Dr. Saleeby's Blog (Part III)

eStatLabs.com & AtroGene.com Launch New Healthcare Model

2011-01-29T17:44:00.001-08:00

http://www.eStatLabs.com

eStatLabs is a direct-access-testing web site allowing anyone to order blood and urine tests online without a doctors visit or prescription. This makes personal healthcare available at very low cost to consumer.

AtroGene is launching an Internet web portal with a new paradigm in medical consultation via telemedicine, Skype and the internet.

AtroGene

http://www.AtroGene.com

eStatLabs.com A web site offering inexpensive lab testing

2011-01-14T07:33:00.000-08:00

An online Direct Access Testing (DAT) web site for low price blood testing without a doctor's prescription.

www.eStatLabs.com

Dr. Saleeby's Blog Part IV

2009-04-11T11:32:00.001-07:00

Links to Blog Sites

www.docsaleeby.blogspot.com

www.docsaleeby2.blogspot.com

www.docsaleeby3.blogspot.com

www.docsaleeby4.blogspot.com

Vita Sanus Nutraceuticals

Dr. Saleeby's Medical-Legal Consultations

Therapeutic Massage Articles from Brenda hughey, LMT & Julie Van Tassel, LMT

2009-04-10T13:39:00.000-07:00

Massage Therapy for Health Maintenance

By Brenda Hughey, LMT

When I tell people that I'm a massage therapist, I'm almost always pleased at their response, which is usually something along the lines of "wow that's great, I'd love to have a massage." It's wonderful to know that so many people are interested in massage therapy and know about its benefits. Yet most of these people only rarely "indulge" themselves with a massage. It is unfortunate that massage therapy is still generally viewed as an occasional luxury rather than an important part of a preventive health maintenance program.

Massage, simply put, is physical manipulation of soft tissue in the body. There are many different bodywork styles and techniques available to meet individual specific needs. And there's something special about the human touch that a machine can never replace. Massage therapy is probably best known for its ability to relax the body and relieve pain. The basic Swedish style uses long flowing stokes to help get the blood flowing to improve circulation throughout the body and lower blood pressure. This type of massage also helps rid toxins after physical exertion or exercise thus speeding recovery time. Skilled hands, working deeply and specifically in the tissue, can help relieve stiff or painful muscles and joints. Massage can also help heal injuries and limit scar tissue formation. These are just a few of the many benefits.

Like regular exercise and good nutrition, receiving frequent massage can promote wellness and improve health. Regular massage keeps muscles supple, can prevent injury and even improve posture. Perhaps more importantly and fundamentally is this RELAXATION aspect. What massage offers is a break from our fast-paced lives and an opportunity to de-stress ourselves. So often we don't really even take the time to notice what's going on in our bodies. And by reducing stress through massage, we're often removing the greatest impediment to healing. Once stress is removed, the body can begin getting well. In the mean time, massage can help alleviate the immediate symptoms of stress like muscle tension, headache, and insomnia.

So take time to experience relaxation. Make massage therapy a part of your regular health maintenance program.
Brenda Hughey is a graduate of the Florida School of Massage in Gainesville, Florida. She is a graduate of St. Bonaventure University where she obtained a B.A. in Sociology. Brenda also served as a logistics officer in the U.S. Army from 1987 - 1999. She was practicing massage therapy part time at the Saleeby Longevity Institute in Downtown Savannah.

Massage for the First Time
By Julie Van Tassel, LMT

One of the biggest barriers that stop people from ever making their first massage appointment may be the fear of the unknown. The truth is: The thought of venturing into a room with a stranger, not knowing what to expect, would make anyone feel somewhat vulnerable. Take a moment to think back. Can you remember any experiences that were not scary the first time you tried something new? Your first day of kindergarten, or as an adult going back to college for many of us, that was scary! Getting your first massage is just another step along the path to self discovery. When you meet with your massage therapist for the first time, you may be asked to fill out an intake form regarding your health history. Following this, your massage therapist may share with you their education background and talk with you specifically about your needs and expectations to the effect of your treatment. Next, your massage therapist may explain how you should get on the massage table, pointing out where you head should be, and whether you should be face up or face down. During your massage, your massage therapist only exposes those areas that he/she is working on at the moment. This technique is known as draping and this makes you feel comfortable. You may then be asked to undress to the level of your comfort, to lie on the table, and to pull the sheet up over your body while the therapist steps out to wash his/her hands. After the massage therapist has left the room, remember to take your time. He/she knocks before coming in, and usually waits longer than necessary.

Your therapist will then make sure you are comfortable, adjust the lights and music. The first moment of contact can tell you a lot about how the rest of the massage is going to feel. When your therapist is attuned to you and your body it becomes a joining together of your consciousness with the consciousness of another, which just doesn't occur often in our modern society. Take advantage of this and pay close attention to what is happening in your own body. This is a great opportunity for you to concentrate on breathing and relaxation.

During your massage feel free to give feedback to your massage therapist. If at any point you would like to change what he/she is doing, you have the right to express it. This is your sacred time! Your massage therapist will let you know when your session has come to an end. He/she may ask you to take your time getting off the table and back into your life. Relish these few moments where your cares and concerns seem a million miles away.

Some people think of massage as a luxury, and may only use it only in times of dire need. With the pressures in modern society, and particularly the increase of stress-related illnesses, touch therapies should become a part of everyday life. Massage is valuable in preventative health- both for the client and the therapist alike. Massage is truly self-discovery that reveals how it feels to be more relaxed and in tune with ourselves, to experience the pleasure of a body that can breathe, stand, and move freely.

Julie Van Tassel is a licensed and nationally certified massage therapist. She completed her requirements for massage & hydrotherapy from the Florida School of Massage in Gainesville, Florida. She previously spent many years as a certified dental assistant. She wa the full time massage therapist and office manager at the Saleeby Longevity Institute. She now practices in NJ.

Acupuncture article by Jane Gregorie, DOM, LAc

2009-04-10T13:37:00.001-07:00

Acupuncture and Chinese Medicine: Getting to the Point

By Jane Gregorie, DOM

In July of last year, the Georgia State legislature passed the "Georgia Acupuncture Act," making it possible for national board certified and qualified practitioners of acupuncture to obtain a state license and practice under the regulation of the medical board. Until that time, only medical doctors, required to have far less training in acupuncture than a national board certified acupuncturist does, were licensed to practice acupuncture in the state. Currently acupuncture is regulated by licensure or registration in at least 40 states, and is covered by insurance plans in many of those states.

Having recently relocated here from Santa Fe, New Mexico, where acupuncture is widely used and accepted, I have been surprised and refreshed by the questions I have been asked as an acupuncturist about what I do. And I have realized that although acupuncture is literally thousands of years old, here in Georgia it is newer than sliced bread. So let's start with the basics. What is acupuncture good for, anyway? How does it work? How big are the needles? And the most frequent and burning question of them all- Does it hurt?

Although many people assume acupuncture is only used for pain relief, acupuncture as a component of TCM (Traditional Chinese Medicine) encompasses a whole system of internal medicine. The modalities of TCM include acupuncture, moxibustion, Oriental bodywork, Chinese Herbology, and nutrition and are useful in treating a wide range of disorders from the common cold to anxiety to the side effects of chemotherapy. The World Health Organization has recognized 43 conditions that are amenable to treatment by acupuncture and Oriental medicine. Over 12 million Americans received acupuncture in 1995, and the numbers are steadily rising.

What makes TCM distinct from Western allopathic medicine is its focus on treating not only the symptoms of illness, but also the deeper imbalances that lead to such pathologies. Traditionally, we refer to this as treating the root along with the branch, or treating the underlying disharmony along with its concomitant symptoms. Acupuncture has always embraced the concept that superior medicine is preventative medicine. This is evidenced by the words of the Yellow Emperor to his student in the ancient (written in 200-100 BCE) treatise on Chinese Medicine, the Neijing:

In the old days the sages treated disease by preventing an illness before it began, just as a good government or emperor was able to take the necessary steps to avoid war. Treating an illness after it has begun is like suppressing revolt after it has broken out. If someone digs a well when thirsty, or forges weapons after becoming engaged in battle, one cannot help but ask: Are not these actions too late?

Treating the root also means that an acupuncturist will not use a set, rigid protocol for any given condition. A patient's treatment plan is entirely dependent on his or her individual presentation. While patient A may be treated a certain way for migraine headaches, patient B may receive an entirely different treatment for migraine headaches, based on the nature of the headache itself, specific organ system imbalances, and constitutional makeup. Chinese medical theory includes a sophisticated system of differentiation that distinguishes syndromes so that the practitioner can pinpoint both the specific qualities of an imbalance and its underlying causes as well. In the case of a migraine for instance, one would treat not only the headache, but also the deficiency or excess or stagnation that caused the pain to arise in the first place. For this reason, one person's migraine may respond to a treatment that is entirely different from a treatment that was effective in treating someone else's migraine. This is what makes acupuncture and Chinese Herbal Medicine so very subtle and powerful. The acupuncturist must act not from rote memory when treating an illness, but must regard every detail of an individual's presentation and history in order to come up with an entirely unique treatment plan that is best suited to the person as a whole.

Acupuncture works by using needles to access the Qi (pronounced "chee") or vital energy at acupoints, and manipulating that energy in specific ways. One can either supplement, drain, or move the Qi in order to restore the proper flow of energy through the meridians (pathways for Qi) in the body. Meridians are similar to rivers or little energy highways in the body. They are all interconnected and correspond to specific organ systems and flow in designated directions. Whenever Qi is stuck in a specific area, something happens like a logjam in a river or a traffic jam on a highway, and that part of the body will react, becoming painful or manifesting signs of pathology in an area associated with its correspondent organ system. Similarly, when there is not enough Qi flowing in a certain meridian, symptoms such as weakness and fatigue may occur, signaling that not enough nourishment is being circulated to all or part of the body. Or if the energy goes the wrong way in a meridian, like an errant car traveling the wrong way down a one way street, other types of imbalance will arise.

In any of the above cases, the acupuncturist accesses the Qi through the use of tiny, hair-like, sterile, disposable, filiform needles, and restores the proper flow. And no, acupuncture needles do not really hurt. Usually the insertion of the needle is completely painless. Rarely, one experiences minor stinging or pricking upon insertion. But once the Qi is accessed, one feels an interestingly achy, or electric, or distended sensation at the site of the needle. Sometimes this sensation radiates, and sometimes it sends waves of warmth or energy throughout the body. At any rate, acupuncture needle sensation is nothing like a hypodermic needle stick, and actually has been reported to be pleasant by some. While the needles are being retained (20-45 minutes), people often doze off, or find themselves in a deeply relaxed and euphoric state of being.

As the Yellow Emperor so eloquently put it, "When the energies are able to circulate smoothly and freely, and the energy of the mind is not scattered, but is focused and concentrated, illness and disease can be avoided." This pithy statement expresses the use of acupuncture at its best. By restoring the smooth and proper flow of energy in the body and inducing a state of mind that is peaceful and composed, acupuncture can be used not only to treat, but to prevent illness as well. Traditional Chinese Medicine is a beautiful, refined system of healthcare that is based on an age-old model of well being and harmony that is still applicable today. The job of the superior acupuncturist is to reunite a person with his or her own natural state of body-mind balance, nurture the roots of vitality, and ultimately enable them to thrive.

What are acupuncture points and meridians? Acupuncture points are those areas on the body that have been shown to have an influence on pain or body function when stimulated by a needle, pressure or heat. These points are quite small, and exact location is important for attaining maximum benefit from a given treatment. By inserting needles into points on the meridian pathways, the normal flow of energy may be restored and balanced. The points are organized into twelve classic meridians which are named after the organ systems to which they correspond. There are also eight extra meridians which have distinct functions and address specific conditions.

How long does a treatment take? The initial visit usually last one to two hours due to the time required for the extensive intake of questions and examination. Follow-up treatments tend to take only 30 minutes to an hour. To learn more attend one of the upcoming lectures at the SLI.

What Can Be Treated By Acupuncture/TCM?

Gastrointestinal disorders- food allergies, peptic ulcers, chronic diarrhea, constipation, indigestion, gastrointestinal weakness, anorexia, gastritis
Urogenital Disorders- stress incontinence, UTI's, sexual dysfunction
OB/GYN- irregular, heavy, painful menstruation, infertility, PMS
Respiratory Disorders- emphysema, sinusitis, asthma, allergies, bronchitis
Disorders of the bones, muscles, joints, and nervous system- arthritis, migraines, neuralgia, insomnia, dizziness, low back pain, neck and shoulder pain.
Circulatory disorders- hypertension, angina pectoris, arteriosclerosis, anemia
Emotional & Physical Disorders- depression & anxiety
Addiction- alcohol, nicotine, and drugs
Ear, Eye, Nose and Throat Disorders
Supportive Therapy for other chronic and painful disorders

The World Health Organization recognizes acupuncture and traditional Oriental medicine's ability to treat over 43 common disorders including those listed above. US FDA has approved acupuncture for the management of pain.

Jane Gregorie is a Nationally and State Licensed Acupuncturist in the states of Georgia and New Mexico. She received her M.S. in Oriental Medicine from Southwest Acupuncture College in New Mexico. She completed her undergraduate degree at The Naropa Institute in Boulder, Colorado. In addition to her formal education, she has spent time in Japan, Nepal, India, and Tibet. She was staff acupuncturist and herbalist at the Saleeby Longevity Institute. Now practices in NM.

Celiac Disease (Gluten Intolerance)

2009-04-03T22:01:00.000-07:00

Celiac Disease

by JP Saleeby, MD

The genetic malabsorptive disorder Celiac Disease (or celiac sprue) a condition where the body has an immunologic reaction to gluten may be more widespread than previously thought. It is estimated that one in 300 Americans have celiac disease. Since this condition can manifest itself from infancy to old age it is sometime overlooked or undiagnosed mainly due to low suspicion and its protean presentation. Symptoms may fall on a continuum from mild to severe, but there are certain key symptoms and signs that should trigger a complete work up for this disorder.

Celiac disease is an inherited disorder and results when gluten proteins from many of the grains we eat spark an immune reaction resulting in a malabsorptive digestive disorder. Rye, wheat and barley are some major offenders, but gluten hides in many prepared foods such as hotdogs. Think of it as an intestinal allergy to gluten and the consequences can be grave. It is important for an individual who is diagnosed with celiac disease to refrain from eating gluten containing foods, as this is the treatment of choice.

Celiac disease often causes diarrhea, fatigue, borborygmus (rumbling stomach), abdominal pain, weight loss, distention of the abdomen, flatulence and iron deficiency anemia. Additionally, signs that present on examination of a patient are a skin disorder called dermatitis herpetiformis, aphthous ulcers (canker sores), low blood counts (anemia), with Diabetes mellitus (Type I) and autoimmune Thyroid disease as associated illnesses. The skin eruptions know as dermatitis herpetiformis is almost pathognomonic for celiac disease as those who present with it should be screened for it is found in up to 20% of patients with celiac disease. Under or misdiagnosis is certainly a problem. According to one study up to 36% of celiac patients were misdiagnosed as having irritable bowel syndrome until the true diagnosis was realized. Left untreated celiac disease can ultimately lead to osteoporosis and intestinal lymphoma.

When it is suspected there are serum (blood) tests that should be ordered first and they include immunoglobulin A (IgA) tissue transglutaminase antibodies (tTG) and anti-endomysial antibody (IgA) analysis. For confirmation a small intestine biopsy can be performed under endoscopy. The Anti-gliadin test has fallen out of favor in recent years due to its lack of specificity and low sensitivity. Additionally, genetic markers such as the HLA phenotypes DQ2 and DQ8 may be helpful as they are found in 99% of people with celiac disease.

Those with celiac disease have a higher mortality due to a risk three to six times higher for developing gastrointestinal cancers and in particular a non-Hodgkin’s lymphoma. Patients with celiac disease need close and routine follow up care. Cancer screening along with routine testing for diabetes, thyroid disease, vitamin deficiencies, anemia and osteoporosis should be performed by their family doctor.

Along with stick avoidance of gluten containing foods, replacement of key nutrients is essential. Those who suffer from celiac disease are prone to deficiencies of iron, calcium, folic acid, vitamin B12 and some fat-soluble vitamins (notably Vitamin D). Therefore, it is good practice to supplement with these vitamins and minerals. There are alternatives to wheat, rye and barley that provide a good balance of fiber and a health supply of vitamins usually associated with the offending grains. While corn, potato, and rice make up the mainstay of starches for celiacs, soybeans, tapioca, arrowroot, carob, buckwheat, millet, amaranth and quinoa are allowable and suitable additions.

A good adjunct to a gluten free diet is a new product on the market offered by BeachBody. This product launched in March 2009 was directed to the health and fitness market as a meal replacement dietary supplement for attaining health weight goals. However, this product is guaranteed gluten free and caries many additional nutrients someone with celiac disease would benefit. Shakeology (www.shakeology.com) has benefits for keeping a celiac patient out of a malnutrition state as it has a health helping of protein (from whey), a well balanced supply of multivitamins and minerals, pre and probiotics, digestive enzymes, fiber and adaptogen herbs. It could conceivably be the healthiest meal of the day for any person suffering from celiac disease.

More information is available about this disease, diagnosis and treatments (including a list of gluten free foods) at the Celiac Disease Foundation web site: www.celiac.org.

---

JP Saleeby, MD is an integrative medicine physician and emergency room doctor with years experience in nutritional medicine and a formulator of several dietary supplements on the market. He authored a book on adaptogen herbs entitled Wonder Herbs: A guide to Three Adaptogens (Xlibris) in 2006. He recently reviewed the research study supporting the new meal replacement shake Shakeology for Product Partners. He can be reached for comment at jpsaleeby@aol.com.

Reference:

Presutti, R.J., et al, Celiac Disease, Am Fam Physician 2007; 76:1795-1802.

Pruessner, H., Detecting Celiac Disease in your Patient, Am Fam Physician 1998; 57;1023-1039

Problems with Evidence Based Medicine

2009-03-26T22:04:00.000-07:00

There is a BIG problem with Evidence Based Medicine that no one really wants to admit. That is the practice of current up to date medical diagnostics and therapeutics but with WHOS evidence.

