Seatbelts Reduce Eye Injury Risk in Auto Accidents

Although airbags in automobiles have helped reduce overall injuries and fatalities by 32 percent since they were introduced in the 1970s, airbag deployment sometimes causes eye injuries, with an estimated incidence of 5 percent. A 2007 study led by Sunil K. Rao, MD, evaluated how seatbelt use correlated with eye injuries and the recovery of visual acuity in auto accidents where airbags deployed. The study concluded that “the use of seatbelts was associated with less severe ocular injuries and better visual outcomes.” Reviewing medical records of the Rhode Island Hospitals general eye clinic January 1997 to August 2005, researchers selected 47 patients who were either the driver or front-seat passenger in an auto accident with airbag deployment, excluding accidents with rollover or ejection. Patients had been questioned by clinic staff regarding seatbelt use, eyewear use, and airbag status.

Injuries were ranked as mild, moderate, or severe using a standardized scale: 49 percent of the patients had severe injuries, 23 percent moderate, 26 percent mild, and 2 percent were not injured. Seventy-one percent of those not restrained by seatbelts had severe injuries versus 31 percent wearing seatbelts. Forty-two percent of restrained patients had only minor injuries. Visual acuity outcomes also depended on seatbelt status, with unrestrained patients significantly more likely than restrained to have 20/200 or worse vision at the three month post-accident follow-up. None of the patients was wearing eyeglasses, and none had previously had cornea transplant or refractive surgery; these variables could influence results in future studies. The patients’ age, gender, accident type and alcohol status were not significantly related to injury severity.

Source: Newswise

Female Vets at Risk of Miscarriage from Anaesthetic Gases and Pestic

Female vets run twice the risk of miscarriage as a result of exposure to anaesthetic gases and pesticides, suggests a study published in Occupational and Environmental Medicine.

The findings prompt the authors to call for young female vets to be more clearly advised of the risks they run, should they want to become pregnant.

The study is based on a survey of women taking part in the Health Risks of Australian Veterinarians Project (HRAV).

This surveyed all those graduating from Australian veterinary schools between 1960 and 2000.

Of the 5700 graduates contacted, some 2800 responded, of whom 1200 were women.

Between them, these women reported a total of 1355 pregnancies, 940 of which occurred while working in clinical practice, and so were eligible for inclusion in the study.

Women carrying out surgery and exposed to anaesthetic gases that were not filtered out of the atmosphere, for an hour or more a week, were almost 2.5 times more likely to miscarry.

Female vets who used pesticides during the course of their work were also twice as likely to miscarry.

And those who performed more than five x rays a week were around 80% more likely to miscarry than those performing fewer procedures.

When the researchers restricted their analyses to those women graduating more recently-between 1980 and 2000-the results were similar.

The authors warn that female vets of childbearing age “should be fully informed of the possible reproductive effects of ionising radiation, unscavenged anaesthetic gases, and exposure to pesticides.”

Women should take protective measures when they are planning to conceive and during pregnancy, they warn. But all staff working in these areas should be aware of the risks and protect themselves accordingly, they suggest.

Source: Newswise


Diagnostic Lab Is Kansas’ First Line Of Defense

Veterinary Diagnostic Lab Is Kansas’ First Line Of Defense Against Bird Flu

If the highly pathogenic strain of avian influenza ever comes to Kansas, diagnosticians at Kansas State University’s Veterinary Diagnostic Laboratory will be the first to know.

The lab, which is part of K-State’s College of Veterinary Medicine, is the first place samples would be tested if there were a suspected case of avian influenza in Kansas.

Dr. Gary Anderson, director of the lab and professor of diagnostic medicine and pathobiology, says that the lab has been certified by the U.S. Department of Agriculture to perform avian flu testing. The lab also tests for swine, equine, and canine versions of influenza.

“K-State’s Veterinary Diagnostic Laboratory is known for thorough and timely diagnostic services,” Anderson said. “And in the case of bird flu, were it to make it to Kansas, time would be of the essence. We presently have five employees who are certified by the National Animal Health Laboratory Network to perform avian influenza testing, which allows handling of a large number of samples and reporting the results within a short time frame.”

Avian influenza was recently in the news because of two pre-Thanksgiving outbreaks in Britain. To date, the pathogenic strain of avian influenza — also referred to as H5:N1 — has been reported in Southeast Asia and a handful of European countries, but not in the U.S. It affects poultry — chickens, turkeys, ducks, etc. — and is particularly contagious among domestic flocks, although the disease is thought to originate with migratory fowl.

