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https://www.readbyqxmd.com/read/29141482/obstetric-practice-guidelines-labor-s-love-lost
#1
Wayne R Cohen, Emanuel A Friedman
Implementation of clinical practice guidelines may moderate health care costs, improve care, reduce medicolegal liability, and provide a uniformity in care allowing meaningful investigation of treatments and outcomes. However, new guidelines are often uncritically embraced by clinicians, risk management organizations, insurance companies, and the courts as the standard of care. Adoption of incompletely vetted recommendations can lead to patient harm. Recent recommendations made by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine for assessment and management of labor provide an example of well-intended guidelines adopted uncritically...
November 15, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29140804/exploration-of-predictive-biomarkers-for-sudden-unexplained-cardiac-death-in-nonelderly-people-a-case-control-study-with-biochemical-parameters-related-to-heart-failure
#2
Sakai Kentaro, Iwadate Kimiharu, Matsumoto Sari, Takasu Shojiro, Kanto Yuko
Sudden unexplained cardiac death (SUCD) can occasionally occur in nonelderly patients with epilepsy, psychiatric disorders, or no medical history. This study was conducted to aim to analyze whether values of the biomarkers for heart failure are associated with the SUCD. Serum concentrations of N-terminal probrain natriuretic peptide, high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor α were analyzed in 57 nonelderly patients with SUCD who was diagnosed at medicolegal autopsy. The subjects were divided into 3 subgroups according to the medical history: (1) epilepsy, (2) psychiatric disorders, and (3) no specific medical history...
November 15, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29140803/use-of-postmortem-computed-tomography-to-detect-bowel-obstruction-and-its-relationship-to-the-cause-of-death
#3
Dominic Gascho, Sarah Schaerli, Lucile Tuchtan-Torrents, Michael J Thali, Guillaume Gorincour
Bowel distension frequently indicates bowel obstruction, which is a common diagnosis in clinical radiology. Typically, symptoms and complaints lead to radiological examinations and the detection of the etiology. Untreated intestinal obstructions can lead to a fatal outcome through cardiac failure due to septic shock. Certain of these cases undergo medicolegal investigations depending on the case history, the condition of the decedent, the location of the finding, or recent visits to medical professionals. Computed tomography (CT) is a recommended method in clinical radiology for the detection of bowel obstruction, which is indicated by bowel distension and further radiological signs (eg, the whirl sign, which indicates a volvulus)...
November 15, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29133333/barriers-and-facilitators-to-orthopaedic-surgeons-uptake-of-decision-aids-for-total-knee-arthroplasty-a-qualitative-study
#4
Samantha Bunzli, Elizabeth Nelson, Anthony Scott, Simon French, Peter Choong, Michelle Dowsey
OBJECTIVES: The demand for total knee arthroplasty (TKA) is increasing. Differentiating who will derive a clinically meaningful improvement from TKA from others is a key challenge for orthopaedic surgeons. Decision aids can help surgeons select appropriate candidates for surgery, but their uptake has been low. The aim of this study was to explore the barriers and facilitators to decision aid uptake among orthopaedic surgeons. DESIGN: A qualitative study involving face-to-face interviews...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29131309/deaths-from-resident-to-resident-aggression-in-australian-nursing-homes
#5
Briony Murphy, Lyndal Bugeja, Jennifer Pilgrim, Joseph E Ibrahim
OBJECTIVES: To describe the frequency and nature of deaths from resident-to-resident aggression (RRA) in nursing homes in Australia. DESIGN: National population-based retrospective cohort study. SETTING: Accredited nursing homes in Australia. PARTICIPANTS: Residents whose deaths resulted from RRA and were reported to the coroner between July 1, 2000, and December 31, 2013. MEASUREMENTS: Cases were identified using the National Coronial Information System, and data on individual, interpersonal, organizational, and societal factors were collected through review of the paper-based coroners' files...
November 13, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29127226/risk-of-sudden-cardiac-death-in-relation-to-season-specific-cold-spells-a-case-crossover-study-in-finland
#6
Niilo R I Ryti, Elina M S Mäkikyrö, Harri Antikainen, Eeva Hookana, M Juhani Junttila, Tiina M Ikäheimo, Marja-Leena Kortelainen, Heikki V Huikuri, Jouni J K Jaakkola
OBJECTIVE: To test a priori hypothesis of an association between season-specific cold spells and sudden cardiac death (SCD). METHODS: We conducted a case-crossover study of 3614 autopsy-verified cases of SCD in the Province of Oulu, Finland (1998-2011). Cold spell was statistically defined by applying an individual frequency distribution of daily temperatures at the home address during the hazard period (7 days preceding death) and 50 reference periods (same calendar days of other years) for each case using the home coordinates...