EBM changes with the seasons, depending on the latest and greatest medical researched published in the top peer-reviewed journals (Lancet, JAMA, NEJM, etc.) But with recommendations changing so often it is confusing to both clinician and patient.

Example, the core-measures treatment of AMI with beta-blockers... considered STANDARD of care for a few years until more current research determined it to be "bad" for patients. So Practice with Caution and don't be too smitten by all that appears between the pages of medical journals. The Art of Medicine still survives.

The recent contribution in this years JAMA illustrates this point:

Scientific Evidence Underlying the ACC/AHA Clinical Practice Guidelines

Pierluigi Tricoci, MD, MHS, PhD; Joseph M. Allen, MA; Judith M. Kramer, MD, MS; Robert M. Califf, MD; Sidney C. Smith Jr, MD

JAMA. 2009;301(8):831-841. (Feb. 25, 2009)

Context The joint cardiovascular practice guidelines ofthe American College of Cardiology (ACC) and the American HeartAssociation (AHA) have become important documents for guidingcardiology practice and establishing benchmarks for qualityof care.

Objective To describe the evolution of recommendationsin ACC/AHA cardiovascular guidelines and the distribution ofrecommendations across classes of recommendations and levelsof evidence.

Data Sources and Study Selection Data from all ACC/AHApractice guidelines issued from 1984 to September 2008 wereabstracted by personnel in the ACC Science and Quality Division.Fifty-three guidelines on 22 topics, including a total of 7196recommendations, were abstracted.

Data Extraction The number of recommendations and thedistribution of classes of recommendation (I, II, and III) andlevels of evidence (A, B, and C) were determined. The subsetof guidelines that were current as of September 2008 was evaluatedto describe changes in recommendations between the first andcurrent versions as well as patterns in levels of evidence usedin the current versions.

Results Among guidelines with at least 1 revision or updateby September 2008, the number of recommendations increased from1330 to 1973 (+48%) from the first to the current version, withthe largest increase observed in use of class II recommendations.Considering the 16 current guidelines reporting levels of evidence,only 314 recommendations of 2711 total are classified as levelof evidence A (median, 11%), whereas 1246 (median, 48%) arelevel of evidence C. Level of evidence significantly variesacross categories of guidelines (disease, intervention, or diagnostic)and across individual guidelines. Recommendations with levelof evidence A are mostly concentrated in class I, but only 245of 1305 class I recommendations have level of evidence A (median,19%).

Conclusions Recommendations issued in current ACC/AHAclinical practice guidelines are largely developed from lowerlevels of evidence or expert opinion. The proportion of recommendationsfor which there is no conclusive evidence is also growing. Thesefindings highlight the need to improve the process of writingguidelines and to expand the evidence base from which clinicalpractice guidelines are derived.

Author Affiliations: Division of Cardiology and Duke Clinical Research Institute (Dr Tricoci), Division of General Internal Medicine and Duke Center for Education and Research on Therapeutics (Dr Kramer), and Division of Cardiology and Duke Translational Medicine Institute (Dr Califf), Duke University, Durham, North Carolina; American College of Cardiology Science and Quality Division, Washington, DC (Mr Allen); and Center for Cardiovascular Science and Medicine, University of North Carolina, Chapel Hill (Dr Smith).

Morphine vs Fentanyl in EMS (MCRS lecture)

2009-03-22T12:51:00.000-07:00

Shakeology Launch at Beach Body Summit '09

2009-03-20T06:03:00.000-07:00

Speaking before a crowd of 700+ coaches ....

California (March 14th, 2009). Shakeology the new meal replacement by BeachBody is launched in Hollywood California at the 2009 Coaches Summit. On hand to speak about the science and research behind this amazing new dietary supplement is..........me. I share the podium with Carl Daikeler (CEO of Beachbody) to launch this product. For video click on this link and visit Day 2 of Summit. http://www.beachbody.com/category/video.do?bclid=6615764001

"Pimp Thi$ Bum" Web Site Letter

2009-03-08T05:18:00.001-07:00

A top story in AOL News (and others) today caused me great concern.... this is the response to the story and the web site (http://www.ascendgence.com/pimpthisbum/index.aspx):

-----Original Message-----
From: JP Saleeby, MD
To: admin@ascendgence.com
Sent: Sun, 8 Mar 2009 8:16 am
Subject: Pimp This Bum

Kevin,

This site raises ethical issues with me. Despite the lengthy explanation you give on your web site, are you really helping the homeless here or is this site exploiting their plight and "celebrity-izing" one particular homeless man. By and large as an ED physician my encounters with the homeless are that the majority have psychiatric issues whether substance abuse or other and they tend to be very manipulative (seeking social admissions for food and shelter in the ED which bogs our healthcare system down, drug seeking, etc.) The title of the site is a bit offensive (I guess it gets you lots of hits and a feature on AOL news and I "get it" from a marketing perspective), but to demean this problem by relating it to an MTV show (Pimp My Ride) is crass.

JP Saleeby, MD
ED Medical DirectorBennettsville, SC
www.saleeby.net
-----

His reply:

-----Original Message-----
From: admin@ascendgence.com
To: JP Saleeby, MD
Sent: Sun, 8 Mar 2009 4:04 pm
Subject: RE: Pimp This Bum

You are a cynic. I know quite a bit  about the homeless. I have lived on the
streets and my brother has been chronically homeless for 30 years. He doesn't
want to change. But I have seen people that had been broken and put there lives
back together with the right help. It never came from typical institutional
organisations. It came from a close group of caring people helping someone to
work through their demons.  If the hoopla bothers you - help people your way.  I
am a marketing guy, and we have created a system that may bail many people out
of homelessness. Some may fall back. That doesn't mean that every one on this
planet shouldn't try to help. I appreciate what you do.

Kevin

-----

(Editors Note: He has got me pegged as a cynic... no argument there as I don't honestly believe his company would promote such a site with a "store" link to buy site merchandise in a purely altruistic manner)

Myers' Cocktail (reprint from 2001)

2009-03-07T14:10:00.000-08:00

Neither Shaken Nor Stirred

by J.P. Saleeby, MD

Rapid intravenous infusion of a concoction containing vitamins and minerals seemed an interesting treatment for a variety of ailments. This was first brought to my attention at the grand opening of my clinic in February of this year. The conversation was with a husband and wife team, well versed in natural medicine, and proprietors of a local health food store. As the conversation progressed, it centered around something known as the “Myers’ Cocktail” or the “Gaby-Wright Cocktail.” The health food store owners knew of a medical doctor who lectured nationally that recommended such a cocktail for a myriad of illnesses. As fate would have it I was to attend a symposium later that same month entitled “Nutritional Therapy in Medical Practice” given by non other than Dr. Alan R. Gaby. This symposium was sponsored by the Beth Israel Medical Center and St. Luke’s- Roosevelt Hospital in New York City.

Of the five hundred or so in attendance from around the country I was hoping to bring back some real pearls of wisdom to Savannah, GA. The most fascinating course included many lectures on the importance of nutrition in daily life and in treating disease. Every lecture was supported and referenced by evidence found in the medical literature. Dr. Alan R. Gaby, MD as well as Dr. Jonathan V. Wright, MD are both luminaries in the field of nutritional / alternative medicine and the gains in knowledge in this area of medicine were tremendous for me.
Dr. Gaby would often interject humorous self-accompanied guitar ditties about medicine, med-school and life. But most important and striking was the topic of the Myers’ Cocktail. First introduced by Dr. Myers in the mid 20th century and then forgotten until it was re-introduced by Dr's. Gaby and Wright a decade ago, it is a mixture of relatively high doses of five vitamins and two minerals, which can to some degree be individualized to each patient and their needs. It is quickly infused through an IV and in some patients the effects may last weeks.

The theory behind high dose and quick infusions is that these vitamins and minerals are forced into the cells by sheer overload and are hence “trapped” intracellularly, where their effects last long beyond the expected short time following the infusion. Currently Dr. Gaby and Dr. Harry Adelson are conducting a pilot study into the effects of the Myers’ Cocktail at the Naturopathic Medical Center at the University of Bridgeport in Bridgeport, CT. Independently, my center is also collecting date on patients undergoing this infusion. The prospects are exciting; will the data back up the case studies and anecdotal claims that have been made over the decades?

The treatment is recommended and has been used with great success according to Dr. Gaby in treating Chronic Fatigue Syndrome, Chronic Depression, Fibromyalgia, Asthma (both acute flair-ups and the chronic condition), Urticaria, Seasonal Allergic Rhinitis, Chronic Sinusitis, Congestive Heart Failure, Ischemic Vascular Disease, Dementia, Reflex Sympathetic Dystrophy, Bronchitis, and especially Acute Viral and Bacterial infections. On a personal note, I was recently infused with a 60cc bolus over 10 minutes after acquiring a “cold.” My recovery, which would usually last 3 to 4 days, was achieved in only 24 hours and all the while working a rough 12-hour ER shift. Needless to say I am most impressed with its success in managing upper respiratory infections.

(c) 2001

-----

JP Saleeby, MD advises via telemedicine consultation services found at www.saleeby.net

MPH ED New Physician Orientation

2009-02-28T13:08:00.000-08:00

Professional Monopolies in Medicine / Drs. Baerlocher, Detsky, JAMA 2/25/2009

2009-02-26T13:48:00.000-08:00

-----Original Message-----
From: JP Saleeby, MD
To: adetsky@mtsinai.on.ca
Cc: jpsaleeby@aol.com
Sent: Thu, 26 Feb 2009 4:45 pm
Subject: Professional Monopolies

Allan,

Enjoyed the commentary in this month's JAMA on Professional Monopolies in Medicine. How it affects me is in EM. I am not EM residency trained or EM board certified but have a stellar 17+ year career in Emergency Medicine both as a clinician and in leadership roles. Non-the-less many hospitals are bamboozled into writing bylaws that prohibit anyone other than an EM-trained BC/BE physician from stepping foot into the department to take care of patients. What is worse I am prohibited by the boards to sit for the exam. I have essentially be constructively evicted from many Emergency Departments.

The blame is in part due to ACEP and it's lobbing that no one outside their organization is adept at servicing ED clients. That is absurd, false and constitutes a monopoly in that field of medicine. It severely limits my ability to work in my field of "specialty" as I face more and more hospitals limiting my ability to apply. In a time of physician shortages (only to get worse in the future) society needs to demand from medical societies that they loosen their grip and set aside their self serving agendas to better serve humanity.

JP Saleeby, MD
Medical Director
Marlboro Park Hospital ED
Bennettsville, SC
www.saleeby.net

Did you know Asthma's impact?

2009-02-16T05:01:00.000-08:00

20 million Americans suffer from asthma
5 million asthma sufferers are under the age of 18
2 million visits to ERs each year are due to asthma
10 million outpatient visits each year are due to asthma
500,000 hospitalizations each year are due to asthma
220,000 (44%) is the number of hospitalizations for children that are asthma related
3 days is the average stay for those hospitalized for asthma
14 million school days are missed due to asthma

Source: Asthma and Allergy Foundation of America

Diet Soda and link to Metabolic Syndrome (MetSyn) & Diabetes

2009-02-11T19:04:00.000-08:00

Daily Consumption of Diet Soda Linked to Metabolic Syndrome, Type 2 Diabetes

News Author: Laurie Barclay, MDCME

Author: Laurie Barclay, MD

February 11, 2009 — Drinking diet soda at least daily is associated with significantly greater risks for select incident components of the metabolic syndrome (MetSyn) and type 2 diabetes, according to the results of an observational study reported in the January 16 Online First issue of Diabetes Care.
"Two longitudinal cohort studies have shown positive associations between diet soda consumption and incident MetSyn independent of baseline measures of adiposity," write Jennifer A. Nettleton, PhD, from the University of Texas Health Sciences Center in Houston, and colleagues. "Replication of previously observed diet soda-MetSyn associations in a distinct cohort would bolster their credibility and provide further insight into the nature of the relationship. Previous studies have not addressed associations between diet soda and individual MetSyn components or risk of type 2 diabetes nor have they fully addressed potential longitudinal mediators of these relationships, i.e., changes in adiposity status."
The goal of this study was to evaluate associations between diet soda consumption and the risk for incident MetSyn, its components, and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA).
Initial evaluation was performed from 2000 to 2002, at which time baseline food frequency questionnaires measured diet soda consumption. Three follow-up evaluations were performed from 2002 to 2003, 2004 to 2005, and 2005 to 2007. Incident type 2 diabetes was defined as fasting glucose levels of more than 126 mg/dL, self-reported type 2 diabetes, or use of diabetes medication. National Cholesterol Education Program Adult Treatment Panel 3 criteria were used to define MetSyn and its components. After adjustment for demographic, lifestyle, and dietary confounders, hazard ratios (HRs) were estimated for type 2 diabetes, MetSyn, and MetSyn components.
Compared with participants who did not drink diet soda, those who drank diet soda at least daily had a 36% greater relative risk for incident MetSyn (HR, 1.36; 95% confidence interval [CI], 1.11 - 1.66) and a 67% greater relative risk for incident type 2 diabetes (HR, 1.67; 95% CI, 1.27 - 2.20).
Of the individual components of MetSyn, only high waist circumference (men: ≥ 102 cm; women: ≥ 88 cm) and high fasting glucose levels (≥ 100 mg/dL) were prospectively associated with consumption of diet soda. Associations between diet soda intake and type 2 diabetes were independent of baseline measures of adiposity or changes in these measures. In contrast, associations between diet soda and MetSyn were not independent of these factors.
"Although these observational data cannot establish causality, consumption of diet soda at least daily was associated with significantly greater risks of select incident MetSyn components and type 2 diabetes," the study authors write.
Limitations of this study include observational design, precluding determination of causality; possible confounding by other dietary and lifestyle/behavioral factors; and difficulties in estimating intake of diet soda or artificial sweetener.
"These results corroborate findings from the ARIC [Atherosclerosis Risk in Communities] and Framingham studies and show stronger adverse associations exist between diet soda and type 2 diabetes," the study authors conclude. "Diet soda consumption, either independently or in conjunction with other dietary and lifestyle behaviors, may lead to weight gain, impaired glucose control, and eventual diabetes."

The National Heart, Lung, and Blood Institute supported this study. The study authors have disclosed no relevant financial relationships.

Diabetes Care. Published online January 16, 2009.

Board Certification requirements in a time of crisis

2009-02-10T19:02:00.000-08:00

This is a letter to the Editor regarding a medscape Article topic "Board Certification"... Issue was whether BC and re-certification really are meaningful, who is profiting from this "certificate" and how does it impact quality of care.

-----Original Message-----
From: JP Saleeby, MD jpsaleeby@aol.com
To: glundberg@medscape.net
Sent: Mon, 9 Feb 2009 3:55 pm
Subject: Who should be allowed to take the board exam?

Re: To the Editor
From Medscape General Medicine
Letters
Readers Respond to "Board Certification -- A Hot Topic for Patients and Physicians"
Posted 05/19/2006Jeffrey A. Marmelzat, MD; Name Withheld on Request; Carla S. Fore, RN, PA-C; J. Michael Miller, PhD, (D)ABMM; Ajoy Chhabra, MD----------------

Board certification is so overrated. I have practiced medicine for over 16 years in Emergency Medicine, I did not complete a residency and therefore am not eligible for taking any board exams, despite the fact that I am very competent, have a stellar track record as a physician and ascended to leadership roles in EM (6 years as assistant medical director and the past 2+ years as director of a department). My record will show that while I am not board-certified in any specialty, my performance as an ER physician outshines some of my associates who are EM-residency trained and BC (and even a few who are double boarded).

I find the board certification process to be faulted in that "any" MD or DO who has completed a PGY-1 year and obtained medical license in any state should be able to sit for any board... should he or she pass.. then give them the certification. What truly is the difference between a physician who is taking his re-certification exam for the 4th time being so far from residence (and in fact what was taught back then may be obsolete or even wrong by today's standards) and a physician who is current in his practice (participates in CMEs) but to did not complete residency? It appears that the boards are in fact profiting (by collecting fees) from requiring re-examination and the training programs profiting from a cheap source of labor.

Because of the desire by some hospitals to staff their EDs with EM-trained BC physicians (who look good on paper) by-laws are excluding good experienced ED physicians (even those BC in Primary Care specialties) and this is making it increasingly difficult for doctors to find work, especially in a time when our nation is facing physician shortages.

JP Saleeby, MD
www.saleeby.net

Chronic Pain (stats and appropriate management)

2009-02-07T09:59:00.000-08:00

Chronic Pain

by JP Saleeby, MD

Chronic pain conditions remain one of the most common reasons for clinical visits to the primary care office and the emergency room. Data from the 1999-2002 National Health & Nutrition Examination Survey (NHANES) shows a prevalence of chronic back pain at 10.1% with other conditions such as leg and feet pain (7.1%), arms and hands (4.1%) and headache (3.1%) as reported by the respondents. There were differences of reported chronic pain by sex, where women were more likely to report headache, abdominal pain and chronic widespread pain than were men. It also crossed ethnic boundaries where the fewest reported complaints of pain came from Mexican-Americans. In a similar Canadian study reports that older adults in institutions (nursing homes) reported pain 38% of the time versus those in community-dwelling homes (private homes) only reporting 27%. Once again the Canadian study reported more women than men complained of chronic pain. Associated symptoms with chronic pain include difficulty with sleep, depression and difficulties with daily activities. Additionally chronic pain suffers tend to report that their medical care was poor.

Interestingly in a survey of over 300 physicians in Michigan, most respondents reported that they treat chronic pain, but were not confident or satisfied in their ability to treat it well. From their own perspectives they felt they fell short on accepted standards and did not choose the appropriate analgesics. There was also a general reluctance to prescribe opioids. Several overwhelming reasons for the lack of prescribing opioid analgesics were the potential for drug dependence and abuse, the untoward effects of those drugs (such as constipation, risk of withdrawal symptoms) and the potential for them finding their way to the streets (as illicit drugs).

