Page 12 - Boca Club News - August '24
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Page 12, Boca Club News
      Medical Matters: Antibiotic Resistance




      By Richard Nagler, M.D., a member                    However, after such a remarkable success story   the time to convincingly explain to the patient why an
      of Broken Sound Club and retired                  with antibiotics curing previously devastating bacterial   antibiotic is not advised for treatment of a viral illness.
      physician. After graduating from                  diseases and saving millions of lives, antibiotic resistance   Instead, too often it’s much easier to write a prescription
      the University of Pennsylvania                    has become an increasingly dangerous worldwide     to just get rid of the patient.
      and New York University’s School                  problem. Last year in the United States more than three      An antibiotic such as a Z Pack is often prescribed for
      of Medicine, Dr. Nagler served                    million Americans  developed  a  bacterial  infection   the common cold, a sore throat caused by a virus or the Flu
      his internship and residency at                   resistant to antibiotics, and 35,000 died as a result.   for which there is absolutely no benefit. The rationale is,
      Baltimore City Hospital and Johns                    Bacteria are everywhere–in water, food, soil, our skin   what harm can it do? But it can do great harm as this is
      Hopkins. He followed that with a                  and inside our bodies. Many of them do not cause disease   what encourages the development of bacterial resistance
      Fellowship in Gastroenterology at Yale University School   and some are beneficial, especially those that normally   to antibiotics.
      of Medicine, and was then Chief of Gastroenterology   reside in our digestive system. The most pathogenic      In addition, patients failing to follow dosage schedules
      at Fitzimmons General Army Hospital in Denver. He   ones are complicit in serious illness and death. Urinary   or discontinuing an antibiotic too soon or being prescribed
      returned to the Yale Medical School for one year as an   tract infection hasellulitis, abscesses, osteomyelitis,   the wrong one encourages bacteria to start reproducing
      Assistant Professor of Medicine before opening his own   sexually transmitted diseases, pneumonia, meningitis,   and mutating, reducing or eliminating the antibiotic’s
      successful private practice in Internal Medicine and   C Difficile enterococcal infections in the digestive tract,   effectiveness. In the USA, 80% of antibiotics are used in
      Gastroenterology. During that time, he also served for   endocarditis, MRSA (methicillin resistant staphylococcus   livestock, which has become a leading cause of resistance.
      ten years as Chief of Medicine at Huntington Hospital   infection), sepsis (blood stream infection) and infections   Patients who have developed bacterial resistance to an
      in Huntington, N.Y.                               complicating recovery after surgery have all become   antibiotic can transmit that bacterium to another patient.
         For centuries infectious diseases caused by bacteria   increasingly common.                          Certain strains of bacteria have naturally adapted
      have afflicted mankind with what were then serious      Most affected are the elderly, the immune compromised,   to antibiotics that previously killed them. They keep
      basically untreatable  diseases such  as  the  plague,   cancer, transplant and AIDS patients. These bacteria can   multiplying and cause serious infections that are
      pneumonia, rheumatic fever and tuberculosis, resulting   spontaneously mutate, changing the makeup of their   unresponsive to a wide variety of antibiotics and, in some
      in millions of deaths.                            DNA and then becoming able to fight off antibiotics that   cases, there is no response to any currently available
         In the 1940s one of the greatest achievements in   previously killed or prevented them from growing.   antibiotic. These are called super bugs.
      medicine was the introduction of penicillin, the first      The most important cause of antibiotic resistance is the      To combat antibiotic resistance, it is important to wash
      antibiotic used successfully to treat a variety of bacterial   misuse of antibiotics. This has been an ongoing problem   your hands thoroughly and often. Only take antibiotics as
      infections. Over the years more potent antibiotics have   for years. Today, when patients are seen in a doctor’s   prescribed by a doctor, follow the dosage schedule and
      evolved with a much broader spectrum of activity against   office they expect to leave with a prescription for their   never stop it prematurely simply because you’re feeling
      many other bacteria.                              illness. This is where a trusting doctor-patient relationship   better. Don’t pressure a doctor to prescribe an antibiotic
                                                        is so important. For example, the doctor should take   just because you expect it or think you need it.