“From a poultry standpoint, our biggest concern is that migratory birds from the North will mix in the summer breeding grounds and spread avian flu when they fly south for the winter,” said Scott Beyer, a K-State poultry expert and associate professor of animal sciences and industry. “However, this has not yet happened in North America, which is somewhat of a surprise.”

According to Beyer, if the bird flu does make it to the United States, poultry producers are prepared and have been taking precautions against the disease for some time.

“The chicken and turkey industries screen all flocks for avian influenza prior to sending them to the processing plant,” Beyer said. “For many years, the U.S. policy has been never to allow any form of avian influenza to persist in the birds. So, even the most benign form is not allowed to exist in flocks. If we do have an H5:N1 outbreak, which is the highly contagious kind, our system would pick it up very quickly.”

If a producer or member of the public sees a sick bird or birds, Kansas State also manages the Avian Influenza Hotline at 1-800-566-4518. The hotline is a cooperative service provided by the Kansas Department of Health and Environment and the Kansas State Veterinary Diagnostic Laboratory. All questions concerning dead birds or birds that appear to be sick can be referred to this number.

Typically, a single dead bird should not cause significant concern, Anderson said. “We start to worry when there is a large group of dead birds or migratory waterfowl in a relatively small area,” he said.

Anderson encourages anyone with questions to call the hotline so the veterinary professionals manning the phones can help determine whether the death or sickness is an indicator of serious disease.

Source: Newswise

From the Editor

I hope you find this issue as informative as previous issues and I hope to continue to give you the most recent up to date articles on health care and management concerns.

In this issue, there is a profile on Dr. Vincent Dolce, DMD of Palm Beach, Florida written by former National Geographic TV producer, Chuck Friedman. Chuck was in the middle of creating a documentary on community leaders and the qualities of leadership when he discovered Dr. Dolce. You should find this to be a very informative article.

Lisa Thayer, co-owner of, returns with the second part of a four-part series on search engine marketing. This is a very interesting article that delves more deeply into the often mysterious world of making yourself known on the Internet.

An article profiling a different Florida dentist, Dr. Lee Sheldon and his charitable activities, has also been added. It contains some excellent ideas on how you can use community outreach to boost the profile of your medical practice whether you are a dentist, optometrist, veterinarian or any medical professional.

In addition, we have our usual complement of profession-specific news stories and our regular practice management articles that you can use right now to benefit your practice.


Cory D. Radosevich

The Practice Solution Magazine

Managing Editor

Guide For Veterinarians

Includes Unusual Species Adopted Into Human Households And Potential Hazards To Human Health

Ferrets, frogs and finches are becoming more common as pets, but the list of unusual species adopted into human households now includes some of the most exotic creatures on the planet. The trade in exotic pets has become a multi-billion dollar enterprise, but expansion of the industry sometimes outpaces veterinary knowledge of how to treat the maladies that afflict these unusual animals.

The new “Manual of Exotic Pet Practice,” published by Elsevier and edited by veterinary experts at the University of Illinois and Louisiana State University, provides detailed information on all of the major exotic animal groups. The book devotes entire chapters to invertebrates, ornamental fish, amphibians, crocodilians, snakes, lizards, chelonians (turtles and tortoises), birds, marsupials, ferrets, rabbits, hedgehogs, chinchillas and guinea pigs. Rats and mice get a chapter, as do hamsters and gerbils. A final chapter offers guidance on the treatment of injured wildlife.

“We felt that there was a strong need for a general exotic pet textbook that could be used by veterinarians to manage any exotic animal that came their way,” the editors wrote in the preface.

University of Illinois wildlife veterinarian Mark A. Mitchell co-edited the book with LSU professor of zoological medicine Thomas N. Tully Jr.

The manual includes a brief history of the age-old tradition of capturing or domesticating wild animals, and a chapter on how to prepare an animal hospital for exotic pets. Each of the other chapters lists common species kept in captivity, and offers guidance on their biology, husbandry, nutritional needs, preventive medicine, common diseases, and potential hazards to human health.

Want to know how to restrain a crocodile so you can give it a proper exam” How do you know if a turtle is suffering from a vitamin A deficiency” Is the lethargic rabbit in your waiting room a victim of heat stroke or cardiac disease” Did that frog swallow something it shouldn’t have” The book offers guidance on these and myriad other potential therapeutic challenges.

Diagnostic approaches and treatment strategies are described in every chapter, and each includes information about surgery and, when applicable, special instructions related to anesthesia.