While a review of some 60 studies looked into the abuse potential of opioid users it found a rather small percentage of those at risk in those patients who had no history of drug or alcohol abuse. However, with those patients with prior history of substance abuse and addictive personality disorders there was much risk for addiction associated with long-term opioid therapy. One of the most feared side effects of long-term opioid therapy is constipation with incidence as high as 40%. As a consequence of this additional medication would need to be prescribed to combat this condition.

The most appropriate place for chronic pain management is in the primary care setting. Emergency room visits should be limited to those suffering from acute pain episodes, not for those who are having pain for more than 2-weeks or longer. Medical management by a primary care physician or a pain management specialist offers a broader treatment plan than just pain medication. This often includes physical and/or occupational therapy, biofeedback, psychiatric counseling, adjunct therapy such as TENS, acupuncture, therapeutic massage, joint and/or muscle trigger point injections to name a few. A sole provider should be at the helm of treating chronic pain patients to insure proper prescription of medications, avoiding the possibility of drug-drug reactions from multiple prescribers and the risk of polypharmacy. From a medico-legal standpoint, only one physician should be prescribing scheduled or controlled drugs (opioid analgesics) to avoid issues of abuse or the illegal distribution of narcotics by either the prescriber or the recipient. Should your local PCP be unable to adequately control pain issues, a referral to a pain management specialist is in order and will often times be very helpful.

- JP Saleeby, MD is the medical director of the emergency department at Marlboro Park Hospital, Bennettsville, SC. He maintains a health and wellness blog at www.docsaleeby.blogspot.com

---
References:
Charles P. Vega, MD, FAAFP WebMD CME programs

Nadstawek J, Leyendecker P, Hopp M, et al. Patient assessment of a novel therapeutic approach for the treatment of severe, chronic pain. Int J Clin Pract. 2008;62:1159-1167.

(c) 2009

EMTALA for EMS (MCRS)

2009-02-02T18:06:00.000-08:00

A lecture given to Marlboro Co. Rescue Squad on the intricacies of EMTALA

Mycobacterium tuberculosis & Scrofula

2009-01-19T05:30:00.000-08:00

M tuberculosis is an obligate, aerobic, nonspore-forming rod. Humans act as its sole reservoir, and it continues to be a major health problem worldwide. Nearly one third of the global population (ie, 2 billion people), is infected with M tuberculosis and is at risk of developing the disease. An estimated 8 million people develop active tuberculosis (TB) every year; of those cases, about 2 million result in death. More than 90% of global TB cases and deaths occur in the developing world, of which 75% are in the most economically productive age group (15-54 years).

Patient-to-patient transmission typically occurs via inhalation of small aerosols and, in most cases, the disease is confined to the respiratory system. It can, however, affect any organ system, particularly in immunocompromised individuals, in whom it can involve multiple extrapulmonary sites, including the skeleton, gastrointestinal tract, genitourinary tract, and central nervous system (among others). After a period of replication within the lungs, dissemination occurs through the lymphatic and circulatory systems to extrapulmonary sites, including the cervical lymph nodes. Approximately 95% of nodal disease cases in the adult population are caused by M tuberculosis; the remaining cases are caused by atypical Mycobacterium or nontuberculous Mycobacterium (NTM). This is often the case in the pediatric population of the United States, in which over 90% of the cases are caused by NTM; most of those cases result from Mycobacterium avium complex (MAC), which is typically considered a surgical disease. Since antituberculosis antibiotics were first developed in the 1940s, there has been a steady decline in the general prevalence of TB; however, since the mid-1980s, there has been a resurgence in TB cases as a consequence of the acquired immunodeficiency syndrome (AIDS) epidemic, as well as increasing immigration from developing countries. An increase in the number of drug-resistant strains of M tuberculosis has played a role as well.^[1,2,4,5,6]

There is evidence that M tuberculosis has been present since antiquity. The mummy of Nesperhan, a priest of the Egyptian god Amun, showed ventral destruction changes of the lower thoracic spine that led to the typical gibbus formation of spinal TB. "Scrofula" is an old term initially used to describe chronic lesions of the head and neck that today are believed to have likely represented TB infection. In 1882, Robert Koch discovered a staining technique that enabled him to isolate the tubercle bacillus, thereby establishing TB as an infectious disease. Head and neck TB is often difficult to diagnose clinically, and it is seldom suspected by clinicians. It is frequently confused for a neoplastic process (as in this case), which results in a delay in treatment. TB of the head and neck represents about 15% of cases of extrapulmonary TB, with about 1.5% of all new cases manifesting in this way. Tuberculous lymphadenitis causes rubbery, painless enlargement of the cervical lymph nodes, usually bilateral, with the posterior cervical chain most commonly involved as well. Lung involvement is most often encountered with lower nodal involvement. If left untreated, the nodes may ulcerate, producing draining sores. Fevers, chills, sweats, and weight loss have been reported to occur in about 20% of individuals. Complications of head and neck disease include scar formation in a draining fistula of the neck, especially after biopsy.

source: http://cme.medscape.com/viewprogram/18843_pnt

BeachBody P90X for Father & Son

2009-01-17T11:18:00.000-08:00

In my 3rd week of P90X and Michael who was visiting for the weekend and has on occasion done the AbRipperX with me joins me for the full 58-minute Chest, Shoulders and Triceps workout.. and does not even dog it. He is becoming a little bad a$$ at the tender ol' age of 9.

Will be heading to Hollywood, CA in March to take in the BeachBody Coaches Summit. A guest of Jonathan of Product Partners and the Staff of BeachBody. Sharon and I are excited. Worked on a new product they will be launching at the Summit and hope to make a presentation for them on the science behind it. Trying to get a bit more cut for the trip to Cali. More later.

USAirways Pilot a hero

2009-01-16T18:45:00.000-08:00

Chesley B. "Sully" Sullenberger, III is a captain for a major U.S. airline with over 40 years of flying experience. A former U.S. Air Force (USAF) fighter pilot, he has served as an instructor and Air Line Pilots Association (ALPA) safety chairman, accident investigator and national technical committee member. He saved the lives of all 155 passengers on the Airbus A320 aircraft when birds hit the engine and rendered the plane severely damaged. He crash landed the plane into the Hudson River and all survived. Kudos Man! Am a faithful USAirways client and will remain one.

http://safetyreliability.com is Captain Sully's web site.

Bee Trivia

2009-01-01T05:34:00.000-08:00

Here's some trivia for you:

1) How many flowers must honey bees tap to make one pound of honey?
Two million.

2. How far does a hive of bees fly to bring you one pound of honey?
Over 55,000 miles.

3. How much honey does the average worker honey bee make in her lifetime?
1/12 teaspoon.

4. How fast does a honey bee fly?
About 15 miles per hour.

5. How much honey would it take to fuel a bee's flight around the world?
About one ounce.

"If the bee disappeared off the surface of the globe then man would only have four years of life left. No more bees, no more pollination, no more plants, no more animals, no more man." -- Albert Einstein. (controversial as to a true Einstein quote, but true never the less)

MRSA (Merry Christmas)

2008-12-25T07:54:00.000-08:00

MRSA

By JP Saleeby, MD

MPH-ED Director

Methicillin-resistant Staphylococcus aureus (MRSA) is in the news a lot these days and on the minds of most healthcare workers in recent years and for good reason. MRSA is a type of bacteria that has acquired resistance to a number of commonly used antibiotics and is becoming a problem bug to treat. Physicians and hospitals are taking action to help stop the spread of this bacterium by ever more aggressive means. Marlboro Park Hospital will soon implement a hospital wide screening process on all high-risk patients to limit spread and help track carriers.

Staphylococcus aureus (or Staph) is a bacterium which causes a multitude of infections in humans. A very common bacteria present on our skin, S. aureus is classified as a gram-positive bacteria with the appearance of a cluster-of-grapes under a microscope. It is distributed worldwide and as many as 11% - 40% of the population is estimated to be colonized with this bug. In the US alone some 3.2 million people are reported to be colonized with MRSA in a 2006 study. Normally, it does not cause problems as it is found on our skin, inside our mouths and in our nostrils. However, when it invades our bodies (gets under our skin, so to speak) then it can cause disease and illness.

S. aureus can become a “super bug” when it mutates and becomes resistant to antibiotics. Bacteria when exposed to certain antimicrobials develop ways to protect itself from them eventually; when this happens we refer to these bacteria as “super bugs” or resistant organisms. In 1959 the antibiotic methicillin (which is a relative of penicillin) was introduced to fight skin infections. Clinicians noticed a number of isolated cases of S. aureus that were resistant to this antibiotic within two years of its use, thus the name methicillin-resistant. However, MRSA shows resistance to many other antibiotics besides the now obsolete methicillin.

There are two classifications of MRSA. Those found in hospitals (HA-MRSA or hospital acquired MRSA) and those found in the community (CA-MRSA or community acquired MRSA). Twenty years ago MRSA was almost unheard of in the community and one would be limited to see cases in hospitalized or ICU patients, today it is a different story. Cultures of ICU patients in 1974 showed only a 2% rate of HA-MRSA. The number has risen to 64% (in surveys from 2004), and probably higher today in our ICU patients. As many as 59% of all skin and soft tissue infections are caused by MRSA today resulting in 94,000 patients each year presenting with serious invasive infections. There are reported approximately 19,000 deaths resulting from this bacterium (a rate higher than deaths due to HIV). Only 14% of these deaths are associated with the lesser virulent CA-MRSA, while HA-MRSA accounts for 86% of deaths.

The bacterium S. aureus causes infections and disease by several mechanisms. They produce proteolytic enzymes (that breakdown tissue proteins and cause pus), enterotoxins that are responsible for vomiting and diarrhea, exfoliative toxins that cause the skin to blister, and exotoxins (TSST-1 for example is a protein implicated in toxic shock syndrome, a very bad and lethal infectious process). When you add antibiotic resistance to the picture, you have a very dangerous pathogen. When mutation occurs in the bacterium changes take place at a genetic or molecular level. When a bacterium acquires resistance to an antibiotic it passes this genetic information to other bacterium. There are at least five types of genes involved. The genes denoted as SCCmec I-V have been isolated. Those S. aureus with genes I-III are associated with the more virulent HA-MRSA, and genes IV & V linked to CA-MRSA. HA-MRSA is the nastier of the two bugs with more drug resistance.

MRSA is transmitted by direct contact (through contact with skin and/or body fluids) and by indirect contact (through towels, toys, diapers, and fomites such as door knobs & counter tops). There are those individuals referred to as carriers who show no symptoms of infection, yet harbor this bacterium. Statistics indicate CA-MRSA is the predominant type found in the population and it can be cultured by a simple screening exam using nasal swabs. Hospitals nationwide will soon implement screening tests for all high-risk patients or those admitted to the ICU by non-invasive nasal swab screening tests to help identify these patients. Screening is a means to help eradicate or lessen the death rates associated with MRSA.

Those at greater risk for harboring this bacterium are those who play contact sports, share towels and toiletries, those who have suppressed immune systems (people with cancer, on immunosuppressant drugs, chemotherapy and HIV (+) patients). Additionally, those who live in unsanitary conditions and the very young or old are higher risk. Healthcare workers are also at increased risk because of their working environment.

While the symptoms of infection are very protean, they do have some commonality. Pus producing skin infections like boils, abscesses and impetigo are most often found to contain MRSA. In the emergency room we often see MRSA infections that are mistaken for “spider bites.” The dermatological presentation of an early MRSA infection is very similar to many insect bites. When a superficial MRSA infection becomes more complex, by expanding and spreading into deeper tissues, colonizing implantable devices (artificial joints, replacement heart valves, etc.) then mortality rises. Symptoms such as high fever, chills, weakness and mental deterioration as well as a drop in blood pressure ensue and result in a condition called sepsis. Mortality rates among septic patients are extremely high.

The only correct way to diagnose MRSA is by culture. Samples from the skin (or in conditions such as pneumonia where blood cultures are drawn) are plated on Baird-Parker agar plates and cultured in an incubator. S. aureus that produces a (+) coagulase test (coagulase is an enzyme that some bacteria produce that allow the bacteria to clot blood) are then subjected to methicillin. Those bacteria that survive are labeled MRSA. Further evaluation of resistance and sensitivity to different antibiotics is accomplished by placing Kirby-Bauer discs on the agar plates and checking for antibiotic susceptibility. This microbiological culture process can take several days.

Treatment of simple topical MRSA infections is accomplished by topical mupirocin (Bactroban ®) cream. For those more serious infections of the deeper tissues oral and IV antibiotics must be used. Sometimes two or more are needed. Drugs like Septra ® (TMP-SMZ), doxycycline, vancomycin, linezolid and rifampin are used. Patients with severe infections are usually hospitalized for intravenous antibiotic therapy. Drainage of the infected tissue and often removal of infected implanted appliances are often required.

A ways to help avoid MRSA infection is by good hygiene practice (washing with warm soapy water upon contact with high risk individuals, using antibacterial hand cleansers, etc.) While the National Institute of Health reports that MRSA pneumonia and blood poisoning (sepsis) have a high death rate, people in general good health with CA-MRSA recover in almost every case.

Reference:

Davis, C., Stoppler, M. MRSA Infection, eMedicineHealth.com

Kuehnert, MJ, et. al. Prevalence of Staphylococcus aureus nasal colonization in the United States, 2001-2002. J Infect Dis. 2006 Jan 15;193(2):172-9.

http://www.cdc.gov/ncidod/EID/vol11no06/04-0831.htm

http://www.cdc.gov/ncidod/dhqp/ar_mrsa_surveillanceFS.html

...at last word back from the HFCS folks

2008-12-19T12:18:00.001-08:00

----Original Message-----
From: John White
To: JP Saleeby, MD
Sent: Fri, 19 Dec 2008 12:10 pm
Subject: Re: Ten Myths about HFCS paper

Dear Dr. Saleeby,

Sorry for the delay in getting back to you. Articles pertinent to your note were pending at the time and I wanted to be able to point you to them. Regarding the comparative metabolism of HFCS and sucrose, I direct you to an article that just published in the most recent issue of AJCN. See Melanson, et al:

http://www.ajcn.org/cgi/content/abstract/88/6/1738S

I also have a background article in the same issue that I hope you find informative:

http://www.ajcn.org/cgi/content/abstract/88/6/1716S

Regarding the protein products of genetically modified corn, I offer the following thoughts:

The manufacture of HFCS involves acid hydrolysis of cornstarch at elevated temperature. This has the effect of denaturing and hydrolyzing corn proteins, which are subsequently removed through filtration. Further purification steps involve ion exchange chromatography and carbon treatment. Thus, the amount of residual protein in HFCS is miniscule. In my opinion, the likelihood of any proteins surviving this process, let alone surviving with substantive biological activity intact, is so low as to be inconsequential.

What little protein survives would be readily denatured and/or hydrolyzed during food preparation and/or human digestion.

I would be pleased to address any additional questions you may have.

With best regards,

John S White, PhD

White Technical Research

HFCS Campaign to Sway American Consumers

2008-12-16T02:20:00.001-08:00

I called into questions some of the claims in a very PRO- HFCS (High Fructose Corn Syrup) flier that was present in a mass mailing by the an HFCS producers industry group. Two scientists wrote a piece to dispel the "10 myths of HFCS". There were several issues, but the most blatant in my opinion was their comments on GMO-DNA. They had an awful spin on the topic, one a reputable scientist would not soil their reputations over. See for yourself, a cut-and-paste of the email is below. As of today this letter (e-mail) has yet to be answered:

From: JP Saleeby, MD
To: white.tech.res@gmail.com; jforeyt@bcm.tmc.edu
Sent: Wed, 26 Nov 2008 9:50 am
Subject: Ten Myths about HFCS paper

Greetings,

I have read with great interest the information enclosed in a packet I received in the mail last week. It included "Ten Myths about HFCS" and one issue I have is with the 10th Myth. Pertaining to whether HFCS has DNA from genetically modified corn... should the question and subsequent answer be related not so much to the DNA but rather to the proteins coded for by GMO DNA? The DNA in and of itself is probably harmless, but the proteins as products of gene modification are what concerns the public and should have probably been addressed.

Also any information you may have comparing the metabolism of HFCS and glucose, sucrose, etc. would be appreciated.

Thanks,

JP Saleeby, MD
www.saleeby.net

Opportunity...

2008-12-03T18:40:00.000-08:00

Opportunity is missed by most people because it is dressed in overalls and looks like work.

- Thomas A. Edison

(was inscribed on the cap of a bottle of Honest Tea)

Tanning Beds may not be such a great idea...

2008-11-25T21:18:00.000-08:00

Why Tanning Beds Are Not Such A Good Idea

Why an article about sun exposure in a winter issue? Well many who have tans acquired during the summer months spent pool side will want to maintain their tans though out the winter or prep for extended summer exposures by utilizing the tanning bed during the winter months or early spring. This article covers the reasons why that may not be such a good idea.

The skin is our largest organ and perhaps the most often ignored or abused. It serves many functions; it is our first line of defense, a protective barrier to disease and injury, a temperature regulator, a means by which some toxins are eliminated by perspiration and the mechanism by which endogenous Vitamin D is produced. It also happens to be the first attribute that someone will notice about us. Our appearance can speak volumes about our general health, attitude and lifestyle. That is why the misconception of a bronzed body as a picture of health should be dispelled.

Woods Lamp enhanced examination (R) of UV damaged facial skin

During the Victorian era the pale porcelain skin tone of the wealthy was sought after. People with suntans were considered commoners or laborers. Today, our runway models and Sports Illustrated cover-girls sport deep dark tans, a look that=2 0adolescents and Gen X and Y-ers want to mimic. However, protecting our skin against harm is very necessary for overall good health. Avoiding exposure to Ultraviolet (UV) rays outside or those present in tanning beds is a must for better looking skin in the long run. While tanning salons boast the safety of their equipment as opposed to direct sunlight, they are in fact not safer and may be even more harmful.

