Dr. Perry Hookman

Cancer Incidence And Mortality Continue To Decline

2011-12-29T07:51:00.000-05:00

Cancer incidence and mortality continue to decline, with the most dramatic decreases in lung, prostate, and colorectal cancers among men, and breast and colorectal cancers in women, according to the latest national report card.

"Overall cancer incidence rates for all racial/ethnic groups combined decreased by 0.7% per year during 1999-2006 for both sexes combined, by 1.3% per year during 2000-2006 for men, and by 0.5% per year during 1998-2006 for women," authors from the American Cancer Society, the CDC, the National Cancer Institute, and the North American Association of Central Cancer Registries concluded. The report, was published online in the ACS journal, Cancer.

There has been a decline in cancer death rates since the early 1990s and that trend appears to be durable.The decreases were slightly larger for men, who had declines of 1.5% per year during 1993-2001 and 2.0% per year during 2001-2006 compared with women, whose cancer death rates declined 0.8% per year during 1994-2002 and 1.5% per year during 2002-2006," the authors wrote.

But the news was not all good. As men saw decreased rates of prostate, lung, oral, stomach, brain, and colorectal cancers, there was a concurrent increase in the cancers of the kidney, renal, liver, and esophagus -- as well as increases in leukemia, myeloma, and melanoma of the skin.

For women the story was similar -- decreased rates of breast, colorectal, ovarian, cervical, uterine corpus, and oral cancers, but an uptick in lung, thyroid, pancreas, bladder, and kidney cancers, as well as increases in non-Hodgkin lymphoma, melanoma, and leukemia.

Colorectal cancer [CRC] is a focus of this year's report, not a surprising choice because the news here is good: "CRC death rates have declined since 1984 in both men and women, with an accelerated rate of decline since 2002 (for men) and 2001 (for women)."

And a "microsimulation model" suggests that death rates from colorectal cancer could be reduced by 36% over the next decade if "1995-2000 trends for risk factor prevalence, screening, and treatment continue."But the authors point out that increased obesity among younger Americans could derail this trend.

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.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com
For more health info and links visit the author's web site www.hookman.com

Americans living longer than ever

2011-12-15T07:48:00.001-05:00

Americans living longer than ever. And every year that gets tacked on to the average life expectancy costs an extra trillion dollars in expenditures by Social Security and Medicare.

Americans are living a record 77 years and 11 months on average...according to two studies that led researchers to suggest raising the retirement age." The first study, from the CDC's National Center for Health Statistics, found that in the "US in 2007, the latest year for which figures are available," the "0.76 percent death rate is the lowest ever," driven by "a decline in deaths from heart disease and other ailments." Meanwhile, a second study published Dec. 14 in the health journal Milbank Quarterly, found that "every year that gets tacked on to the average life expectancy costs an extra trillion dollars in expenditures by Social Security and Medicare."

Overall, the 2007 data "show continued improvements in life expectancy for all Americans, although women are faring better than men, and whites fare better than other racial groups" by a "race differential" of about "4.6 years." But, even amid this progress, vast geographical discrepancies remain -- with people in southern states still facing higher death rates than those living in other parts of the country." And, "even though Americans can expect to live longer than their parents, life expectancy in the" US "is still lower than in many other industrialized countries, including Canada and Japan. Even so, the "dramatic improvements in the health of Americans over the last 20 years" will "have unforeseen effects on the country. The Social Security and Medicare "programs weren't designed to support people for that long."

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.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com
For more health info and links visit the author's web site www.hookman.com

Maternal Use of Sertaline, Citalopram Linked to Septal Heart Defects in Offspring

2011-11-30T07:28:00.000-05:00

Women who use the antidepressants sertraline (Zoloft) or citalopram (Celexa) early in pregnancy face increased risk for septal heart defects in their offspring, BMJ reports online.

Researchers examined data on more than 490,000 infants born in Denmark between 1996 and 2003. They found that women who filled prescriptions for sertraline and citalopram (but not other SSRIs) during their first trimester were significantly more likely to have children with septal heart defects (but not other malformations) than those who didn't use SSRIs (odds ratios: 3.2 and 2.5, respectively).
The authors and an editorialist (both with ties to SSRI manufacturers) note that the absolute risks for septal heart defects were low: 0.9% in children exposed to at least one SSRI and 2.1% in those exposed to more than one.
The editorialist concludes: "Clinicians and patients need to balance the small risks associated with SSRIs against those associated with undertreatment or no treatment."

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.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com
For more health info and links visit the author's web site www.hookman.com

Patient Balance Problems

2011-11-15T07:30:00.000-05:00

Millions of people may suffer from inner-ear disorders that affect their balance but not be aware that they have a problem, a new study has found.Writing in The Archives of Internal Medicine, researchers noted the connection between balance problems and falls, especially among the elderly. The findings of the study, they said, suggest that doctors should make balance tests a routine part of checkups. This is especially true in nursing and assisted-living homes, they said.

“The big deal here really is falls,” the lead author, Dr. Yuri Agrawal of Johns Hopkins, said in an e-mail message, adding that a serious fall can be the beginning of the end for an older patient.The researchers drew on data from a federal study in which more than 5,000 people age 40 and over were surveyed about their history of falls and balance problems. They were then given examinations to determine how well they could maintain their balance in a variety of situations, including with their eyes closed.

More than a third of the subjects, the researchers found, had the balance disorder known as vestibular dysfunction — a figure that would translate to 69 million Americans.They also found that 32 percent of the volunteers who did not report problems with dizziness showed evidence of balance problems. Though they did not experience symptoms, they were still at higher risk for falls, the study said.
For doctors, Dr. Agrawal said, detecting balance problems in a patient is not very complicated. And treatment is available, including exercises that help people compensate for inner-ear problems that lead to poor balance.The cost of the treatment, they said, would most likely be less than medical costs associated with falls.

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.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com
For more health info and links visit the author's web site www.hookman.com

Banned Herbal Ingredient Linked to Urinary Tract Cancer

2011-10-30T08:31:00.000-04:00

Natural does not equal safe, and any herb strong enough to have a potential benefit is strong enough to have potential to cause harm."
Exposure to aristolochic acid, found in some Chinese herbal products such as Mu Tong and Fangchi, significantly increased the risk for urinary tract cancer, according to a retrospective study.Researchers in Taiwan found prescription of more than 60 grams of Mu Tong and consumption of more than 150 mg aristolochic acid were independently associated with an increased risk for urinary tract cancer.

• Mu Tong, 61 to 100 g: OR 1.6, 95% CI 1.3 to 2.1
• Mu Tong, >200 g: OR 2.1, 95% CI 1.3 to 3.4
• Aristolochic acid, 151 to 250 mg: OR 1.4, 95% CI 1.1 to 1.8
• Aristolochic acid, >500 mg: OR 2.0, 95% CI 1.4 to 2.9

Used in Chinese herbal preparations taken for weight loss or urinary tract infections, aristolochic acid has been banned in several countries, including in Taiwan and in the U.S.The latest study found a linear, dose-dependent relationship between the amount of aristolochic acid consumed and an increased risk for urinary tract cancer (P<0.001). This was independent of arsenic exposure through drinking water, which has also been associated with bladder and urinary tract cancers.Among the more than 4,000 patients analyzed, 57% had bladder cancer and 43% had upper urinary tract cancer.
The International Agency for Research on Cancer has classified herbal remedies containing high concentrations of aristolochic acid as carcinogenic. Traces of aristolochic acid may still be found in adulterated remedies currently on the market.
Wang, et al "Population-based case-control study of chinese herbal products containing aristolochic acid and urinary tract cancer risk" J Nat Can Inst 2009; DOI:10.1093/jnci/djp467.

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.

2011-10-18T06:13:00.000-04:00

About 2 million older adults undergo abdominal surgeries in the U.S. every year, a number that's expected to grow as the proportion of older adults increases rapidly: by 2020, one in six adults is expected to be older than 65, and 15% will be over 85.
The patient records came from the Comprehensive Hospital Abstract Reporting System, a state-wide database that contains information on the age, sex, zip code, and billed charges of patients, as well as the codes for their diagnosis and procedures.
The study focused on complications that occurred within 90 days of discharge and deaths within 90 days of hospital admission.

After adjusting for various factors, including hospital volume and patient characteristics, the study found that the odds of early death after abdominal surgery increased considerably for each five-year increase in age beyond 65. These associations held for patients with cancer and other diagnoses, and for both elective and nonelective procedures (P<0.001).

The likelihood of complications increased as patients aged beyond 65 years, with the researchers finding the following associations between age and complication frequency (trend test, P<0.001):

• 65 to 69 years, 14.6%
• 70 to 74 years, 16.1%
• 75 to 79 years, 18.8%
• 80 to 84 years, 19.9%
• 85 to 89 years, 22.6%
• 90 and older, 22.7%

Similarly, older patients were at higher risk of mortality. Death rates by age group were (trend test, P<0.001):

• 65 to 69 years, 2.5%
• 70 to 74 years, 3.8%
• 75 to 79 years, 6.0%
• 80 to 84 years, 8.1%
• 85 to 89 years, 12.6%
• 90 and older, 16.7%

Massarweh N, et al "Impact of advancing age on abdominal surgical outcomes" Arch Surg 2009; 144: 1108-14.

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.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com
For more health info and links visit the author's web site www.hookman.com

Certain dietary supplements Selenium and Omega-3s may reduce colorectal cancer risk

2011-09-26T08:34:00.001-04:00

Certain dietary supplements appear to affect the development of colorectal cancer or its recurrence," according to two new studies presented during a medical conference. In one, "researchers from the US National Institute for Environmental Health Sciences found that eating a diet high in omega-3 fatty acids cut the risk of developing colorectal cancer by nearly 40 percent. In the other study, from cancer researchers in Italy, consumption of a dietary supplement containing selenium was found to reduce the chances of having polyps recur by a similar amount."

In one study, researchers from the U.S. National Institute for Environmental Health Sciences found that eating a diet high in omega-3 fatty acids cut the risk of developing colorectal cancer by nearly 40 percent. In the other study, from cancer researchers in Italy, consumption of a dietary supplement containing selenium was found to reduce the chances of having polyps recur by a similar amount.

In the selenium study, 411 people, 25 to 75 years old, who'd had one or more colorectal polyps removed took either a supplement or a placebo. The supplement, described as an antioxidant compound, contained 200 micrograms of selenomethionnine (a combination of selenium and methionnine), 30 milligrams of zinc, 6,000 international units of vitamin A, 180 milligrams of vitamin C and 30 milligrams of vitamin E.

Participants had a colonoscopy one year, three years and five years after starting the regimen.

The researchers estimated that, after 15 years, about 48 percent of those taking the supplement were free of polyps, versus about 30 percent of those not taking the supplement.

Among the white participants, those whose diets were in the highest fourth of omega-3 fatty acid consumption were 39 percent less likely to have colorectal cancer than those in the lowest fourth. However, for reasons the authors said they did not know, no association was noted between omega-3s and a reduction of colorectal cancer risk among black participants. The disease occurs at a higher rate among blacks than whites.
"Our finding clearly supports the evidence from previous experimental and clinical studies showing that long-chain omega-3 fatty acids inhibit tumor growth," said the study's lead author, Sangmi Kim, a postdoctoral fellow at the U.S. National Institute of Environmental Health Sciences in Research Triangle Park, N.C.

Kim said the research supports boosting omega-3 intake through diet or perhaps by taking an omega-3 supplement. Omega-3 fatty acids are found in fish, especially oily fish such as salmon, mackerel, herring, anchovies, sardines and tuna. Plant-based sources include flax and flaxseed oil, Brussels sprouts, soybeans and soybean oil, canola oil, spinach, walnuts and kiwi.

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.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com
For more health info and links visit the author's web site www.hookman.com

HOW TO LOWER PROSTATE CANCER RISK

2011-09-02T08:33:00.001-04:00

Harvard scientists have discovered that "drinking coffee may lower the risk of developing the deadliest form of prostate cancer." In fact, "the five percent of" study participants "who drank six or more cups a day had a 60 percent lower risk of developing the advanced form of the disease than those who didn't consume any."."

A Frontiers in Cancer Prevention Research conference" also touched on the "role that exercise...could play in the fight against prostate cancer. An analysis of activity levels among 2,686 prostate cancer patients showed that men who jogged, played tennis, or participated in other comparable exercise for an average of three or more hours per week had 35% lower mortality rates than those who exercised less frequently or not at all." As for walking, those who did so "for four or more hours per week" had "overall mortality rates [that] were 23% lower than those of men who walked for fewer than 20 minutes per week."

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.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com
For more health info and links visit the author's web site www.hookman.com

Autism increases in the US

2011-08-21T07:51:00.000-04:00

Almost one percent of American children had an autism spectrum disorder (ASD) in a large CDC surveillance study whose lead author called the condition a "significant public health issue."

Across 11 sites in the U.S., ASD prevalence in 2006 ranged from about one out of 80 children to one out of every 240 children, with an overall prevalence of one in 111 youngsters, according to a report by investigators from the CDC's Autism and Developmental Disorders Monitoring (ADDM) Network.

Among 10 ADDM sites that reported data in both 2002 and 2006, there was an average 57% increase in ASD prevalence. No single factor could explain the rise, researchers said. Overall ASD prevalence was 4.5 times higher in boys than in girls: about one in every 70 boys and one in every 315 girls.

From 2002 to 2006, prevalence increased 60% in boys and 48% in girls (P<0.001 for both).
The American Academy of Pediatrics has recommended that all children be screened for autism when they are 18 and 24 months old which is especially important, as early recognition and treatment improves outcomes.

ASD diagnosis was made at a slightly younger age in 2006 than in 2002, but it was still delayed to an average age of 53 months. That was so despite the fact that anywhere from 70% to 95% of children had developmental concerns noted in their records before age 3.

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.

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

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

Cluster Headaches

2011-08-08T08:48:00.000-04:00

Concerned about recent overdoses of radiation in CT perfusion scans, an FDA official urged imaging practitioners to go "back to basics" when they're performing the scans.
The advice comes after more than 250 patients in two states were exposed to excess radiation during CT perfusion brain scans.

"Until we get through whether we're dealing with errors that people are making (or) whether these are problems with the CT scanners themselves, we're saying go back to basics," said Jeffrey Shuren, MD, acting director of the FDA's Center for Devices and Radiological Health.

Shuren and colleagues released a set of interim recommendations while the agency continues to investigate cases of overexposure reported in California and Alabama.
They include:

• Imaging facilities should review their radiation dosing protocols for all CT perfusion studies to ensure that dosing is correct for each study.

• They should implement quality control procedures to ensure that protocols are followed and correct radiation is used.

• For each patient, technologists should check the CT scanner displays to make sure the radiation to be delivered is appropriate.

• If more than one study is performed during one session, practitioners should adjust the radiation dose so it is appropriate for each study.
The agency also urged imaging facilities to check whether any patients who underwent CT perfusion scans have received excess radiation.

"We're reminding (practitioners) of good practices that they should be employing routinely," said Charles Finder, MD, also of the agency's Center for Devices and Radiological Health.

The issue arose when the FDA was told of more than 200 cases of excess radiation delivered during CT perfusion brain scans at Cedars-Sinai Medical center in Los Angeles. (See CT Safety Warnings Follow Radiation Overdose Accident)
Since then, the agency has received reports of 14 cases at Glendale Adventist Medical Center, also in Los Angeles, as well as an undetermined number of cases at St. Joseph's Medical Center in Burbank, Calif., according to Simon Choi, PhD, also of the Center for Devices and Radiological Health.

Choi said the the agency is investigating reports in Alabama, too, but he did not give numbers or the name of the facility involved.

The agency said scanners made by two manufacturers, GE and Toshiba, are involved in the incidents.
Affected patients had redness of the skin and some hair loss, but potential long-term consequences include an increased risk of cancer and cataracts, Finder said.
The standard radiation dose for a CT perfusion scan is between 0.5 and 1.0 Gray, but it was reported that some patients at Cedars-Sinai got as much as 3.0 or 4.0 Gray.
According to a statement from the hospital, "there was a misunderstanding about an embedded default setting applied by the machine."

The recommendations apply to all CT perfusion imaging, since the methods involved are the same as for brain perfusion scans, the FDA said.

While the agency is probing cases in the two states, Shuren said, "we would not be surprised to find there are similar occurrences in other states."

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.

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

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

Good News & Bad News

2011-07-20T14:17:00.001-04:00

NIH Report Finds Cancer Incidence Has Declined.
A report by the NIH found that "the incidence in men of cancers of the prostate, lung, oral cavity, stomach, brain, colon and rectum has declined." However, "rates in men continue to rise for kidney/renal, liver, and esophageal cancer, as well as for leukemia, myeloma and melanoma," the agency said.

Heavy Margarines May Be Increasing Their Risk Of A Painful Inflammatory Bowel Disease,

People who eat lots of red meat, cook with certain types of oil, and use some kinds of polyunsaturated fatty acid (PUFA)-heavy margarines may be increasing their risk of a painful inflammatory bowel disease, a study in more than 200,000 Europeans shows.
These foods are high in linoleic acid and the study have found that people who were the heaviest consumers of this omega-6 PUFA were more than twice as likely to develop ulcerative colitis as those who consumed the least.

