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    Monday, December 28, 2009

    7 REASONS WHY MEDICAL ERRORS OCCUR

    Approximately 100,000 people per year die from medical errors caused by doctors alone. According to Dr. RJ Roberts of the University of Wisconsin Medical School there are 7 reasons why medical errors occur:

    1. Failure to Obtain Informed Consent: This allegation stems from the failure of the physician to ensure the patient is fully informed of expected outcomes, potential risks and reasonable alternatives to the recommended course of action advised by the doctor resulting in damages to the patient.

    2. Cancer Misdiagnosis or Failure to Diagnose or a Delay in Diagnosis: This is especially true of breast cancer patients. Doctors who rely on false negative mammogram studies rather than on patient complaints and following up appropriately may cause harm to the patient and be liable for medical malpractice. Approximately 29 percent of screening mammograms return false negative results.

    3. Physician Malpractice Resulting From Negligent Procedures or Surgical Errors: Physicians do not necessarily have to be performing unfamiliar procedures for such a medical malpractice suit to ensue. Many physicians are sued because they performed procedures they are trained for when the doctor was not alert due to physical exhaustion or mental distraction. In these circumstances, sleep deprivation or mental stress may cause a deficiently performed procedure leading to patient complications.

    4. Wrong Diagnosis and Negligent Misdiagnosis of Fracture or Trauma: This medical malpractice claim occurs when a doctor assumes that a fracture is merely a sprain or other minor injury without follow through investigation with x-rays or other proper diagnostic tests. Dependent on the location of the fracture, this can have severe consequences, including loss of a limb.

    5. Delay in Diagnosis or Failure to Consult in a Timely Manner: A doctor who is sued for failure to consult in a timely manner has hesitated too long before making a referral and the patient has suffered adverse repercussions as a result. Within a reasonable amount of visits to the family doctor, the patient should be referred to a specialist if the family doctor is having difficulty pronouncing a diagnosis or symptoms are not improving or worsening despite treatment.

    6. Medication Errors or Medication Malpractice Resulting From Negligent Drug Treatment: This is the third leading cause of death. Medical error or negligence in prescribing medications may be the cause of 225,000 deaths per year. Lack of patient education about the medications prescribed is a component of negligent drug treatment. Prescription drug malpractice claims can also result from a doctor's poor handwriting on the prescription order and misinterpretation by a pharmacist.

    7. Birth Injury Malpractice or Negligent Maternity Care Practice: The two most common birth defect or birth injury medical malpractice claims arise from excessive use of oxytocin, specifically if the baby is experiencing distress, and the doctor's failure to ensure their patient is covered by another physician informed about the patient's clinical history should the primary doctor be unavailable.

    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    *Tune in later for THE BEST TREATMENT FOR PATIENTS WITH HEART DISEASE AND DIABETES.

    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Monday, December 21, 2009

    THE SIX QUESTIONS:
    A GUIDE TO JUDGING FAVORABLY

    As Jews approach the High Holy days it is useful to remember that the Torah teaches that, whenever we experience or hear about the negative behavior of another person, we must "judge favorably." In simple terms, that means giving the benefit of the doubt. But how can one follow that advice when it seems that the facts clearly point to someone's guilt?

    Sometimes we jump to the wrong conclusion because the facts are different from what we perceive them to be. Even if our facts are accurate, we often misinterpret the intent behind them. When we drop the assumption that there was a negative intention behind someone's actions towards us, we automatically deflate much of the anger and hurt that we feel.

    Here are six possible ways to analyze a situation and jump to a good conclusion:
    1. Are you sure it happened at all? Sometimes our perceptions of what we see and hear are mistaken.

    2. Are you sure the details are correct? One small detail can completely alter the scenario. Something may have been exaggerated or omitted that would make a big difference.

    3. Do you know if the other person intended harm? Often the consequences are unforeseen.

    4. Do you know the assumptions the other person was operating under? Maybe the other person was operating under a misconception that would explain their behavior.

    5. Could the other person's act have been the result of an innocent, human error? Everyone has limitations. Perhaps this person lacked experience, was forgetful, distracted or simply didn't think carefully enough before acting.

    6. Do you know what events preceded the negative action? The other person may be enduring a great deal of pain, frustration or stress. This might be a response to a specific situation, like an illness or financial loss. Or it could be a deeper, more pervasive problem that effects the person's entire life.

    Although the Torah requires us to judge others with favor and compassion, we are not required to accept abusive behavior from others. Physical, verbal or emotional abuse must be addressed and corrected.