The two major types of ultraviolet radiation are UV-A and UV-B. Both are found in direct sunlight. Ozone in our atmosphere block out much of the UV-B. UV-B is a shorter wavelength and tends to cause the “burn” in sunburn (remember B is for burn). UV-A rays are longer wavelength and penetrate deeply into skin and the undersurfaces of skin. There UV-A rays damage collagen and elastin which are responsible for soft flexible skin. Destruction of these important proteins will cause a leathery, dry, wrinkly skin (remember A is for aging). While both types can cause skin cancer, UV-A is associated with melanoma (an often-fatal cancer). UV-B plays a significant role in skin cancers called basal cell carcinoma and squamous cell carcinoma. Individuals that live closer to the polar regions or at high altitudes suffer more UV exposure as the ozone layer and atmosphere is thinner there. Quite a bit of photo-aging and skin cancers are seen in the mountain folk of Peru for example.

Tanning beds produce UV-A rays. This is intentional as they will cause the melanocytes in the skin to pr oduce more melanin (brown pigment) and thus the “nice bronze tan” and reduce the chances of a burn. Melanin is the body's way of producing a natural sun block. That is why individuals with dark complexion are less likely to suffer from skin cancers than are fair skinned Caucasians. Tanning beds do not prevent deep penetration and destruction of collagen and elastin layers by UV rays and thus result in rapid photoaging. So you may have a sexy tan for a few years but pay for it with old wrinkly skin a few years later. Not a wise investment if you ask me.

It is easy to avoid tanning beds, just don't go. It is not so easy to avoid natural sunlight unless you live in a cave, so sunscreens and protective clothing is important. Most sunscreens provide protection from UV-B rays, but most sunscreens fall short against UV-A rays. Only those products containing Parsol 1789 (avobenzone) or zinc oxide protect against both UV-B and all types of UV-A rays. Make sure the sun block you use contains one of those ingredients.

Some natural considerations pertaining to nurturing and protecting the skin from aging are as follows. Adequate oral hydration is crucial. Essential fatty acids such as evening primrose oil, borage oil and black currant seed oil have gamma-linolenic acid (GLA), which appears beneficial in some research studies. Some eczema and dry skin suffers benefit from fish oils containing eicosapentaenoic acid (EPA). Vitamin E (orally) appears to be helpful. Antioxidants such as Green Te a extract and coenzyme Q10 taken orally or topically help with slowing the aging process of skin. Another potent antioxidant, Vitamin C in higher doses has been shown effective in controlling skin aging and disease. Traditional Chinese herbal preparations of licorice root, chamomile, calendula and chickweed have reported benefits, and the anti-inflammatory properties of Sarsaparilla and mint extract seem useful as do creams containing witch hazel and phosphatidyl choline.

If you want the golden glow of a tan without exposure to damaging UV light, consider using sunless tanning products or bronzers. An alternative is the "spray on tan", while temporary is much safer than the tanning bed. But keep in mind that many of these products don't contain sunscreen and won't protect you from the sun.

Probably the only true utility for tanning beds is in the medical treatment of psoriasis. It is termed UV-phototherapy. Psoriasis phototherapy is the use of ultraviolet light to slow the rapid growth of new skin cells. This is extremely helpful in treating this disease, which causes skin cells to grow too rapidly. Both types of ultraviolet (UV) light therapy are utilized. PUVA (the use of psoralen medications with UV-A light therapy) is used when psoriasis is disabling and safer treatments have failed. UV-B light alone (without any drugs) is used for widespread plaque psoriasis and guttate psoriasis.

You need some sunlight exposure to make Vitamin-D and full spectrum light to maintain good mood. So do your skin a fa vor, when exposing your skin to light, keep it natural and cover up with protective clothing and sunscreens to help maintain healthy, beautiful youthful skin. Shun the tanning beds, as they do more harm than good in the long run.

So as you get ready to head on down to the beaches for spring break in a few months, remember to avoid the harmful skin aging effects of too much sun, tobacco and alcohol. Eat a well balanced diet with whole grains, fresh veggies, fruit, and “good” fats. Take in the proper daily supplements and plenty of water. Avoid prolonged exposure to natural sunlight, use SPF of 15 or better when outdoors, and avoid those harmful tanning beds for any pre-tanning you are thinking of doing before you go.

--------

JP Saleeby, MD is medical director of the Emergency Department at Marlboro Park Hospital. He is also an integrative practitioner offering telemedicine services at www.saleeby.net. He may be reached for comment at jpsaleeby@aol.com

Ref: www.fda.gov/cdrh/consumer/tanning.html

(c) 2007-2008

Inflammation

2008-11-23T20:51:00.000-08:00

Inflammation

(due for publication in AFAA's American Fitness)

For those of you who have sprained your ankle and witnessed the associated swelling, warmth and pain will refer to the process as inflammation. But does the general public or the fitness instructors actually have a thorough understanding of this disease process? Inflammation is a very common part of our lexicon, we read about it in journals and articles and hear it mentioned on television. To give the reader more than a perfunctory introduction to the topic, this article will focus on the pathophysiology, define acute versus chronic inflammation, and identify those end organs that are harmed from chronic inflammation. Finally a mention of prescription medications used in the treatment of inflammation and some natural ways to fight it.

Inflammation simply put is a non-specific response to cell injury. Injury may occur due to trauma, infection or auto-immune responses. This complex process involves white blood cells (WBC), blood vessels and chemical mediators. The body relies on the inflammatory process for its own protection. Inflammation actually destroys organisms such as viruses and bacteria to prevent their reproduction and propagation in our tissues. It also limits the tissue damage to a finite area and slows the spread of invading microbes. Inflammation is also responsible for clearing debris and making way for the repair of injured tissues and organs. There are two major aspects to inflammation, cellular and vascular. The cellular component involves immune cells called neutrophils and monocytes which are responsible for “eating up” the bad guys (viruses, bacteria, etc.) by a process called phagocytosis. These cells are jointly referred to as phagocytes and will in the case of acute injury or insult migrate and adhere to vessel walls at the site of injury (a process called margination). Marginated cells will go through the vessel walls to the exact location of the injury or diseased tissue in a process called emigration. This can take six to 24 hours in the case of neutrophils and 24 – 48 hours in the case of monocytes. This accounts for the delay we see after an acute insult in the inflammation process. The vascular component is responsible for the vasodilatation, increase in blood flow and increased capillary permeability at the site of injury.

Yet another component of inflammation is the complement system or which plasma proteins are produced by our bodies to attract WBCs and degranulate mast cells. They are known as C-3, C-5, kinins (as in bradykinin and prostaglandin E). These chemical mediators are known for causing pain at the site of injury, responsible for the swelling of the diseased tissue. Plasma proteins in the aracodonic acid category produce leukotrienes which maintain inflammation (PGD2, E2, F2, Thromboxane A2). Non-steroidal Anti-inflammatory Drugs (NSAID) and steroids (cortisone) block the thromboxanes and aracodonic acid pathways to help alleviate inflammation. That is why aspirin or Motrin® is routinely prescribed when an acute insult occurs.

Other chemical mediators are interferon (alfa, beta and gamma) and tumor necrosis factor (TNF). These chemical mediators are also partly responsible for causing fever amongst other things. Fever is one of the body’s mechanisms for dealing with viral and bacterial invasion. These chemical mediators are known to respond to NSAIDs, and for this reason they are useful in combating fevers.

The result of inflammation is leukocytosis (an elevated blood WBC count), loss of appetite, fever, increase in our deep sleep time, weight loss and weakness. With the resolution of inflammation we see a return to normal vascular permeability, lessening of edema or swelling of the tissues as plasma proteins are removed by the lymphatic system and the removal of damaged cellular debris by macrophage phagocytosis.

Chronic inflammation while sharing some of the molecular components is a bit of a different animal. By definition chronic inflammation lasts for more than 2 weeks, occurs when the invading organism is not totally destroyed, a foreign body or ongoing irritant is still present, auto-immune response continues, and/or there is a very significant amount of tissue destruction. While the mechanisms of acute inflammation are well known, the pathways of chronic inflammation with their molecular pathways, propagating mechanisms and resultant disorders are far less known and understood. It is known however that chronic inflammatory conditions are a result of an overzealous immune system that continues to attack our body once its work is done on diseased tissues from an acute insult.

Chronic inflammation has an impact on almost every organ system in the human body, from our skin to the alimentary (gastrointestinal) tract, from our hearts and lungs to our brains, joints and vascular system. Examples better known to the public are rheumatoid arthritis with our joints, periodontal disease of our gums, asthma of the lungs and Crohn’s disease of our intestines. However, we also see evidence of inflammation at work in other organ systems such as psoriasis of the skin, multiple sclerosis of the neurological system and coronary disease with plaque development in our heart to name a few. Cancers are another disorder that inflammation has a part to play, it is theorized that chronic inflammation prompt a malignant change in cells and conversely cancer cells perpetuate an inflammatory microenvironment.

There are links between lipid metabolism and inflammation. Studies show a correlation between chronic inflammation and atherosclerosis (hardening of the arteries) as a pro-inflammatory state incites low-density cholesterol (LDL-C) to form plaques on artery walls. The link between periodontal disease and coronary artery disease is evident by this relationship. Poor dentition with inflammation is an independent risk factor for development of plaques on your coronary arteries. It is well documented that a sedentary lifestyle is a risk factor for chronic disease. Lack of exercise is linked to immune system dysfunction where inactivity and obesity results in a low-grade systemic inflammatory state that promotes diseases. Those individuals who do not partake in routine exercise are subject to chronic inflammation and the ravages of it on end organs. Runaway chronic inflammation is a harmful disease process that increases morbidity and mortality.

A test that has made the news lately is the high sensitivity C-reactive protein (hs-CRP) or cardiac CRP (c-CRP), they are essentially one in the same. This is a test for inflammation that correlates with cardiovascular disease (CVD). CRP is a protein produced in the liver. It is in the pentraxin family of proteins and was discovered in 1930 by Drs. Tillert and Francis as an acute phase protein of inflammation that reacted with C polysaccharide of pneumococcus in pneumonia patients thus the name C-reactive protein. The blood test throughout the years has been fine tuned and the high sensitivity CRP test is designed to assess inflammation levels that indicate risk of heart disease. For those individuals with hs-CRP of less than 1.0 mg/L they are at low risk for CVD. Those with a range of between 1.0 and 2.9 mg/L are considered at intermediate risk and those with levels greater than 3.0 mg/L are high risk for CVD.

The treatment options offered by traditional western medicine include anti-inflammatory drugs in a few different classes. Examples are NSAIDs mentioned earlier, used to treat osteo- and rheumatoid arthritis. NSAIDs are proven effective in managing pain and inflammation, but at a cost of some untoward effects on the stomach lining (resulting in ulcerative disease and gastrointestinal bleeding) and impacting the function of the kidneys (nephrotoxicity). Cortisone or corticosteroids are also used and again they have impacts on metabolism, weight gain and other hormonal axises. They are also implicated in mineral loss in our skeletal system (osteoporosis). The HMG-coA Reductase inhibitor (statin) class of drugs used to treat elevated cholesterol are reputed to have anti-inflammatory properties and are being promoted as the most important medication in the 21st century to treat cardiovascular disease, not only from the standpoint of lowering lipids, but also reducing inflammation within the coronary arteries that is responsible for plaque formation. There is even a link between inflammation and Alzheimer’s disease. Researchers have tried to persuade the medical community that statin drugs have a place in the treatment of dementia. However, in recent years it has become controversial and statins are falling out of favor as a preventive measure for Alzheimer’s disease.

It is at this point that I depart from the party line recommendations of the American College of Cardiology/ American Heart Association/National Heart, Lung and Blood Institute, and most medical society practice guidelines on the use of statin drugs. The pharmaceutical industry to the average observer is pushing hard to have statin drugs prescribed for nearly everyone in almost any situation. Physicians and medical societies are being swayed by “evidence based studies” that are in fact supported by the manufacturers of these drugs. It is my opinion that these drug companies would welcome the suggestion of placing statins in every municipal water system in the country. First, the science is biased. These studies are selected specifically by the drug companies for publications as they report the results they want. Often “negative” studies are banished from publication or hidden is some obscure journal. Secondly, these drugs are very powerful and laden with serious side effects. Only patients with severe coronary artery disease (CAD) or markedly elevated lipids or other risk factors should be prescribed these drugs and only after it is determined the benefits will outweigh the risks of these medications. In other words they should not be prescribed lightly.

The same arguments can be made for the widespread prescription of NSAIDs. The use of COX-2 inhibitors (a subclass of NSAIDs) in recent years has turned up some problems with high incidence of NSAID-induced gastrointestinal bleeding, cardiac and renal complications. Cardiac and hepatic involvement with some selective COX-2 inhibitors resulted in the FDA pulling the drugs Vioxx® and Bextra® off the market. Again the search for drugs to fight chronic inflammation is an important research priority as well as a profitable endeavor for pharmaceutical companies. The industry must proceed cautiously to find safe and effective medications and not be impetuous to turn a quick profit.

Safer and more natural ways to control chronic inflammation with fewer side effects involve the use of specific herbs. Herbs such as Arnica, Boswellia, Bromelain, Devils claw, Echinacea, Chamomile, Ginger, Turmeric, White Willow and Witch Hazel can be used as a remedy for acute and chronic inflammatory conditions. Ayurvedic and Traditional Chinese Medicine have been using them for thousands of years. Another way to protect oneself from chronic inflammation is to maintain a regular exercise routine, keeping yourself active and fit. Diet plays a major role as well, since research has shown that diets high in saturated-fats and carbohydrates are pro-inflammatory. A well balanced low-carb diet helps prevent and reduce inflammation. Not to be forgotten are the host of dietary supplements touted to reduce inflammation, too numerous to mention here, but include Vitamins A, C, D and E, along with Vitamin B-12 and the minerals copper and zinc to name a few.

References:

http://en.wikipedia.org/wiki/C-reactive_protein
http://www.uspharmacist.com/index.asp?show=article&page=8_1234.htm
http://www.natural-holistic-health.com/general/natural-anti-inflammatory-herbs
http://www.drweil.com/drw/u/id/QAA142972
http://www.mc.vanderbilt.edu/reporter/index.html?ID=4168
http://www.inflammation-at-interfaces.de/en_entzuendung.phtml
http://www.webmd.com/alzheimers/news/20080116/statins-may-not-curb-alzheimers-risk
Weiss, Ursula, Inflammation, Nature 454, issue 7203, 427 (24 July 2008)

Werbach, M.R., The Effects of Vitamins and Minerals on Inflammation. Townsend Letter, May 2004, #250, p.164+

ACS

2008-11-17T07:02:00.000-08:00

The American Cancer Society

When we think of the American Cancer Society (ACS) we often think Relay for Life. But the ACS is much more than just the Relay for Life folks. This organization is a nationwide community based organization dedicated to the elimination of cancer by prevention, research, and doing what it can to diminish the suffering associated with cancer in those suffering from the myriad of oncological diseases. This is accomplished chiefly through funding research, education, advocacy and service to the public. A significant portion of the dollars generated by their annual Relay for Life events nationwide go towards research grants to scientists and doctors to help understand and treat cancer. Nationwide more than $120 million was invested in research programs last year, but there is more. In the South Atlantic region the ACS has invested more than $19 million into patient support programs and some $16 million in cancer prevention efforts this year alone.

As the medical and scientific communities strive to find cures for cancers, the ACS offers local communities many helpful services. For example, there are cancer survivor groups for women with breast cancer and men with prostate cancer. There are programs to help locate volunteers and train them in the transportation of cancer patients back and forth from their treatment centers. ACS also provides family and caregivers free personalized nutritional counseling for those living with cancer patients so providers can customize individual diet plans for whatever type of cancer is involved. Another one of the lesser known programs the American Cancer Society has is the Hope Lodge. This is free overnight lodging and support (on the order of the Ronald McDonald House) for cancer patients and their family who have to travel to distant cancer treatment centers in major metropolitan areas, such as Atlanta, GA, Charleston, SC and Greenville, NC to name a few. The ACS also offers college scholarship opportunities for those who have survived childhood cancers and meet eligibility requirements. Up to $2,500 in college scholarships can be awarded per student cancer survivor.

This very worthwhile organization does a lot in the community for those undergoing cancer treatments, those survivors of cancer and their families. So next time you donate to the Relay for Life or participate in the fundraiser think of all the good uses your donated time and money is going. For more information on the American Cancer Society and the programs and services they offer, you can visit their homepage at www.cancer.org or call their toll free number at 1-800-ACS-2345.

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JP Saleeby, MD is the medical director of the Emergency Department at Marlboro Park Hospital, Bennettsville, SC. He maintains a wellness blog at www.docsaleeby.blogspot.com.

© 2008

AdapTx Labs goes to market

2008-11-13T18:55:00.000-08:00

AdapTx Labs' CardioFactor & PreFight Formulas
(formulated by Dr. Saleeby) go to market.

Longevity..... some tips that work!

2008-11-02T09:02:00.000-08:00

Dara Torres (Olympic swimmer Gold Medalist in her 40's)

How to Live Longer

Some tips that really work
(provided by Prevention)

Consider this:

In the 20th century, the average life expectancy shot up 30 years--the greatest gain in 5,000 years of human history. And this: Centenarians--folks who make it into the triple digits--aren't such an exclusive club anymore, increasing 51% from 1990 to 2000. How to account for these dramatic leaps? Advances in health, education, and disease prevention and treatments are high on the list--and that makes sense. But what you may not know is that seemingly unimportant everyday habits, or circumstances in your past, can influence how long and how well you'll live. Here, the latest research on longevity--science-based signs you're on a long-life path, plus tips on how to get on track.

Your Mom Had You Young

If she was under age 25, you're twice as likely to live to 100 as someone born to an older mom, according to University of Chicago scientists. They suspect that younger moms' best eggs go first to fertilization, thus healthier offspring.

You're a Tea Lover

Both green and black teas contain a concentrated dose of catechins, substances that help blood vessels relax and protect your heart. In a study of more than 40,500 Japanese men and women, those who drank 5 or more cups of green tea every day had the lowest risk of dying from heart disease and stroke. Other studies involving black tea showed similar results.