November 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/29122395/the-clinical-and-medicolegal-implications-of-radiology-results-communication
#7
Barun Aryal, Derek A Khorsand, Theodore J Dubinsky
Multiple guidelines and legal precedents have established the radiologist's duty to inform clinicians directly of critical findings, or findings that will greatly impact patient health in a timely manner [1]. While the number one cause for radiology malpractice cases is misdiagnosis, the literature shows a growing portion of lawsuits surrounding breakdowns in communication between radiologists and ordering providers [2,3]. As such, a review of guidelines related to the communication of imaging results is warranted...
October 12, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/29117603/-clinical-tests-for-symptom-validity-assessment
#8
Bernhard Widder
Assessing symptom validity is essential both in the clinical and medicolegal contexts. If neurological symptoms are demonstrated and/or a patient complains of pain that is not or cannot be fully explained by an underlying disease, it is necessary to recognize reliably a possible psychological cause in order to avoid further unnecessary examinations. In the medicolegal context, malingering or exaggeration of complaints for obtaining financial benefit is to be differentiated in a further step. The present overview contains a summary of clinical observations and tests for neurologists and psychiatrists used for symptom validity assessment of sensorimotor symptoms, tremor, gait, equilibrium and visual disturbances as well as pain...
November 8, 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/29108867/medicolegal-issues-for-the-respiratory-paediatrician
#9
REVIEW
Ian M Balfour-Lynn
The legal profession depends on expert witnesses, and indeed the first time an English Court relied on an expert medical witness was in the 14th century. Asking a specialist to comment on the standard of professional practice expected in their own specialty was first introduced in a 1767 case [1]. This article draws on 20 years of experience in medicolegal work relating to paediatric respiratory medicine. It highlights some of the legal principles that lie behind an expert opinion and what constitutes clinical negligence...
October 12, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/29108808/fatal-intracranial-aneurysms-and-dissections-causing-subarachnoid-hemorrhage-an-epidemiological-and-pathological-analysis-of-607-legal-autopsy-cases
#10
Shinjiro Mori, Shirushi Takahashi, Akira Hayakawa, Kazuyuki Saito, Aya Takada, Tatsushige Fukunaga
BACKGROUND: There are no detailed reports, in terms of epidemiology and pathology, on intracranial aneurysms and on dissections that were found in unexpected fatal subarachnoid hemorrhage (SAH) cases. In this report we analyzed, based on large-sized medicolegal autopsy cases, the detailed epidemiology and pathological aspects of both lesions. METHODS: We analyzed 607 autopsy cases of unexpected fatal SAHs including 496 aneurysms and 111 dissections. RESULTS: The following results were obtained: (1) Patients who died of dissections were younger than those who died of aneurysms; (2) symptom prevalence rates of aneurysms were 31...
November 3, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29098638/epicardial-adipose-tissue-volume-estimation-by-postmortem-computed-tomography-of-eviscerated-hearts
#11
Louise Hindsø, Lykke S Jakobsen, Christina Jacobsen, Niels Lynnerup, Jytte Banner
Epicardial adipose tissue (EAT) may play a role in the development of coronary artery disease. The purpose of this study was to evaluate a method based on postmortem computed tomography (PMCT) for the estimation of EAT volume. We PMCT-scanned the eviscerated hearts of 144 deceased individuals, who underwent a medicolegal autopsy. Using Mimics® we performed segmentation of the images and obtained the volumes of EAT and myocardium. Total heart volume was calculated by adding the volumes of EAT and myocardium...
November 2, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/29090735/learning-from-the-law-a-review-of-21%C3%A2-years-of-litigation-for-pain-during-caesarean-section
#12
K McCombe, D G Bogod
The large majority of caesarean sections in the UK are now carried out under neuraxial anaesthesia. Although this technique is widely accepted as being the safest option in most circumstances, the use of regional anaesthesia increases the risk of patients experiencing intra-operative discomfort or pain. Pain during operative obstetric delivery is the commonest successful negligence claim relating to regional anaesthesia against obstetric anaesthetists in the UK. In the following article, using a database of over 360 cases spanning 21 years, we break down and examine the recurrent components of medicolegal claims concerning pain during caesarean section and consider how anaesthetists might avoid litigation...