But eating more eicosapentaenoic acid, an omega-3 fatty acid found in fish and fish oils, was associated with a lower risk of the disease.

To investigate the role of fatty acids and ulcerative colitis, a life-long disease characterized by inflammation of the lining of the large intestine, investigators analyzed the problem. Their analysis included 203,193 men and women 30 to 74 years old. During follow-up, which ranged from about 2 to 11 years, 126 people developed ulcerative colitis.

People in the top quartile of linoleic acid intake (they were consuming around 13 to 38 grams a day) were 2.5 times more likely to have developed the disease than people who consumed the least, about 2 to 8 grams daily.

While a Western-style, red-meat-heavy diet is high in this fatty acid and low in omega-3s, a more Mediterranean style eating pattern -- with plenty of fruits and vegetables, fish, and nut oils -- would be low in linoleic acid and high in omega-3.
It is estimated that if omega-3s do help prevent ulcerative colitis, eating a couple of servings of fish a week would probably be protective.

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.

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

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

High coffee, tea intake may reduce chances of developing type 2 diabetes.

2011-07-15T07:12:00.000-04:00

According to a study spublished in the Archives of Internal Medicine, "drinking four cups of coffee, decaf, or tea daily can reduce the chances of getting type 2 diabetes by about 25 percent to 35 percent." Harvard University "researchers reviewed 18 studies of almost 500,000 people" and discovered that "for each cup of coffee people drank, their likelihood of getting diabetes dropped by seven percent."

"Even better results were found for bigger coffee and tea consumers -- drinking three to four cups a day was associated with about a 25% reduced diabetes risk, compared with those who drank between none and two cups day.. In addition, investigators found "positive results with decaf coffee and tea." Specifically, those "who drank more than three to four cups of decaf a day had about a one-third lower risk than those who didn't drink any," while "tea drinkers who consumed more than three to four cups a day had about a one-fifth lower diabetes risk than non-tea drinkers."

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.

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

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

Osteoporosis prevention and nutrition

2011-06-27T07:12:00.000-04:00

Although calcium and vitamin D have been the primary focus of nutritional prevention of osteoporosis, recent research has clarified the importance of several additional nutrients and food constituents. Further, results of calcium and vitamin D supplementation trials have been inconsistent, suggesting that reliance on this intervention may be inadequate. In addition to dairy, fruit and vegetable intake has emerged as an important modifiable protective factor for bone health. Several nutrients, including magnesium, potassium, vitamin C, vitamin K, several B vitamins, and carotenoids, have been shown to be more important than previously realized.

Rather than having a negative effect on bone, protein intake appears to benefit bone status, particularly in older adults. Regular intake of cola beverages shows negative effects and moderate alcohol intake shows positive effects on bone, particularly in older women. Current research on diet and bone status supports encouragement of balanced diets with plenty of fruit and vegetables, adequate dairy and other protein foods, and limitation of foods with low nutrient density.

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.

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

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

Radiation overexposure from CT scans may be more widespread than previously estimated.

2011-06-15T19:07:00.000-04:00

The problem of too much radiation during CT scans may be more widespread than anyone thought." In fact, "new research...found a wide variation in radiation dose for the most common CT scan like abdomen, pelvis, and chest. A survey of four hospitals found some patients received 13 times more radiation than others for the same type of scan." "Depending on the part of the body being scanned, each CT exposes a patient to an amount of radiation equal to between 30 and 440 chest X-rays." But, in a separate study, "researchers calculated that 72 million CT scans are performed in this country a year and concluded that could lead to 29,000 excess cancers and 15,000 excess deaths a year in the future." In that study, published in the Archives of Internal Medicine, researchers at the National Cancer Institute "found that people may be exposed to up to four times as much radiation as estimated by earlier studies.

Meanwhile, the second study, appearing in the same journal, of over 1,000 patients at four hospitals, showed that one woman out of 270 and one man out of 600 would suffer from cancer after undergoing a single heart scan at age 40. Researchers noted that the differences in radiation doses may be due to a lack of standardized settings and disparities in technology use.

Ian accompanying editorial, it was noted that "the articles...make clear that there is far more radiation from medical CT scans than has been recognized previously because even many otherwise healthy patients are being subjected to the radiation...because emergency [departments] are often sending patients to the CT scanner before they see a doctor."

The authors predicted that lung cancer will be the most common radiation-related cancer followed by colon cancer and leukemia." For its part, the FDA "issued interim regulations requiring closer monitoring of CT scans after more than 250 cases of exposure to excess radiation were reported since October."

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.

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

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

Americans living longer than ever

2011-05-14T08:23:00.000-04:00

Americans are living a record 77 years and 11 months on average...according to two studies that led researchers to suggest raising the retirement age." The first study, from the CDC's National Center for Health Statistics, found that in the "US in 2007, the latest year for which figures are available," the "0.76 percent death rate is the lowest ever," driven by "a decline in deaths from heart disease and other ailments." Meanwhile, a second study published Dec. 14 in the health journal Milbank Quarterly, found that "every year that gets tacked on to the average life expectancy costs an extra trillion dollars in expenditures by Social Security and Medicare."
Overall, the 2007 data "show continued improvements in life expectancy for all Americans, although women are faring better than men, and whites fare better than other racial groups" by a "race differential" of about "4.6 years." But, even amid this progress, vast geographical discrepancies remain -- with people in southern states still facing higher death rates than those living in other parts of the country."
And, "even though Americans can expect to live longer than their parents, life expectancy in the" US "is still lower than in many other industrialized countries, including Canada and Japan. Even so, the "dramatic improvements in the health of Americans over the last 20 years" will "have unforeseen effects on the country. The Social Security and Medicare "programs weren't designed to support people for that long."

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.

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

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

Concerned About Switching From A Brand Name To A Generic?

2011-04-23T07:16:00.000-04:00

For many people, generic drugs work very well. But if you are concerned about switching from a brand name to a generic, or among different generics, then you need to keep tabs on your meds and how they are affecting you.
Here’s some guidance:

1. KEEP THE PACKAGING If you take a generic medication or are switched to one, keep the label.
Most state laws require that the manufacturer’s name be on the label, according to Kathleen Jaeger, chief executive of the Generic Pharmaceutical Association.
If the label does not state the name of the maker, ask your pharmacist to add it or write it down for you. You can also look up the pill at Drugs.com or RxList.com (click on pill identifier) to find the maker.

2. KEEP A DIARY Or at least make notes about any side effects you experience when taking a new drug.
Generic drugs are allowed to contain different inactive ingredients from the brand drug — like flavors, fillers and dyes — which could potentially cause side effects.

3. BE CHOOSY If one generic version works better than another, shop around for it.
“Don’t assume your pharmacist will continue to carry a specific product indefinitely,” said Joe Graedon, who runs a consumer advocacy Web site, the People’s Pharmacy (peoplespharmacy.com). “Call ahead and ask.”

4. ENLIST YOUR DOCTOR If you are convinced that only the brand name of a drug works for you, discuss the issue with your doctor.
You can ask him or her to write “DAW” — dispense as written — on your prescription. This will usually ensure that the pharmacist gives you exactly what the doctor ordered.
If your insurer balks, ask your doctor to make a phone call for you or write a letter explaining why only the brand name is appropriate for you. Sometimes this actually works.

5. REPORT PROBLEMS If you do have side effects or reactions to a specific drug, tell your doctor and then report it to the Food and Drug Administration’s MedWatch Web site and post a message on the People’s Pharmacy Web site.
If enough people complain about a specific medication, there’s a good chance the F.D.A. or an independent group will investigate it.

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.

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

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

DANGEROUS SIDE EFFECTS OF OSTEOPOROSIS DRUGS

2011-04-15T07:13:00.000-04:00

The FDA sent out a nationwide announcement about "the potential side effects of osteoporosis drugs like Fosamax [alendronate]." the agency "said in their announcement...physicians need to watch for the possibility of possible risk of femur fractures. And this didn't just apply to Fosamax, this applied to all four drugs that are in this group Fosamax, Actonel [risedronate], Boniva [ibandronate], and Reclast [zoledronic acid]."

Studies show the bones of some post-menopausal women who take bisphosphonates...to ward off osteoporosis can stop rejuvenating and become brittle after long-term use." Researchers found that "the drugs are effective initially in slowing bone loss," but "the quality of the bone diminished after long-tern bisphosphonate use." A separate study indicated that "bone densitometry (DXA) scans show a buckling potential in the femur area of the hip in patients being treated for osteoporosis with bisphosphonates."

The FDA is now examining whether long-term use of the drugs increases the risk of atypical subtrochanteric femur fractures, but so far, the agency said the data it "has reviewed have not shown a clear connection."

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.

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

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

DANGEROUS SIDE EFFECTS OF OSTEOPOROSIS DRUGS

2011-03-21T08:39:00.001-04:00

Medical Malpractice Is Frequent On TV

2011-03-05T08:37:00.000-05:00

According to the American Academy of Neurology Television dramas are potentially a powerful method of educating the public so it is a concern to find that TV shows inaccurate showed seizure management which would qualify for medical malpractice. Medical malpractice is rife on the television medical shows with specifically nearly half of TV doctors and nurses committing seizure management errors. Researchers screened the popular medical dramas Grey's Anatomy, House, Private Practice and ER to see if TV medical dramas were helping to educate the public about first aid and seizures. The study found inappropriate practices occurred in 25 cases, or nearly 46 per cent of the incidents.

The researchers found in 327 episodes screened, 59 seizures occurred. Fifty-one seizures took place in a hospital. Nearly all first aid was performed by nurses or doctors.

"People with epilepsy should lobby the television industry to adhere to guidelines for first aid management of seizures," the study’s lead author said.

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.

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

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

RISKY HUMAN GROWTH HORMONE USE

2011-02-28T07:44:00.000-05:00

H.G.H. is among the drugs prescribed some doctors to athletes.

The United States, however, determined that potential harm from H.G.H. is so great that federal law puts it in an unusual category of drugs that doctors cannot prescribe for unapproved, or off-label, uses. (No such ban exists in Canada.)

Its approved uses are not conditions common among professional athletes: it can be used in children with severe growth problems, H.I.V. patients may receive it if they have muscle wasting, and it can be prescribed to offset exceptional weight loss in people who have had much of their small intestine surgically removed.

Physicians and medical researchers who have studied people with medical conditions that lead to growth hormone overproduction said that available evidence suggested that athletes who cheat by using costly" human growth hormone (HGH) as a performance-enhancing drug may "simply wind up" exposing themselves to "cardiovascular problems, an increased risk of diabetes, arthritis, carpal tunnel syndrome, glucose intolerance, colon polyps, skin growths, excessive sweating," and "serious headaches," as well as "abnormal bone growth in the face, head, hands, and feet," and possibly even cancer.

Growth hormone does not act directly. Instead it prompts the body to produce insulin-like growth factor 1, or I.G.F.-1, which then triggers growth. The overwhelming majority of I.G.F.-1 is produced by the liver and delivered through the blood stream. Evidence shows, however, that growth hormone can prompt local I.G.F.-1 production in other cells of the body

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.

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

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

Stuttering may have "strong" genetic component

2011-02-20T07:57:00.000-05:00

While environmental factors and stress can play roles in stuttering, new research provides further evidence of a strong genetic component." Led by geneticist Dennis Drayna, PhD, at the National Institute on Deafness and Other Communication Disorders and reporting in the New England Journal of Medicine, researchers "have discovered the first genes linked to stuttering -- a complex of three mutated genes that may be responsible for one in every 11 stuttering cases, especially in people of Asian descent." "The takeaway message of this is stuttering is not a social or emotional disorder. ... It is not the fault of a bad parent, or unwilling child. It is a serious disorder and worthy of treatment."

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.

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

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

Hospitals Continue To Leave Foreign Objects Inside Patients

2011-02-04T07:52:00.001-05:00

"Utah hospitals continue to mistakenly leave equipment such as sponges inside patients -- many of them women undergoing obstetrical or gynecological surgeries," according to data "on 'sentinel events'" released by the Utah state health department and the state hospital association. Notably, "out of 101 sentinel events reported in 2009 -- up from 80 reported in 2008 -- 58 were related to surgery," which "could include performing the wrong surgery on the wrong patient, death during surgery, and retention of foreign objects." Sponges -- large pieces of gauze used to stop or absorb bleeding -- are the most common items left inside patients because they can be hard to spot after surgery."

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.

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

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

Stuttering may have "strong" genetic component

2011-01-29T07:27:00.000-05:00

Zinc supplements cause problems

2011-01-20T07:25:00.000-05:00

With at least two flus and plenty of colds, coughs and sore throats circulating this season, some Americans are turning to zinc to ward off viruses.

Lozenges, supplements and nasal sprays that contain the mineral claim to boost immunity, and there is some evidence that they might do so. In an effort to stay well, though, we might be making ourselves sick. Lozenges, supplements, and nasal sprays that contain" zinc "claim to boost immunity, and some doctors have prescribed supplements containing "80 milligrams of zinc" for age-related macular degeneration (AMD) patients to stave off blindness. However, according to a 2007 study published in the journal Experimental Eye Research, zinc "builds up in the back of the retina in people with macular degeneration and that "people who take these extra-large" zinc "supplements for years are 50% more likely to end up in the hospital with urinary tract problems."

Also excessive amounts of zinc, according to early evidence, could lead to learning and memory problems, nerve damage, urinary tract problems and other negative effects.

With supplements that provide many times the recommended daily intake, cold medicines that are loaded with zinc and an abundance of fortified foods -- on top of the zinc already in a healthy diet -- overdoing it might be easier than you think.
Where can zinc be found?

There are more than 75 milligrams of zinc in six oysters, nearly 9 milligrams in a 3-ounce serving of cooked beef shanks, more than 3 milligrams in a cup of baked beans, 15 milligrams in a cup of some fortified cereals and 15 milligrams in many multivitamins.

All that zinc adds up. Studies show that consuming at least 50 milligrams a day for a few months could lead to copper deficiency, which can cause anemia, bone loss, nerve damage and other problems. Taking in 80 or 100 milligrams or more for months or even years can cause bigger problems, some irreversible. A typical, over-the-counter zinc supplement contains 50 milligrams. There are 13 milligrams in one popular brand of zinc lozenges.

Zinc, copper and iron are all found in the plaque that builds up in brains of Alzheimer's patients. And while researchers try to figure out what that means, data suggest that removing zinc from the brain slows mental decline.

Denture cream

Zinc raised other alarms last year, when researchers began to notice weakness, balance and memory issues and other neurological trouble in some patients. Sleuthing revealed the only common link: All of the patients used large amounts of denture cream enhanced with zinc.

Patients in the study,had been using up to two tubes a week of Poligrip or Fixodent creams for many months or even years.
Zinc concentrations ranged from 17 to 34 milligrams per gram of denture cream, testing showed. That means that some people were exposed to as much as 330 milligrams of zinc a day, Packages of Super Poligrip now include inserts telling people to talk to their doctors if also taking zinc supplements and to use the products as directed.

Nasal sprays

Researchers recommend avoiding nasal sprays containing zinc, as well. An October study in the journal PLoS One found that the Zicam brand of homeopathic zinc-enriched nasal spray caused long-term damage to the sense of smell in mice and signs of nasal nerve damage in people.

When it comes to supplements, sucking on zinc lozenges as soon as you get a cold may help and probably won't hurt, experts say, as long as you don't suck on them all day every day for the entire flu season. A week should be fine.

Some promising research is also starting to suggest that a tiny bit of copper supplementation can help override the dangers of getting too much zinc. In the meantime, experts suggest staying well the old-fashioned way: Eat a healthy diet, and stop staying up so late.

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.

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

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

10 Tips on Dietary Fiber

2011-01-11T07:11:00.000-05:00

10 Tips on Dietary Fiber

1. Keep in mind that a high-fiber diet may tend to improve:
• Chronic constipation
• Coronary heart disease
• Hemorrhoids
• Diabetes mellitus
• Diverticular disease
• Elevated cholesterol
• Irritable bowel syndrome
• Colorectal cancer

2. Try to double your daily fiber intake.
• Average American intake: 10-15 grams per day
• Recommended intake: 20-35 grams per day

3. Understand what fiber is, where it comes from:
• Insoluble fiber
• Cereals
• Wheat/wheat bran
• Whole grains
• Soluble fiber
• Brans
• Fruit
• Oatmeal/oat bran
• Psyllium
• Vegetables

4. Substitute high-fiber foods for high-fat and low-fiber foods.

5. Keep your daily fiber intake stable. Consider a fiber supplement if you:
• Travel
• Eat away from home often
• Find it difficult to get enough fiber through food choices alone

6. Don't shock your system: Increase fiber levels in your diet gradually.

7. Always increase fluids (water, soup, broth, juices) when you increase fiber.

8. Add both soluble and insoluble fiber, from a variety of sources.

9. Compare fiber content of foods:

Grams of Fiber
1 cup of Rice Krispies® 1
1/3 cup of 100% Bran® 9
1 slice of white bread 0.5
1 slice of whole wheat bread 1.4
1/2 cup white rice 0.5
1/2cup brown rice 1.5
Bowl of chicken broth 0
Bowl of thick vegetable (minestrone) soup 1

1. Choose foods high in fiber content.
Fruits and Vegetables
Highest in Fiber Per Serving
Fruits
Artichokes
Apples, pears (with skin)
Berries (blackberries, blueberries, raspberries)
Dates
Figs
Prunes Vegetables
Beans (baked, black, lima, pinto)
Broccoli
Chick-peas
Lentils
Parsnips Peas
Pumpkin
Rutabaga
Squash (winter)
Other Good Fiber Choices
Barley
Bread, Muffins (whole wheat, bran)
Cereals (branflakes, bran, oatmeal, shredded wheat)
Coconut
Crackers (rye, whole wheat)
Nuts (almonds, Brazil, peanuts, pecans, walnuts)
Rice (brown)
Seeds (pumpkin, sunflower)

Eating high-fiber foods is a healthy choice for most people. If you have ever received medical treatment for a digestive problem, however, it is very important that you check with your doctor to find out if a high-fiber diet is the right choice for you.