You really need only 1 or 2 cups of tea daily to start doing your heart some good--just make sure it's a fresh brew. Ready-to-drink teas (the kind you find in the supermarket beverage section) don't offer the same health benefits. "Once water is added to tea leaves, their catechins degrade within a few days," says Jeffrey Blumberg, PhD, a professor of nutrition science and policy at Tufts University. Also, some studies show that adding milk may eliminate tea's protective effects on the cardiovascular system, so stick to just lemon or honey.

You'd Rather Walk

"Fit" people -- defined as those who walk for about 30 minutes a day -- are more likely to live longer than those who walk less, regardless of how much body fat they have, according to a recent study of 2,603 men and women. Similarly, overweight women can improve their heart health by adding just 10 minutes of activity to their daily routine, says recent research. So take a walk on your lunch hour, do laps around the field while your kid is at soccer practice--find ways to move a little more, every day.

You Skip Soda (Even Diet)

Scientists in Boston found that drinking one or more regular or diet colas every day doubles your risk of metabolic syndrome -- a cluster of conditions, including high blood pressure, elevated insulin levels, and excess fat around the waist, that increase your chance of heart disease and diabetes. One culprit could be the additive that gives soda its caramel color, which upped the risk of metabolic syndrome in animal studies. Scientists also speculate that soda drinkers regularly expose their tastebuds to natural or artificial sweeteners, conditioning themselves to prefer and crave sweeter foods, which may lead to weight gain, says Vasan S. Ramachandran, MD, a professor of medicine at Boston University School of Medicine and the study's lead researcher. Better choices: Switch to tea if you need a caffeine hit. If it's fizz you're after, try sparkling water with a splash of juice. By controlling blood pressure and cholesterol levels, preventing diabetes, and not smoking, you can add 6 to 9 1/2 healthy years to your life.

You Have Strong Legs

Lower-body strength translates into good balance, flexibility, and endurance. As you get older, those attributes are key to reducing your risk of falls and injuries -- particularly hip fractures, which often quickly lead to declining health. Up to 20% of hip-fracture patients die within 1 year because of complications from the trauma. "Having weak thigh muscles is the number one predictor of frailty in old age," says Robert Butler, MD, president of the International Longevity Center USA in New York City. To strengthen them, target your quads with the "phantom chair" move, says Joan Price, author of The Anytime, Anywhere Exercise Book. Here's how: Stand with back against wall. Slowly walk feet out and slide back down until you're in a seated position, ensuring knees aren't beyond toes and lower back is pressed against wall. Hold until your thighs tell you, Enough! Do this daily, increasing your hold by a few seconds each time.

You Eat Purple Food

Concord grapes, blueberries, red wine: They all get that deep, rich color from polyphenols -- compounds that reduce heart disease risk and may also protect against Alzheimer's disease, according to the new research. Polyphenols help keep blood vessels and arteries flexible and healthy. "What's good for your coronary arteries is also good for your brain's blood vessels," says Robert Krikorian, PhD, director of the Cognitive Disorders Center at the University of Cincinnati. Preliminary animal studies suggest that adding dark grapes to your diet may improve brain function. What's more, in a recent human study, researchers found that eating 1 or more cups of blueberries every day may improve communication between brain cells, enhancing your memory.

You Were a Healthy-Weight Teen

A study in the Journal of Pediatrics that followed 137 African Americans from birth to age 28 found that being overweight at age 14 increases your risk of developing type 2 diabetes in adulthood. Adults with diabetes are two to four times more likely to develop heart disease than those without the condition, according to the American Heart Association

You Don't Like Burgers

A few palm-size servings (about 2 1/2 ounces) of beef, pork, or lamb now and then is no big deal, but eating more than 18 ounces of red meat per week ups your risk of colorectal cancer -- the third most common type, according to a major report by the American Institute for Cancer Research. Colorectal cancer risk also rises by 42% with every 3 1/2-ounce serving of processed meat (such as hot dogs, bacon, and deli meats) eaten per day, the report determined. Experts aren't sure why red and processed meats are so harmful, but one of their suspects is the carcinogens that can form when meat is grilled, smoked, or cured -- or when preservatives, such as nitrates, are added. "You can have an occasional hot dog at a baseball game, but just don't make it a habit," says Karen Collins, RD, a nutrition advisor at AICR. And when you do grill red meat, marinate it first, keep pieces small (kebab-size), and flip them often--all of which can help prevent carcinogens from forming. If you're baking or roasting it, keep the oven temp under 400F.

You've Been a College Freshman

A recent Harvard Medical School study found that people with more than 12 years of formal education (even if it's only 1 year of college) live 18 months longer than those with fewer years of schooling. Why? The more education you have, the less likely you are to smoke. In fact, only about 10% of adults with an undergraduate degree smoke, compared with 35% of those with a high school education or less, according to the CDC.

You Really Like Your Friends

"Good interpersonal relationships act as a buffer against stress," says Micah Sadigh, PhD, an associate professor of psychology at Cedar Crest College. Knowing you have people who support you keeps you healthy, mentally and physically: Chronic stress weakens the immune system and ages cells faster, ultimately shortening life span by 4 to 8 years, according to one study. Not just any person will do, however. "You need friends you can talk to without being judged or criticized," says Sadigh.

.....and They're Healthy

If your closest friends gain weight, your chance of doing the same could increase by 57%, according to a study in the New England of Journal of Medicine. "To maintain a healthy lifestyle, it's important to associate with people who have similar goals," says Nicholas A. Christakis, MD, PhD, the study's lead researcher. Join a weight loss group, or train with a pal for a charity walk.

You Embrace the Challenge

People who consider themselves self-disciplined, organized achievers live longer and have up to an 89% lower risk of developing Alzheimer's than the less conscientious, according to two studies. When you're good at focusing your attention, you use more brainpower, says the lead researcher in both studies, Robert S. Wilson, PhD, a professor of neurological sciences and psychology at Rush University Medical Center in Chicago. Set personal or career goals, and challenge yourself to meet them by a certain time. Also, try new things to stimulate your brain: If you always read fiction, pick up an autobiography instead. The next day, try to recall three facts you learned from the reading.

You Don't Have a Housekeeper

Just by vacuuming, mopping floors, or washing windows for a little more than an hour, the average person can burn about 285 calories, lowering risk of death by 30%, according to a study of 302 adults in their 70s and 80s.

source: http://www.aolhealth.com/healthy-living/aging-well/live-longer-surprising-signs

AMA's Solution

2008-10-27T14:25:00.000-07:00

AMA's Healthcare crisis solution:

1. Subsidies for those who most need financial assistance obtaining health insurance.

This assistance could take the form of tax credits or vouchers, should be more generous at lower income levels, and should be earmarked for health insurance coverage. It is important to note that the government already gives people financial assistance to buy private health insurance—well over $125 billion each year—with an employee income tax break on job-based insurance that is hidden from public view. This tax break gives more assistance to those in higher tax brackets, and gives no assistance to those without employee health benefits. Shifting some or all of this assistance to tax credits or vouchers for lower-income people would reduce the number of uninsured and improve fairness in the health care system.

2. Choice for individuals and families in what health plan to join.

Today people are effectively locked into the health plans their employers offer, often just one or two plans, which are subject to change from year to year. A change in employment typically means a change in insurance coverage. In contrast, under the AMA plan, people could use tax credits or vouchers to help pay for premiums of any available insurance, whether offered through a job, another arrangement or the open market. As with job-based insurance today, health plans would still have to meet federal guidelines for covered benefits, but people would have greater say in what types of benefits and plan features they value. Coupled with individual choice, tax credits benefit recipients directly, and everyone indirectly, by stimulating the market for health insurance. If enough people have enough purchasing power—and enough say over how that purchasing power is used—insurers will be compelled to offer better, more affordable coverage options.

3. Fair rules of the game that include protections for high-risk patients and greater individual responsibility.

For markets to function properly, it is important to establish fair ground rules. A proliferation of state and federal health insurance market regulations has made it more difficult and expensive for insurers to do business in many markets. The AMA proposes streamlined, more uniform health insurance market regulations. Regulations should permit market experimentation to find the most attractive combinations of plan benefits, cost-sharing and premiums. It is also important that market regulations reward, not penalize, insurers for taking all types of patients. People should have a guarantee that they will not lose coverage or be singled out for premium hikes due to changes in health status. Market regulations intended to protect people who have high health risks typically have backfired, sometimes disastrously, by driving up premiums for younger, healthier people and leading them to drop coverage.

To help high-risk people obtain coverage without paying astronomical premiums, additional targeted government subsidies are needed for high-risk people that would allow insurers to keep premiums down in the regular market. Individuals also need to be encouraged to play fairly by taking responsibility for obtaining health insurance without waiting until illness strikes or medical attention is needed. People who are uninsured despite being able to afford coverage should face tax implications.

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No health insurance reform proposal would be complete without giving serious consideration to managing health care costs. The AMA’s work on developing solutions to address rising health care costs is ongoing, and its current focus highlights areas that physicians can influence. The AMA has identified four broad strategies to contain health care costs and achieve greater value for health care spending: reduce the burden of preventable disease; make health care delivery more efficient; reduce nonclinical health system costs that do not contribute to patient care; and promote value-based decision-making at all levels. The AMA’s approach to gaining better control of health care costs is to ensure that we get the best value for our health care dollar.

source: http://voicefortheuninsured.org/index.html

Nasty Food

2008-10-25T04:43:00.000-07:00

As Exercise Guru Tony Horton (of P90X fame) would say:
"Don't eat that nasty food."

Could I order a side of "A family of 4 to help me eat this burger"?

Das Restaurant Waldgeist in Hofheim Germany serves up some XXXL Supersized Junk Food... can you say Global Obesity Epidemic.

Take note of the button popping girth of this fellow ready to dig into some 40,000 Calories of food and drink.... Is that really necessary?

When to use the ER.

2008-10-16T08:53:00.000-07:00

Appropriate Use of the Emergency Room

By JP Saleeby, MD

Medical Director of MPH ED

Recent national statistics collected by the American Hospital Association illustrate that between the years 1990 and 2004 there was an increase in the utilization of our emergency departments (ED) of about thirty percent (30%). This represents an average increase of more than 1.5 million visits to emergency rooms per year. Mirroring the increased use was the closures of our nation’s EDs at a rate of 12.4% during the study period. These are quite disturbing statistics as it all points to the poor delivery of health care in the emergency rooms. Certainly a multi-factorial problem the main stress on emergency rooms are the large number of uninsured or self-pay patients where payment for services is delayed or non-existent. The Federal and State governments are contributing by cutting into the already thin financial margins by reducing reimbursements for services. With the cost of delivering health services increasing yearly, this financial stress is catastrophic for hospitals to support their ED.

A thirty percent (30%) increase in the number of patients seen in the ED is quite significant and is leading to delays in care (with wait times exceeding two hours on average, greater in our larger urban centers). It also leads to increased department length-of-stay for patients being treated, admitted from and transferred from the ED. With the increase crush of patients in the ED coupled with nursing and staffing shortages there is an inevitable rise in ambulance diversion (a situation where ambulances are told by radio communications to go to another less crowded hospital further away). Additionally, one can expect medical errors and increased mortality and morbidity due to delays in care. Part of the problem stems from the dysfunction of our current healthcare system. Many patients today are under or un-insured and often turned away from primary care practices. When sick or in need of medical care they come to the ED. Often times the emergency room visit is not for an emergency condition. During the decade long analysis of EDs it was determined that 21.8 percent of patients seen were classified as semi-urgent and 12.5 percent were classified as non-urgent. Education of the populace will help alleviate the inappropriate overuse of the ED for non-emergent conditions and lessen the burden on the system.

This article will be focused on some general guidelines for the use of the emergency department. Typically they are broken down into two types of general conditions: acute medical conditions and chronic medical conditions. The emergency rooms for the most part are set up to diagnose and treat acute conditions such as falls with fractures and sprains, chest pains (heart attacks), sudden changes in mental status (stroke or hypoglycemia) for example. Sudden medical illness ranging from sudden infections (stomach virus with profuse vomiting and dehydration for example), to almost any type of trauma (motor vehicle accidents, lacerations, etc.) is the realm of the ED physician. Additionally, acute exacerbations of chronic illness (examples being a flare up of asthma, shortness of breath due to congestive heart failure, ketoacidosis in a diabetic patient, to name a few) are also appropriately handled in the ED. Keeping our rooms open for true emergencies in the department is crucial for our system to work.

Circumstances such as minor non-urgent illness and chronic conditions are not efficiently or economically managed in the ED as the department is typically not set up for these things. Examples would be medication refills (patients often present to the ED only to have their blood pressure or pain medication refilled, and that is not an appropriate use of this healthcare entity), pregnancy testing, simple colds and coughs. Chronic pain management is best and almost exclusively handled by a primary care physician (PCP) or pain management specialist and not by an ED physician. It is the responsibility of the patient to make appointments prior to medication running out. There are legal ramifications of not following protocol when dealing with scheduled/controlled pain medication. Additionally, the PCP is better adept at managing the sometimes complex regiments that can include opiates, antidepressants and pain-modulator drugs. This is certainly not the realm of the ED doctor.

Other wellness and health concerns fall through the cracks when patients with chronic conditions or situations not appropriate use the ED as a primary care clinic. For example annual physical examination of men’s prostate (PSA, DRE) are not performed in the ED. For women the recommended cancer screening tests such as the breast examination (and mammogram) and PAP smear are not performed in the department. Should patients utilize the ED for their medical maintenance and preventive care, they are sure to miss out on obtaining these critical tests and more (cholesterol screening, diabetic screening, routine immunizations, etc.) In recent years ED’s have been implementing programs to better educate patients who present inappropriately to the ED, not only as a means to lighten our burden, but to refer those patients to the most appropriate healthcare provider. With an estimated 112-million ED visits annually in this country and steadily rising, it is critical for the population to know where to turn for the best and most affordable care. If education of the public is ignored it will only contribute to the implosion of our healthcare system, which would be disastrous for all.

Dr. Saleeby is the medical director of the ED at Marlboro Park Hospital. He is also medical control of Marlboro Co. Rescue Squad. He maintains a blog at docsaleeby.blogspot.com.

References:

Emergency Room Crowding: High Impact Solutions, April 2008, ACEP

The Disappearing Hospital Emergency Department, Phillip Kletke, August 2006, HHN Magazine

http://www.cdc.gov/nchs/data/ad/ad372.pdf

http://www.aaem.org/corporatepractice/history.php

Thomas Jefferson in his own words

2008-10-02T01:13:00.000-07:00

After spending a long weekend in Charlottesville, VA, and taking in Monticello, UVa and Jefferson's summer home at Poplar Forest, Forest, VA. I was again inspired by this great thinker and Renaissance man. From time to time I will quote him in this forum.

From the book "The Man: In his own words" edited by R C Baron we have Jefferson's feeling on Religion:

In a letter dated Jan. 29th, 1815 to Rev. Charles Clay a minister in Williamsburg he writes:

"I abuse the priests indeed who have so much abused the pure and holy doctrines of their master and who have laid me under no obligations of reticence as to the tricks of their trade. The genuine system of Jesus and the artificial structures they erected to make him the instrument of wealth, power, and preeminence to themselves are as distinct things in my view as light and darkness."

Visit to a Topiary Garden in Bishopsville, SC

2008-09-19T08:14:00.000-07:00

A Man Named Pearl

Today was something of a special day. We drove with Michael and Madison to visit a humble man from a small sleepy southern town in South Carolina. The town of Bishopsville may be known as the home of the Cotton Museum and also the birthplace of Heisman Trophy winner Felix "Doc" Blanchard. But today the town may be most memorable for a quiet creative gardner. His name is Pearl Fryar and after a career in the local soda can producing industry he retired six years ago to devote his full attention to the creative masterpiece in his 3 acre back yard.

Back in 1984 Pearl sought to win the local "yard of the month" contest, but what started out as a small project grew into this life long hobby and full time dedication. People from all around come and visit his garden. He charges no admission, but does accept donations. When home he seems unrushed and will chat it up with you as he did us today.

A feature film/documentary entitled "A Man Named Pearl" is currently playing at independent theaters around the country and for 2008 at the Heartland Film Festival he won the Audience Choice Award and was also awarded the Audience Award a the Salem Film Festival. For more on the movie visit: http://www.amannamedpearl.com.

For more on Pearl's topiary garden visit: http://www.fryarstopiaries.com
and
http://www.gardenconservancy.org

Michael Phelps .... in the begining

2008-08-27T08:01:00.000-07:00

SMASHED - Ups and Downs -

2008-08-10T06:50:00.000-07:00

My Maserati as she lay in a ditch after the accident.

Today was a day of ups and downs.... last of 3 days in the ER. While on my way to work 1.5 miles away I lost control of my Maserati only 1/2 mile from the hospital and wrecked into the ditch. My immaculate, show quality Italian sports car was totaled in milliseconds. Do I have new respect for a 400BHP Ferrari engineered engine......yes I do.

Ecstatic American Swimmers after winning Gold

After a long 12 hr shift, stiff and sore from the MVA not to mentioned some complicated patients, I came home spent. Watching the Olympics on TV was a good distraction... watching the American 4X100 Freestyle Relay team of Michael Phelps, Garrett Weber-Gale, Cullen Jones
& Jason Lezak who were considered underdogs and not expected to win against the very strong French team.

The US has not won this relay in the last 2 Olympic games. The Americans were faced with the immense pressure of not ruining Phelps' shot at snapping Mark Spitz's record of seven gold medals at the Olympics.

The victory was extra sweet for the Americans in making Bernard eat his words. Earlier this week, the French swimmer boasted that his team would "smash" the United States in the relay event. "The Americans? We're going to smash them," Bernard said. "That's what we came here for." The French team was stunned and "smashed" by the come from behind Americans. They shattered the world record by almost 4-seconds to boot.

Diets from Around the World

2008-06-15T13:43:00.000-07:00

This is a typical example of family size & diet of old world, new world and third world countries, the availability of food & cost of what is eaten in one week.

