamin D metabolites. The active metabolite will bind to Vitamin D Receptors (VDR) located on Natural Killer Cells (NKC), enhance phagocytosis in macrophages, increase T- and B- Cell function, and increase cathelicidine, a natural antimicrobial peptide (yet another downstream metabolite of Vitamin D). All of these properties together have a pretty big impact on our immune system.
Every fall season we worry about the impact of Influenza on our lives. What is Vitamin D’s link to the Flu? It has been noted that with lower endogenous production due to decreased sun exposure in winter, in theory, a drop in Vitamin D affects immune system function to the point that we are more susceptible to Influenza. There are other cofounding factors that may prove this theory incorrect with further research. However, it is recommended that higher doses of daily Vitamin D be taken when exposed to the flu, or during the flu season.
Vitamin D has also been linked to lowering elevated blood pressure and cholesterol, as well as helping with Peripheral Vascular Disease (PVD). VDRs in the renin system, which is integral in blood pressure control can regulate the ACE- Angiotensin II conversion process that affects blood pressure. Low Vitamin D can cause Non-Insulin Dependent Diabetes Mellitus patients to produce less insulin secretion from the pancreas, thus worsening their serum glucose levels.
With regard to drug interactions, there are some medications that block or interfere with production, others that interfere with the vitamin’s ability to bind with VDRs and block metabolism in the liver. Steroids impair Vitamin D metabolism, Xenical® (Orlistat) and Cholestyramine reduce Vitamin D absorption in the gut. And with lower Vitamin D levels, this affects the way calcium and magnesium is absorbed by the intestines. Phenobarbital and Dilantin® (Phenytoin) (both seizure medications) reduce absorption and metabolize Vitamin D into less active compounds.
Institute of Medicine, Food and Nutrition Board. (1997) Dietary Reference Intakes: Calcium, Phosphorus,
Sigmund CD. (2002) Regulation of Renin Expression and Blood Pressure by Vitamin D(3).
Houghton, LA, Vieth, R. (2006) The Case Against Ergocalciferol (vitamin D2) as a Vitamin Supplement.
Friday, October 22, 2010
|Category:||Family, Internal Medicine, General Medical Questions|
|Subject:||low thyroid - natural things to do before replacement therapy|
|Question:||I was wondering if it's worth trying out some foods containing iodine or what other things you might recommend for a low thyroid?|
I am a healthy older woman who has never needed medication for anything and I would like to see if there is before I commit to a low dose synthroid the Doctor prescribed for me.He said he caught this early and that is good but I really would like to try anything before a medication.
A friend that has it told me I should not take the soy nuts and soy milk that I had been having for a year or so for menopause.
My low thyroid symptoms are only some hair breakage,occasional nail breakage and mild fatigue at times.
Can you recommend any herbal or diet for me to atleast try for a couple of weeks first?
Thankyou for any info
Treating folks for subclinical or lab normal hypothyroidism is my forte. A few things you should know you will find at the following links. The powerpoint hits on a few things you can try prior to taking prescription whether it be synthetic or natural HRT.
Soy and some other foods are goitrogenic. I would avoid too much soy or for a time at least don't take any to see if that affects your numbers/levels. Make sure free-T3 and free-T4 levels are checked along with hsTSH.
Besides soy isoflavones, cruciferous vegetables (those containing isothiocyanates), such as cabbage, Brussels sprouts, broccoli, broccolini, cauliflower, mustard greens, kale, turnips, and collards are also goitrogenic and can reduce thyroid hormone levels, so watch out for over consumption. Gluten sensitivity or intolerance may also contribute in some people. So limit gluten intake and see if that has an effect. If you enjoy soy and soy based foods, it has been established that cooked, fermented or aged soy products have a much reduced isoflavone effect on thyroid. Cooking soy apparently "turns off" the goitrogenicity of soy. Also paring up soy foods with those high in iodine content counteracts the effect. Moderation in all things I say.
If you desire a tele-medicine conference call with me regarding this issue and more details and better management I am at your service. Visit www.saleeby.net for more information.
The links are:
Slide #7 gives you some "natural non-hormone" things to try.
I also highly recommend the use of Armour or bioidentical HRT (natural T4/T3) for bHRT versus the synthetic levothyroxine compounds.
In Good Health,
JP Saleeby, MD
Saturday, October 2, 2010
"We could certainly slow the aging process down if it had to work its way through Congress."