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.

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

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

Holiday Gastric Distress

2010-12-31T16:19:00.000-05:00

At hospitals, gastric distress is a part of the holiday tradition." Indeed, "in the early hours of Thanksgiving...emergency rooms are typically empty," but certain turkey-cooking practices "can easily strike a blow" to diners. Typically, a frozen turkey is left on a counter top for 12 hours, while a roasted bird may sit "for two or three hours before" reaching the table. "During that time, a virus or bacterium can land on the food and start growing," causing gastroenteritis. "Although bacteria will die" once the bird is reheated, "the toxins made by the bacteria that cause illness can survive even in a hot oven." Bones have also been known to trigger "trips to the hospital," and those "with heart conditions should avoid too much salt, which can trigger an accumulation of fluid in the lungs."

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.

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

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

10 Tips on Constipation and Incontinence of Stool

2010-12-15T07:51:00.000-05:00

1.Despite widespread belief, constipation is not necessarily a part of growing older.

2.Bowel habits are similar in both younger and older healthy people.

3.Constipation is defined as stools that are:
Too small
Too hard
Too difficult to pass
Infrequent (less than 3 per week)

4.Constipation is caused by:
Not enough dietary fiber or fluids
Medication side effects
Emotional or physical stress
Misconception about normal bowel habits
Lack of activity
Medical problems

5.How to manage mild-to-moderate constipation:
Gradually add dietary fiber from variou sources
Increase fluids (water, soup, broth, juices)
Eat meals on a regular schedule
Chew your food well
Gradually increase daily exercise
Respond to urges to move your bowels
Avoid straining
See your doctor if these measures don't work

6.Dietary therapy (increased fiber and fluids) and fiber supplements are the preferred treatment for chronic constipation.

7.In some cases, your doctor may recommend the use of stool softeners.

8.Use of mineral oil or stimulant laxatives regularly, consult your doctor to make sure what you are using is right for you.

9.Incontinence of stool or fecal soiling is most often due to leakage around a fecal impaction. Removing the impaction will usually restore continence.

10.Incontinence of stool in healthy older people deserves full education and treatment. Treatment options include:

Adjustment in dietary fiber to reduce amount of stool
Medications to decrease stool frequency
Prescribed use of enemas (not soap enemas)
Biofeedback training
Surgery to restore anal function

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.

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

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

Gastric distress-related ED visits may increase during the holidays

2010-12-09T08:02:00.000-05:00

At hospitals, gastric distress is a part of the holiday tradition." Indeed, "in the early hours of Thanksgiving...emergency rooms are typically empty," but certain turkey-cooking practices "can easily strike a blow" to diners. Typically, a frozen turkey is left on a countertop for 12 hours, while a roasted bird may sit "for two or three hours before" reaching the table. "During that time, a virus or bacterium can land on the food and start growing," causing gastroenteritis. "Although bacteria will die" once the bird is reheated, "the toxins made by the bacteria that cause illness can survive even in a hot oven." Bones have also been known to trigger "trips to the hospital," and those "with heart conditions should avoid too much salt, which can trigger an accumulation of fluid in the lungs."

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.

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

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

Small study indicates paroxetine may damage men's sperm, impair their fertility

2010-11-24T07:50:00.000-05:00

Add anti-depressants to the list of substances that can damage men’s sperm and potentially impair their fertility.

According to a study published online in the journal Fertility & Sterility, antidepressants may "damage men's sperm and potentially impair their fertility." For the study, researchers from the Weill Cornell Medical College "followed 35 healthy men who took paroxetine for five weeks." The investigators then performed tests "to examine DNA fragmentation, which occurs when sperm DNA is missing pieces of the genetic code. The results showed that 50 percent of men had signs of abnormal DNA fragmentation while taking the drug, compared with less than 10 percent at the start of the trial." Following discontinuation of the drug, "the men's sperm returned to normal." The authors theorized that the "antidepressant caused men's sperm to slow down as it makes its way through the male reproductive tract," thereby "allowing it to age and become damaged."

“It’s fairly well known that SSRI anti-depressants negatively impact erectile function and ejaculation. This study goes on step further, demonstrating that they can cause a major increase in genetic damage to sperm,” said Dr. Peter Schlegel, the study’s senior author and professor of reproductive medicine at Weill Cornell Medical College in New York.

“Although this study doesn’t look directly at fertility, we can infer that as many as half of men taking SSRIs have a reduced ability to conceive. The amount, concentration and motility of sperm were not significantly changed by the medication.
Though men may not know it, sperm can be damaged by various substances, including smoking, alcohol, heat, anabolic steroids, drug abuse, sexually transmitted diseases and some environmental exposures.

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.

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

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

Study indicates top medical journals published significant number of ghostwritten articles

2010-11-10T07:47:00.000-05:00

"Six of the top medical journals published a significant number of articles in 2008 that were written by ghostwriters financed by drug companies," according to a study in The Journal of the American Medical Association. The findings are of "concern" because "the work of industry-sponsored writers has the potential to introduce bias, affecting treatment decisions by doctors and, ultimately, patient care," the researchers said. The study included "authors of 630 articles who responded anonymously to an online questionnaire." Researchers found that "7.8 percent acknowledged contributions to their articles by people whose work should have qualified them to be named as authors on the papers but who were not listed."

The New England Journal of Medicine had "the highest rate of ghostwritten articles" at 10.9 percent, while "Nature Medicine had the lowest rate of unnamed writers, at two percent." Annette Flanagin, managing deputy editor of the Journal of the American Medical Association, said that with ghostwriters, "you lose transparency and potential accountability." She added, "Why would they be ghosted if they didn't have an agenda?"

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.

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

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

Survey suggests fatigued, stressed hospital residents report making more major medical errors.

2010-11-03T07:46:00.000-04:00

"Internal medicine residents who report higher levels of fatigue, sleepiness, and distress are at greater risk for reporting major medical errors," according to a study in the Journal of the American Medical Association. Researchers issued questionnaires to residents who had enrolled in a "Mayo Internal Medicine Well-being Study between July 2003 and February 2009."

Among the "356 participants, 139 (39 percent) reported making at least one major medical error." Of those who reported an error, "68.7 percent screened positive for depression at some point during the study." The researchers also found that "one-point increases on the fatigue and sleepiness scales were associated with 14-percent and 10-percent increased likelihoods of an error being reported during the subsequent three months."

Other factors associated with subsequent error were "burnout, depersonalization, emotional exhaustion, lower personal accomplishment, a positive depression screen," and overall quality of life. The study authors concluded that "in addition to the national efforts to reduce fatigue and sleepiness, well-designed interventions to prevent, identify, and treat distress among physicians are needed." Still, they stressed that "additional research is necessary to determine the most effective strategies for accomplishing these goals."

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.

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

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

CT scans may diagnose heart attacks faster than standard tests.

2010-10-28T20:45:00.000-04:00

A rapid CT scan of the heart may provide doctors with a more efficient way to diagnose blocked arteries in people complaining of chest pain," according to research reported at the American Heart Association meeting. In "a study of 701 patients," researchers found that CT angiography "cuts in half the time it usually takes for a doctor to detect a blockage in an artery supplying the heart."

The procedure also provides a "cheaper way to diagnose a heart attack when someone goes to the" emergency department (ED) with chest pains. The study showed that CT scan patients' testing cost "$2,137 on average versus $3,458 for standard screening."

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.

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

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

Survey suggests more adults searching Internet for health information.

2010-10-15T07:48:00.000-04:00

The number of adults who turn to the Internet for health information has nearly doubled in the past two years, from 31 percent to 60 percent," according to a study conducted by the Pew Internet & American Life Project. Researchers surveyed "2,253 people by landline phone and 502 by cellphone." Ranking highest "as the source adults most often turn to for health information" was healthcare professionals at 86 percent, followed by "family and friends" at 68 percent. Notably, "about half of all online health searches are on behalf of someone else, and...59 percent of users who go to the Internet for health information have read blogs or online comments made by others." Yahoo's Web life editor, speculates that "many adults may turn to the Internet for health advice," because "unlike the doctor's office, the Web is open 24/7, and it's increasingly accessible."

"Unlike the doctor's office, the Web is open 24/7, and it's increasingly accessible in all of the spaces where we live and work," she says.

"People are becoming advocates for themselves as patients by researching illnesses and health care information through the vast resources of the Web."

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.

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

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

THE TWO OTHER INFLAMMATORY BOWEL DISEASES (IBD)

2010-10-05T07:46:00.000-04:00

Most people know about the two most common idiopathic [cause not known] inflammatory bowel disorders—Crohn’s disease and ulcerative colitis. There are also two other inflammatory bowel diseases that most people don’t know about.
That is collagenous colitis and lymphocytic colitis. The diagnosis is made by biopsy through a colonoscope. The treatment is a type of steroid called Budesonide.
Results of studies show that Histologic remission was observed in 73% of patients given budesonide compared with 31% given placebo (P = .030). During a mean follow-up period of 14 months, 15 patients (44.1%) experienced a clinical relapse (after a mean of 2 months); 8 of the relapsing patients were retreated with and responded again to budesonide. Budesonide effectively induces clinical remission in patients with lymphocytic colitis and significantly improves histology results after 6 weeks.
Clinical relapses occur but can be treated again successfully with budesonide.

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.

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

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VITAMIN B12 DEFICIENCY DUE TO METFORMIN

2010-09-27T23:00:00.000-04:00

Vitamin B12 deficiency due to metformin is a less common, but potentially severe complication that is often overlooked. Patients at risk for vitamin B12 deficiency include those taking more than 1,000 mg daily of metformin for three years or longer. Patients receiving metformin therapy should be monitored for signs and symptoms of vitamin B12 deficiency such as megaloblastic anemia or peripheral neuropathies.

Also, advise patients on metformin to take a multivitamin with B12 and encourage them to get their recommended daily amount of calcium, although there's no proof this will prevent B12 deficiency.
While neuropathy can be related to hyperglycemia, vitamin B12 deficiency should be ruled out as a cause, especially in those patients with diabetes who are taking metformin.

In patients with vitamin B12 deficiency, supplemental oral vitamin B12 should be administered. Calcium supplementation to assure that the recommended daily allowance is being met can also be considered

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.

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

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

Clinically Significant Statin Drug Interactions

2010-09-14T07:13:00.000-04:00

Perhaps the most serious consequence of statin interactions is rhabdomyolysis. The risk of myopathy is increased when statins are coadministered with medications that inhibit their metabolism. Atorvastatin (Lipitor), lovastatin (Mevacor), and simvastatin (Zocor) are CYP3A4 substrates and when coadministered with potent CYP3A4 inhibitors the incidence of myopathy is increased by about five fold.
The extent of interaction between atorvastatin and CYP3A4 inhibitors is less than that with lovastatin and simvastatin. Lovastatin and simvastatin are termed "sensitive substrates" because their levels may be increased five-fold or higher by CYP3A4 inhibitors.

Fluvastatin (Lescol) is primarily metabolized by CYP2C9 and to a lesser extent by CYP3A4 and CYP2D6. Pravastatin (Pravachol) is not significantly metabolized by the cytochrome P450 system and does not interact with other CYP substrates. Rosuvastatin (Crestor) is also not extensively metabolized by the cytochrome P450 system. Statins are substrates for P-glycoprotein; therefore, drugs that inhibit p-glycoprotein (e.g., cyclosporine, diltiazem, etc) may increase statin levels.
The increased risk of myopathy is well recognized when statins and fibric acid derivatives are coadministered since both classes of drugs have the potential for inducing myopathy. However, the risk is less with fenofibrate than gemfibrozil. This may be because gemfibrozil inhibits hepatic glucuronidation of statins, thereby interfering with statin elimination.

In managing statin interactions, choosing a non-interacting medication or switching to a non-interacting statin (i.e., for chronic therapy) may be the safest or easiest option. For certain statin interactions, reducing the statin dose may be an acceptable management technique.

Interactions between lovastatin or simvastatin and strong CYP3A4 inhibitors (e.g., clarithromycin, itraconazole) are managed by stopping the statin as soon as the interacting drug is started. Recommendations vary, but some experts suggest restarting the statin three days or so after the interacting drug has been discontinued. The cardiovascular risk of stopping a statin must be considered when managing drug interactions. Stopping a statin for up to six weeks in a stable patient appears safe. The cardiovascular risk of stopping a statin is higher in unstable patients. Morbidity and mortality is increased in acute myocardial infarction (MI) patients whose statins are discontinued.The results of statin discontinuation in high risk patients may be seen quickly. In one study there was increased risk of in-hospital death in patients with non-ST segment elevation MI whose statin was discontinued. In addition, stopping statin therapy in acute ischemic stroke patients resulted in early neurologic deterioration and poorer outcomes in an unpublished study. Therefore, statins should only be discontinued in acute MI or stroke when indicated (e.g., rhabdomyolysis).

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.

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

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

10 Tips on Hemorrhoids

2010-09-08T10:11:00.001-04:00

1.Hemorrhoids are masses of swollen veins in the lower rectum (internal hemorrhoids) or at the anus (external hemorrhoids).

2.Symptoms of internal hemorrhoids include:
Bright red rectal bleeding
Staining of undergarments with mucus

3.Symptoms of external hemorrhoids include:
Pain and itching when irritated by constipation or diarrhea
Difficulty with hygiene

4.Hemorrhoids are caused by:
Straining
Work strain (lifting, etc.)
Straining while defecating
Chronic constipation
Passing hard, dry, small stools
Laxative abuse

5.Do not assume rectal bleeding is from hemorrhoids. See your doctor to rule out cancer or other disease.

6.To prevent or manage hemorrhoids, increase your fiber and fluid intake. Consider adding a fiber supplement.

7.Avoid straining at stool or sitting on the toilet for a long time.

8.Clean the external rectal area gently with soap and water following stool evacuation.

9.Try a topical cream or sitz baths to reduce inflammation.

10.See your doctor if you don't improve.

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.

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

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

Safe Biopsy: Validated Method for Staging Liver Fibrosis in Hep C

2010-08-27T07:00:00.000-04:00

Study results in Hepatology indicate that safe biopsy is a rational and validated method for staging liver fibrosis in hepatitis C with a marked reduction in the need for liver biopsy. It is an attractive tool for large-scale screening of hepatitis C virus carriers.

The staging of liver fibrosis is pivotal for defining the prognosis and indications for therapy in hepatitis C. Although liver biopsy remains the gold standard, several noninvasive methods are under evaluation for clinical use. Researchers validated the recently described sequential algorithm for fibrosis evaluation biopsy. The safe biopsy detects significant fibrosis and cirrhosis by combining the AST-to-platelet ratio index and Fibrotest-Fibrosure, thereby limiting liver biopsy to cases not adequately classifiable by noninvasive markers.

The researchers enrolled hepatitis C virus patients in nine locations in Europe and the U.S. The diagnostic accuracy of safe biopsy versus histology, which is the gold standard, was investigated. The reduction in the need for liver biopsies achieved with safe biopsy was also assessed. Safe biopsy identified significant fibrosis with 90 percent accuracy, and reduced the number of liver biopsies needed by 47 percent. Safe biopsy had 93 percent accuracy for the detection of cirrhosis, obviating 82 percent of liver biopsies. A third algorithm identified significant fibrosis and cirrhosis simultaneously with high accuracy and a 36 percent reduction in the need for liver biopsy. The patient's age and body mass index influenced the performance of safe biopsy, which was improved with adjusted Fibrotest-Fibrosure cutoffs.
The team found that 10 percent of cases had discordant results for significant fibrosis with safe biopsy versus histology, whereas 8 percent of cases were discordant for cirrhosis detection. The research team also found that 71 of the former cases and 56 of the latter cases had a Fibroscan measurement within two months of histological evaluation. Fibroscan confirmed safe biopsy findings in 83 percent and 75 percent, respectively.

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.

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

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

Gastric distress-related ED visits may increase during the holidays.