Germany: The Melander family of Bargteheide
Food expenditure for one week: 375.39 Euros or $500.07

United States: The Revis family of North Carolina
Food expenditure for one week $341.98

Italy: The Manzo family of Sicily
Food expenditure for one week: 214.36 Euros or $260.11

Mexico: The Casales family of Cuernavaca
Food expenditure for one week: 1,862.78 Mexican Pesos or $189.09

Poland: The Sobczynscy family of Konstancin-Jeziorna
Food expenditure for one week: 582.48 Zlotys or $151.27

Egypt: The Ahmed family of Cairo
Food expenditure for one week: 387.85 Egyptian Pounds or $68.53

Ecuador: The Ayme family of Tingo
Food expenditure for one week: $31..55

Bhutan: The Namgay family of Shingkhey Village
Food expenditure for one week: 224.93 ngultrum or $5.03

Chad: The Aboubakar family of Breidj ing Camp
Food expenditure for one week: 685 CFA Francs or $1.23

As Americans we should count our blessings and reduce our caloric intake. And waste not what we don't need. Just some "food" for thought.

My Garage.

2008-06-06T17:57:00.000-07:00

My baby (Ciao Bella) a 1971 Alfa Romeo GTAm-R (L)
My daily driver a 2002 Maserati GT (R)

OUCH!!!

2008-06-05T17:54:00.000-07:00

Scene of a Bicycle Race gone bad. In Mexico near the TX border a drunk driver fell asleep at the wheel and hit a group of cyclist 15 minutes into a race. 10-cyclists were hit, injuring 9 and resulting in the death of one. I am glad I was not working the nearest ER that day.

Existentialism

2008-05-28T21:49:00.000-07:00

Kierkegaard and Nietzsche

Main article: Kierkegaard and Nietzsche comparisons

The first philosophers considered fundamental to the existentialist movement were Søren Kierkegaard and Friedrich Nietzsche, though neither used the term "existentialism" and it is unclear whether they would have supported the existentialism of the 20th century. Their focus was on human experience, rather than the objective truths of math and science that are too detached or observational to truly get at human experience. Like Pascal, they were interested in people's concealment of the meaninglessness of life and the use of diversion to escape from boredom. But Pascal did not consider the role of making free choices, particularly regarding fundamental values and beliefs: such choices change the nature and identity of the chooser, in the view of Kierkegaard and Nietzsche.^[10]^[11] Kierkegaard's knight of faith and Nietzsche's Übermensch are examples of those who define the nature of their own existence. Great individuals invent their own values and create the very terms under which they excel.

Kierkegaard and Nietzsche were also precursors to other intellectual movements, including postmodernism, nihilism, and various strands of psychology.

Heidegger and the German existentialists

Main article: Existential phenomenology

One of the first German existentialists was Karl Jaspers, who recognized the importance of Kierkegaard and Nietzsche and attempted to build an "Existenz" philosophy around the two. Heidegger, who was influenced by Jaspers and the phenomenologist Edmund Husserl, wrote his most influential work Being and Time which postulates Dasein (dah-zine), translated as, all at once, "being here", "being there", and "being-in-the-world"—a being that is constituted by its temporality, illuminates and interprets the meaning of being in time. Dasein is sometimes considered the human subject, but Heidegger denied the Cartesian dualism of subject-object/mind-body. [paragraph needs citations and clarifications]

Although existentialists view Heidegger to be an important philosopher in the movement, he vehemently denied being an existentialist in the Sartrean sense, in his "Letter on Humanism".

Sartre, Camus, and the French existentialists

Jean-Paul Sartre is perhaps the most well-known existentialist and is one of the few to have accepted being called an "existentialist". Sartre developed his version of existentialist philosophy under the influence of Husserl and Heidegger. Being and Nothingness is perhaps his most important work about existentialism. Sartre was also talented in his ability to espouse his ideas in different media, including philosophical essays, lectures, novels, plays, and the theater. No Exit and Nausea are two of his celebrated works. In the 1960s, he attempted to reconcile existentialism and Marxism in his work Critique of Dialectical Reason.

Albert Camus was a friend of Sartre, until their falling-out, and wrote several works with existential themes including The Rebel, The Stranger, The Myth of Sisyphus, and Summer in Algiers. Camus, like many others, rejected the existentialist label, and considered his works to be concerned with man facing the absurd. In The Myth of Sisyphus, Camus uses the analogy of the Greek myth to demonstrate the futility of existence. In the myth, Sisyphus is condemned for eternity to roll a rock up a hill, but when he reaches the summit, the rock will roll to the bottom again. Camus believes that this existence is pointless but that Sisyphus ultimately finds meaning and purpose in his task, simply by continually applying himself to it.

Source: http://en.wikipedia.org/wiki/Existentialism

Some prominent Saleebys: Eliyya & Kalib Saleeby

2008-05-27T21:14:00.000-07:00

Saleeby, Eleyya (Metropolitan Archbishop of Beirut) was born in Souk El-Gharb in 1881, and was elected Bishop in 1926 for the Archdiocese of Beirut. He was made Metropolitan Archbishop of Beirut in 1936 after the passing of Bishop Gerasimous Msarrá. Archbishop Eleyya was a cornerstone of the town and the region. He believed in Lebanon, in freedom and peaceful coexistence of sects and religions. He worked for the Palestinian cause and for Jerusalem. He dedicated his efforts on improving Greek Orthodox schools and in sending seminarians for further theological education abroad.

Source:

Salim George Khalaf
"A Bequest Unearthed, Phoenicia"
http://phoenicia.org/souk_el_gharb_bmakine.html

Saleeby, Kalib/ Ghalib (MD) was born in Souk El-Gharb in 1876 and studied in its school. He left to Scotland where he completed his medical studies. He pioneered and excelled in the study of Eugenics -- improvement of human development and evolution. He participated in the establishment of the world renowned Lancet Medical Journal in London. He published dozens of volumes in English such as: Improve Human Reproduction, Health Strength and Happiness, Success of Modern Surgery, He established theories in nutrition, later to be known as the study of vitamins. He is considered one of the greatest scientific writers and reformers by British Scientific circles.

Source: http://phoenicia.org/souk_el_gharb_bmakine.html

Restless Leg Syndrome

2008-05-21T22:39:00.000-07:00

This lecture was created and given by Sharon & JP Saleeby to the Senior Circle on May 21st, 2008.

Pearls from the Emergency Room

2008-05-12T10:34:00.000-07:00

A lecture presented to Marlboro Park Hospital Lunch & Learn 5/8/2008

Adaptogen Herb lecture by Dr. Saleeby

2008-05-09T10:00:00.000-07:00

This is a slide show of a lecture on Adaptogen Herbs by Dr. Saleeby
Enjoy.

George C. Scott tells it like it is.

2008-04-21T05:05:00.000-07:00

April 15, 1971: George C. Scott refuses his Best Actor Oscar for 'Patton,' having previously said the awards ceremony is "a two-hour meat parade, a public display with contrived suspense for economic reasons." (Everett Collection).

I knew I liked that man! Hello world... wake up.

Dith Pran (of "Killing Fields" fame) dies at age 65

2008-03-30T07:58:00.000-07:00

Dith Pran depicted by award-winning actor Dr. Haing S. Ngor (himself a survivor of the Pol Pot regime in Cambodia and later killed by Asian gang members in the US in 1996) in the movie Killing Fields succumbed to pancreatic cancer today.

Dr. Noah N. Langdale passes

2008-03-29T14:17:00.000-07:00

Dr. Noah Noel Langdale Jr., president of Georgia State University from 1957 to 1988, died at Piedmont Hospital Saturday, Feb. 23, 2008 of cardiac arrest. He was 87 years old.

During Langdale's 31 years as president, Georgia State College grew to become Georgia State University. Its student population went from 5,000 students with only one degree program to more than 20,000 students and over 200 programs. The school expanded the campus' facilities from only two buildings to many blocks of buildings in downtown Atlanta.

During his tenure, the school was transformed from a racially segregated institution to the most diverse institution in the University System of Georgia. He was known throughout Georgia and the region as an eloquent orator.

He is credited with building a major urban university in the heart of Atlanta.

An erudite man, Dr. Langdale could quote great thinkers from Spinozo to Walter Lippmann or discuss such concepts as "The Equity of the Universality" as glibly as he could quote dialogue from Marx Brothers movies.

He is the scion of one of South Georgia's most powerful and wealthy families, a clan of timber barons and businessmen whose clout has reached far beyond their headquarters in his native Valdosta in Lowndes County, according to a 1986 Atlanta Journal-Constitution article.

Dr. Langdale was 37 when he left his law practice in Valdosta to head up Georgia State, then a college with two buildings, 5,200 students, a $1.9 million budget and offered only one degree, in business.

When he retired, the university had more than 22,000 students and 20 buildings, a budget of $118.6 million and offered 50 degrees in more than 200 fields.

Langdale, a native of Valdosta, was captain of the 1936 State Champion Valdosta High Wildcats. He graduated from the University of Alabama where he played tackle on the Crimson Tide varsity squad.

During his years at Alabama, Langdale was a member of Phi Beta Kappa, Omicron Delta Kappa, Delta Chi and the Jasons Society. He was awarded the Service Trophy by his fellow students for the class year 1940-41.

At 6' 1", 235 pounds, Langdale was a starting tackle on the Alabama team that defeated Texas A&M in the Cotton Bowl in 1941. He became line coach of the 1942 Alabama team that defeated Boston College in the Orange Bowl.

After the 1942 season, Langdale joined the U.S. Navy and, among other assignments, served a stint in the Pacific during World War II.

While he was stationed at the Navy Supply School in Athens, Georgia, he met Alice "Wiggie" Cabaniss, whom he eventually married. Mrs. Langdale died in 2005.

He received degrees from the Harvard University School of Law and Harvard Business School, and he practiced law in Georgia for seven years.He also was a department chairman at Valdosta State College and received an honorary doctorate from the University of Alabama in 1957.

In 2005, Dr. Langdale received the Paul W. Bryant Alumni-Athlete Award. The award recognizes former athletes whose accomplishments since leaving the University are outstanding based on character, contributions to society, professional achievement and service.

He is survived by his son, Michael.

----

While I was attending GSU and working on my BS in Biology with a minor in Chem and Philosophy I had the honor of meeting Dr. Langsdale who was very pro-student. As co-President of the Mortar Board an honor society there were opportunities to converse with the then President of GSU. He retired after 31 years the year after I graduated in 1988. I will always remember his as a very kind and gentle giant of a man. He is responsible for what GSU is today as a leading university in urban studies and a top ranked business school. -JP

source:

http://www2.gsu.edu/~wwwexa/news/archive/general/08_0225-noahlangdale.htm

http://www.legacy.com/Atlanta/Obituaries.asp?Page=LifeStoryPrint&PersonID=104189980

Honey

2008-03-25T10:53:00.000-07:00

Honey

Honey has been used for centuries as a source of food, a commodity to be traded, a highly sought after luxury item, a medicinal and more. How about an all natural remedy that requires no refrigeration, will not grow mold or bacteria and has an amazingly long shelf life. In ancient cultures, honey was used to treat burns and wounds. Some 4000 years ago ancient Egyptians used honey in medicine and make-up. There are records of its use to treat wounds and open sores to prevent infection on the battlefield. In more recent folk medicine it is used to treat coughs and bronchitis.

In a modern day “hot totty” honey is mixed with lemon juice, tea and brandy to treat the cough or viral upper respiratory infection. Recent FDA recommendations to doctors are that they not use over-the-counter cold and cough medications on children under 2 years of age and warn that more research is needed before widespread acceptance of these medications to be used in children under six. What is a parent to do who has a child up all night coughing? Honey may be the answer.

A recent study at Penn State College of Medicine in Hershey, Pennsylvania, researchers found a dose of buckwheat honey before bedtime is far more effective than dextromethorpan (DM) found in most over the counter cough suppressants.

Buckwheat honey is a dark honey. It is gathered by bees foraging for nectar from the buckwheat grain’s little white flowers. Light honey, of which we are more familiar, has fewer of the properties of cough suppression as does this darker honey. Pound for pound there is much more nutritional value and medicinal effect in the darker honeys.

Honey main constituent parts are levulose and dextrose. These two sugars in near equal amounts make up almost 80% of the sugars in honey. Levulose is a unique sugar in that it is readily assimilated by the human alimentary tract without the use of any digestive enzymes. It also is absorbed rather slowly, not allowing for a large spike in blood sugars. This low glycemic index property makes honey safe for use in diabetic patients. The slow uptake of levulose allows for this sugar to reach the large colon which is most likely responsible for the laxative effect of honey. Honey also contains polyphenols which makes it a good source of antioxidants. These antioxidant properties play a role in cleansing the body of free radicals implicated in serious illness, such as cancer and heart disease. Honey is said to be relaxing and taking it in the evenings can offer a natural and safe way to induce sleep. It is also thought to have anti-inflammatory properties. Some researchers believe that the bee may spray the comb with small amounts of venom before placing honey in them, and while this is controversial it may account for some of the healing properties of honey and its anti-inflammatory properties.

Honey contains a number of nutrients in addition to the levulose and dextrose sugars namely some proteins and enzymes. Three important enzymes are present in honey: invertase, diastase, and glucose oxidase. Enzymes are most likely a result of the bee’s process of converting nectar into honey, since they are not found in the nectar. Invertase converts sucrose into levulose and dextrose, while diastase an enzyme used to convert starch to simpler sugars (of which nectar has no starch) is a mystery. Researchers are still not sure why this enzyme is present in honey. In Europe diastase has its usefulness in the honey industry as it is measured to check for product quality. Finally glucose oxidase found in the pharyngeal glands of bees and they honey they produce forms hydrogen peroxide during its action on dextrose (a lesser sugar in honey). This peroxide is what is probably responsible for the heat-sensitive antibacterial activity of honey. Other bacterial and yeast/fungi fighting properties of honey include the high sugar content (with the osmotic effect of literally drying out microbes) and its relative acidity (malic acid and other natural acids) that inhibit microbial growth and make honey bacteriastatic. Honey produced exclusively for medical purposes in New Zealand and Australia have antibacterial phenol-like substances from bees that forage within the native Leptospermum species of trees.

Depending on the type of honey there can be found quite a few minerals such as potassium, sulfur, calcium, phosphorus, magnesium, iron, manganese, copper & and many more trace elements. Very few vitamins in low amounts are also present, but not in any quantity to become a significant source. While there is the misconception that bee venom contains formic acid (like that seen in red/fire ants) it has been scientifically proven not to exist, yet the general public is still under this impression. Some studies have shown that the active ingredient melittin in bee venom may have curative properties in the rheumatologic and arthritic diseases.

Since the American Academy of Pediatrics and the American College of Chest Physicians do not condone the use of dextromethorpan for childhood cough, as this medication has been implicated in accidental overdoses and in recent years been used by teenagers in order to get high, a viable alternative in dark honey. However, it is not recommended for children under the age of one-year. Honey can harbor the spores of Clostridium botulinnum the cause of infant botulism. This bacterium is harmless in older children and adults.

--------------

JP Saleeby, MD is medical director of the emergency department at MPH, Bennettsville. He maintains a blog at www.saleeby.net

References:

http://www.news-medical.net/?id=33207

http://www.honey-health.com/honey-6.shtml

http://mysite.verizon.net/mshapiro_42/honey.html

http://www.beesource.com/pov/usda/beekpUSA82.htm

http://www.mayoclinic.com/health/infant-botulism/HQ00854

http://www.sciencedaily.com/releases/2006/07/060727090308.htm

http://www.medicalnewstoday.com/articles/15901.php

Tea Experience Digest Q&A

2008-03-13T14:39:00.001-07:00

Tea Q&A with Dr. Saleeby

Q: My mother is a diabetic. I've heard tea is good for diabetics as long as they don't add sugar. Is this true? Do you think that by drinking tea I can avoid getting diabetes, too?

A: Green, Oolong and Black tea appear to be beneficial in reducing risk of Diabetes Mellitus type II (DM II). Dr. Richard Anderson, at the USDA's Beltsville Human Nutrition Research Center in Maryland published such findings in animal trials in the Journal of Agricultural & Food Chemistry in 2002. It appears from the research that epigallocatechin gallate (EGCG) is the most insulin-enhancing chemical of all those found in tea. The researchers studied other herbal teas, spices and plants but found tea as the most potent in reducing diabetes risk. Tea produced a 15-fold increase in insulin activity. EGCG showed evidence of working with insulin receptors on cells to enhance the effects of circulating insulin. Cinnamon was another plant that showed promise. Caffeine does not appear play a major role, thus de-caffenated teas had the same beneficial effect as regular tea. A later study published in 2005 in the International Journal of Obesity (involving some seven-thousand human subjects) by Dr. J. Greenberg showed a reduction in DM risk by tea drinkers only in the non-elderly population who had previous weight-loss.

Adding milk, nondairy or soy creamers to your tea does inhibit the insulin boosting effect. Lemon juice however did not have a negative effect on the tea. Adding simple sugars would not necessarily be a problem for a non-diabetic, but a sugar alternative such as a non-caloric commercial sweetener or a natural sugar alternative such as stevia may be healthier and recommended for the diabetic patient. The diabetes lowering effects of tea only last a few hours, therefore making it necessary to drink tea several times throughout the day to benefit from its properties. My recommendation is to drink three to four cups of tea (Camellia sinensis) a day flavored with lemon or cinnamon as opposed to sugar.

Ref:

Tsuneki, H., et al, Effect of green tea on blood glucose levels and serum proteomic patterns in diabetic (db/db) mice and on glucose metabolism in healthy humans. BMC Pharmacology (2004) 4:18:10.1186/1471-2210-4-18

Greenberg, JA, et. al., Coffee, tea and diabetes: the role of weight loss and caffeine. International Journal of Obesity (2005) 29, 1121–1129.

Anderson, RA, et. al., Tea Enhances Insulin Activity. Journal of Agricultural and Food Chemistry (2002) 50(24), 7182-7186.

