Page 12 - Boca Club News - August '24

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?
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In 2018 voters failed to approve another increase
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