2010-08-21T21:16:00.000-04:00

At hospitals, gastric distress is a part of the holiday tradition." Indeed, "in the early hours of Thanksgiving...emergency rooms are typically empty," but certain turkey-cooking practices "can easily strike a blow" to diners. Typically, a frozen turkey is left on a countertop for 12 hours, while a roasted bird may sit "for two or three hours before" reaching the table. "During that time, a virus or bacterium can land on the food and start growing," causing gastroenteritis. "Although bacteria will die" once the bird is reheated, "the toxins made by the bacteria that cause illness can survive even in a hot oven." Bones have also been known to trigger "trips to the hospital," and those "with heart conditions should avoid too much salt, which can trigger an accumulation of fluid in the lungs."

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.

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

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

Safe Biopsy: Validated Method for Staging Liver Fibrosis in Hep C

2010-08-11T14:38:00.001-04:00

Study results in Hepatology indicate that safe biopsy is a rational and validated method for staging liver fibrosis in hepatitis C with a marked reduction in the need for liver biopsy. It is an attractive tool for large-scale screening of hepatitis C virus carriers.

The staging of liver fibrosis is pivotal for defining the prognosis and indications for therapy in hepatitis C. Although liver biopsy remains the gold standard, several noninvasive methods are under evaluation for clinical use. Researchers validated the recently described sequential algorithm for fibrosis evaluation biopsy. The safe biopsy detects significant fibrosis and cirrhosis by combining the AST-to-platelet ratio index and Fibrotest-Fibrosure, thereby limiting liver biopsy to cases not adequately classifiable by noninvasive markers.

The researchers enrolled hepatitis C virus patients in nine locations in Europe and the U.S. The diagnostic accuracy of safe biopsy versus histology, which is the gold standard, was investigated. The reduction in the need for liver biopsies achieved with safe biopsy was also assessed. Safe biopsy identified significant fibrosis with 90 percent accuracy, and reduced the number of liver biopsies needed by 47 percent. Safe biopsy had 93 percent accuracy for the detection of cirrhosis, obviating 82 percent of liver biopsies. A third algorithm identified significant fibrosis and cirrhosis simultaneously with high accuracy and a 36 percent reduction in the need for liver biopsy. The patient's age and body mass index influenced the performance of safe biopsy, which was improved with adjusted Fibrotest-Fibrosure cutoffs.

The team found that 10 percent of cases had discordant results for significant fibrosis with safe biopsy versus histology, whereas 8 percent of cases were discordant for cirrhosis detection. The research team also found that 71 of the former cases and 56 of the latter cases had a Fibroscan measurement within two months of histological evaluation. Fibroscan confirmed safe biopsy findings in 83 percent and 75 percent, respectively.

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.

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

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

10 Tips on Belching, Bloating, and Flatulence

2010-07-30T07:22:00.000-04:00

1.Belching is caused by swallowed air from:
Eating or drinking too fast
Poorly fitting dentures; not chewing food completely
Carbonated beverages
Chewing gum or sucking on hard candies
Excessive swallowing due to nervous tension or postnasal drip
Forced belching to relieve abdominal discomfort

2.To prevent excessive belching, avoid:
Carbonated beverages
Chewing gum
Hard candies
Simethicone may be helpful

3.Abdominal bloating and discomfort may be due to intestinal sensitivity or symptoms of irritable bowel syndrome. To relieve symptoms, avoid:
Broccoli
Baked beans
Cabbage
Carbonated drinks
Cauliflower
Chewing gum
Hard candy

4.Abdominal distention resulting from weak abdominal muscles:
Is better in the morning
Gets worse as the day progresses
Is relieved by lying down

5.To prevent Abdominal distention:
Tighten abdominal muscles by pulling in your stomach several times during the day
So sit-up exercises if possible
Wear an abdominal support garment if exercise is too difficult

6.Flatulence is gas created through bacterial action in the bowel and passed rectally. Keep in mind that:
10-18 passages per day are normal
Primary gases are harmless and odorless
Noticeable smells are trace gases related to food intake

7.Foods that are likely to form gas include:
Milk, dairy products, and medications that contain lactose--If your body doesn't produce the enzyme (lactase) to break it down.
Certain vegetables--baked beans, cauliflower, broccoli, cabbage
Certain starches--wheat, oats, corn, potatoes. Rice is a good substitute.

8.If flatulence is a concern, see your doctor to determine if you are lactose intolerant.

9.Identify offending foods. Reduce or eliminate these gas-forming foods from your diet.

10.Activated Charcoal may provide some benefit.

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.

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

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

8 Tips on Peptic Ulcer Disease

2010-07-23T07:15:00.000-04:00

1.Ulcers are "sores" that frequently affect the stomach and the first part of the small intestine (duodenum).

2.Bacterial infection is the most common cause of duodenal ulcers.

3.Stomach ulcers are often a side effect of pain killers and anti-inflammatory drugs used primarily to treat arthritis.

4.Alcohol ingestion, cigarette smoking, and emotional stress may also influence the development of an ulcer or interfere with its healing.

5.Upper abdominal pain is the most common symptom of ulcers, but many ulcers cause no symptoms at all.

6.Ulcers may hemorrhage (bleeding) into the gastrointestinal tract; this results in the passage of black ("tarry") stool. Very serious ulcer disease may also cause a blockage between the stomach and small intestine and this complication results in persistent vomiting. Severe pain results from the most urgent complication of ulcers - peritonitis caused by a tear through the wall of the stomach or duodenum.

7.Almost all ulcers can be treated successfully, usually without surgery. Many ulcers can be prevented.

Ulcer treatments include antibiotics, agents that neutralize gastric acid or reduce its secretion, and drugs that strengthen the resistance of the stomach and duodenum

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.

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

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

6 Tips on Hepatitis

2010-07-16T07:43:00.000-04:00

1.Five different hepatitis viruses have been identified: type A; type B; type C; type D, or delta virus; and type E. Type A is probably the most prevalent type of viral hepatitis worldwide, followed by types B, E, C, and D.

2.Hepatitis A and E are transmitted through fecally contaminated food or water. Other modes of transmission include needle sharing among intravenous drug abusers; sexual contact; maternal transmission; and transmission by blood transfusion.

3.A simple blood test is used to determine that a person has one or more of the different types of hepatitis.

4.Acute hepatitis is typically characterized by flu-like symptoms (including fever, headaches, fatigue, nausea and vomiting) and jaundice. Chronic hepatitis is often asymptomatic.

5.Vaccines are available to protect against hepatitis A and B. Additionally, immune globulin for hepatitis A or hepatitis B is recommended when someone has been exposed to an infected person.

6.Among the ways to care for your liver are: limiting alcohol consumption; avoiding liver- damaging drugs; practicing safe sex; avoiding use of illegal drugs; avoiding high doses of vitamins unless prescribed; avoiding tattoos and the sharing of razors; not eating raw shellfish from questionable sources; and carefully following directions for use of toxic substances (e.g., cleaning products).

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.

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

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

5 Tips on Use of Medications

2010-07-09T07:40:00.000-04:00

1.Use of medications increases with age: 80% of older Americans who live independently receive 20 or more prescriptions per year Residents of nursing homes receive an average of 8-10 drugs per day

2.It is important to take medications as prescribed. Reasons for not following directions include:
Too many drugs
Error due to visual or mental impairment
Sharing drugs
Changing doctors
Use of over-the-counter drugs
Sparing expense
Drug side effects
Symptoms not improving

3.See your doctor regularly to check on medications and their effect (bring your medications with you for an office visit or to an emergency room): Drug effect changes with aging There is decreased absorption of drugs through the intestinal tract Decreased kidney function slows drug elimination Metabolism of drugs changes with age

4.The effect medications have on your body will change with aging. For example: Drug action may last longer Drugs may produce toxicity at a lower dose in mature adults than in younger adults

5.Remember that all changes you experience are not necessarily due to aging. For example, decrease in salivary flow is: Due to disease or medication not due to aging

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.

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

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

5 Tips on Swallowing and Heartburn

2010-07-02T07:00:00.000-04:00

1.Abnormal swallowing is commonly perceived as food "sticking on the way down." If this complaint persists, it is sometimes due to a serious condition and should always prompt medical attention.

2.Swallowing difficulty may be caused by a number of different problems including:
* Poor or incomplete chewing (possibly the result of dental problems, poorly fitted dentures, or eating too quickly)
* Abnormal muscle contraction
* Scar tissue from chronic inflammation
* Infection
* Cancer

3.Heartburn is a very common problem caused by regurgitation or reflux of gastric acid into the esophagus, which connects the mouth and the stomach.

4.Heartburn can often be eliminated by avoiding:
* Smoking
* Fatty food in the diet
* Caffeine
* Chocolate
* Peppermint
* Overeating
* Bed-time snacks
* Tight-fitting clothes that constrict the abdomen
* Certain medications
* Heavy lifting, straining

5.It is important to consider the possibility of heart disease before attributing any kind of chest pain to gastroesophageal reflux.

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.

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

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

4 Tips on Circulatory Disorders of the GI Tract

2010-06-25T07:30:00.000-04:00

1.The small intestine and the colon have a relatively restricted blood supply and are frequently affected by circulatory disorders, whereas the esophagus, stomach, and rectum are well supplied with blood and are only occasionally involved in circulatory disturbances.

2.The colon is commonly affected by ischemia (reduction of blood flow to a level not permitting normal function). In most cases, symptoms subside within days and healing is seen within 2 weeks. Antibiotics and bowel rest usually suffice. In complicated disease, damaged parts of the colon must be removed surgically.

3.Acute mesenteric ischemia results from inadequate circulation of blood to the small intestine. Treatment is aimed at dilating (opening) the blood vessels with drugs and/or surgery to restore intestinal blood flow and to remove any irreversibly damaged bowel.

4.Chronic mesenteric ischemia results when blood flow to the small intestine is reduced to an insufficient level. It causes pain associated with eating. Surgery is often warranted to correct the problem.

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.

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

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

People who suffer chronic pain may be at higher risk for falls.

2010-06-18T13:02:00.000-04:00

According to a study in the Journal of the American Medical Association, "people who suffer chronic pain may be at higher risk for falls." Researchers "followed more than 700 people over age 70" in the Boston area. "After 18 months," the investigators "found that people who said they felt pain in two or more joints in one month were 50 percent more likely to fall in the following month than people who did not report joint pain."

"Severe pain and pain that affected participants' ability to do daily activities also made falls more likely, the researchers found." Moreover, "having pain in one month made falling in the next month likely. People who reported severe pain in one month had a 77 percent increased risk of falling the next month," but "even people reporting very mild pain were more likely to fall the following month, the group found."

"Pain contributes to functional decline and muscle weakness, the researchers said, and it has been associated with mobility limitations that could predispose patients to falls." The study authors suggested that "paying closer attention to pain and falls 'could result in better health and help people to continue living actively and independently in the community.'"

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.

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

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

NHS decides not to make sorafenib, bevacizumab available

2010-06-11T07:27:00.000-04:00

"In the United Kingdom, the National Health Service (NHS) has decided not to make two more cancer drugs available because of cost." According to the National Institute for Health and Clinical Excellence, [NICE] the use of "sorafenib (Nexavar) for liver cancer and...bevacizumab (Avastin) for metastatic colorectal cancer" is "not cost-effective." But, the decision on bevacizumab "is preliminary, and the manufacturer, Roche, has said that it will continue to work with NICE on making the drug available." The moves "have sparked headlines about cancer patients being denied life-prolonging drugs" as well as criticism from some oncologists. Karol Sikora, MD, medical director of Cancer Patterns UK, noted that "the British decision about sorafenib puts it 'hopelessly out of step with the rest of Europe,' because every other country within the European Union makes the drug available."
Commentary-Disseminate to those people who want us to emulate the British system of Healthcare-such as Roger Moore of “Sicko”

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.

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

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

Seniors taking psychotropic medications may be at increased risk for falls

2010-06-04T09:47:00.000-04:00

According to a study published in the Archives of Internal Medicine, seniors who take certain "psychotropic medications may be at increased risk for falls." After analyzing "22 published studies" including "79,081 participants older than 60," University of British Columbia researchers "concluded that there was a significant association between the use of sedatives, hypnotics, antidepressants, and benzodiazepines and the risk of falls in older adults."

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.

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

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

Gastric distress-related ED visits may increase during the holidays.

2010-05-28T07:15:00.000-04:00

At hospitals, gastric distress is a part of the holiday tradition." Indeed, "in the early hours of Thanksgiving...emergency rooms are typically empty," but certain turkey-cooking practices "can easily strike a blow" to diners. Typically, a frozen turkey is left on a countertop for 12 hours, while a roasted bird may sit "for two or three hours before" reaching the table. "During that time, a virus or bacterium can land on the food and start growing," causing gastroenteritis. "Although bacteria will die" once the bird is reheated, "the toxins made by the bacteria that cause illness can survive even in a hot oven." Bones have also been known to trigger "trips to the hospital," and those "with heart conditions should avoid too much salt, which can trigger an accumulation of fluid in the lungs."

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.

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

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

Cigarettes "widely contaminated" with hundreds of bacteria

2010-05-17T07:07:00.000-04:00

"DNA examination of four cigarette brands shows, for the first time, that cigarettes are 'widely contaminated' with hundreds of different types of bacteria. In fact, there appears to be as many bacteria in cigarettes as there are chemicals." According to the University of Maryland study in Environmental Health Perspectives, the bacteria "are linked to lung, blood, and food-borne-related infections." For example, investigators found "acinetobacter -- associated with certain blood and lung infections" -- and "bacillus -- some types are associated with anthrax and food poisoning." And, if those "organisms can survive the smoking process," the study authors said, "they could possibly go on to contribute to both infectious and chronic illnesses in both smokers and individuals who are exposed to environmental tobacco smoke."

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.

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

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

The Latest Opinions In Preventing Hospital-Acquired Infections (HAIs)

2010-05-10T07:41:00.000-04:00

The US is contending with a growing "problem that cost billions of" dollars: hospital-acquired infections (HAIs). Some "100,000 people die with hospital transmitted infections every year." Now, two new studies published in the New England Journal of Medicine "demonstrate that simple measures could dramatically reduce the number of hospital-acquired infections."
        Indeed, many hospitals throughout the nation have already launched campaigns against HAIs, including programs that encourage "stepped-up hand-washing by doctors and nurses. The new studies looked at the bacteria patients may be carrying before entering the hospital, especially...Staphylococcus aureus. The lead author of the first study explained that "about one-third of people at any one time carry this bacterium in their nose or on their skin," and "it does not give them any problem." But, if "they go to a hospital and the skin is somehow breached, they are really prone to invasion or infection by their own bacteria."
        With that in mind, a team at the Erasmus University Medical Center set about identifying which patients scheduled for surgery carried the bacteria in their nostrils. Once identified, using a rapid test, patients either received placebo treatment or Bactroban (mupirocin), an antibiotic nose gel, and daily baths with chlorhexidine.
        Over the course of six weeks, "about 3% of the treated group had staph infections, compared to about 8% in the dummy treatment group.. The "treatment also cut average hospital stays by two days." Meanwhile, researchers in the US aimed to find an alternative to "the reddish-brown iodine solution that's been used for decades to swab the skin before an operation."
        In the second study, a team at Baylor College "randomly assigned 849 surgical patients, scheduled for clean-contaminated surgery in six hospitals, to have either a chlorhexidine/alcohol scrub or a scrub and paint with povidone-iodine.. In short, the former "reduced infections by 41% compared with povidone-iodine."
        What's more, the method used by the Texas team is "'much more effective, very simple, and very inexpensive,' compared to that reported by the Dutch group," according to an accompanying editorial. There is, however, "no barrier to both methods being used in people at high risk of infection after surgery, such as those with compromised immune systems.".

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.

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

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

IOM releases updated pregnancy weight gain guidelines.

2010-05-07T08:33:00.001-04:00

for the first time "in nearly two decades," officials at the Institute of Medicine "have issued...new guidelines" regarding weight gain during pregnancy. This is of great importance to many mothers-to-be, because the "health of the newborn depends a lot on the mom's weight."
        In fact, "excessive weight gain during pregnancy has short-term and long-term adverse effects, such as a greater risk of having a C-section and retaining those extra pounds for the mother," There is also an increased risk "of being born prematurely or large with extra fat for the baby. Women who are overweight to begin with also have a greater risk of developing pregnancy-related high blood pressure and diabetes." These are problems that may be hard to avoid, considering that "half of all pregnancies are unplanned, so many women weigh too much when they conceive."
        More than 60 percent of US women of childbearing age are overweight or obese -- a significant increase from 20 years ago." Figures like those, alongside pregnancy complications and the "growing rates of obesity in children," put "pressure on the" IOM "to revise a set of 1990 guidelines that were written primarily to prevent excessively low infant birth weights." But, "with few exceptions, such as putting a limit on how much weight obese women should gain, the new guidelines are the old guidelines wrapped up in a lecture."
        For the majority of women, "including those who are underweight, normal weight, or even overweight at conception," the unchanged guidelines still suggest that "women with a healthy body mass index, or BMI...of 18 to 25 are advised to gain 25 to 35 pounds during pregnancy," while "overweight women with a BMI of 25 to 29.5 should gain less, up to 25 pounds; underweight women, with BMIs below 18.5, should gain more, up to 40 pounds."
        In regards to obese women,"obese moms-to-be should limit their weight gain during pregnancy to between 11 and 20 pounds," whereas the 1990 guidelines "recommended that obese mothers-to-be gain at least 15 pounds during pregnancy." The IOM committee is also urging clinicians to "provide diet and exercise counseling to women before conception so that women can achieve a normal BMI before becoming pregnant."
        Michael Katz, MD, senior vice president for research at the March of Dimes, a co-sponsor of the study, "said the aims of the report are laudable, but 'the effects are very difficult to achieve'" through a "concerted effort".While Dr. Katz said the new guidelines are more conservative than those past, others say they are not conservative enough." Nonetheless, the report's authors are calling "for further study of pregnancy in obese women, as well as the impacts of gestational weight gain on maternal and child outcomes."