Addendum to Water Article

2008-03-09T17:01:00.000-07:00

How appropriate. AOL News posts a piece on drinking water:

http://news.aol.com/health/story/ar/_a/probe-finds-drugs-in-drinking-water/20080309184409990001

Water: Bottled or Tap?

2008-03-08T14:48:00.001-08:00

Water: Bottled or Tap?

Water, while not listed on the food pyramid it is quite possibly the most significant substance we as humans require. We are made up of about 60% water (H20), somewhere around 84% of our blood, 75% of our muscles and 22% of our bone is water. Without water we simply would not exist. Even a slight reduction in our water content will lead to gross imbalances and even death.

It is a posteriori that water is necessary for life and good health, so I will not belabor that issue. How much to drink? That is another important question, but again for another article. I will say this however, assuming a pure source free of heavy metals, PCBs and other contaminants one should drink in ounces (oz) their weight in kilograms (or the simple formula: your weight in pounds divided by 2, in ounces) as daily intake.

Lets take a long look at what water we are drinking. Ever go into a fine-dining restaurant and the snobbish waiter asks, "Will that be Sparkling, Still or Tap this evening?" Boy that really annoys me to no end, as if ordering "free" tap water is some venial sin. While the pseudosophisticates may assume that tap water is the least health, he may be very wrong.

OK, so what about the bottled water they serve up in fancy restaurants? Well they come in a variety of forms: natural mineral water, sparkling water, pure water, distilled water, filtered water and on and on. Some have natural carbonation and some have it added prior to bottling. Remember the winter of 1990 recall of Perrier® carbonized water which contained benzene. Benzene is a toxin known to cause cancer and was found in rather high levels as a contaminant in this particular brand of water as a consequence of their carbonation process.

A watch dog group called the NRDC studied some 103 brands of bottled water, testing over 1,000 bottles to find that most were of high quality, but some brands contained contaminants like synthetic organic chemicals, bacteria, and arsenic. One sample exceeded the allowable limits under state law of such contaminants. Ouch.

Choose your source well. Municipalities must check their water quality and adhere to strict standards. The FDA is responsible for bottled water safety, however, the industry is exempt if the water is packaged and sold within state lines (roughly 60 - 70% of bottled water sold) and only four in five states regulate their own bottled water. Carbonated and seltzer water is also exempt from FDA scrutiny. Less than half of the states require carbonated waters to meet their bottled "still" water standards.

The Coca-Cola Company entered the bottled water arena in the spring of 1999 with the release of Dasani® bottled water. Where does it come from? The company states that it comes from "the local water supply" near its bottlers (well that could mean anything), then it is filtered for purity by a state-of-the-art process called reverse osmosis. Finally they add a mineral blend for taste. Sounds like they are trying too hard. When there is no alternative I suppose you could buy it, but do you want to support a company that sells rather unhealthy soda pop (again another article)?

A single water molecule is said to take 38,000 years to "recycle" itself through our environment, from rain to land to sea to rain again as it is stored for years in water tables (aquifers) and perculates through our soil/earth. Our industrial waste products may be mostly responsible for the contamination in our water supply. Heavy metals such as Arsenic, Lead and Mercury are always a concern. Less known to Americans are the environmental estrogen endocrine disruptors or endocrine disruptor chemicals (EDCs). You place water in a plastic container and you open up a can of worms.

Remember that famous line in the 1967 movie the Graduate staring Dustin Hoffman. Dustin's character is getting career advice that "Plastics" is the future. Well, we can hardly avoid, let alone live without plastics in the 21st century, but they do pose a health problem to some degree. There is much concern and debate in the scientific community that the use of some plastics to store water may leach certain chemicals into the water (when the water is frozen or heated in these containers). Estrogen-like compounds in styrene containing plastics and Styrofoam® may contaminate water if they are microwaved to heat the water in these containers. The byproduct of polycarbonated plastics like bisphenol-A (BPA) hold estrogenic properties and can increase the risk for certain cancers (breast cancer and prostate cancer). Also they have an influence in the development of the fetus and our children’s endocrine balance, possibly explaining the precociousness of our school age children.

The Safe Drinking Water Act requires community water systems to monitor their water supply. They are also responsible for monitoring and reporting contaminants such as the heavy metals, dioxins, and bacteria. For more information on the EPA's Safe Drinking Water program you can call 1-800-426-4791. If you have a well, you are responsible for testing it yourself. Also consider the environmental impact of bottled water. According to one source nine out of every ten plastic bottles, at a rate of 30 million per day, ends up in a land fill (taking up valuable space) or incinerated, releasing pollutants into the air (dioxins from chlorinated compounds for example.)

To summarize, there are numerous potential contaminants in both glass and plastic bottled water. You take a chance of drinking something harmful if the brand you choose either picks a bad source of water or packages it in the wrong container. Unless you are sure of the brand and have researched its quality and purity, and are sure it is subject to inspection, stick with municipal tap water. Every time we toss an empty water bottle in the trash we contribute to polluting our own back yards. Oh, and if you do decide on the bottled water under the supercilious glance of your waiter, have the waiter break the seal at your table, since there are reports that some unscrupulous proprietors have filled their empty bottles with tap water and why should you pay extra for that.

JP Saleeby, MD is medical director of the Emergency Department at MPH, Bennettsville, SC. He maintains a blog at www.saleeby.net

Some interesting facts

2008-03-08T05:21:00.000-08:00

Religion: One-third (1/3) of Americans in the USA are raised Catholic. One-quarter (1/4) of these Catholics are now stating that they practice the faith. About 10% of American Catholics consider themselves ex-Catholic or practicing another religion.

Economy: Two years ago one-half (1/2) of the top 20 most wealthy people in the world were from the USA. Today only 4 of the top 20 are Americans.

Cheryl Haworth wins Gold.

2008-03-02T15:30:00.000-08:00

Two-Time Olympian, Cheryl Haworth, of Savannah, GA and Coastal Empire Weightlifting, won her 11th National Championships today. Cheryl snatched 102kg, clean & jerked 130kg for a gold medal total of 232kg. Making 6 for 6 lifts for a total of 232kg to win the gold and progress her way to her third Olympic Games this August in Beijing, China.

Cheryl's next step will be to increase her total at the Olympic Trials in Atlanta, GA May 16-17th.

-Kerri Goodrich
CEW Coach

2008-03-01T20:25:00.001-08:00

1952 Alfa Romeo Prototype... wouldn't own one, but interesting non-the-less

Interesting....

2008-03-01T20:24:00.000-08:00

Don't usually do this but here goes.

Take a look at this video:

http://youtube.com/watch?v=GUHLa1qSy24

2008-03-01T14:51:00.000-08:00

Testicular Cancer

What better a spokesman for the fight against cancer than Lance Armstrong. In particular this seven time Tour de France winner is a reminder of how we can beat cancer and move on with our lives. In 1996 Lance Armstrong was diagnosed with testicular cancer and if that were not bad enough for an athlete, his disease spread (metastasized) to his brain and lungs. He was given a 50% chance for survival. Because Lance was unfamiliar with the way the disease presented itself, he chalked it up to side effects of his intense training regimen. So there was some delay in his diagnosis.

"Of course, I should have known that something was wrong with me. But athletes, especially cyclists, are in the business of denial," Armstrong writes in his bestseller, It's Not About the Bike. "Everything hurts. Your back hurts, your feet hurt, your hands hurt, your neck hurts, your legs hurt, and of course your butt hurts. So no, I didn't pay attention to the fact that I didn't feel well in 1996. When my right testicle became slightly swollen that winter, I told myself to live with it, because I assumed it was something I had done to myself on the bike, or that my system was compensating for some physiological male thing."

Finally after 6 months of severe headaches, visual disturbances, coughing up blood, and worsening testicular pain he sought medical attention. The cancer, an aggressive type called choriocarcinoma that is difficult to arrest, had spread. Tests revealed 40 tumors in his lungs and two in his brain.

"I was given less than a 40 percent chance of surviving," Lance wrote. "And frankly, some of my doctors were just being kind when they gave me those odds."

After researching the disease Lance sought the best in the field to treat him. The one name that kept coming up was Dr. Larry Einhorn at Indiana University Medical Center (IUMC), who in the mid-1970’s pioneered the use of three chemotherapeutic drugs to treat testicular cancer. Dr. Einhorn’s work saved hundreds of lives. Lance also learned that the IUMC was the world's leader in treating testicular cancer, so he flew out to met with Dr. Einhorn and his associates the following day.

After brain surgery to remove the tumors and an intense course of chemotherapy Lance Armstrong returned to the arena of competitive cycling a year later and went on to win seven consecutive Tour de France victories a challenge in and of itself making him the athlete of the decade or maybe the century.

Dr. Lawrence Einhorn states in an interview with reporter Patrick Perry that: “Thirty years ago, if you took every single patient with testicular cancer, about 50 percent of them survived their disease. Ninety percent of patients in whom the cancer had metastasized, or spread to distant parts of the body, died. Today, 95 percent of all patients with testicular cancer and 80 percent of patients with metastatic disease are cured.”

Lance is not alone. Another well-known athlete who conquered this disease is Scott Hamilton the champion figure skater. There was even an MTV personality who went on TV with his diagnosis and video taped his surgery. All for the ratings I am sure, but none-the-less gave great exposure to the disease. Testicular cancer accounts for almost two percent of neoplasms in men. It occurs in approximately 4 per 100,000 men. Those at highest risk are between the age of 20 and 35 years. The incidence of this cancer has doubled over the last forty years and continues to rise, especially in white males. A few risk factors include tobacco use, family history, (for example if your brother has testicular cancer your risk is six- to ten-fold), non-descended testicles (cryptorchidism), and a mutation on chromosome Xq27.

Testicular exams should be a part of every young man's annual physical exam. Early detection increases the chances for cure. It is one of the many cancers that can actually be cured with very good long-term survival rates. Self-exams should be done each month from the age of 15 to 35 just as a woman would examine her breasts for breast cancer. A lump with or without pain should be brought to the attention of your physician for further work-up.

Cisplatin was the chief drug used to treat testicular cancer but when it was combined with other drugs the success rate of cure went up drastically. The “Einhorn Regiment” nicknamed PVB for the three chemo drugs used (cisPlatin, Vinblastine, & Bleomycin ) had huge success and was the treatment that Lance Armstrong received. Another type of testicular cancer responds to radiation. After surgery and chemo there are blood tests that are used (HCG and alpha-fetoprotein) as markers to monitor for cure. Early detection and treatment enables a 90% cure rate.

---

© 2005-2008

JP Saleeby, MD is the medical director of the Emergency Department at MPH in Bennettsville, SC. He maintains a blog at www.saleeby.net

Reference:

An interview with Dr. Larry Einhorn: Champion in the war on cancer. Patrick Perry of the Sunday Evening Post, Jan-Feb., 2002

http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=cmed.table.22420

Shaw, J., Diagnosis & Treatment of Testicular Cancer. Am. Fm Phys., Vol. 77, Num. 4., 2008.

William F. Buckley, Jr. dead at 82

2008-02-29T20:31:00.000-08:00

The founder of modern American Conservatism dies at 82.

http://www.cnn.com/2008/POLITICS/02/27/buckley.obit/index.html?eref=rss_showbiz

How important is your small town doc?

2008-02-14T07:53:00.000-08:00

Impact of small town physicians.

By JP Saleeby, MD

Don’t underestimate the value or impact of your local small town medical doctor. Medical Meccas such as Duke University, Emory or even Harvard are not the only venues of heady research and medical advancements. There is an old Arabic proverb my father often shared with me that goes: “There are those folks that can never seem to find a miracle at their local church.” Referring to those of a particular mindset who will often ignore local resources to seek out an answer some distance from home. Medicine lost a pioneer in epidemiological research when on January 6th, 2005 Dr. Curtis G. Hames, Sr. passed away in Savannah, GA. Dr. Hames, a 1944 graduate of the Medical College of Georgia, in Augusta, literally revolutionized the way the world viewed the rural primary care physician. By becoming a luminary in the field of epidemiology, he gave us great insight into medicine and took research out of the hands of ivory towered institutions and into the hands of community based physicians. No longer could university programs claim exclusive rights in expanding the frontiers of medical knowledge. This humble individual spent much of his life in the study of how his small town patients interacted with their environment.

Dr. Hames started out as a primary clinical practitioner in Claxton, Georgia. Claxton is a rural small town known for its poultry industry. Another noteworthy badge of honor the town has is that it is the fruitcake capital of the world. More fruitcake is produced in this town than anywhere else in America. One would not think of this place as hosting a physician researcher that would have made a global impact on medicine and health. By the mid-1950’s Dr. Hames began an epidemiological study of Evans County residents that attracted international attention. The National Institutes of Health (NIH) funded the Evans County Heart Study from 1958-95. This spotlighted Dr. Hames' research into examining patients within their environment, their local microcosm. He made some very noteworthy discoveries that doctors today utilize on a daily basis.

Over 560 scientific papers in major medical peer-reviewed journals worldwide are credited to Dr. Hames, on subjects including heart disease, genetics, cancer, hypertension, stroke, pesticide pollution, neuro-hormones, immunology, viral disease and the effects of social interaction on disease.

The value of High Density Lipoprotein (HDL) Cholesterol was elucidated in one of his first studies. Dr. Hames looked into the subject of cholesterol’s impact on cardiovascular health. It showed the protective value of HDL-Cholesterol. In another study he researched the possible impact of the absence of a certain trace mineral called selenium in the diet of these Georgia residents.

Dr. Hames’ study brought selenium much recognition. Selenium is necessary for the production of glutathione peroxidase an important antioxidant in liver detoxification. It has known protective effects against cancer as well as heart disease. The cardiac condition known as Keshan’s Disease is one that responds favorable to adequate levels of selenium. This mineral also works in conjunction with Vitamin E to enhance the antioxidant effects of this important fat-soluble vitamin. Levels found in nature depend on soil content, and apparently subjects in Dr. Hames studies that fell victim to heart disease were ingesting far less selenium (due to depletion in the soil) than what was necessary to be protective. Today’s top dietary supplements contain therapeutic doses of selenium thanks in part to Dr. Hames research. Because of the impact of his findings the Evans County Heart Study became the model for many other family practice community-based research projects.

To make these astonishing discoveries attention to detail prevailed in his data collection. In his introductory article in the Archives of Internal Medicine (1971) Dr. Hames wrote, "… from the clinical observations that coronary heart disease appeared to occur less frequently among blacks than whites, even though hypertension was obviously more common in blacks and they consumed higher animal fat diet." African-American men with high blood pressure and high fat diets were thought to be at much higher risk for heart disease, but his data showed otherwise and thus the hunt was on for that factor which yielded his counties difference. He would tirelessly note specifics on households, age, and marital status of subjects entered into the study as well as characterize the terrain composition, diet and industry in the area. He referred to this as "the total approach" to understanding the basis of disease and health. Where others failed it was his great patient rapport as a physician that was credited with an astonishing 92% success rate in studies designed to include every adult resident in the county. So not only was he a scientist, but he was also a humanitarian who genuinely cared about his patients.

It has been noted that Dr. Hames' basement yielded freezers that contained soil and water samples. There were environmental substances labeled by time and location as well as clinical specimens stuffed away in his home. Not even the locally harvested butter bean escaped his scrutinizing eye.

Dr. Hames held posts as a clinical professor at the Medical College of Georgia (MCG) and professor in the department of epidemiology at the University of North Carolina. He was also adjunct professor of Health Studies at Georgia Southern University and at Mercer Medical School. He was truly a dedicated epidemiologist in a rural setting and produced finding that affect medicine to this day. For this we can be thankful. Hopefully other young local physicians will follow and take up the torch in his footsteps. In 2007 the medical library at MCG dedicated a room in honor of Dr. Hames and to house his collection of manuscripts.

---

JP Saleeby, MD is medical director of the Emergency Department at Marlboro Park Hospital, Bennettsville, SC. For more information please visit www.saleeby.net

Shelby Farris interviews Dr. Saleeby

2008-01-28T13:53:00.000-08:00

Shelby Farris a high school student in South Carolina (and daughter of one of the ER nurses I work with at Marlboro Park Hospital) interviewed me last month for a school project. What follows is the interview:

INTERVIEW

Bibliographic Information:
I planned to interview a physician or physician’s assistant from Marlboro Park Hospital in South Carolina.

Name: Dr. Saleeby
Date: December 20th, 2007

Questions:
1. Have you always wanted to be a Physician, if yes –why? And if no, then what did you want to be and why?
~ He said when he was younger he either wanted to be in architecture or in the medical field. He was influenced to be in the medical field by a lot of his teachers and through learning about biology and chemistry.

2. Do you have any medical interests outside of your primary job?
~He said that his full time job is an E.R physician but he also has a private practice in which is preventative medicine. With this he practices integrated medicine or CAM which integrates traditional American preventative medicine and Eastern medicine with herbology.

3. What do you dislike most about your career?
~He said he dislikes the high pressure he is put under and the high expectations of patients and families.

4. Can you explain the tasks you perform on a daily basis while working?
~Dr.Saleeby said that on a daily basis he performs physical exams and listens to the patient’s medical history, he has to keep his knowledge of medicine fresh and keep his focus on at all times when working so he can make correct diagnosis, he has to order tests, sometimes suture patients, and he puts splints on patients regularly.

5. Can you explain one of the most difficult things you have had to deal with while working?
~He said one of the most difficult things he has had to deal with is patient death and explaining things to the family, and one of the most difficult procedures he performs is putting in chest tubes.

6. How many years of school did you take and was it difficult?
~He said that he did 4 years undergraduate, 4 years med school, and 1 year of post graduate and that it was difficult.

7. What college did you attend and why did you choose that college?
~He said that he attended Georgia tech and Georgia State because he was near that area and liked the medical program there.

8. What advice would you give a potential student entering the medical field?
~He said that you really have to have a passion for this and not to ever pick a career for the money because it will make you unhappy. He also said you have to be very focused.

9. What is the area of medicine you most enjoy and why?
~He said he most enjoys the preventative medicine, counseling patients, and teaching.

10. What do you do outside of you career?
~He said he likes to write, collect cards, travel, and he loves good cuisine and wine.