    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    *Tune in later for THE SEVEN REASONS WHY MEDICAL ERRORS OCCUR.

    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Monday, December 14, 2009

    Thin Thighs Associated with Increased Risk for Death, Cardiovascular Disease

    Thin Thighs Associated with Increased Risk for Death, Cardiovascular Disease
    Adults with very thin thighs may be at increased risk for cardiovascular disease and death, BMJ reports. Published 3 September 2009, doi:10.1136/bmj.b3292
    Cite this as: BMJ 2009;339:b3292

    Researchers measured thigh circumference in some 2800 men and women, aged 35 to 65, and then followed them for about 10 years to assess incident cardiovascular disease, coronary heart disease (CHD), and mortality.

    In adjusted analyses, a thigh circumference below roughly 24 inches (60 cm) was associated with significantly elevated risk for death and cardiovascular disease (but not CHD), with risk increasing as circumference decreased. While a circumference above 24 inches appeared to be protective, the benefit did not continue to increase with increasing circumference. As a potential underlying mechanism, the authors cite research suggesting that low subcutaneous thigh fat results in poor glucose and lipid metabolism. They and an editorialist call for further research to confirm these findings.

    Participants 1436 men and 1380 women participating in the Danish MONICA project, examined in 1987-8 for height, weight, and thigh, hip, and waist circumference, and body composition by impedance.

    Main outcome measures 10 year incidence of cardiovascular and coronary heart disease and 12.5 years of follow-up for total death.
    Results A small thigh circumference was associated with an increased risk of cardiovascular and coronary heart diseases and total mortality in both men and women. A threshold effect for thigh circumference was evident, with greatly increased risk of premature death below around 60 cm. Above the threshold there seemed to be no additional benefit of having larger thighs in either sex. These findings were independent of abdominal and general obesity, lifestyle, and cardiovascular risk factors such as blood pressure and lipid concentration.

    Conclusion A low thigh circumference seems to be associated with an increased risk of developing heart disease or premature death. The adverse effects of small thighs might be related to too little muscle mass in the region. The measure of thigh circumference might be a relevant anthropometric measure to help general practitioners in early identification of individuals at an increased risk of premature morbidity and mortality. Several studies have shown a U-shaped association between body mass index (BMI) and mortality, suggesting both a high and a low BMI are associated with premature death. More recent data suggest that while the increased risk seen with a high BMI is mirrored by the risk associated with a high body fat mass, the risk observed at low BMI seems more closely linked to the risk associated with low fat free mass than low fat mass. A larger hip circumference relative to BMI and waist circumference seems a strong inverse predictor of both morbidity and mortality. In this context, a recent study suggested that lower body muscle mass is particularly related to the development of type 2 diabetes. Indeed, studies have reported that insulin resistance could be provoked in lower body muscle, such as leg muscle, but not in arm muscle,8 9 suggesting that the size of the lower body muscle might have great relevance for developing type 2 diabetes. These findings are in line with results from a study among patients with chronic obstructive pulmonary disease, a condition characterized by wasting of muscle, particularly of the lower extremities, which found that the cross sectional area of mid-thigh muscle was a far better predictor of mortality than BMI. Lower body fat, however, might also offer cardioprotection through endocrine secretion of various adipokines, such as adiponectine, a peptide with apparent anti-inflammatory properties.

    DISCUSSION
    The asuthors found independent inverse associations between thigh circumference and total death and morbidity from cardiovascular disease in both men and women that were particularly evident when thigh circumference was below a threshold of around 60 cm. Above this threshold there did not seem to be any further benefit of having larger thighs. The increased risk associated with smaller thigh circumferences was seen independently of percentage body fat mass and height or of waist circumference and BMI for all end points, suggesting that for any given degree of general and abdominal obesity, smaller thighs are a disadvantage to health and survival for both sexes. Further analyses with adjustment for systolic blood pressure, total cholesterol and triglyceride concentrations, and alcohol weakened the associations only slightly, and suggested that associations between thigh size and the end points were not mediated by differences in these variables. Some power was lost, however, by the inclusion of more covariates and the associations between thigh circumference and particularly coronary heart disease did not remain significant. Their analyses indicated that associations were independent of heavy smoking as measured by pack years, and associations seemed to be stronger for smokers than for never smokers, but this difference was not significant, probably because of too few end points in the two groups of the stratified analysis.