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.

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

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

GREAT SITES ON THE INTERNET FOR USE BY PATIENTS AND DOCTORS

2010-05-03T07:00:00.003-04:00

The Internet has become a critical medium for clinicians, public health practitioners, and laypeople seeking health information. Data about diseases and outbreaks are disseminated not only through online announcements by government agencies but also through informal channels, ranging from press reports to blogs to chat rooms to analyses of Web searches (see Digital Resources for Disease Detection). Collectively, these sources provide a view of global health that is fundamentally different from that yielded by the disease reporting of the traditional public health infrastructure.

Broader Web-based networks are also proving useful for surveillance. Social-networking sites for clinicians, patients, and the general public hold potential for harnessing the collective wisdom of the masses for disease detection. Given the continued deployment of personally controlled electronic health records, we expect that patients' contributions to disease surveillance will increase. Eventually, mobile-phone technology, enabled by global positioning systems and coupled with short-message-service messaging (texting) and "microblogging" (with Twitter), might also come into play. For instance, an organization called Innovative Support to Emergencies, Diseases, and Disasters (InSTEDD) has developed open-source technology to permit seamless cross-border communication between mobile devices for early warning and response in resource-constrained settings.

Digital Resources for Disease Detection.
Sample Web-based data sources for flu and other infectious diseases worldwide.
ProMED-mail, www.promedmail.org
Global Public Health Intelligence Network (GPHIN),www.phac-aspc.gc.ca/media/nr-rp/2004/2004_gphin-rmispbk-eng.php
HealthMap, www.healthmap.org
MediSys, http://medusa.jrc.it
EpiSPIDER, www.epispider.org
BioCaster, http://biocaster.nii.ac.jp
Wildlife Disease Information Node, http://wildlifedisease.nbii.gov
H5N1 Google Earth mashup, www.nature.com/avianflu/google-earth
Avian Influenza Daily Digest and blog, www.aidailydigest.blogspot.com
Google Flu Trends, www.google.org/flutrends
Google Insights for Search, www.google.com/insights/search
DiSTRIBuTE, www.syndromic.org/projects/DiSTRIBuTE.htm
GeoSentinel, www.istm.org/geosentinel/main.html
Emerging Infections Network, http://ein.idsociety.org
Argus, http://biodefense.georgetown.edu
Sample health-related social-networking sites
Physicians, www.sermo.com
Patients, www.patientslikeme.com
Everyone, www.healthysocial.org

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.

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

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

Researchers say novel cleaning methods reduce hospital-room bacteria by nearly 90 percent.

2010-04-30T08:00:00.001-04:00

Two "studies on new cleaning methods show that they can reduce bacteria, including hard-to-remove Clostridium difficile spores, by almost 90 percent," according to research presented at the 49th Interscience Conference on Antimicrobial Agents and Chemotherapy in San Francisco. In the first study, cleaning with "ultramicrofiber mops and cloths plus copper biocide removed 80...to 85 percent of bacteria," and the "antibacterial effect of the copper biocide persisted for 23 hours after cleaning." In the second study, researchers used an "automated UV radiation device," the Tru-D, to "decontaminate hospital rooms. ... Tru-D reduced methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus bacteria by 89 percent and C. difficile spores by 83 percent" in 40 hospital rooms

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.

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

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

PHYSICIAN URGES RETURN TO MORE PERSONAL CARE

2010-04-26T07:06:00.000-04:00

In an op-ed for the New York Times Dr. Dena Rifkin, a physician at the University of California-San Diego, writes that since the Institute of Medicine's report on deaths caused by medical errors, "there has been tremendous focus on how many mistakes physicians and hospitals make, how much they cost and how to prevent them." She says that many hospitals reacted with a "brisk and multifaceted" response, but that "none of these interventions, however well meant, address a fundamental problem that is emerging in modern medicine: a change in focus from treating the patient toward satisfying the system."

A close family member was recently hospitalized after nearly collapsing at home. He was promptly checked in, and an electrocardiogram was done within 15 minutes. He was given a bar-coded armband, his pain level was assessed, blood was drawn, X-rays and stress tests were performed, and he was discharged 24 hours later with a revised medication list after being offered a pneumonia vaccine and an opportunity to fill out a living will.The only problem was an utter lack of human attention. An emergency room physician admitted him to a hospital service that rapidly evaluates patients for potential heart attacks. No one noted the blood tests that suggested severe dehydration or took enough history to figure out why he might be fatigued.
A doctor was present for a few minutes at the beginning of his stay, and fewer the next day. Even my presence, as a family member and physician, did not change the cursory attitude of the doctors and nurses we met.Yet his hospitalization met all the current standards for quality care.

It has been 10 years since the Institute of Medicine’s seminal report on deaths caused by medical errors (numbering at least 44,000 a year). Since then, there has been tremendous focus on how many mistakes physicians and hospitals make, how much they cost and how to prevent them.

The response at most hospitals has been brisk and multifaceted. Hospital accreditation committees now audit charts for outdated abbreviations and proper signing of notes. Electronic prescription systems are rapidly becoming the norm. Pay-for-performance interventions by insurers promise to reward those who make the grade and to refuse payment to those whose treatments cause complications like hospital-acquired infections.

But as we bustle from one well-documented chart to the next, no one is counting whether we are still paying attention to the human beings. No one is counting whether we admit that the best source of information, the best protection from medical error, the best opportunity to make a difference — that all of these things have been here all along. The answers are with the patients, and we must remember the unquantifiable value of asking the right questions.

She adds that medical professionals "are paying attention to the details of medical errors," yet "no one is counting whether we are still paying attention to the human beings."

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.

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

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

Illinois consumers can view hospital quality data on state-sponsored website.

2010-04-23T07:55:00.001-04:00

Six years after Illinois passed "legislation in 2003" calling "for a Hospital Report Card and Consumer Guide" to "document hospital-acquired infections and the adequacy of nursing staffs," as well as "to compare hospitals' performance on 30 leading medical procedures with wide variation in outcomes and costs," the "report card and consumer guide are" now "a reality" for "11 conditions," with "more data" to "be added in the months ahead."

For the first time, consumers can pore over abundant data -- much of it previously unpublished -- about Illinois hospitals and surgery centers on a state-sponsored website." These "data include information about what these medical providers charge, how many procedures they perform, how often they deliver recommended care, and how consumers rate their care." The Tribune adds that "some of the information comes from Medicare Compare, published by the federal government, but it is presented on the state website in a much more accessible form."

But Public report cards ranking performance may not encourage hospitals to improve.
One might assume that public report cards ranking their performance would encourage hospitals to improve, but a new...study " published in the Journal of the American Medical Association "finds that isn't the case." Investigators "examined medical records from 86 hospitals in Ontario that admitted patients with heart attack or heart failure." The researchers found that "even after report cards were released, the hospitals, in general, didn't show improvement.

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.

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

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MEDICATION EXPIRATION DATES

2010-04-19T06:57:00.002-04:00

Is the expiration date a marketing ploy by drug manufacturers, to keep you restocking your medicine cabinet and their pockets regularly? You can look at it that way. Or you can also look at it this way: The expiration dates are very conservative to ensure you get everything you paid for. And, really, if a drug manufacturer had to do expiration-date testing for longer periods it would slow their ability to bring you new and improved formulations.

One of the largest studies ever conducted that supports the above points about "expired drug" labeling was done by the US military 15 years ago, according to a feature story in the Wall Street Journal (March 29, 2000), reported by Laurie P. Cohen. The military was sitting on a $1 billion stockpile of drugs and facing the daunting process of destroying and replacing its supply every 2 to 3 years, so it began a testing program to see if it could extend the life of its inventory. The testing, conducted by the US Food and Drug Administration (FDA), ultimately covered more than 100 drugs, prescription and over-the-counter. The results showed that about 90% of them were safe and effective as far as 15 years past their original expiration date.

In light of these results, a former director of the testing program, Francis Flaherty, said he concluded that expiration dates put on by manufacturers typically have no bearing on whether a drug is usable for longer. Mr. Flaherty noted that a drug maker is required to prove only that a drug is still good on whatever expiration date the company chooses to set. The expiration date doesn't mean, or even suggest, that the drug will stop being effective after that, nor that it will become harmful. "Manufacturers put expiration dates on for marketing, rather than scientific, reasons," said Mr. Flaherty, a pharmacist at the FDA until his retirement in 1999. "It's not profitable for them to have products on a shelf for 10 years. They want turnover."

If the expiration date passed a few years ago and it's important that your drug is absolutely 100% effective, you might want to consider buying a new bottle. And if you have any questions about the safety or effectiveness of any drug, ask your pharmacist. He or she is a great resource when it comes to getting more information about your medications.

First, the expiration date, required by law in the United States, beginning in 1979, specifies only the date the manufacturer guarantees the full potency and safety of the drug -- it does not mean how long the drug is actually "good" or safe to use. Second, medical authorities uniformly say it is safe to take drugs past their expiration date -- no matter how "expired" the drugs purportedly are. Except for possibly the rarest of exceptions, you won't get hurt and you certainly won't get killed.

Even 10 years after the "expiration date," most drugs have a good deal of their original potency. So wisdom dictates that if your life does depend on an expired drug, and you must have 100% or so of its original strength, you should probably toss it and get a refill, in accordance with the cliché, "better safe than sorry." If your life does not depend on an expired drug -- such as that for headache, hay fever, or menstrual cramps -- take it and see what happens.

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.

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

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Sharing hospital room may increase infection risk during stay

2010-04-16T07:27:00.001-04:00

Sharing a hospital room increases your risk of picking up an infection during your stay, a new study shows." The work, by researchers from Queen's University in Kingston, Ont., "found that each new roommate raised a patient's risk of picking up an infection in hospital by about 10 percent." The study's senior author, Dr. Dick Zoutman, said in a statement, "That's a substantial risk, particularly for longer hospital stays when you can expect to have many different roommates."

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.

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A BETTER ANSWER FOR DOCTORS WORRIED ABOUT HIGH MALPRACTICE INSURANCE PREMIUMS ?

2010-04-12T07:13:00.001-04:00

Tom Baker, a professor at the University of Pennsylvania Law School, is the author of “The Medical Malpractice Myth. Says that our medical liability system needs reform. But anyone who thinks that limiting liability would reduce health care costs is fooling himself. Preventable medical injuries, not patient compensation, are what ring up extra costs for additional treatment. This means taxpayers, employers and everyone else who buys health insurance — all of us — have a big stake in patient safety.

Eighty percent of malpractice claims involve significant disability or death, a 2006 analysis of medical malpractice claims conducted by the Harvard School of Public Health shows, and the amount of compensation patients receive strongly depends on the merits of their claims. Most people injured by medical malpractice do not bring legal claims, earlier studies by the same researchers have found.
On the other hand, risk managers, for example, and spurring anesthesiologists to improve their safety standards and practices. Even medical societies’ efforts to attack the liability system have helped, by inspiring the research that has documented the surprising extent of preventable injuries in hospitals. That research helped start the patient safety movement. When it comes to rising medical costs, liability is a symptom, not the disease. Getting rid of liability might save money for hospitals and some high-risk specialists, but it would cost society more by taking away one of the few hard-wired patient safety incentives.
Besides, there’s a better answer for doctors worried about high malpractice insurance premiums.

Critics point to defensive medicine as the hidden burden that liability imposes on health care. Yet research shows that while the fear of liability changes doctors’ behavior, that isn’t necessarily a burden. Some defensive medicine is, like defensive driving, good practice. Too often, we can’t distinguish between treatments that are necessary and those that are wasteful. Better research on what works and what doesn’t — evidence-based medicine — will help. And it will address the more general challenge of avoiding costly but unnecessary care.
Just as we need evidence-based medicine, we also need evidence-based medical liability reform. The research shows, overwhelmingly, that the real problem is too much malpractice, not too many malpractice lawsuits. So medical providers should be required to disclose injuries, provide quicker compensation to deserving patients and — here’s the answer for doctors worried about their premiums — shift the responsibility for buying malpractice insurance to hospitals and other large medical institutions. Evidence-based liability reform would give these institutions the incentive they need to cut back on the most wasteful aspect of American health care: preventable medical injuries.

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.

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

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Which Antiseptic Is Best To Reduce The Risk Of Staph Infection?

2010-04-09T07:02:00.000-04:00

The chemical antiseptic chlorhexidine does a better job than povidone-iodine in reducing the risk of surgical site infections, even in carriers of Staphylococcus aureus, according to two new randomized studies.Researchers in the U.S. found that chlorhexidine and alcohol, used for preoperative skin cleansing, reduced infections by 41% compared with povidone-iodine.

And Dutch investigators found that screening and decolonizing patients who are nasal carriers of S. aureus, combined with washing with chlorhexidine soap, reduced the risk of infection by 58%.

The two prospective studies are reported in the New England Journal of Medicine and offer "valuable insights for controlling surgical-site infections. An accompanying editorial, wrote that the findings "offer remarkably safer strategies for all patients who require surgery."

Overall, the researchers found, the rate of infection was 9.5% in the chlorhexidine group, compared with 16.1% in the povidone-iodine group. The chlorhexidine/alcohol scrub proved more protective against superficial incisional infections and deep incisional infections.

The researchers concluded that better skin antisepsis could result in a "significant clinical benefit."

The study is a "landmark", according to the University of Michigan Health Systems in Ann Arbor.If the study is eventually translated into national guidelines," the impact would be huge. That would include those undergoing cardiac surgery, patients receiving an implant, and those with a compromised immune system.

In the Netherlands, researchers enrolled 808 people who were positive for S. aureus and underwent a surgical procedure that was expected to keep them in hospital for at least four days.

They found:
In the mupirocin/chlorhexidine group, 17 of 504 patients (or 3.4%) got an S. aureus infection, compared with 32 of 413 patients (or 7.7%) in the placebo group.

The benefit was greatest for deep surgical-site infections, where the relative risk was 0.21, with a 95% confidence interval from 0.07 to 0.62.

The time from admission to the onset of S. aureus infections was significantly shorter in the placebo group than in the mupirocin/chlorhexidine group, at P=0.005.
The "weight of evidence" is now firmly on the side of chlorhexidine and alcohol as a preoperative skin cleansing, rather than povidone and iodine.

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.

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

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At What Age Should Mammograms Should Begin?

2010-04-05T07:38:00.000-04:00

The Journal of the American College of Radiology urges women to begin seeking mammograms every year beginning at age 40. The suggestion is "at odds with controversial advice by the US Preventive Services Task Force that women put off mammograms until age 50 and even then just get them every two years, in most cases." A professor of radiology at Harvard, charged that the USPTF "didn't pay enough attention to the results of studies

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.

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

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Are Statin Medicines Good For Everyone?

2010-04-02T07:50:00.000-04:00

Statins like Lipitor have gotten great publicity-with some advocating putting it in the drinking water. New research,however, shows that statin drugs may negatively impact some patients with cardiac disorders. A new study presented at the 75th annual international scientific assembly of the American College of Chest Physicians found that statins benefit patients with systolic heart failure (SHF), but not those with diastolic heart failure (DHF). These patients experienced increased dyspnea, fatigue, and decreased exercise tolerance. “It is possible that statins would help patients with systolic heart failure more than patients with diastolic heart failure due to the cholesterol-lowering and anti-inflammatory effects of statins. US Pharm. 2009;34(12):10.

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.

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

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THE ABCs Of Colon Cancer [CRC] Screening

2010-03-29T07:52:00.000-04:00

Involved organizations promote a message for adults: get screened if you are 50 or older.

It is predicted that if all individuals aged 50 or older had regular colorectal screening tests resulting in the removal of all precancerous polyps, up to 90% of deaths from colorectal cancer could be prevented. The premise for the utility of cancer screening, in general, is that early diagnosis may reduce cancer mortality, result in less radical therapy, and decrease costs. Colorectal cancer screening, in particular, is capable of detecting precancerous polyps in the colon or rectum for removal and can detect early-stage cancer so that treatment may be initiated when it is more effective, often leading to a cure.

Screening for colorectal cancer begins soon after an individual turns 50 years of age, then continues at regular intervals. People at higher risk for colorectal cancer should be tested at a younger age and/or more frequently, including individuals who 1) have a personal or close family history of colorectal polyps or colorectal cancer; 2) have inflammatory bowel disease; 3) have genetic syndromes such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer. Patients should speak to their health care provider to ascertain when they should begin screening and how often they should be tested.

