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March 2013 Archives

Group Appointments Increasing

Recently, doctors have begun group appointments when they see up to a dozen patients with similar medical concerns all at once. Reasons for this trend include allowing more patients to be seen by a doctor each day, allowing doctors to spend more time with patients even if not on an individual basis, easier scheduling availability and improved health outcomes. Some people see group appointments as a way to ease the developing physician shortages. At least 8,000 more physicians are needed to accomodate the more than 27 million people newly insured under the Affordable Care Act. There aren't enough physicians to handle this increase.

Robotic Hysterectomy Not Superior to Traditional Methods

The use of robotically assisted hysterectomy has become more frequent since the FDA approved the use of the robotic surgical platform for gynecologic procedures. Although robotic surgery is more costly, a recent study has shown that the outcomes for robotic surgery are not superior to open abdominal, vaginal and laparoscopic surgery for benign disease. The study looked at 275,000 cases  at 441 hospitals between 2007 to 2010 and compared the rate of intra-operative complications, surgical site complications, medical complications, transfusion requirements, reoperation rates and mortality. Robotically assisted surgery did not significantly improve outcomes or reduce complications. The frequency of abdominal and vaginal approaches for hysterectomy declined from 54% to 41% of cases and from 22% to 20% respectively. The frequency for laparoscopic hysterectomy rose from 24% to 30%. But the frequency for robotic surgery skyrocketed from 0.5% to 30% of procedures during the study.

Failure to diagnose pediatric stroke puts kids at risk

Kids are not adults in smaller bodies. Teenagers, in particular, may seem to be physically big enough to be viewed with an adult lens. When it comes to the treatment of a stroke, however, the inability to recognize their unique needs can constitute medical malpractice.

Oral Argument in the Comedian Municipal Court Judge Case

Partner, E. Drew Britcher appeared before the New Jersey Supreme Court on February 26th on behalf of the Municipal Court Judge of South Hackensack, New Jersey seeking an interpretation of the Canons of Judicial Ethics that would allow Judge Vince Sicari to continue his very successful primary career as a comedian and actor under his stage name Vince August.

Infection Control Crisis Carbapenem-Resistant Enterobacteriaceae

Infection Control is critical as there is a dangerous new strain of antibiotic resistant bacteria that has been found in about 5% of US hospitals last year. The Center for Disease Control warns that this new superbug is Carbapenem-Resistant Enterobacteriaceae (CRE). It is a difficult infection to treat and has a high mortality rate. Most of the CRE cases involved Klebsiella species of bacteria. CRE infections are important because once these bacteria invade the blood stream, mortality rates are greater than 40%. Most of these infections start in the urine. CRE strains frequently have other antibiotic resistant capabilities that make them immune from most antibiotics and several strains resistant to all antibiotics have been detected. New antibiotics that might be effective against CRE strains are years away from commercial availability. Because Enterobacteriaceae are the most common infective CRE organism in the health care setting, with pseudomonas and acinebacter species being others, these bacteria have the potential for moving out of the hospital and into our communities.

Lung Cancer CT Screening Could Prevent 12,000 Deaths

Lung cancer screening of all current and former smokers with low-dose CT scanning would result in preventing 12,000 deaths in the United States each year. A study in Cancer reported that, compared with chest x-ray, CT screening would reduce lung cancer mortality by 20%. The total number of potentially avoidable deaths could even be greater. The patients in the study were 55 to 74 years of age and smoked at least one pack a day for 30 years. Even though these patients are at risk for cancer, screening is generally performed by chest x-ray which misses 20% of tumors.

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