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Dermatology Digest: A rare ulcer with a common cause

To the Editor:

I was reading the Dermatology Digest case by Robyn Gieseking, “A rare ulcer with a common cause,” which was published in May 2007. I was confused by the sulfasalazine dosage given to the patient. In the TREATMENT section, Ms. Gieseking states that the patient’s prior dose was 0.5 mg twice a day and it was increased to 1 g three times a day. Did she mean to say 0.5 g twice a day?

Maribel Hernandez-Jones, RPA-C

Author’s response:

Ms. Hernandez-Jones is right. The dosage of sulfasalazine should have read 0.5 g twice a day, not 0.5 mg twice a day.

Robyn, Gieseking, RPA-C

A Day in the Life: James R. Kilgore, PhD, PA

To the Editor:

In the June 2007 issue of JAAPA, the PA highlighted in “A Day in the Life” mentioned that “I’m one of those drivers who make you cringe.” Reading of his continuous cell phone usage while commuting, I must comment and encourage this behavior be modified. Not only is cell phone usage while operating a vehicle unsafe and results in many accidents and “near misses,” it is definitely the wrong message to send to the young people and children who witness this behavior.

I have cited some recent references that corroborate the impact of using cellular phones while driving.

Drews F, Siegel L, Strayer D. Drivers on cell phones are as bad as drunks. University of Utah News Center. http://unews.utah.edu/p/?r=062206-1. Accessed June 29, 2007.

Winfield N. Vatican has Ten Commandments for drivers. Associated Press. June 19, 2007. http://news.yahoo.com/s/ap/20070619/ap_on_re_eu/vatican_road_rage. Accessed June 29, 2007.

Lee JD. Technology and teen drivers. J Safety Res. 2007;38(2):203-213. Epub 2007 Mar 26.

Lin CJ, Chen JH. Verbal and cognitive distractors in driving performance while using hands-free phones. Percept Mot Skills. 2006;103(3):803-810.

Nabi H, Rachid Salmi L, Lafont S, et al. Attitudes associated with behavioral predictors of serious road traffic crashes: results from the GAZEL cohort. Inj Prev. 2007;13(1):26-31.

Technology has indeed supplanted common sense in many areas. Let us, as PAs, not perpetuate and participate in the danger.

Charlene M. Morris, MPAS, PA-C
2007 SPAP CME Chair and Treasurer

Author’s response:

For what it is worth, the author uses a hands-free device and encourages the use of such. Please note there are arguments on both sides of the issue.

Cohen JT, Graham JD. A Revised Economic Analysis of Restrictions on the Use of Cell Phones While Driving. Risk Anal. 2003;23(1):5-17.

Quantifying the risks and benefits associated with cell phone use while driving is complicated by substantial uncertainty in the estimates of several important inputs, including the extent to which cell phone use increases a driver’s risk of being involved in a crash, the amount of time drivers spend using cell phones (and hence their aggregate contribution to crashes, injuries, and fatalities), and the incremental value to users of being able to make calls while driving. Two prominent studies that have investigated cell phone use while driving have concluded that the practice should not be banned.

Rick Kilgore, PhD, PA-C