Showing papers in "Journal of the Medical Association of Georgia in 1995"

Firearm violence and public health. Limiting the availability of guns.

Abstract: FIREARM violence has reached epidemic proportions in this country and is now a public health emergency, accounting for one fifth of all injury deaths in the United States and second only to motor vehicles as a cause of fatal injury. 1 In addition, for every fatal injury, an estimated seven nonfatal injuries occur. 2 Further, firearm-related injuries imposed an estimated $19 billion economic burden on the United States in 1990 in addition to the direct health care costs. 3 If firearm violence continues to increase, it is expected that by the year 2003, the number of deaths from firearms will surpass the number of deaths caused by motor vehicles, and firearms will become this country's leading cause of injury-related death. 4 The burden of firearm violence is borne to a considerable degree by our country's most vulnerable population—its young people. Homicide is the leading cause of death for young black

Laboratory diagnosis of tuberculosis: past, present, and future.

Abstract: Resurgence of tuberculosis justifies extraordinary efforts to expedite TB diagnosis and susceptibility testing. This demands that laboratory support expand to a "second generation" of methods and procedures, including rapid availability of fluorochrome smears of concentrated specimens, faster techniques for detection (e.g., the BACTEC radiometric broth system and microcolony detection), quicker identification (e.g., high-pressure liquid chromatography, nonisotopic genetic probes), more rapid susceptibility testing methods (e.g., BACTEC), and reporting of these results as critical values. Guidelines have been established for turnaround time for results of smears, TB organism identification, and susceptibility testing to usual first-line drugs. A "third generation" of laboratory techniques soon will make testing not only more effective but also more efficient. These methods include direct testing of respiratory specimens through nonisotopic genetic probes as well as nucleic acid amplification techniques utilizing polymerase chain reaction (PCR) and other molecular procedures. These new procedures and protocols place heavy demands on laboratory test volume, technologist time and costs. For the healthcare system or clinical laboratory without the resources to deal with these new demands, referral of TB specimens represents a reasonable alternative, as long as transport is adequate to meet current CDC and other guidelines for turnaround time.

The politics of health care reform.

Abstract: In many ways the reform debate is a struggle among competing ideologies. The risk we take is that the politics becomes more important than the results. For the ordinary citizen, it matters little who gets the credit. What matters is how well the system addresses the critical issues of access coverage, and cost. The choices are difficult. Those who think we have the resources necessary to conquer all our problems fail to admit that the United States is not the Garden of Eden. It would be nice if government were able to legislate away the negative effects of our human nature. But since that is impossible, we must set realistic goals and establish reasonable priorities. The challenge is before us.