The book includes hundreds of color photographs of the maladies and injuries that sometimes afflict exotic animals, with more photos of common examination and treatment techniques. An in-depth index allows quick reference to items of interest.

“Dr. Tully and I were interested in pursuing this book because we saw a real need for an ‘all-exotics’ text for the general practitioner,” Mitchell said. “Historically, veterinary texts for exotic pets have been group-specific (for example, devoted entirely to reptiles or birds). Although invaluable, many veterinarians have expressed a desire to have a single point, primary reference to obtain clinical information on these animals. We hope this text will serve the tens of thousands of veterinarians managing exotic pet and wildlife cases as an invaluable resource to manage their patients.”

Source: Medical News Today


Are Cataract Rates Declining?

The population-based Beaver Dam Eye Study was designed by Barbara E. K. Klein, MD, MPH, and colleagues to determine through long-term observation whether there were differences among age cohorts regarding rates of cataract prevalence and surgery, as well as type of cataract. Five thousand residents of Beaver Dam, Wisconsin were examined for the three most common forms of cataract-nuclear, cortical and posterior sub-capsular—at baseline in 1990 and five, 10 and 15 years later. Results were analyzed by age group and gender for this population, which was 99 percent white. The rates of all three cataracts increased with age for all cohorts and are described in the study in detail by age cohort and gender.

An interesting decline in prevalence of nuclear cataract—the type characterized by hardening of the center of the eye’s lens—was found when participants were considered in five-year age and birth cohorts (excluding the 75+ group, which had too few participants). Even after adjusting for expected higher prevalence at older ages, the study found that prevalence declined in each successive birth cohort. The authors suggested that this decline may be related to negative health habits shared by people in the older cohorts and to more positive health habits in the younger cohorts. The researchers write: “Possible protective exposures include a decrease in smoking and increase in exposure to healthy lifestyle habits.” Rates of cataract surgery also increased in the 15-year time period, as surgical techniques and outcomes improved significantly and more people elected cataract surgery at earlier points in the disease process.

Source: Newswise

“Fluorescent” Cells Give Early Warning for Eye Disease

Scientists at the University of Michigan have shown that their new metabolic imaging instrument can accurately detect eye disease at a very early stage. Such a device would be vision-saving because many severe eye diseases do not exhibit early warning signals before they begin to diminish vision. The testing is noninvasive and takes less than six minutes to administer to a patient.

In a recent study, two researchers from the U-M Kellogg Eye Center used the instrument to measure the degree to which a subtle visual condition affected six women. Victor M. Elner, M.D., Ph.D., and Howard R. Petty, Ph.D., report their findings in the February issue of Archives of Ophthalmology. The women had been recently diagnosed with pseudotumor cerebri (PTC), a condition that mimics a brain tumor and often causes increased pressure on the optic nerve that can lead to vision loss.

Because each woman’s disease was in a very early stage, the researchers could evaluate how accurately the instrument would detect vision loss as compared to several standard tests used to evaluate vision: visual fields, visual acuity, and pupillary light response. In each case the imaging instrument provided results that were equal to and often superior to the standard tests.

The study grew out of Petty and Elner’s observation that metabolic stress at the onset of disease causes certain proteins to become fluorescent. To measure the intensity of this flavoprotein autofluorescence (FA), they designed a unique imaging system equipped with state-of-the art cameras, filters, and electronic switching, together with customized imaging software and a computer interface.

Petty, a biophysicist and expert in imaging, explains why FA data is a good predictor of disease. “Autofluorescence occurs when retinal cells begin to die, often the first event in diseases like glaucoma and diabetic retinopathy,” he says. “Cell death can be observed microscopically, but not as yet though any current imaging methods. We believe this study is a big step forward toward creating a diagnostic tool that can characterize disease long before symptoms or visible signs appear.”

The women in the study were newly diagnosed with PTC and had not yet received treatment. According to standard tests they had good visual acuity, and their visual field tests indicated either subtle abnormalities or none at all. Visual field testing, used to measure the area seen by the eye, is a standard tool for evaluating eye diseases such as glaucoma.

After the standard vision tests were administered, the researchers measured FA values for the six women and the age-matched control group. All of the patients with PTC had higher FA values in the eye that was more severely affected. In fact, FA values averaged 60% greater in the more affected eye of these women. By contrast, the control group had no significant difference in FA values between their healthy eyes.

The researchers also found that FA data more accurately described the different degree of disease in each eye for a given patient, as compared to the standard vision tests.