Dr. Saleeby had written a book on herbology called “Wonder Herbs”. He has influenced me to further pursue my future career as a PA or Physician.

- Shelby Farris

IQ Test

2008-01-26T12:02:00.000-08:00

The following short quiz consists of 4 questions and will tell you

something or other. Scroll down for each answer.

The questions are NOT that difficult. But don't scroll down UNTIL
you have answered the question!

1. How do you put a giraffe into a refrigerator?

The correct answer is:

Open the refrigerator, put in the giraffe, and close the door. This question

tests whether you tend to do simple things in an overly complicated way.

2. How do you put an elephant into a refrigerator?

Did you say, open the refrigerator, put in the elephant, and close
the refrigerator?

Wrong Answer.

Correct Answer:

Open the refrigerator, take out the giraffe, put in the elephant
and close the door. This tests your ability to think through the
repercussions of your previous actions.

3. The Lion King is hosting an animal conference.

All the animals attend.... except one.

Which animal does not attend?

Correct Answer:

The Elephant. The elephant is in the refrigerator. You just put him
in there. This tests your memory.

Okay, even if you did not answer the first three questions correctly,

you still have one more chance to show your true abilities.

4. There is a river you must cross but it is used by crocodiles,
and you do not have a boat. How do you manage it?

Correct Answer:

You jump into the river and swim across. Have you not been listening?

All the crocodiles are attending the animal conference.
This tests whether you learn quickly from your mistakes.

According to Anderson Consulting Worldwide, around 90% of the
professionals they tested got all questions wrong, but many preschoolers

got several correct answers. Anderson Consulting says this conclusively
disproves the theory that most professionals have the brains of a four-year-old.

Requiescat In Pace Al Leake

2008-01-25T14:45:00.000-08:00

From: STEVE JENIK <COLFAM.2@ATT.NET>
To: jpsaleeby@aol.com
Sent: Sat, 26 Jan 2008 11:01 pm
Subject: Al Leake

Dear Dr.Saleeby,
My name is Steve Jenik. I and my wife Julie are friends, neighbors and caretakers
for Al and Myr Leake. It is with great regret that I must inform you that Al has crossed
the final finish line in his race against cancer. He passed away, quietly, at home,
amidst family and friends on Jan., 25, 2008 @ approx 2:45 P.M.
I am being presumptious by issuing this notice, as I have no formal family approval
to do so. Yet, after searching the web and finding many references to Al, not
only his racing prowess, but his restoration work and finding your name, I hope that
this takes some burden off of Myr. I presume that you know how to contact the family.
I found the picture of your son with the pinewood derby racer. That choked me up.
I printed it out, but, my printer is not the best quality beast in the world.
Nonetheless, I intend to pass it on to Myr.

Our regards sir,
Steve and Julie

Pax et Requiem Dear Al

Dorothy Hamill fights Breast Cancer

2008-01-05T09:17:00.000-08:00

Dorothy Hamill (age 51) was recently diagnosed and is undergoing treatment for Breast Cancer. Ms. Hamill, an Olympic medal winner is a ice skating champion and sports icon.

FAT AMERICA

2008-01-02T15:52:00.000-08:00

"Hey I'm trying to loose weight.... I'm drinking a Diet Coke."

Diet Pill Phenom

Americans love their food. We love those all-you-can-eat buffets. Lately it has been with a lot of fast food. The national girth has proven in recent years that we are a nation of fat people. Those of us that actually care about our appearance and our general health often times want a quick fix. Heaven forbid we actually have to shut our pie-holes to the offerings of McDonalds and Burger King. Oh no, we need some painlessly easy means of fixing things. Both big pharma and the nutritional supplement industry provide us with the lots of options. Yes just one more thing to stuff into our mouths. Diet pills have been around for years, but there are a few new agents on the market and Americans are spending hard earned cash on them.

Meridia is one of only two FDA approved long-term medications for weight loss. It is a sister drug to Prozac and Zoloft and alters the feel-good brain chemical serotonin in our brains. This can be a rather useful start to a weight loss program if used in conjunction with proper diet and exercise. However, some side effects include a rise in blood pressure. Not a good idea for the obese hypertensive.

Xenical came out a few years ago. It is the other FDA approved drug for weight loss. Was the FDA on crack? Does the drug company that manufactures Xenical have a very evil sense of humor? This drug from day one was on my poop-list (no pun intended). Besides commanding a price tag of over $100 per month it is dangerous if you ask me. Xenical (and it's over the counter twin Alli) inhibits the absorption of fat in the digestive tract. As a consequence it can block absorption of the very good fat-soluble vitamins (A, D, E and K) as well as some rather important Omega-Fatty Acids. If that ain’t enough, it can cause severe bloating and diarrhea. OK, you are at a dinner party and sample the duck pate and bang you have created a very embarrassing moment.

There is a new drug in the wings called Acomplia, currently under FDA review under the name Zimulti for the US market. This drug is an antagonist to the Cannabinoid-1 receptors in the brain. This drug turns off the eating pleasure sensors in the brain lowering the urge to overeat. Preliminary studies show side effects from dizziness to diarrhea. There is even some reports that this drug may be useful in smoke cessation. Jury is still out on this one until the studies are published and drug goes to market. The other drugs used by doctors are typically stimulant (amphetamine like drugs) which should only be used for a very short term.

Then there are those late night infomercials that boast “too good to be true” weight loss promises. Most are untested, most are absolutely false in the claims they make and they hide under the skirt of the Dietary Supplement Health and Education Act (DSHEA) of 1994, so the government can’t touch them. Shame on them. Oh come on guys, do some real research to prove these supplements effective. If they are you will make four-fold in profits on what you spend on R&D. They are worth mentioning here because you are bound to come across them at the supermarket checkout line next to issues of tabloids the Star and National Enquirer. There are quite a number out there, but a popular supplement is Zantrex-3. Alleged to boost metabolism with caffeine and guarana. Same effect as a double expresso from Starbucks and side effects are about the same: increased heart rate, jitters and some serious insomnia. Hoodia is all the rage these days. Like an old Arab saying goes “There are those that cannot find a miracle at their local church”. The exotic herb from far off lands may yield the answer. Hoodia originates from a cactus-like plant in South Africa and Namibia, and was used by natives for stamina. Rumors leaked out that the cast members of “Desperate Housewives” used the stuff and sales of the herbal supplement have gone nuts. Once again no good peer-reviewed articles that show if this really works to reduce weight and keep it off. So in conclusion, Americans need to put less in their mouths including diet pills and muster up enough will power to get off their ever widening rear ends make a trip to the gym to work those extra pounds off and not stop at the Krispy Kreme on the way home.. Good luck with your New Year's resolutions.

---

JP Saleeby, MD is medical director of the Emergency Department at Marlboro Park Hospital. He lectures at GSU School of Nursing to graduate Nurse Practitioners. He maintains a blog at docsaleeby.blogspot.com and can be reached for comment at jpsaleeby@aol.com

© 2006-2007

This guy may actually make a good President

2007-12-31T23:59:00.000-08:00

Dr. Ron Paul

Remember Doctor Who?

2007-12-29T17:57:00.000-08:00

"The very powerful and the very stupid have one thing in common. They don't alter their views to fit the facts. They alter the facts to fit their views."

-- Doctor Who, "The Face of Evil"

CatchWine

2007-12-08T00:55:00.000-08:00

CatchWine Web Site

Visit my blog on CatchWine:

http://www.catchwine.com/users/jpsaleeby/journal/

Wine Snobs Redux

2007-12-07T00:19:00.000-08:00

In a Letter to the Editor of Connect Savannah back in August 11th 2004...... I write:

Don’t forget ‘the Drunks’

Dear Editor,

As cofounder of the Savannah Wine Club (www.members.aol.com/savannahwine), I read last week’s “Corkscrew” column with great pleasure.

However, there is one wine consumer you left out. It is the "Drunk." That is the person who shows up at a wine tasting or dinner to get ripped. They tend to say nothing until their blood alcohol content reaches 150. Then they spew out all sort of sophomoric crap (loudly and slurred) to rival even the "bullshitters."

After being in the company of some wine-greats such as Larry Stone amongst others over the years, I found that the not-so-greats at the wine tastings and dinners became increasingly less entertaining. Quite honestly, the Educators, Prognosticators and Bullshitters in the groups became annoyingly obnoxious and bored me to tears on near every occasion.

Some in the industry are the worst offenders. That is never a good thing when trying to enjoy a fine wine. Not enough Newbies (of which I have always considered myself) to balance out the others.

Hence, I have given up on large scale tasting and wine events for the very small 2 to 4 person gathering over a fine bottle or two of wine, good food and interesting conversation.

Just though I would add my two cents, and I haven’t even uncorked this evening’s bottle yet.

JP Saleeby, MD

Josh Squyers Wins Silver

2007-12-03T01:32:00.001-08:00

Josh Squyres (my pal and fellow lifter while training at Team Savannah) wins a Silver Medal in the 94Kg class in the 2007 American Open December 1st in Birmingham, AL.

Taoist teachings

2007-11-29T21:58:00.000-08:00

The Treasures of Lao Tzu (father of Taoism c. 600 BC)

I have Three Treasures
Guard them and keep them safe.
The first is Love.
The second is Moderation.
The third is Never be the First in the World.

Having Love, one will be courageous.
Through Moderation, one has power to spare.
Through not presuming to be the First in the world, one can develop one's talent and let it mature.

If one forsakes love and courage, forsakes restraint and reserve power,
forsakes following behind and rushes in front, he is doomed!

For love is victorious in attack and secure in defense.
Heaven arms with love those it would not see destroyed.

- Tao Te Ching (The World's Great Religions)

Remote Past, Past and Present

2007-11-17T10:10:00.000-08:00

18,000 US Armed Services men in our early military days form a human Statue of Liberty

A US P-38 Fighter/bomber comes afloat off the shores of Britain

Anak Krakatau Erupting.

Veteran's Day

2007-11-11T07:32:00.000-08:00

Honoring all Veteran's past and present.

For the history of Veteran's Day in the USA click here.

Western Societal Ills Spred

2007-11-07T17:31:00.000-08:00

The USA does not stand alone in troubled youth and societal ills. We now see evidence in other parts of the world, this time Finland where a young gunman strikes down 8 innocents and attempts to take his own life.

Mark Twain quote on statistics

2007-11-04T09:02:00.000-08:00

There are three kinds of lies: lies, damned lies and statistics.
–Mark Twain, attributed by him to Benjamin Disraeli

Happy Halloween

2007-10-31T06:40:00.000-07:00

Happy Halloween

from Tea Ect.

2007-10-27T09:00:00.000-07:00

www.teasetc.com/tea/mailings/102607wholesale.html

14 Days in 1962

2007-10-27T02:18:00.000-07:00

The 14 days of the Cuban Missile Crisis brought this planet to within hours of a potential chain of events that could have lead to an escalating war intimately with the use of nuclear weapons. The only know casualty was U-2 Pilot Maj. Rudolf Anderson, Jr. who was shot down and killed on October 27, 1962. The U-2 he piloted was hit by a SA-2 over Cuba. Anderson was killed with scrapnel punctured his pressure suit causing the suit to decompress at altitude. He was posthumously awarded the Air Force Cross. He was buried in Greenville, SC on Nov. 6th, 1962 (no body). An elementary school in Arkansas bears his name.

13-year Voyage Completed

2007-10-06T08:52:00.000-07:00

Jason Lewis (a 40-year old British man) finished a 13-year journey to be the first to complete a human-powered circumnavigation of the world. It took him 10 years longer than anticipated.

Cheers ol boy.

source: http://news.aol.com/story/ar/_a/adventurer-finishes-13-year-odyssey/20071006183009990001?ncid=NWS00010000000001

1st Year Wedding Anniversary

2007-09-26T10:28:00.000-07:00

To commemorate our 1st Year Wedding Anniversary Sharon and I remember the day

We had "ink done" as it was a permanent mark on our bodies for our devotion to one another.

The Kufi styled knotted Arabic Calligraphy above was tattooed onto my inner left ankle. Sharon had an old-school sparrow tattooed on hers.

And Guess what I got to drive today? Took Sharon for a spin in a '86 Ferrari Testarossa. Was on loan from Dr. Tony Battista (our friend in Bville). Was my first taste of the awesome performance of a v-12 Ferrari. Now I have the "bug" and want one! PS: I did wear my seatbelt and did not break any traffic laws (wink).

Source: http://www.islamicart.com/main/calligraphy/styles/kufi.html

Breast Cancer & Exercise in American Fitness Magazine

2007-09-01T05:03:00.001-07:00

The September / October 2007 issue of American Fitness Magazine (AFAA) features a cover article on Breast Cancer for national breast cancer month entitled "Beyond Pink Ribbons and Walkathons" by JP & Sharon Saleeby. (Page 56-61 w/ CEUs)

Tea and Diabetes Mellitus

2007-08-28T07:00:00.000-07:00

Tea Q&A with Dr. Saleeby for Tea Experience Digest Magazine

Q: My mother is a diabetic. I've heard tea is good for diabetics as long as they don't add sugar. Is this true? Do you think that by drinking tea I can avoid getting diabetes, too?

References:

Greenberg, JA, et. al., Coffee, tea and diabetes: the role of weight loss and caffeine. International Journal of Obesity (2005) 29, 1121–1129.

Anderson, RA, et. al., Tea Enhances Insulin Activity. Journal of Agricultural and Food Chemistry (2002) 50(24), 7182-7186.

incense burning increases risk of respiratory cancers

2007-08-09T01:10:00.000-07:00

In a presentation by Dr. Jeppe Friborg researching cancers of the respiratory tract in relation to the use of incense it was found that there is a relative risk of 1.7 to 1.8 times the incidence of those that are subjected to constant exposure of burning incense. Some 61,000 Singapore Chinese were entered in a long term study and found squamous cell carcinomas of the lung rose almost 2 fold in this population. The subject group was adjusted for co-founding factors such as cigarette smoking, isothiocyanate intake and alcohol consumption. Asian partake in almost daily incense burning as part of their daily culture. About one-half of Asians burn incense in their homes on a daily basis. Aromatherapy may be good for cleansing the mind, but remember moderation in all things. Incense burning releases particulate matter such as polyaromatic hydrocarbons, carbonyls and benzene into the air that is inhailed and acts as a carcinogen on lung tissues.

Source: Dr. Jeppe T. Friborg's poster presentation at the Annual Meeting of the American Association for Cancer Research at Los Angeles, June 21, 2007

Diverticular Disease and Nuts

2007-08-08T01:02:00.000-07:00

Long held opinion on the intake of high-fiber foods such as nuts, corn and popcorn as being bad for people with diverticulosis may be dashed. Recently published studies conducted by Dr. Lisa Strate reported that in more than 47,000 men followed with diverticular disease since 1986 there was no untoward effect in consumption of nuts and corn. Matter of fact there were noted benefits and reduction in the hazard ration by consuming these healthy fiber foods.

Source reference:
Strate LL et al. "Can Patients with Diverticular Disease Eat Nuts, Corn and Popcorn?" Digestive Disease Week 2007, Abstract 769.

Black Mans Burden

2007-08-05T17:24:00.000-07:00

Can't Blame White People

by Bill Cosby

>They're standing on the corner and they can't speak English.

>I can't even talk the way these people talk:

>Why you ain't,Where you is,

>What he drive, Where he stay,

>Where he work, Who you be...

>And I blamed the kid until I heard the mother talk.

>And then I heard the father talk

>Everybody knows it's important to speak English...

>except these knuckleheads.

>Mushmouth is what they speak!?

>You can't be a doctor with that kind of crap coming out of your mouth.

>In fact you will never get any kind of job making a decent living.

>People marched and were hit in the face with rocks to get an education,

>and now we've got these knuckleheads throwing that all away.?

>The lower economic people are not holding up their end in this deal.

>These people are not parenting.

>They are buying things for kids. $500 sneakers for what?

>And they won't spend $200 for Hooked on Phonics.

>I am talking about these people who cry

>when their son is standing there in an orange suit.

>Where were you when he was 2?

>Where were you when he was 12?

>Where were you when he was 18?

>And, how come you didn't know that he had a pistol?

>And where is the father?

>Or who is his father?

>People putting their clothes on back ward:

>Isn't that a sign of something gone wrong?

>People with their hats on backward,

>pants down around the crack,

>isn't that a sign of something?
They're walking around with their nasty underwear showing, and

>holding onto their pants to keep them from falling to the ground!

>Or are you waiting for Jesus to pull his pants up?

>Isn't it a sign of something

>when she has her dress all the way up to her panty line,

>and got all types of needle piercings

>going through her body?

>What part of Africa did this come from?

>We are not Africans.

>Those people are not Africans;

>they don't know a thing about Africa .

>With names like Shaniqua, Taliqua and Mohammed and all of that crap, and all of them are in jail.

>Brown or black versus the Board of Education

>is no longer the white person's problem.

>We have got to take the neighborhood back.

>People used to be ashamed.

>Today a woman has eight children

>with eight different 'husbands' --

>or men or whatever you call them now.

>We have millionaire football players

>who cannot read.

>We have million-dollar basketball players

>who can't write two paragraphs.

>We as black folks have to do a better job.

>Someone working at Wal-Mart

>with seven kids saying...

>you are hurting us.

>We have to start holding each other

>to a higher standard.

>We cannot blame the white people any longer.

>It is not for media or anyone of this time

>anymore to say whether I'm right or wrong.

>It is time, ladies and gentlemen,

>to look at the numbers.

>Fifty percent of our children are dropping out

>of high school.

>Sixty percent of the incarcerated males

>happen to be illiterate. There's a correlation.

>Tell the media to stop asking me what I think about people who don't believe what I'm saying or feel that I'm too harsh or feel that I'm just running my mouth because I'm old.

>Seventy percent of the teenagers pregnant happen to be African American girls.

>Don't ask me to soften my message.

-Bill Cosby

My GTAm

2007-08-03T21:26:00.001-07:00

My restored 1971 Alfa Romeo GTV/GTAm is soon to join me from California