- Will Rogers
Thursday, September 30, 2010
Monday, September 20, 2010
Reference: Proceedings of the National Academy of Sciences (vol 103, p 17979)
Saturday, September 18, 2010
A report conducted by physicians at the University of Alabama (UAB) focusing on injuries sustained on golf carts was published in the Journal of Trauma-Injury Infection & Critical Care in mid-2008. The report studied the number of injuries occurring in golf cart accidents. The numbers are surprising. During a period between 2002 and 2005 there were reported some 48,000 golf cart accidents nationwide, that amounts to 1,000 accidents a month. With the rise of golf carts use in America as a low cost, fun mode of transportation (specially with adolescents and teenagers) this has accounted for the rising number and projected higher numbers of future injuries and deaths.
Half of the injuries that occur, happen off the golf course, on private roads, public property and public road systems. Golf carts are not designed for road use and do not come with many safety features found on roadworthy vehicles. Head injuries and fractures make up the greatest number of injuries as passengers and drivers are ejected from the vehicles or are apart of rollovers. Highest rate of injuries occurred in boys 10- to 19-years of age and in those over 80 years old. While there is little federal regulation and in most states there are no requirements or licenses for operators, it is no wonder there are such a high number of injuries and fatalities. It makes common sense to guard against some basic misuse of golf carts.
Children are not mature enough or experienced drivers to handle golf carts on public roads and should not be left to operate them without adult supervision. Just today I grew concerned when a group of children (no older than 14 years of age) were clambering over a stalled golf cart. One child was trying to push the golf cart up a hill and was in a very precarious position to have the heavy cart roll over her. Some years ago a physician acquaintance of mine lost his adult daughter in a golf cart accident. She was in the drivers seat on a golf course, with her 3-year old child in her lap. As they were motoring along, the child grabbed the steering where and jerked it, causing the cart to roll over. The woman was thrown from the golf cart, and landed on her neck. She sustained a fatal cervical fracture and died moments later.
On September 11th, 2010 three teenagers in Alabama suffered a golf cart accident. The two girls and one boy were 15-years old and upon arrival to the trauma center the boy was listed as critical, the girls as serious but stable. In March of this year another 15-year old boy was killed in the same community after falling off a golf cart. Parents and guardians should keep children using golf carts off public roads and property, never let them drive unattended anywhere and keep the speeds limited (governored) to 15 miles or less. Children under the age of 13 should probably refrain from driving golf carts.
Wednesday, September 15, 2010
Saturday, August 21, 2010
Monday, August 16, 2010
Saturday, August 7, 2010
Your patients increasingly are relying on their cell phones and wireless Internet via laptop computers instead of landlines and Internet connections via desktop computers.
Six in 10 American adults now go online wirelessly using either a mobile phone or a laptop with a wireless Internet connection (versus 51 percent in 2009), according to a recent telephone survey of 2,252 American adults by the Pew Research Center's Internet and American Life Project. The report also found that the use of non-voice data applications on cell phones has grown over the past year.
Compared with a similar point in 2009, cell phone owners are now more likely to use their mobile phones to:
• Take pictures (76 percent versus 66 percent)
• Send or receive text messages (72 percent versus 65 percent)
• Access the Internet (38 percent versus 25 percent)
• Send or receive email (34 percent versus 25 percent)
• Play games (34 percent versus 27 percent)
• Record a video (34 percent versus 19 percent)
• Play music (33 percent versus 21 percent)
• Send or receive instant messages (30 percent versus 20 percent).
"The growing functionality of mobile phones makes them ever-more powerful devices for on-the-go communications and computing," said Aaron Smith, research specialist and the author of the Pew Internet Project report. "Cell phones have become for many owners an all-purpose chat-text-gaming-photo-sharing media hub that is an essential utility for work and a really fancy toy for fun."
Among other findings of the survey:
• More than half (54 percent) of mobile phone owners participating in the survey said they have used their phone to send someone a photo or video, 20 percent reported watching a video on their phone, and 15 percent said they have posted a photo or video online from their mobile device.
• More than half of cell phone Internet users (55 percent) participating in the survey said they go online from their mobile phone every day.
• Most wireless laptop users participating in the survey said they go online wirelessly at home, and six in 10 wireless laptop users said they go online from multiple locations. Twenty percent of participants said they do so from home, work, and somewhere other than home or work.
• Fifty-five percent of those participating in the survey own a laptop computer, and 62 percent own a desktop machine.
Demographically, the survey found:
• Cell phone ownership is higher among African-Americans and Latinos than among whites (87 percent versus 80 percent), and African-American and Latino cell phone owners use a greater range of their phones’ features compared with white mobile phone users.
• Adults aged 18 to 29 years are avid users of mobile data applications, but adults aged 30 to 49 years are gaining fast. Adults in this older age group are significantly more likely to use their mobile device to send text messages, access the Internet, take pictures, record videos, use email or instant messaging, and play music in 2010 than they were in 2009.
(c) Medical Economics 2010
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