A consensus guideline for colorectal cancer screening was released in March 2008 by the American Cancer Society, the U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology (ACS/USMSTF/ACR), while the USPSTF updated its screening recommendations in October 2008. Ongoing studies drive the constantly evolving recommended screening schedules. For the latest in cancer screening point your medical professional to these articles. Ask your medical professional where you fit in.

Levin B, Lieberman D, McFarland B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin. 2008;58:130-160. U.S. Preventive Services Task Force. Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;149:627-637.

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.

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

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USE CELL PHONES TO PROTECT FROM ALZHEIMERS?

2010-03-26T07:31:00.000-04:00

If you’re a mouse using a cell phone you’ve got it made. In mice prone to an animal form of Alzheimer's disease, long-term exposure to electromagnetic radiation typical of cell phones slowed and reversed the course of the illness. Cell phone exposure, begun in early adulthood, protects the memory of mice otherwise destined to develop Alzheimer's symptoms. And the electromagnetic waves generated by cell phones actually reversed memory impairment in old Alzheimer's mice. A similar exposure in normal mice -- for two hours a day over seven to nine months -- improved their cognitive abilities compared with controls reports the Journal of Alzheimer's Disease, which is the research journal of the Alzheimer's Association.

Rreactions to the study ranged from "interesting" to "nonsense” because it's too early to say whether the findings have any relevance to humans. Even science published in reputable journals can turn out to be wrong, adding "extreme caution is necessary until this outcome has been confirmed independently in other laboratories. And even if the science is correct, "humans are not just big mice, and we must always be cautious in extrapolating results from mice to man."

The report comes almost exactly two years after researchers at the University of Sunderland, in England, said they had shown that infrared light could improve cognition in mice.That report led to the development of the so-called "Alzheimer's helmet," aimed at slowing or reversing the disease in humans. Whether that works has not been shown yet.

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.

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

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DENTAL CARIES FROM GERD

2010-03-22T07:37:00.000-04:00

Patients with gastroesophageal reflux [GERD] sometimes develop dental erosion owing to chemical dissolution of enamel. Researchers used optical coherence tomography to assess tooth demineralization and enamel loss in 30 patients receiving either placebo or esomeprazole [Nexium] acid suppression. The researchers describe significantly diminished loss of enamel thickness and reduced tissue demineralization in patients randomly assigned esomeprazole versus those given placebo

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.

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

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inverse association between coffee consumption and liver disease

2010-03-19T07:44:00.000-04:00

Investigators who studied the coffee-drinking habits of 766 patients with chronic hepatitis C report an inverse association between coffee consumption and liver disease progression. A dose-dependent trend was observed, in which participants who consumed three or more cups a day had significantly less disease progression than coffee nondrinkers.This ought to send Starbucks stocks skyrocketing.

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.

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

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WHITE FLOUR GOOD-WHOLE GRAIN BAD!

2010-03-15T07:45:00.001-04:00

Insoluble fiber may actually aggravate IBS.

In the U.S. many patients with Irritable Bowel Syndrome [IBS] modify their diets, hoping to alleviate certain symptoms. Now, research from the UK "shows conclusively that eating extra bran and other fiber is likely to do more harm than good." Instead of insoluble fiber, investigators recommend that IBS patients consume "white bread, white pasta, biscuits, cakes, and cream crackers -- anything, as long as its made from refined white flour."

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.

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

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HOW ACCURATE ARE NUTRITION PACKAGE LABELS?

2010-03-11T19:41:00.000-05:00

According to a study published in the Journal of the American Dietetic Association, "prepared foods may contain an average of 8% more calories than their package labels own up to, and restaurant meals may contain a whopping 18% more." The misleading labels are also said to be "perfectly o.k." with the Food and Drug Administration, which "plays no role in checking the calorie claims in restaurants." Without federal regulation, "it's up to the states to handle the job - with the predictable patchwork results." Susan Roberts, who conducted the study, described the unregulated menu counts as "the Wild West when it comes to this."

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.

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

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Hormone Replacement Drug Lawsuits

2010-03-08T07:09:00.001-05:00

Most of the hormone lawsuits in the U.S."focus on the drug Prempro [conjugated estrogens and medroxyprogesterone]," which was "prescribed to treat" menopausal symptoms.

On Jan. 6, 2010 the 8th US Circuit Court of Appeals "reinstated more than 100 lawsuits against drug companies filed by women or their surviving relatives who claimed that hormone replacement therapy caused breast cancer." The move overturned "a 2008 district court ruling that had blocked almost all of the suits from being sent back to state court in Minnesota and dismissed most of the lawsuits that were being heard in Little Rock." The appeals court also "reversed the dismissal of dozens of cases that the lower court ruled should not have been part of the litigation because they duplicated claims pending in California."

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.

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

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Does Radiation Exposure From Transportation Security Administration (TSA) Full-Body Scanners Pose Health Risks For Passengers?

2010-03-05T07:13:00.001-05:00

Most of the scanners deployed in the US use x-rays to look for objects hidden under clothes. While "exposure to x-rays, to radiation, can increase the risk of cancer," according to "the machine's manufacturers, and an independent study...the scanners pose little risk."

The American College of Radiology has issued" an official statement that the group "is not aware of any evidence that either of the scanning technologies that the TSA is considering would present significant biological effects for passengers screened."

James Thrall, MD, FACR, of the American College of Radiology and chief of radiology at Massachusetts General Hospital, said, "All of the concerns that we have about the medical use of X-rays really don't apply to" the two types of scanners, millimeter wavelength imaging and backscatter X-ray scanners, because "the exposure is extremely low."

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.

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

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SHOULD TIES BE BANNED FROM HOSPITALS?

2010-03-01T06:49:00.001-05:00

In June,2009 the American Medical Association considered Resolution 720, which advocates a new dress code for doctors "due to evidence that neckties, long sleeves and other clothing items and accessories have been implicated in the spread of infections in hospitals." An AMA committee is seeking solid scientific evidence before it brings the matter to a vote.
The British Medical Association already decided the issue. It recommended in 2006 that physicians jettison "functionless" articles of clothing, including neckties, "as superbugs can be carried on them."

Neckties are rarely, if ever, cleaned. When a patient is seated on the examining table, doctors' ties often dangle perilously close to sneeze level. In recent years, a debate has emerged in the medical community over whether they harbor dangerous germs. Several hospitals have proposed banning them outright. Some veteran doctors suspect the anti-necktie campaign has more to do with younger physicians' desire to dress casually than it does with modern medicine. At least one tie maker is pushing a compromise solution: neckwear with an antimicrobial coating.

An 2004 analysis of neckties worn by 42 doctors and medical staffers at the New York Hospital Medical Center of Queens found that nearly half carried bacteria that could cause illnesses such as pneumonia and blood infections. That compared with 10% for ties worn by security guards at the hospital.

But many doctors favor ties for the air of formality they lend the profession. Professionals say neckwear conveys "respect for patients" and shouldn't be jettisoned. That has turned into an opportunity for SafeSmart Inc. The St. Augustine, Fla., company sells ties treated with a stain-resistant coating that the company says thwarts microbes.Independent lab tests, show the coating "repels bacterial contamination." Two years ago, her firm rolled out a line of ties aimed at doctors. One client is Wilson Memorial Hospital, north of Dayton, Ohio. The institution's infection-control committee recently advised physicians to keep their arms bare and scrubbed from the elbows down, and their ties tucked away. Some doctors quit wearing ties, but not everyone was willing. So the committee bought a batch of antimicrobial ties. They're black and gold and sport the caduceus, the symbol of the medical profession.

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.

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

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FDA Approves New Treatment for Shingles-Related Pain

2010-02-26T06:51:00.001-05:00

The FDA has approved Qutenza, a patch containing 8% capsaicin, to treat postherpetic neuralgia. Qutenza must be applied to the skin by a healthcare professional. It can be used for 60 minutes, as often as once every 3 months, according to the manufacturer.

Before placing a patch, providers should treat the affected area with a topical anesthetic. In addition, they should monitor patients for at least 1 hour after patch application because of the risk for increased blood pressure. Other side effects may include pain, swelling, itching, redness, and bumps at the application site.Capsaicin, a compound in chili peppers, is available in over-the-counter products in lower concentrations, but this is the first prescription-level formulation approved by the FDA.

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.

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

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5 Tips on Nutrition and Aging

2010-02-22T07:00:00.000-05:00

1. Nutrition plays a role in cardiovascular disease, some malignancies, adult-onset diabetes, osteoporosis, alcoholism, and recovery from major injury.

2. Malnutrition can weaken the immune system, impair healing following surgery or injury, lessen mobility, and reduce mental capabilities and function. It is common in older adults.

3. To maintain good health, total fat intake should be reduced to 30% or less of calories. Saturated fat intake should only account for 10% (one third of fat calories). Salt and alcohol intake also should be limited.

4. Dietary fat content composed primarily of monounsaturated fat (eg, olive oil) and polyunsaturated fat (eg, canola, corn and fish oils) may be associated with a lower incidence of cardiovascular disease.

5. Foods to be avoided include whole milk and dairy products (ice cream, cheese, butter); commercially baked goods (cookies and crackers); hot dogs, ham, and cold cuts; and oils, gravies, and salad dressing.

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.

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

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

5 Tips on Irritable Bowel Syndrome

2010-02-19T06:53:00.001-05:00

1. Irritable bowel syndrome (IBS) is a digestive problem also known as "spastic colon" or "irritable colon."

2. IBS symptoms include:
• Abdominal pain (colicky, periodic or continuous dull pain)
• Erratic bowel activity; frequent constipation or diarrhea
• Accompanying symptoms of bloating, nausea, headache, fatigue
• Sensitivity to intestinal gas (cramping, flatulence)

3. The cause of IBS is unknown:
• No evidence of specific disease
• May be triggered by psychological factors or ingestion of food

4. IBS is a condition that:
• Is more common in women
• Usually starts at an early age (20s and 30s) and recurs from time to time
• Rarely starts past age 55

5. Treatment of IBS includes:
• Careful explanation of the syndrome, including what it is not
• Better management of key triggers: stress and diet
• Modification of diet to reduce or exclude foods that promote gas
• Drug therapy to relieve symptoms (bulk fiber products, antispasmodics, antidiarrheals)
• Occasionally, psychiatric therapy and medication

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.

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

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

5 Tips on Inflammatory Bowel Disease

2010-02-15T08:29:00.001-05:00

1. Inflammatory bowel disease (IBD) is an inflammation of the small or large intestine that may cause these symptoms:

• Diarrhea
• Rectal bleeding
• Sharp abdominal pain or cramping
• Intestinal obstruction
• Fever
See your doctor if you have any of these symptoms

2. There are two types of IBD:
• Ulcerative Colitis
• Starts in rectum and spreads upward
• Affects men more than women
• Crohn's Disease
• More patchy inflammation
• Can start anywhere in the digestive tract
• Affects women more than men

3. The cause of IBD is unknown. What is known about IBD includes the following:
• IBD is not Contagious.
• IBD is not caused by diet.
• IBD is not a form of cancer.
• IBD affects young and old alike.
• IBD can usually be treated with medicine but sometimes requires surgery.

4. Diagnosis of IBD is based on:
• Family history, travel history, current medications
• Stool sample to rule out infection
• Flexible sigmoidoscopy/colonoscopy and biopsy to rule out cancer and to identify
• IBD
• X-ray studies

5. Treatment of IBD may include:
• Medications to reduce or eliminate inflammation
• Special diet or elemental formula diet
• Surgery

Time is critical. If you suspect IBD, call your doctor

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.

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

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

5 Tips on Gallstone Disease

2010-02-12T07:43:00.000-05:00

5 Tips on Gallstone Disease
1. Gallstones typically develop over many years, although they can form in months. Gallstones are present in about 20% of women and 10% of men over the age of 55.

2. There are two basic types of gallstones: cholesterol and pigment. Cholesterol gallstones are the most common type in the United States.

3. About 75% of gallstones do not cause symptoms. The most common symptom caused by gallbladder stones is episodic upper abdominal pain.

4. For healthy patients who have no symptoms, no therapy or change in diet is needed. Patients with uncomplicated symptomatic gallbladder stones should reduce dietary fat and consider surgical removal of the gallbladder (cholecystectomy). An alternate approach is oral bile acid therapy. For complicated disease, gallbladder removal is warranted.

5. Patients who undergo rapid weight loss are at risk for the development of small cholesterol gallstones and may benefit from bile acid therapy. Gallstones can seldom be prevented, although a low-fat diet may provide some protective benefit.

CONTACT
Web: www.Hookman.com
Phone: 561.445.0486
E-Mail: hookman@hookman.com
Book Website: www.MedMalBook.com

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.

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

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

JAMA-Journal of the American Medical Association -acclaims "MEDICAL EXPERT TESTIMONY." Calls his new book “Crowning achievement” and “Definitive text.

2010-02-08T07:09:00.000-05:00

Washington, D.C., February 2, 2010 --"'MEDICAL EXPERT TESTIMONY' is The Definitive Text for physicians seeking to augment their income as medical expert witnesses or for clinicians forced to participate in the civil litigation arena," according to the Journal of the American Medical Association. The book review is published in JAMA. 2010; 303 (4): 369 by reviewer Alan G. Williams, JD, in the Book and Media Reviews of the Journal of the American Association. Perry Hookman MD, board certified in both Gastroenterology and Internal Medicine, is the author of the new Book II Medical Expert Testimony: Advanced Syllabus for Health Care Professionals (Hardcover) 33 chapters; 936 pages. Publisher: Potomac Press-CRC; ISBN: 978-0-9817570-0-1; ISBN: 10:0-9817570-0-6 - Price $289.95; including CD-ROM.

This recent JAMA review points out that:

"Although Perry Hookman has previously written a valuable reference manual regarding medical expert testimony in malpractice cases (Book I Medical Malpractice Expert Witnessing: Introductory Guide for Physicians and Medical Professionals),[his new Book II] -Medical Expert Testimony: Advanced Syllabus for Healthcare Professionals - represents his crowning achievement."

"The novice medical expert can greatly benefit from the keen observations and astute recommendations in the chapters regarding "Strategies and Tactics Designed to Trick the Expert"; "Questions to Make the Medical Expert Look Biased, Incompetent, Embarrassed"; and "How Attorneys Use Cross-Examination Mishaps, Errors, and Testimony Control for Impeachment of the Medical Expert Witness."

"Hookman begins by explaining what the particular strategic move by the attorney is and then follows with the recommended counter-move. The advice contained in these chapters alone makes the book well worth reading."

"The format of Medical Expert Testimony contributes to its appeal; each topic is clearly delineated and interspersed with text boxes of facts and examples. As opposed to page after page of text (the book totals nearly 1000 pages), Medical Expert Testimony succeeds as a reference manual owing in part to its staccato bursts presenting the identified problem, the recommended remedy, and the likely result. Each section is followed by a list of sources to aid the reader in exploring additional references or materials."

"'Medical Expert Testimony,' written by a veteran expert witness who obviously knows his subject, serves as a thorough explication of serving as an expert witness in a medical malpractice case. Other than omitting few superfluous sections, it is difficult to imagine a better way to meaningfully improve on this textbook. Medical expert witnesses would do well to heed the recommendations and advice presented in this unique and insightful reference."

CONTACT
Web: www.Hookman.com
Phone: 561.445.0486
E-Mail: hookman@hookman.com
Book Website: www.MedMalBook.com

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.

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

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

5 Tips on Diverticular Disease

2010-02-05T07:59:00.000-05:00

1. Diverticulosis is a condition with pouch-like protrusions in the colon:
• Rare before age 30
• Common after age 60
• Usually no symptoms

2. Complications of diverticulosis include:
• Bright red rectal bleeding with clots
• Diverticulitis

3. Ways to prevent and manage diverticular disease include:
• Increasing dietary fiber to keep bowel movements soft
• Avoiding stimulant laxatives

4. Diverticulitis is a serious complication in which pouches become inflamed or infected. Symptoms of diverticulitis include:
• Pain in left lower abdomen
• Fever
• Sudden change in bowel habit
See your doctor immediately if you have any of these symptoms.

5. Treatment of diverticulitis may include:
• Antibiotics
• Special feeding
• Surgery

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.

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

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

ONE DRUG CAUSES LIFE EXTENSION BY 14%

2010-02-01T06:35:00.000-05:00

The antitumor drug rapamycin targets TOR, a kinase that is part of the PI3K–AKT–mTOR cascade, involved in regulating protein translation, cell growth and autophagy. Reducing TOR function is known to extend the life of yeast, worms and flies.
Now experiments replicated in three different laboratories demonstrate that rapamycin, fed to male and female mice in a dose that substantially inhibits TOR signalling, can extend their median and maximal lifespan by up to 14%. This life extension was observed in mice fed rapamycin from 270 days of age and also at a late stage in their life, from age 600 days.

These findings point to the TOR pathway as a critical point in the control of ageing in mammals and in the pathogenesis of late-life illnesses. The small molecule rapamycin, already approved for clinical use for various human disorders, has been found to significantly increase lifespan in mice.

Is this a step towards an anti-ageing drug for people?
From Rapamycin fed late in life extends lifespan in genetically heterogeneous mice
David E. Harrison, et al.doi:10.1038/nature08221

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.

