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Thursday, September 30, 2010
Monday, September 20, 2010
So goes the old saying: "Lick your wounds." Well it may not be such a bad idea. Human saliva has been found to harbor some antibacterial substances and wound regeneration compounds. More recently a substance in saliva has been shown to control pain as well.
A team of neurobiologists lead by Dr. Catherine Rougeot at the Pasteur Institute in France has discovered a substance in human saliva that has analgesic/pain killing properties some six times more potent than Morphine. Thisneuropeptide compound in saliva has been named opiorphin and may lead to the development of a new class of pain killers. Incidentally , the researchers found that this compound not only has analgesic properties, but may also harbor anti-depressant properties. The human body produces endogenousneuropeptides to control pain. They are morphine like compounds in three classes called enkephalins, endorphins and dynorphins. These naturally produced neuropeptides attach to opioid receptors in our nervous system to inhibit pain. Short acting they are broken down by two enzymes called ectopeptidases. Pharmaceutical companies have developed drugs that mimic these neuropeptides in such drugs as morphine, opium, Fentanyl, Dilaudid and others. However, these very powerful drugs come at a cost of side effects and addiction.
Administration of opiorphin does two things, one, it attaches to the opioid receptors much like our natural endorphins and similarly synthetic morphine-like compounds, but it also inhibits the ectopeptidase enzymes thus allowing the pain killer neuropeptides to act longer. Tests by the French researchers on rats demonstrated that when injected into rats with controlled pain stimulated conditions, 1 milligram ofopiorphin per kg of body weight achieved the same analgesic effect as 3 mg of Morphine. There also appears to be less of an addictive nature to this natural substance. These are all good properties when developing new drug therapy for pain management.
While it is possible to extract or harvest this neuropeptide from human saliva, it is not necessary as the substance is simple enough to synthesize in the lab. A purified version of opiorphin could lead to the development of opiorphin-based pain medication in the near future. These findings were published in the Proceedings of the National Academy of Sciences.
Reference: Proceedings of the National Academy of Sciences (vol 103, p 17979)
Saturday, September 18, 2010
Golf Cart Injuries
by JP Saleeby, MD
MPH Emergency Medicine
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.
Journal of Trauma-Injury Infection & Critical Care:
June 2008 - Volume 64 - Issue 6 - pp 1562-1566
The Birmingham News (9/2010)
Wednesday, September 15, 2010
With some recent patient encounters, I think it is fine time to revisit an article I penned back in 2002 at the dawn of my Saleeby Longevity Institute practice. As I embark on another Primary Care - Integrative & Preventive medicine practice near Myrtle Beach, this needs to be said.
While I embrace some of CAM/ Alternative medicine, I say with caution that I do not do so wholly. I am very very selective as to what I add to my allopathic repertoire of therapeutics and diagnostics. I consider myself a practitioner of practical, sensible and sane medicine, staying away from the weird and granola as much as possible. Enjoy.
Forget those crystals
A doctor looks at quackery
by J.P. Saleeby published in XPress Mountain Magazine (Asheville, NC) Vol. 9 / Iss. 9, 10/02/2002
As an integrative medical practitioner, I keep my mind open to new modalities for evaluating illness and treating disease. My interest in and exploration of complementary or alternative medical therapies has led me to selectively incorporate into my practice some of what I've come across. For example, I embrace acupuncture for the diagnosis and treatment of certain disease states. Both traditional Chinese herbal medicine and Western herbs have also been quite helpful, producing successful outcomes for many of our patients.
But as one who subscribes to substantiated complementary medical practices while not turning my back on traditional allopathic medicine, I believe I have a license to be a critic.
Many self-proclaimed practitioners of "alternative medicine" prey on the gullible and ignorant. This fact hit home as never before when I attended and participated in a "Holistic Expo" in Atlanta a few weeks ago.
I was a guest speaker; my topic was the role of supernutrients in health and longevity. I also had a booth on the Expo floor to promote my dietary-supplement line and integrative practice in Savannah. But after viewing more than 160 vendor booths and reviewing the list of topics being presented, I was appalled.
To my amazement, the bulk of the "practitioners" present at this supposed health fair were charlatans, fakes and quacks. Even more astonishing was the number of visitors to the expo who were duped into believing that there was actually healing going on. Many of the vendors -- whom I view as entertainers, but certainly not as healers -- offered their services or wares for sale on the spot.
A typical "divine-psychic reading" could cost up to $35. A channeling session with crystals was $5 per minute. People were lining up for this!
I felt very uncomfortable and out of place amongst this group. To my immediate left were three "healers": one who would sketch your spiritual drawing, plus a psychic and a tarot-card reader. Across from me was a vendor for a distance-learning "institution" that offered "degrees" in nutrition, herbology, spiritual healing and reiki. To my right was a "massage therapist/channeler/healer" who on several occasions had his victims on a table where he would rub them rather aggressively and wave rocks and crystals over their head and chest.
Yet another booth offered "spontaneous healing" in which practitioners pranced around their victim, chanting and waving their hands in an effort to expel the evil forces causing disease. They also repeatedly showed a videotape of a nonsurgical way of extracting tumors from the body, seemingly through the skin, to promote instantaneous healing.
Others, both at booths and in the lecture hall, purported to be able to deliver unbelievable advice "channeled" from celebrities on the other side. Many claimed to be divine psychics, and one booth offered "aromatherapy" for people and pets. One Native American fellow in traditional garb spoke of "meeting your totem animal"; others talked about "sonic angel music" and "turbo tantra." One couple was selling "Chakra Life" -- a set of crystal balls in a wooden box that could supposedly diagnose illness. Still others offered means of "accessing the Akashic Records."
My astonishment at seeing such a large number of people interested in miraculous healing claims led me to some basic questions: Where did modern medicine go wrong that it encouraged people to accept or believe in such craziness? What have we done as physicians to push people to embrace such silly notions and odd alternative therapies? Why is the traditional physician despised by these people?
There is genuine dislike of allopathic medicine and its practitioners. The rhetoric one overhears at these booths is ridiculous but nonetheless embarrassing. Many complaints about medical doctors are based on misguided casual observations, anecdotal horror stories with a lot of "spin," or reports from those with an ax to grind. Some complaints are legitimate, I must admit, but they are never bad enough to warrant the alternative.
Have we sold our souls to the pharmaceutical companies, as has been charged? Have we been overly caught up in the pressures placed upon us by the current system of managed care? Have we been embittered by our feelings about governmental and private insurance reimbursements and medical-malpractice litigation? Whatever the answers, I still have faith in our ability to turn this trend around, salvage our reputations, and dissuade those seeking health from wasting their time and energy on quacks and charlatans.
As Libertarian editor Charles T. Sprading once said, "Knowledge consists in understanding the evidence that establishes the fact, not in the belief that it is a fact." And if we ignore our patients, we will only intensify this movement away from what we know to be effective medical care toward the circus of harmful "caregivers."
This is a call to those who are seeking healing and wellness. Don't give up on the medical establishment just yet. Despite the negative press, we still offer the best health/patient care around, with a proven track record. And despite widely disseminated misinformation, many of us do subscribe to and uphold our Hippocratic Oath. A few of us are even open-minded enough to realize that our allopathic education doesn't give us all the answers. We continuously seek new and better ways to take care of our patients. And the consequences of not giving us another chance could be devastating.
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