Elner, who is an ophthalmologist and a pathologist, says that the ability to detect subtle distinctions is important. “Early treatment for eye disease is so important, and this study suggests that FA activity is a very good indicator of eye disease,” he says. “Cardiologists have long used blood pressure testing to head off heart disease. We believe that FA testing will likewise be a helpful diagnostic tool for eye doctors looking to prevent blindness.”

Elner and Petty have patented the device through the University of Michigan Office of Technology Transfer. They are investigating its use as a screening device in diabetes and other major eye diseases.

This study was supported by grants from the National Eye Institute. Dr. Elner is a Research to Prevent Blindness Senior Scientific Investigator.

Source: Newswise

Guest Column: The Business Sense of Dentistry

Profile of Dr. Vincent Dolce, DMD

By Charles Friedman

Dr. Vincent Dolce

Dr. Vincent Dolce

As a National Geographic documentary producer, I have had the opportunity to see the world, weave between cultures, and meet many extraordinary individuals. Currently I am working on a documentary for the Florida Department of Education which will be shown to high school students throughout the state. This particular presentation is career oriented with a heavy focus on leadership skills and innovation. Eleven careers were chosen and Dentistry was one of them.

The essence of leadership, which is the core of the documentary, is the combination of personality, integrity, setting a consistent standard, and the ability to motivate and inspire your staff. Yet it is important to convey to these future leaders that an individual who exhibits these traits is still not guaranteed that the end results will be positive. We had to find a common thread among leaders that wasn’t just success.

The common thread between all eleven leaders chosen for the documentary was vision, which takes courage and there are still no guarantees. Vision means thinking outside the box, it means change, and it means taking chances and that’s why our dentist of choice was Dr. Vincent Dolce of Palm Beach County.

But beyond just a documentary, I thought that his own profession would be interested in knowing more about him. I found him to be exceptional. My first indication that Dr. Dolce was unique was when I learned he hosted a weekly radio show throughout southern Florida. He actually brings on other dentists to educate the public about the future of dentistry and the health risks if you do not take care of your oral health. He pays for the show out of his own pocket and he does not take any sponsorship, nor does he run any commercials. This humane gesture revealed to me the caliber of his character. It’s the manner in which he thinks, the manner in the way he acts, the manner in the way he talks, and the manner in which people respond to him. He is a man of dignity, and substance. But dignity and substance are still no guarantees of success.

As I was proceeding with my documentary I was also being introduced to the Dolce philosophy of Dentistry. It was most reassuring that Dr. Dolce turned out to be who I thought he was. When I asked him if I could write this article knowing that I would be giving away certain business techniques, I was fully expecting to receive his approval but not really sure. He was not protective of his techniques in the least and there was no hesitation, he wants every dentist to get the most joy, satisfaction, and financial gain out of the profession that can be achieved. A great deal of his personality is his passion for people to succeed, as well as his lightning quick sense of humor. What made a significant impact on me was his ability to captivate other dentists during a lecture. Although Dr. Dolce is only 51 years old, other dentists approach him with the awe of approaching an ancient Zen dentistry master. These other dentists are curious about his approach because Dr. Dolce has noticeably doubled his income and is expanding his business while many are trying to keep theirs alive. He developed training programs that improve the efficiency of the hygienist, treatment coordinator, dental assistant, and receptionist. After a few of his industry friends saw his numbers start to increase he developed a series of training modules so that dentists could be smarter and better business people.

Dr. Dolce’s business sense of dentistry can be broken down into roles which even include the environment. The roles are divided between the staff and the atmosphere.

The Office of Dr. Vincent Dolce

The Office of Dr. Vincent Dolce

When you walk into Dr. Dolce’s West Palm Beach, Fl office it appears like any other dental office. However, beyond the reception area, sequestered yet not obtrusive, is a room that felt more like an elegant showroom than a dental office. This room would make George Lucas envious, and it was done at very little expense.

That is another aspect of Dr. Dolce’s business sense. It is part photography gallery, part exhibit hall, part high technology – with all the elegance of a museum setting.

“This room has more than paid for itself,” Dr. Dolce explained. “As I’m explaining how each patient (whose before and after pictures appear) benefited from taking their oral health seriously, I’m also educating the patient on how their oral health is integrated into their overall health.”

When someone is in the consulting room, they can be taken on a pathway to possible consequences of neglecting their oral health. This one room opens up a whole new line of dialog with his patients. Instead of reacting to the dentist’s office in a negative way, they now begin to understand the dentist and his office as a proactive approach to their health.

“That is the beginning of a new form of relationship between a dentist and his patients.” Dr. Dolce told me.