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

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

Caution Not to Take Sertaline, Citalopram in Pregnancy Because of Link to Heart Defects in Offspring

2010-01-29T08:01:00.001-05:00

Women who use the antidepressants sertraline (Zoloft) or citalopram (Celexa) early in pregnancy face increased risk for septal heart defects in their offspring, BMJ reports online.

Researchers examined data on more than 490,000 infants born in Denmark between 1996 and 2003. They found that women who filled prescriptions for sertraline and citalopram (but not other SSRIs) during their first trimester were significantly more likely to have children with septal heart defects (but not other malformations) than those who didn't use SSRIs (odds ratios: 3.2 and 2.5, respectively).

The authors and an editorialist (both with ties to SSRI manufacturers) note that the absolute risks for septal heart defects were low: 0.9% in children exposed to at least one SSRI and 2.1% in those exposed to more than one.

The editorialist concludes: "Clinicians and patients need to balance the small risks associated with SSRIs against those associated with under-treatment or no treatment."

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 ONE DRUG CAUSES LIFE EXTENSION BY 14%.

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

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

MAKE MEDICAL ERROR REPORTING COMPULSORY?

2010-01-25T08:30:00.000-05:00

Few states have instituted compulsory medical error admissions. William M. Sage et al., The Relational Regulatory Gap: A Pragmatic Information Policy For Patient Safety and Medical Malpractice, 59 Vand. L. Rev. 1263 (2006) noted that four states recently passed legislation requiring patients to be informed when they were the victim of medical errors. One state that has is New Jersey, which, in 2004, enacted the Patient Safety Act, N.J.S.A. 26:2H-12.23 (PSA). This landmark legislation changed the way medical errors are dealt with in New Jersey by creating a legal duty to immediately disclose medical errors to patients who are harmed by them. N.J.S.A. 26:2H-12.25.

Should The Law in New Jersey be the Same in Other States?
Under the PSA, when the patient is a victim of a serious preventable adverse event, he or she must be informed no later than the end of the episode of care; or, if discovery occurs after the end of the episode of care, in a timely fashion. N.J.S.A. 26:2H-12.25(d). A "serious preventable adverse event" is any adverse event that is preventable and results in death, loss of a body part, or disability or loss of bodily function either lasting more than seven days, or that is still present at the time of discharge. N.J.S.A. 26:2H-12.25(a). In addition to requiring adverse events to be reported to the victims of medical malpractice, the PSA also requires health care providers to report medical errors to the New Jersey Department of Health and Human Services (the Department). N.J.S.A. 26:2H-12.25(c).

On Jan. 24, 2008, the Department enacted regulations that gave teeth to the notification and reporting requirements of the Act. As of March 3, 2008 (for hospitals), Aug. 30, 2008 (for ambulatory care facilities, home health care agencies and hospice providers), and March 3, 2009, (for nursing homes and assisted living facilities), health care providers have five business days after discovery of a serious preventable adverse event to notify the Department that a preventable adverse event has occurred. N.J.A.C. 8:43E-10.1, N.J.A.C. 8:43E-10.6(b). The notification requires the inclusion of specific categories of information, including: 1) the date and time the event occurred; 2) a brief description of the event; 3) a statement about the impact of the event on the health of the patient; 4) the date and time the facility became aware of the event; 5) how the event was discovered; 6) the immediate corrective actions the facility took to eliminate or reduce the adverse impact of the event on the patient; and 7) what steps were taken to prevent the occurrence of future similar events. N.J.A.C. 8:43E-10.6(c).

Failure to comply with these reporting requirements results in a fine of $1,000 a day. N.J.A.C. 8:43E-3.4(14).

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 Caution Not to Take Sertaline, Citalopram in Pregnancy Because of Link to Heart Defects in Offspring.

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

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

Hospitals And Medical Staffs Have Failed To Be Effective In Reducing Medical Errors

2010-01-22T08:32:00.001-05:00

A recent Medicare policy change has brought into critical focus the fact that hospitals and medical staffs have failed to be effective in reducing medical errors. The Centers for Medicare and Medicaid Services (CMS) announced that it would no longer pay hospitals for the extra costs of treating injuries, infections, or other complications caused by preventable errors (never events). At the same time that hospitals are encountering this looming payment restriction from Medicare, they also are confronting the possibility of payment restrictions from commercial payors. Cigna, Aetna, Health Net, and Health Partners are among the payors that have indicated they are considering making nonpayment for “never events” a standard part of their provider contracts.

There are significant potential liability concerns that may arise from the new CMS payment plan and from similar state and commercial plans.

Not all of the qualifying "preventable" complications selected by CMS are comparable in terms of their preventability, nor are they entirely within the control of the hospital or its medical staff. It is without question that instruments or sponges left behind after surgery should be never events. However, current best efforts may not entirely prevent vascular infections from catheter use, for example. Similarly, the amount of effort and expense required to prevent the formation of pressure ulcers is far greater than that required to avoid retained instruments. This alone could lead hospitals to alter admission policies and practices. The aspect of the Medicare never event payment policy change requiring hospitals to report Present on Admission Indicators may make it inevitable.

This Heller article suspects that plaintiff’s attorneys may well argue that never events should be viewed as res ipsa occurrences or, at the least, that they should always be viewed as representing below standard care. This would appear to be an excellent example of the law of unintended consequences as "the mere designation of never events will likely result in both more numerous and more valuable plaintiffs’ verdicts nationwide."

Some sets of these never events, for example those recently approved by the Washington State Hospital Association and the Washington State Medical Association, employ the modifier "serious," penalizing hospitals only for "serious disability associated with a fall" or "serious disability from medication error," without, not surprisingly, offering criteria for defining the term "serious."

This may then be left for the legal system to define. It is not clear how far out in time from the never event the ban on hospital charges extends. On the one hand, says Heller, if a patient sustains a hip fracture from an in-hospital fall, it is clear that the hospital may not bill for the fracture repair. If, on the other hand, three months post-discharge, the patient develops what appears to be a nonhospital acquired infection at the hip repair wound site and the patient is readmitted, who pays the bill? What if a patient develops a deep pressure ulcer in the hospital (clearly, not reimbursable) and is discharged when the ulcer appears to be healed, but is readmitted after two weeks at home with an ulcer at precisely the same site. Who pays? It is possible to develop many confusing and confounding scenarios that may evolve from the new CMS rule and its progeny, and the end effects are not in sight.

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 Reducing Medical Errors.

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

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

A Balance Disorder Known As Vestibular Dysfunction

2010-01-18T08:00:00.000-05:00

A Balance Disorder Known As Vestibular Dysfunction

Which Affects Up To 69 Million Americans Should Be Part Of The Routine Medical Checkup

Millions of people may suffer from inner-ear disorders that affect their balance but not be aware that they have a problem, a new study has found. Writing in The Archives of Internal Medicine, researchers noted the connection between balance problems and falls, especially among the elderly. The findings of the study, they said, suggest that doctors should make balance tests a routine part of checkups. This is especially true in nursing and assisted-living homes, they said.
“The big deal here really is falls,” the lead author, of Johns Hopkins, adding that a serious fall can be the beginning of the end for an older patient. The researchers drew on data from a federal study in which more than 5,000 people age 40 and over were surveyed about their history of falls and balance problems. They were then given examinations to determine how well they could maintain their balance in a variety of situations, including with their eyes closed.
More than a third of the subjects, the researchers found, had the balance disorder known as vestibular dysfunction — a figure that would translate to 69 million Americans. They also found that 32 percent of the volunteers who did not report problems with dizziness showed evidence of balance problems. Though they did not experience symptoms, they were still at higher risk for falls, the study said.
For doctors, detecting balance problems in a patient is not very complicated. And treatment is available, including exercises that help people compensate for inner-ear problems that lead to poor balance. The cost of the treatment, would most likely be less than medical costs associated with falls.

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 Reducing Medical Errors.

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

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

COLONOSCOPY IS RISKIER IN OLDER AGE

2010-01-15T08:24:00.001-05:00

Despite low overall adverse event risk with colonoscopy, every age group 70 and older is at elevated risk of adverse gastrointestinal and cardiovascular events from the procedure, reports Joan L. Warren, Ph.D., of the National Cancer Institute in Bethesda, Md.. The risk of intestinal bleeding or perforation is 75% higher at age 80 to 84 than at age 66 to 69.These findings, from the Medicare claims database, support the controversial upper age limit for screening colonoscopy set by the U.S. Preventive Services Task Force.
Because competing causes of mortality often outweigh the potential benefit from detecting colon cancer at progressively older ages, guidelines do not recommend screening past age 75 and recommend against it after 85 The reason for the increased complication risk in older persons and those with these conditions may be related to the preparation, sedation, or the procedure itself, the researchers noted.
Certain preparations, such as sodium phosphate, can increase the likelihood of electrolyte imbalances, especially in elderly persons. In addition, persons taking ACE inhibitors, angiotensin-receptor blockers, diuretics, and nonsteroidal anti-inflammatory drugs -- all of which are commonly used in elderly persons -- may have more adverse events related to the bowel preparation for colonoscopy speculates Dr.Warren.
Indeed Warren cautions, that the use of administrative claims data to determine complication risks -- rather than medical record review -- might underestimate the true risk of adverse events.
Source reference:
Warren JL, et al "Adverse events after outpatient colonoscopy in the Medicare population" ANN INTERN MED 2009; 150: 849-57.

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 A Balance Disorder Known As Vestibular Dysfunction.

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

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

Only 24% of Doctors Report Medical Errors Committed On Their Patients

2010-01-11T06:55:00.001-05:00

Under the American Medical Association Code of Ethics, physicians have an ethical obligation to advise a patient when they commit consequential acts of medical malpractice where "a patient suffers significant medical complications that may have resulted from the physician’s mistake or judgment." Am. Med. Ass’n Code of Medical Ethics A-02 Edition, E-8.12 Patient Information, 77. Similarly, the American College of Physicians Ethics Manual mandates disclosure of errors if disclosure of this information is "material to the patient’s well-being." Lois Snyder & Cathy Leffler, Ethics Manual, Fifth Edition, 142 Ann Intern Med 560, 563. Finally, the Joint Commission requires that patients be informed of unanticipated results that differ from the expected outcome in a significant way when a medical error occurs at a hospital. Joint Comm’n on Accreditation of Health Care Orgs., Revisions to Joint Commission Standards in Support of Patient Safety and Medical/Health Care Error Reduction 12 (2001).
Disclosure of medical errors is not only ethically mandated, it is consistent with the fiduciary nature of the physician-patient relationship, since in most instances, disclosure of errors will be help the patient to understand why unexpected problems have developed. Some commentators have suggested that since patients need information about errors to make decisions about their medical care, disclosure of malpractice is part of a physician’s duty to provide a patient with informed consent. Thomas H. Gallagher, Wendy Levinson, Disclosing Medical Errors to Patients: a Status Report in 2007,177(3) Can Med Assn J 265 (2007).
In theory, physicians agree that they have an ethical obligation to disclose medical errors. One study suggests that between 70% and 90% of the physician population believes that doctors should disclose errors to patients. Kathleen M. Mazor et al., Communicating with Patients about Medical Errors, 164 Arch Intern Med 1690, 1692 (2004). In another study, 97% of the faculty and resident population surveyed indicated that they would disclose medical errors that caused minor harm, and 93% indicated that they would disclose an error causing major harm. Lauris Kaldjian, et al., Disclosing Medical Errors to Patients: Attitudes and Practices of Physicians and Trainees, 22(7) J Gen Intern Med 988-96 (2007). This being the case, one would expect physicians, nearly universally, to report medical errors to their patients. However, research does not bear this theory out. For example, one study revealed that only 24% of residents surveyed reported the medical errors they committed to their patients. Albert Wu, et al., Do House Officers Learn from Their Mistakes? 12 Quality & Safety Health Care 221, 224 (2003). Another study estimated that, nationwide, physicians are only disclosing errors to patients about 1/3 of the time. Robert J. Blendon et al., Views of Practicing Physicians and the Public on Medical Errors, 347 New. Eng. J. Med. 1933, 1935 (2002).

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 COLONOSCOPY IS RISKIER IN OLDER AGE.

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

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

CDI is one Infection you Don’t Want to Get IN the Hospital-Clostridium Difficile Infections (CDI) Are Difficult To Treat

2010-01-08T08:32:00.002-05:00

Episodes of recurrent Clostridium difficile infection (CDI) are difficult to treat for several reasons. Foremost, data are lacking to support any particular treatment strategy. In addition, treatment of recurrent episodes is not always successful, and repeated, prolonged treatment is often necessary. Identification of subgroups at risk for recurrent CDI may aid in diagnosing and treating these patients. Two likely mechanistic factors increasing the risk of recurrent CDI are an inadequate immune response to C. difficile toxins and persistent disruption of the normal colonic flora. Important epidemiologic risk factors include advanced age, continuation of other antibiotics, and prolonged hospital stays. Current guidelines recommend that the first recurrent episode be treated with the same agent (i.e., metronidazole or vancomycin) used for the index episode. However, if the first recurrence is characterized as severe, vancomycin should be used. A reasonable strategy for managing a subsequent episode involves tapering followed by pulsed doses of vancomycin. Other potentially effective strategies for recurrent CDI include vancomycin with adjunctive treatments, such as Saccharomyces boulardii, rifaximin “chaser” therapy after vancomycin, nitazoxanide, fecal transplantation, and intravenous immunoglobulin. New treatment agents that are active against C. difficile, but spare critical components of the normal flora, may decrease the incidence of recurrent CDI.

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 INFORMING THE PATIENT OF MEDICAL ERRORS.

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

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

What is the Best Treatment for Patients with BOTH Heart Disease and Diabetes?

2010-01-04T07:00:00.001-05:00

For patients with both coronary artery disease and type 2 diabetes, outcomes are similar regardless of whether revascularization or medical therapy is used — and whether insulin sensitization or insulin provision is used — reports an industry-supported study published online in the New England Journal of Medicine.

Researchers randomized some 2400 patients to either prompt revascularization or medical treatment, and to either insulin-sensitization or insulin-provision therapy. At 5 years, all-cause mortality did not differ between the revascularization and medical-therapy groups or between the insulin-sensitization and insulin-provision groups. Similarly, major cardiovascular events did not differ between groups.

Patients were stratified before randomization according to type of revascularization, and patients in the CABG (but not PCI) group had fewer major cardiovascular events with revascularization but a similar mortality rate.

Asked to comment, Journal Watch Cardiology Editor-in-Chief Dr. Harlan Krumholz said that the failure of the study to show clear superiority of revascularization and insulin sensitization "reinforces the need to incorporate the patient's preferences, values, and goals — and costs — into decisions about which strategy to pursue."

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 CDI is one Infection you Don’t Want to Get IN the Hospital-Clostridium Difficile Infections (CDI) Are Difficult To Treat.

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

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

7 REASONS WHY MEDICAL ERRORS OCCUR

2009-12-28T07:00:00.000-05:00

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

2009-12-21T07:00:00.000-05:00

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

Thin Thighs Associated with Increased Risk for Death, Cardiovascular Disease

2009-12-14T07:00:00.001-05:00

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

WHAT IS GERD?

2009-12-07T06:50:00.001-05:00

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

Section III of III The Debate between Doctors and Insurance carriers about “pay for performance” [P4P] reimbursement plans

2009-11-30T08:00:00.001-05:00

Section III of III The Debate between Doctors and Insurance carriers about “pay for performance” [P4P] reimbursement plans

MY OPINION:
The idea of paying physicians more for providing guideline-based care has taken the American health system by storm in the last decade. Today, more than 150 pay-for-performance programs are centered on the notion that rewarding evidence-based care is key to improving health care quality.

Does evidence based research show that P4P is efficacious and improves quality care? No. At least not yet.

Some P4P efforts have shown beneficial results, according to the Centers for Medicare & Medicaid Services. An evaluation of its Physician Group Practice Demonstration found that all 10 participating practices hit or exceeded targets on at least seven of 10 quality metrics of diabetes care. A Feb. 1, 2007, New England Journal of Medicine study found that Medicare's pay-for-performance demonstration project was associated with a modest improvement on quality metrics, compared with hospitals not in the project.

Steven D. Pearson, MD, president of Harvard Medical School's Institute for Clinical and Economic Review says that "Unless you look at a control group of some kind, you may be misled about what's really happening."

There appears to be a fundamental problem with current P4P programs. They have had little to no impact on quality. That is the conclusion of many studies, including an analysis of quality incentives, published in the July/August, 2008 of Health Affairs. It compared 81 Massachusetts physician groups eligible for quality incentives with 73 that were not. The study did find, however, that overall performance from 2001 to 2003 improved on 73% of preventive care measures such as diabetes hemoglobin A1c testing, breast cancer screening and well-child visits. But the performance of the 5,350 physicians analyzed was statistically indistinguishable. Everyone's quality improved, regardless of whether the physician group stood to earn a bonus, which ranged from $200 to $2,500 per quality measure for an individual physician, depending on the health plan.

Another study that examined the CMS hospital P4P data also wasn't positive about P4P. A June 6, 2007, Journal of the American Medical Association study of heart attack care found no significant improvement for 54 hospitals in the CMS P4P demonstration, compared with 446 nonparticipating hospitals.

