The patient's page.

One Hundred Years of the Southern Medical Association

This year marks the 100th anniversary of the Southern Medical Association. In 1906, the SMA was founded, with the goal of providing quality continuing medical education for physicians, particularly in the South. A lot has changed over the last 100 years. The SMA is now made up of physicians from all across the United States, and provides ongoing education for medical students, residents, physician assistants and nurse practitioners, as well as for physicians. In spite of these changes, however, the original goal of the SMA has remained the same. We still strive to provide quality education--to our members, as well as to our patients, through venues such as "The Patient's Page." We hope this page will help educate the public about a variety of medical conditions, and will foster better communication between patients and their health care providers.

Addicted to Gambling?

Pathological gambling, defined by the American Psychiatric Association as "a chronic progressive failure to resist impulses to gamble, and gambling behavior that compromises, or damages personal, family, or vocational pursuits" is estimated to affect up to 15 million Americans, and costs 5 billion dollars annually. As with all addictions, it is difficult for family members and loved ones to understand the motivation behind this self-destructive behavior. Recent neurological studies, however, are providing insight into this devastating disorder. Studies have shown that pathologic gamblers have abnormal functioning in the regions of the brain which are involved in reward-based decision making, obsessive-compulsive syndromes, and addiction. Additionally, a high percentage of gamblers also suffer from mood and anxiety disorders, such as major depression, bipolar, post traumatic stress, obsessive-compulsive and panic disorders. These factors make treatment of severely addicted gamblers difficult, as they may require treatment for a long list of problems, including addiction, cravings, impulse control, and mood and anxiety problems. Fortunately, medications and therapies are available, as well as support groups, such as Gambler's Anonymous. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), individuals who have at least 5 of the following characteristics are considered to be compulsive gamblers, and should be encouraged to speak to their physician immediately.

* Preoccupation with gambling, such as frequently reliving past gambling experiences, or planning the next gambling experience.

* Needs to gamble with increasing amounts of money in order to achieve the desired excitement.

* Repeated unsuccessful efforts to control, cut back or stop gambling.

* Restlessness or irritability when attempting to cut down or stop gambling.

* Gambles as a way of escaping problems or of relieving depression or anxiety.

* After losing money, often returns again in order to get even ("chasing" one's losses).

* Lies to family members, therapists or others to conceal the extent of involvement with gambling.

* Has committed illegal acts such as forgery, fraud, theft or embezzlement, in order to finance gambling.

* Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.

* Reliance on others to provide money to relieve a desperate financial situation caused by gambling.

From "Neuropsychological Performance, Impulsivity, and Comorbid Psychiatric Illness in Patients with Pathological Gambling Undergoing Treatment at the CORE Inpatient Treatment Center." By Dr. James C. Patterson II and colleagues. Southern Medical Journal. January 2006.

Sleep Apnea and Your Heart

Sleep apnea, the repeated cessation of breathing during sleep, affects approximately 12 million Americans. In addition to causing excessive daytime sleepiness, decreased memory, impotence, and depression, long-term side effects include stroke, ischemia, coronary heart disease, cardiac arrhythmias and hypertension. In fact, approximately 50% of all patients who suffer from sleep apnea also have hypertension. Additionally, sleep apnea is associated with abnormalities in metabolism, which may lead to obesity and in severe cases, diabetes. If you suffer from sleep apnea, be sure to speak with your physician regarding treatment.

From "Inflammatory Aspects of Sleep Apnea and Their Cardiovascular Consequences," by Dr. Ehab Kasasbeh and colleagues. Southern Medical Journal. January 2006.

Jennifer McKinney, MA