    SUMMARY
    Low BMI and low fat free mass are associated with early mortality
    High BMI, waist circumference, waist to hip ratio, and low hip circumference are also associated with early mortality
    Among both men and women, smaller thighs were associated with increased risk of cardiovascular disease and total mortality
    A threshold effect for smaller thigh circumference was seen at around 60 cm; above this threshold the protective effect of having larger thighs carried no further survival advantage
    A focus on thigh circumference might help medical providers identify individuals who are at increased risk of early morbidity and mortality


    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

    *Tune in later for THE SIX QUESTIONS: A GUIDE TO JUDGING FAVORABLY.

    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Monday, December 7, 2009

    WHAT IS GERD?

    WHAT IS GERD?
    Acid reflux [GASTRO-ESOPHAGEAL REFLUX DISORDER]occurs when the lower esophageal sphincter (LES) muscle allows the stomach's contents to splash back into the esophagus, resulting in painful heartburn, chest pain, coughing or choking while lying down, or increased asthma symptoms while sleeping. Eating too much at one time, too much acid in the stomach, or food remaining in the stomach for too long a time can all prevent this muscle from doing what it is supposed to. Ideally, food should move smoothly and relatively quickly through the stomach and on to the lower digestive tract.

    WHAT FOODS TO AVOID?
    Foods that can increase acid production include coffee (caffeinated and decaffeinated), chocolate, soft drinks and cocoa. Acidic foods that should be avoided include citrus fruits and juices (orange, lemon, grapefruit), cranberry juice, lemonade, pineapple, tomatoes and tomato products (spaghetti sauce, salsa, soup).
    Other foods that can cause heartburn are those high in fat, such as french fries, ground beef (chuck), marbled steak, chicken nuggets, buffalo wings, sour cream, milkshakes, ice cream, regular cottage cheese, macaroni and cheese, doughnuts, corn chips, regular potato chips, brownies, butter cookies, mayonnaise, butter, margarine, creamy sauces, salad dressing and whole-milk dairy products.
    Raw onions and spicy foods can cause heartburn and alcohol relaxes the LES muscle causing it to allow acid reflux.
    Avoid when possible processed foods, white sugar, white flour and wheat, which can produce an acidic reaction. Healthcentral.com suggests that wheat, a known allergen, may be the sole cause of some acid reflux and that eliminating gluten from your diet might be all that is necessary to stop acid reflux.

    LOW-RISK FOODS
    Foods that carry little risk of causing heartburn include apples (juice, dried and fresh), bananas, baked potato, broccoli, cabbage, carrots, green beans, peas, extra lean ground beef, London broil, skinless chicken breast, egg whites, egg substitute, fish prepared with no additional fat, feta or goat cheese, fat-free cream cheese and sour cream, low-fat soy cheese, multi-grain or white bread, bran cereal or oatmeal, corn bread, graham crackers, pretzels, brown or white rice, rice cakes, mineral water, low-fat salad dressing, fat-free cookies, jelly beans, red licorice, angel food cake, baked potato chips.

    WORTH TRYING
    These foods may require some experimentation, but may be tolerated in moderate amounts by some GERD patients: low-acid orange juice, peaches, blueberries, raspberries, strawberries, grapes and dried cranberries, garlic, cooked onion, leeks, chicken salad, eggs scrambled in butter, fried eggs, tuna salad, beef or pork hot dogs, ham, yogurt, 2-percent or skim milk, frozen yogurt, cheddar or mozzarella cheese, garlic bread, granola, non-alcoholic wine or beer, root beer, small amounts of ketchup.
    Complex carbohydrates, whole grains and starchy vegetables, including sweet potatoes and plantains, are not only gentle on the stomach, but also help control excess stomach acid. Among the best whole grains for long-term acid reflux reduction are millet, couscous and amaranth, all of which are considered alkaline.

    MORE TIPS
    Eating five or six small meals per day instead of three large ones prevents the stomach from becoming too full.
    Putting your fork down between bites will prevent you from eating too much too fast.
    After dinner, chewing gum stimulates saliva production which can help neutralize stomach acid and increase peristalsis, the contractions and relaxation of muscles along the digestive tract that helps move stomach contents along the digestive system.
    Drinking a glass of lukewarm water or herbal tea after a meal can dilute and flush out stomach acid.
    An after-dinner cigarette, cigar or pipe can cause problems by weakening the LES muscle.

    WEB SITES
    www.heartburn.about.com/library/bl_samplemenu_charts.html.
    http://www.drgourmet.com/gerd

    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    *Tune in later for Thin Thighs Associated with Increased Risk for Death.

    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com