      Legal: Homestead Exemption Ballot Measure




      By  Michael  J  Posner,  Esq.,  is  a                A new proposal was raised in the Florida state legislature   because it will result in a reduction of revenues to the
      partner in Ward Damon a mid-sized                 this past spring which would give the voters of Florida the   counties which rely on real property taxes for a majority of
      real estate and business-oriented law             opportunity to pass a new constitutional amendment that   their income. These reductions will lead to either a loss of
      firm serving all of South Florida, with           would increase the homestead exemption by an amount equal   services or an increase in other taxes and charges by local
      offices in Palm Beach County. They                to the change in the Consumer Price Index reported by the   governments to make up for the shortfall, assuming that the
      can be reached at (561)594-1452, or               U.S. Department of Labor if the change is positive.  voters approve the amendment.
      at mjposner@warddamon.com.                           This proposal passed in the State House by a vote of 86 in      If recent history is a determining factor, it is very likely
         Voters will be asked to again                  favor and 29 opposed. Among House Democrats, five were   that the proposed constitutional amendment will not pass.
      amend the constitution of Florida                 in favor and 29 were opposed. Among House Republicans,   While the 2008 amendment increasing the exemption from
      to add an annual inflation adjustment to the amount of   81 were in favor and none were opposed. The amendment   $25,000 to $50,000 passed overwhelmingly, with 64% of
      assessed value that is exempt from property taxation. This   was approved in the Florida State Senate by a vote of 25-  Florida voters voting in favor of the exemption, the exemption
      proposal would require approval of at least sixty percent   15. Twenty-five Senate Republicans were in favor and three   increases proposed in 2018 and 2022 both failed to pass, albeit
      of voters, as all constitutional amendments require a super   were opposed, and all 12 Senate Democrats voted against   by very slim margins.
      majority for approval.                            the amendment.                                        Many voters will fail to take into account the effect of
         The history of the homestead tax exemption is very      Those supporting the measure argue that the increase   the new tax savings on government services. However, if the
      interesting and has been modified many times since   is necessary to help homeowners who are most harmed by   exemption does pass it may increase home sales by reducing
      its  initial  adoption  in  1934,  which  exempted  the  first   inflation: low-income workers and seniors on fixed incomes.   the monthly costs of home ownership, allowing more people
      $5,000 in home value from real property taxes. At that   Should the measure pass and inflation rise 5% in one year,   to qualify to finance the purchase of their home by reducing
      time most homes were worth less than $5,000 and,   the exemption would increase from $25,000 to $26,250,   their cost to income ratio. This will likely lead to lobbying
      therefore, taxes were only assessed against a few wealthier   providing a modest tax savings.        by groups such as the Florida Realtors Association in support
      homeowners. With  inflation  that  exemption  would  be      This new proposal was opposed by most Democrats   of the ballot measure.
      worth approximately $115,000 in 2023. However, as
      home prices increased the government, without any sales
      tax revenue, became more dependent upon real property
      taxes and was less willing to raise the exemption with   Are You Ready                                                  Hurricane?
      either inflation or the growing cost of homes in Florida.
         In the 1960s the exemption amount was increased to
      $10,000, and then further increased to $25,000 in 1980     For The Next Storm?
      (approximately $94,000 today). An increase took place in
      2008 when the exemption amount was raised to $50,000,
      assuming a house value of at least $75,000, which was                                                               No Air Conditioning?
      approximately $73,000 in 2023. Note that the second                                                                   No Refrigeration?
      exemption does not apply to school taxes.
         In 2018 voters failed to approve another increase
      in the exemption amount to $75,000 for homes worth                                                      FREE                 10% OFF
      more than $100,000, which was approximately $92,000                                                    7 Year Warranty
      in 2023. The proposal was approved by 58% of voters,                                                   on Select Air Cooled    Of A Service Call*
      which was insufficient for passage. Another attempt at an                                              Standby Generators*
      increase in the homestead exemption on property owned                                                    $ 350                     $ 1,000
      by certain public service workers including teachers,
      law enforcement officers, emergency medical personnel,                                                    One-Time                OFF
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      put before the voters in 2022. This measure also failed to
      pass, falling 1.5% short of the 60% requirement.                                                           561.774.7714
         Since home values average a little over $400,000 today
      the current exemption provides only a 12.50% reduction                                                      2271 Palm Beach Lakes Blvd.
      on the taxable value. With an average millage rate of                                                        West Palm Beach, FL 33409
      approximately two mils a $50,000 exemption saves the
      average Florida resident approximately $1,000 in real
      property tax. Despite the increase of the exemption from
      $5,000 to $50,000, inflation and rising home prices has
      resulted in a steep reduction of the value of the exemption.               GeneratorSupercenterofThePalmBeaches.com
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