November 1, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29079241/ankle-fracture-associated-with-rupture-of-the-achilles-tendon-case-report-and-review-of-the-literature
#13
Mohammed Elmajee, Asan Rafee, Tolupe Williams
Solitary ankle fracture or Achilles Tendon (AT) rupture might not be an uncommon injury. However, concomitant ipsilateral ankle fracture with AT rupture is rare. The present report discusses this rare combination. A 30-year-old female had fallen while rock climbing and sustained a closed fracture of the medial malleolus with an ipsilateral complete AT rupture. Most of the reported cases had similar patterns, not only in terms of history, but also in terms of a similar fracture pattern. This rare combination of orthopedic injuries tends to occur when an abrupt excessive force is applied to the forefoot, with subsequent ankle hyperextension or hindfoot inversion...
November 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29078769/this-moral-coil-a-cross-sectional-survey-of-canadian-medical-student-attitudes-toward-medical-assistance-in-dying
#14
Eli Xavier Bator, Bethany Philpott, Andrew Paul Costa
BACKGROUND: In February, 2015, the Supreme Court of Canada struck down the ban on medical assistance in dying (MAiD). In June, 2016, the federal government passed Bill C-14, permitting MAiD. Current medical students will be the first physician cohort to enter a system permissive of MAiD, and may help to ensure equitable access to care. This study assessed medical student views on MAiD, factors influencing these views, and opportunities for medical education. METHODS: An exploratory cross-sectional survey was developed and distributed to medical students across all years of a three-year Canadian undergraduate medical program...
October 27, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/29072958/medicolegal-malpractice-and-ethical-issues-in-radiology
#15
Leonard Berlin
No abstract text is available yet for this article.
November 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29067946/can-post-operative-antibiotic-prophylaxis-following-elective-laparoscopic-cholecystectomy-be-completely-done-away-with-in-the-indian-setting-a-prospective-randomised-study
#16
Vikram Singh Chauhan, P L Kariholu, Sabyasachi Saha, Himanshu Singh, Jasmine Ray
Premise and Objective: Elective laparoscopic cholecystectomy (LC) has low risk for post-operative infectious complications; still most clinicians use persistent post-operative prophylactic antibiotics out of habit, tradition, or simply as defensive practice due to evolving medicolegal implications of a large number of surgeries being showcased as daycare or next day discharge procedures. This randomised prospective trial was done to test the need for such prophylaxis in cases of elective LC in a rural/semi-urban setting...
October 23, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29063459/tension-pneumopericardium-following-suicidal-stab-wounds-to-the-chest
#17
Jakob Heimer, Stephan A Bolliger, Michael J Thali, Wolf Schweitzer
Pneumopericardium (PPC) and Tension Pneumopericardium (TPPC) refer to collections of gas in the pericardial cavity, the latter resulting in air tamponade and cardiac compromise. Following penetrating chest injuries, PPC and TPPC appear to be uncommon findings associated with a high mortality and correlated with other thoracic trauma. Diagnosis of PPC and TPPC is difficult relying on conventional autopsy alone, while postmortem computed tomography (PMCT) shows a high sensitivity for the detection of internal gas collections...
October 23, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/29049576/medicolegal-illegal-prescribing-of-intoxicating-liquor
#18
(no author information available yet)
No abstract text is available yet for this article.
October 10, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29049120/a-contemporary-medicolegal-analysis-of-outpatient-medication-management-in-chronic-pain
#19
Christopher R Abrecht, Ethan Y Brovman, Penny Greenberg, Ellen Song, James P Rathmell, Richard D Urman
BACKGROUND: Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO)...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29044399/barriers-and-facilitators-to-public-access-defibrillation-in-out-of-hospital-cardiac-arrest-a-systematic-review
#20
Christopher M Smith, Sarah N Lim Choi Keung, Mohammed O Khan, Theodoros N Arvanitis, Rachael Fothergill, Christopher Hartley-Sharpe, Mark H Wilson, Gavin D Perkins
Public access defibrillation initiatives make automated external defibrillators available to the public. This facilitates earlier defibrillation of out-of-hospital cardiac arrest victims and could save many lives. It is currently only used for a minority of cases. The aim of this systematic review was to identify barriers and facilitators to public access defibrillation. A comprehensive literature review was undertaken defining formal search terms for a systematic review of the literature in March 2017. Studies were included if they considered reasons affecting the likelihood of public access defibrillation and presented original data...
October 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
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