And a systematic review of 17 studies, published in the Aug. 15, 2006, Annals of Internal Medicine, found positive or partially positive effects of P4P programs, but the impact was usually small.

We actually have remarkably few evaluations that have a comparison group of any kind, so the evidence on pay-for-performance is rather spotty.
Overall the P4P programs evaluated over the last five years have been largely unimpressive in their results.

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 Acid reflux foods.

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

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

Section II of III. The Debate between Doctors and Insurance carriers about “pay for performance” [P4P] reimbursement plans

2009-11-23T06:54:00.002-05:00

1. From Woolf, SH, JAMA, Vol. 282, 1999 - Estimated savings for good treatment of DM, HTN, MI, Colorectal CA, Pneumonia over current treatment levels.
a. DM control could prevent 2,600 cases of blindness and 29,000 cases of kidney failure.
b. HTN control could prevent 68,000 deaths
c. Following evidence guidelines in MI could prevent 37,000 deaths
d. Administration of pneumoccal vaccine could prevent an estimated 10,000 deaths per year
e. Colorectal cancer screening could prevent an estimated 9,600 deaths per year (not to mention the cases where multiple hospitalizations and chemotherapy are needed.)

2. From Diabetes Care - Vol 20, Number 12, Dec 1997 - Cost of diabetic with A1c at 6-7% is $378/year, with A1c of 9-10% is $1205 per year. Cost of Diabetic with CAD and HTN is $1505/year at A1c of 6-7%, $4116/year at a1c of 9-10%

3. Premier Report came out last month: Simple adherence to basic medical treatment guidelines for Medicare patients hospitalized for CABG, MI, and Knee replacement would save $1.35 billion per year. 5,700 deaths, 8,100 complications and 10,000 readmission to the hospital could be averted if clinicians followed medically prescribed treatment steps.

4. Bridges to Excellence (Bridgestoexcellence.org) has found that for every $1 bonused to a primary care doctor, there was a savings of $3 to the payor (not insurance company in this case, but employer). BTE is an initiative initally by fortune 500 companies and was outside of insurance companies.

Doctors say:
The doctors respond with their argument is not that P4P is the solution to all problems. Instead, the main focus now should be on the current reimbursement system that does not simply not pay for good care, but it encourages bad care.
The recent study that showed that over half of elderly patients leave the doctor's office without proper medication advice is a good example. Why is this? It happens because doctors are pressured to see as many patients as possible to meet overhead and consequently spend less time on each patient. Medicare cuts should only add fuel to this fire.

There’s plenty of data that shows that medical care in the US is not nearly at the quality it should be. It is not the doctors that are at fault (in their opinion) but the system that does not reward good care, but instead rewards doctors who spend as little time as possible with patients.

Doctors say:
The doctor’s main point, is that the current payment system is broken, CMS is dead set on fixing it via P4P.
But say the doctors instead of being judged for whether a test was done (without EMR, this is the only way to measure performance, as it is based on claims data), but whether it was addressed by the physician.
If a patient chooses to not have a mammogram, the doctor should be able to report that they refused it and get credit for addressing the issue.
If blood pressure is up and the doctor responds appropriately, he/she should be credited for doing the right thing, regardless of the outcome.
The concept should be that measuring physician behaviors on an EMR system so as to accurately record the intent of the physician.

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 Section III of III. The Debate.

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

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

Section I of III. The Debate between Doctors and Insurance carriers about “pay for performance” [P4P] reimbursement plans

2009-11-16T06:49:00.002-05:00

Doctors say:
"Pay for Performance" (often abbreviated P4P) is based on the false concept that doctors will take better care of patients if they're paid more.
Big insurers in each state; are discussing P4P as the next thing as they ratchet down reimbursements and pile on the denial hassles according to practicing physicians.
Why P4P?
Is it to save more money for medical insurance carriers.
Or is it truly to reward better quality medical care?

Capitation is broken say doctors.
Capitation is/was a way to shift the risk of having to pay for a doctor's visit away from the insurance company and onto the doctor. Somehow or another back in the early '80s enough people were fooled, but have since wised up say doctors. If no one's willing to take it on, capitation won't work. That's why it's fading away, say doctors.

Fee for service is broken say the insurance carriers.
Baloney- say the doctors. “Pay me a reasonable rate for what I do and I'll be happy as a clam.”

Insurance carriers say:
• Fee for service has no incentive for quality
• Thus we need Fee for service + bonus/incentive to reward quality
Doctors say:
At no point in P4P discussions has the word "Quality" ever effectively been defined in the context of medical care.

Insurance carriers say:
What percentage of your diabetic patients have A1C's under 7%; how many of your hypertensives' blood pressures are controlled?
What % of patients had mammograms and colonoscopies?
That’s what tells us that your patients are getting food or bad quality care.

Doctors say:
The central element of "quality" will forever remain fundamentally un-measureable; and here's why:

In the primary care context, the essence of a given encounter for medical care consists of an interaction between two people: the doctor and the patient. There are certain things doctors expected to do: ask appropriate question to elicit sufficient information to come to an accurate diagnosis; decide upon and discuss various treatment options with the patient; make sure that the patient has enough information, education and emotional support to understand and implement the treatment (or work up) plan; and so on.
But the key element is that the encounter is an interaction. There are two of us. The quality of that interaction is not 100% dependent on me. Any attempt to "measure" it implies that it is. And doctors don't buy it.

The discussions on P4P inevitably turns to EMRs (electronic medical records) as an integral part of P4P. Everyone has to have them; that's how they're going to get the performance data they're going to pay doctors.
But once all the numbers are crunched, though, it turns out a doctor will see only about $3,000 in P4P bonuses for a $30,000 EMR investment..
The response by insurance carriers is that the real return is more likely to be in the areas of quality and lifestyle.
Doctors reply:
Imagine presenting a proposal to an insurance company -- actually to any kind of business -- and saying, "Now, you'll only make back about 10% of your initial investment, but you're likely to see improvement the areas of quality and lifestyle."

Doctors see P4P as in the early 1990’s when the buzzword was "vertical integration." Hospitals and health systems were buying up medical practices. The idea was that by consolidating the referral base, the "system" would rake in the profits, which would then trickle down to the now employed physicians. The private office, especially solo, was considered an unworkable business model. Over the next ten years, it didn't work out quite the way the hospitals and health systems said it would. So docs were stuck either buying back their own practices, or being subjected to more and more outrageous working conditions (required to see 56 patients in 8 hours, etc.)

Doctors say:
This whole "pay for performance" thing doesn't sound quite right for many reasons. They believe that when everyone seems to think something is so, but can't explain it in a way that it makes sense to them, there's something wrong with what they're saying.

And what is quality they ask?
Openly discussing both benefits and risks of screening or just using scare tactic to get more patients screened?
If you are not mentioning the risks, if you using relative mortality reduction and not mentioning the real chance of your patient benefitting, are you not misleading the patient?
It happens already, but at least now, the doctors respect the right to choose.

Doctors say:
With P4P doctors will be loosing money for every patient with LDL 4 points above guidelines (even those with 10-year heart attack risk of 1%). A 40-something ballet teacher with no family history of heart disease and normal ratio, albeit slightly elevated LDL is complaining of muscle side effects that interfere with her ability to do her job (saw this woman's post on one of the forums) - "what would you rather have: a heart attack or muscle pain?"

No explanation of the actual magnitude of benefit for her; after all if you mention that you are only talking about 0.3 percentage points in ARR, a patient might refuse and here goes you P4P. "It'll reduce your heart attack risk by whopping 30%".

Very few patients would think to ask "n% of what number exactly?"
Incidentally, maybe P4P should also evaluate physicians on providing honest and accurate information (to the best of the existing evidence) to the patients and respecting their right of informed refusal?

Anybody thought of making this one of the criteria?
Whether or not it is cost effective depends on absolute risk reduction for a particular person. For diabetics or people who already had heart disease it may well be (although if someone doesn't take drugs and dies sooner, will this person save money or use more of it?)
But when you are talking about measures with small absolute benefit, it should be individual choice.
As a patient I have a right to decide for myself whether certain small risk reduction worth the risks or side effects for me or not.
I don't want an incentive for a doctor that would depend on the choices I have a right to make.
I want an incentive to provide accurate information but without the vested interest in my decision.

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 Section II of III. The Debate between Doctors and Insurance carriers about “pay for performance” [P4P] reimbursement plans.

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

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

Survey suggests more than two-thirds of Americans may be overweight or obese.

2009-11-09T06:57:00.002-05:00

Vital Statistics reports that, according to a "nationwide survey of obesity" based "on data for 2005 through 2009 gathered by state health departments with the help of the" CDC, "more than two-thirds of Americans are now overweight or obese, and the percentage is still rising." The study, which was "published by the Robert Wood Johnson Foundation and the Trust for America's Health," defined "overweight as a body mass index (BMI) of 25 to 30, and obesity as a BMI over 30." Specifically, "compared with 2008, obesity rates rose in almost half the states, and decreased in none." Notably, in Alabama, Mississippi, Tennessee, and West Virginia, "more than 30 percent of adults are obese," and "eight of the 10 states with the highest obesity rates are in the South." The study also revealed that "in 30 states, 30 percent or more of children ages 10 to 17 were overweight or obese." In 1991, no state had an obesity rate above 20 percent, and in 1981 the national average was 15 percent."

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 Section I of III. The Debate between Doctors and Insurance carriers about “pay for performance” [P4P] reimbursement plans.

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

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

Stroke, tPA & Statistical Chance

2009-11-02T06:59:00.002-05:00

Knowledge should accompany any patient experiencing the symptoms of stroke when presenting at an emergency room for treatment. Assuming the facility is not a stroke center, with enhanced diagnosis resources and treatment options for combating the effects of ischemic stroke, one’s prospects for full or partial recovery could well depend upon the confidence in and willingness of the E.R. physician to administer tissue plasminogen activator or "tPA," a thrombolytic agent, capable of recanalizing a passage through an arterial clot in the brain tissue.

Although the use of tPA is recommended by the American Heart Association as a first line treatment for ischemic stroke the use of the drug is controversial because of significant risk of inducing intracranial hemorrhage and other organic damage in a small but significant number of patients.

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 Survey suggests more than two.

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

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

Post-cholecystectomy cystic duct stump leak: a preventable morbidity

2009-10-26T06:51:00.001-04:00

Irshad Ahammed et al writes that “While major bile duct injury is the most serious complication following laparoscopic cholecystectomy, bile leak from the cystic duct stump remains the commonest morbidity.” This is a retrospective assessment of all patients who had a cholecystectomy over a 5-year period from April 2003 to March 2008.

Data related to bile leakage were obtained from the Unisoft endoscopic retrograde cholangio-pancreatography (ERCP) database.

Overall 2011 cholecystectomies were performed, of which 488 were done as emergency procedures. Thirteen patients had significant bile leakage, three of which were from accessory ducts, in one the source could not be identified and nine had a cystic duct stump leak (CDSL), which formed the basis of this study. Emergency cholecystectomies seem to have a higher incidence of CDSL Eight of the nine CDSL patients had successful ERCP and stenting. One had a percutaneous trans-hepatic cholangiography and stenting. CDSL following emergency laparoscopic cholecystectomy was up to threefold higher than after elective procedures.

CONCLUSION: The CDSL of 0.44% was comparable to the reported incidence in the literature. Endoscopic management remains the treatment of choice.

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 STROKES.

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

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

COLLISIONS BETWEEN MEDICAL HUMANISM AND EVIDENCE-BASED GUIDELINES FOR STANDARDIZED MEDICAL CARE

2009-10-23T06:34:00.002-04:00

Outright collisions between medical humanism and evidence-based guidelines for standardized care can be avoided as long as clinical guidelines (beyond safety measures) remain recommendations rather than mandates. Hartzman and Groopman believe it is essential to respect the ethical principle that any choice of treatment must ultimately be made by the patient who will benefit or suffer from it. Many patients have become aware of the scientific limitations of guidelines through reports in the media about recent reversals of expert advice on hormone-replacement therapy for postmenopausal women, low-fat diets for obesity, the use of erythropoietin for cancer-associated anemia, and tight regulation of glucose levels in various settings. Because guidelines are derived from clinical studies carried out in selected groups of patients and their statistical conclusions are based on study populations, they may not apply to an individual patient, especially if he or she has coexisting conditions. In many instances, the results of larger and better-designed clinical trials have contradicted what appeared to be firm conclusions from earlier research. Furthermore, there are frequently experts who dissent from the majority opinion on which guidelines are based, and their views are not routinely represented in the guidelines.

What is the remedy ask Hartzband and Groopman writing in the NEJM?
They suggest that shared decision making be central to any changes resulting from current health care reform initiatives. All national guidelines should acknowledge the dissenting opinions of experts. Furthermore, these guidelines should indicate which specific populations were studied and which important coexisting conditions constituted criteria for exclusion from the trials, so that physicians can judge whether and how the guidelines apply to an individual patient. Currently, some guideline committees receive financial support from pharmaceutical and device companies, and there are indications that such support has influenced the recommendations.4,5 In order to assure the public that there is no potential for a conflict of interest that would taint the guidelines, an independent government body should be established to develop guidelines without industry support — analogous to the role of the Food and Drug Administration as an unbiased party for the approval of treatments. Funding could come instead from the federal monies already designated for comparative-effectiveness research.

*Tune in later for Post-cholecystectomy cystic duct stump leak.

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

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

CHILDHOOD POISONINGS RESULT IN 71,224 EMERGENCY DEPARTMENT VISITS NATIONWIDE EVERY YEAR

2009-10-20T07:07:00.001-04:00

Children are twice as likely to be poisoned by the medicine cabinet than by cleaning products or other household substances, researchers found.

Emergency department visits for unintentional poisoning involved prescription or over-the-counter medication in 68.9% of pediatric cases, according to Daniel S. Budnitz, MD, of the Centers for Disease Control in Atlanta, and colleagues.

Children taking medications without supervision caused 10 times as many poisonings as overdose errors by a parent or other caregiver in the national study of emergency department surveillance, the authors reported online ahead of print in the AMERICAN JOURNAL OF PREVENTIVE MEDICINE.

The findings held few surprises but emphasize the need for prevention, particularly with toddlers, commented Carl Baum, MD, of the Center for Children's Environmental Toxicology at Yale-New Haven Children's Hospital, who was not involved in the study.

Children 5 and under accounted for 81.3% of pediatric accidental poisonings in the study, which Baum chalked up to their inventiveness in bypassing adult measures to prevent access. "You have to be careful because toddlers are often one step ahead of adults," he asserted.

Budnitz' group analyzed data from the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS), which receives reports from a random sample of adult and pediatric hospitals across the country.

The database included 3,034 emergency department visits or hospital admissions of patients under 19 during 2004-2005 for a condition the treating physician attributed to a medication overdose (more than the intended dose or inadvertent exposure), or to poisoning from a nonpharmaceutical consumer product.

Cases included ingestion and skin or eye exposures but excluded illicit substances, alcohol, tobacco, bee stings, and lead.
The population rate of emergency care for medication overdoses was significantly higher than those for nonpharmaceutical products at 9.2 visits per 10,000 individuals per year (95% CI 7.3 to 11.0) compared with 4.2 (95% CI 3.3 to 5.0).
Commonly available over-the-counter medications accounted for 33.9% of cases overall. The most commonly implicated drugs were:
• Acetaminophen (9.3%).
• Cough and cold medications (7.3%).
• Antidepressants (6.1%).
• Nonsteroidal anti-inflammatory drugs (NSAIDs, 5.3%).

Inclusion of cough and cold medicines on this list highlights the risks emphasized recently by both the FDA and trade groups representing the manufacturers.

(See Pediatric OTC Cough and Cold Remedies Should be Shunned in Toddlers and FDA Repeats Warning on Cough and Cold Medicines and Hopes That Parents Get the Message )
Cough and cold medicines "do a very poor job of treating symptoms that are usually self-limiting" and are potentially dangerous for children, Baum noted.

Medication overdose rates peaked at age 2 years (54.7 per 10,000 individuals per year) and fell with age until adolescence, when rates again rose (1.8 per 10,000 per year at ages 12 to 14 versus 3.3 at ages 15 to 18).

"The fact that, annually, one of every 180 children age 2 years is treated in an emergency department for a medication overdose, despite current prevention efforts, underscores the size of this public health issue," Budnitz's group concluded.
If anything, the results probably underestimate the scope of childhood poisonings, since poison control centers receive many more calls about pediatric poisonings, they noted. However, only a quarter of those result in direct treatment by a healthcare professional, they noted.Since unsupervised ingestion of medications by children 5 and under accounted for more than 75% of childhood poisonings, prevention efforts should concentrate on this problem, the investigators recommended.

Child-resistant bottles, blister packs, and other packaging have been effective against childhood medication overdoses, Baum noted, though these can be defeated by failure to use them properly, such as cross-threading a lid. Further efforts are recommended to focus on improving packaging for the drugs most commonly implicated in poisonings, such as bottles that release only a single dose at a time or restrict the amount that can be ingested by an unsupervised child, the researchers said.

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