How is that new relationship best defined? Dr. Dolce and his staff continually educate a patient of the correlation between their overall health and their oral health. This is accomplished in a genuine and sincere matter-of-fact nature that the patients are 100% attentive to. Dr. Dolce’s training initiates the patient to inquire and investigate what they need to be healthier and happier. Empowering the patient is a major first step; a dentist’s office has to make money to prosper.

Dr. Dolce reminded me of a typical visit to the dentist – put the patient in the chair, take x-rays, and diagnose what they need. What they don’t do is energize and inspire the patient to be proactive in taking care of their oral health. “That’s not what they teach you in college. They don’t teach you the psychology of dentistry, they teach you the mechanics. There is a psychology of dentistry, there is a philosophy of dentistry, and there is a business of dentistry,” he said.

The next phase is the human element phase. This is where teamwork and training comes into play. Dr. Dolce assembled a team of training specialists which included curriculum developers from the United States Navy, Harvard University, and the Department of Justice. He wanted to develop interactive training modules that challenged and educated every one of his employees to meet the individual needs of every patient. These interactive training modules are the basis for his expansion initiative. His goal was to increase his gross amount considerably without depending on new patients as his only source of growth. To Dr. Dolce’s satisfaction, the training method worked.

An x-ray machine is an x-ray machine is an x-ray machine, but the dialog between the person taking the x-rays and the patient does not have to be the typical conversation. Dr. Dolce’s training teaches his staff a new way to communicate with the patients. Basically Dr. Dolce believes that the lifeline of successful dentistry is education in communication with the patients. Dr. Dolce also believes that every patient should be secure in the fact that his staff has listened to them.

Since I was producing a documentary, his patients that participated had all agreed to be on camera. My original thoughts were to observe the doctor and his leadership skills and the patients were just props. However, as I was seeing and experiencing his philosophy I really became curious about what the patients thought of their interaction with him. So before he even started working with them I started asking patients what they thought about their introduction to the doctor.

Everyone felt that this was a person who could be trusted. I did not know exactly what that meant until the next phase. The next phase as you probably know is the reviewing of the treatment plan. I did not even really realize what was happening or the impact that the doctor training modules had had. I learned through a conversation at lunch with his treatment coordinator.

The treatment coordinator said, “I have worked for three other dentists before Dr. Dolce. I have never experienced patients so willing to pay for their dental health and so willing to be proactive about their dental health as here in Dr. Dolce’s office. Usually there is a wall of resistance as soon as you explain the costs of dental work. People are not usually proactive about oral health, but the way Dr. Dolce has trained us in explaining their dental needs has them lower their resistance.”

Dr. Dolce invited me to attend a lecture that was being given for dentists in his region. It focused on the restorative phase of implants. I went because I wanted to talk to other dentists and see how they interacted with their patients. What I learned and overheard was that most of these dentists were there to learn how to make more money.

I asked him about this as we were heading back to his office. He said, “Most dentists don’t look at their office or their office procedures as a combination of trained staff and bedside manner. They expect their staff to bill properly and know the techniques as well as the sterile parts of dentistry, but really they expect their staff to be already trained to be business oriented.” The most unique difference being that Dr. Dolce inadvertently reaps the rewards of a high volume of the most expensive and most productive dental procedures such as veneers, implants, and total reconstruction through a highly trained staff, an aesthetic environment, and personal attitude.

I would like to leave you with an excerpt from one of Dr. Dolce’s speaking engagements to a local group of high school students:

“The future of dentistry could never be brighter. With the aging of the baby boomers, and the population in general, plus the cosmetic revolution, not to mention the direct health connection between the mouth and the body, the business of dentistry is perfectly positioned to make any dentist a millionaire. However, if you do not have passion, if you do not consider the patient an individual and a treasure, and you only enter the field of dentistry to make money you will be disappointed. Dentistry is a competitive field. The business sense of dentistry is not a course that is offered in college. The business sense of dentistry is developing a highly trained staff, providing an education and vision to the patient, and nourishing and maintaining the patients trust.”

Chuck Friedman is a former executive producer for National Geographic Television. Mr. Friedman has worked as a video producer/director for a long list of companies and government agencies that include the United States Army and Navy, State of Florida, U.S.D.A., St. John’s University, Michelin, Minolta, Pony Shoes, United Way, the Air Force, Drug Free America, Major League Baseball, DuPont and many others. Mr. Friedman is also well known for developing effective multimedia training programs, and for providing marketing and strategy consultation for a wide variety of clients.