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Patients And Health Care Providers Seek Improved Quality As Report Shows Extensive Errors
The Washington Post reports on efforts by hospitals to tally their avoidable mistakes and describes "hundreds of incidents of death or serious medical harm disclosed in the past year by hospitals in the Washington region, preventable errors that until recently have not required public reporting. Under laws that took effect last year in Virginia and a few years earlier in the District and Maryland, hospitals must report to health regulators many serious injuries that patients suffer in the course of treatment. The laws are different in each jurisdiction. For example, Virginia"s public records identify the hospitals by name, while Maryland"s and the District"s do not. But they all allow the public to glimpse the breadth of mistakes that health experts dub "never events" (because they should never happen): sponges left inside patients after surgery, operations on the wrong limb, medication errors, falls that lead to needless deaths (as well as other events). At least 20 states require hospitals to report every incidence of hospital-acquired infection. Patients, insurers and regulators are beginning to use this information to prod health-care providers to ensure that such events really never happen."
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Breast Cancer Research Highlights From The American Association Of Physicists In Medicine Meeting In Anaheim, July 26-30
Half of all Americans will be diagnosed at some point in their lives with cancer, the number two killer in the United States. One of the most common types, especially among women, is breast cancer. According to the National Cancer Institute, 192,370 women will be diagnosed with breast cancer in 2009, and more than 40,000 women will die from the disease this year alone.
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Role Of Liver Transplantation Techniques In Surgical Management Of Advanced Renal Urothelial Carcinoma With/without Inferior Vena Cava Thrombus
UroToday.com - Large urothelial carcinoma of the renal pelvis poses a diagnostic as well as surgical challenge to the urologist. This type of malignancy is frequently mistaken preoperatively for renal cell cancer due to its low incidence (10% of all renal malignancies) especially when associated with tumor extension into the inferior vena cava. The presence of a large renal mass should therefore not dissuade the urologist to perform cystoscopy and cytology in order to complete hematuria work-up. Opening the specimen in the operating room will provide clues for the origin of the tumor.
Public Health

Vitamin D And Calcium Supplements Help Prevent Bone Fracture In The Elderly

We all know that vitamin D and calcium are good for bones, but research teams in Europe and USA have shown that both taken daily reduces the rate of hip fracture in older people by 20%. Speaking at the European Symposium on Calcified Tissue in Vienna today (27 May), Professor Bo Abrahamsen from the Copenhagen University Hospital Gentofte in Denmark, described the results from a major study analysing seven trials examining the effects of low doses of vitamin D with calcium in 68,500 patients. Participants in the study were aged 47 - 107 years old, average age 69. Their age, gender and fracture history were taken into account, together with medication such as hormone replacement therapy and bisphosphonates (used in the treatment of post-menopausal osteoporosis and osteoporosis in males). Patients in all the trials included were randomised to receive either vitamin D (given alone or with calcium, usually in the form of 1000 mg calcium carbonate daily) or no active treatment. "The real strength of this study was that we were looking at groups and individuals, not just summary statistics. We were able to calculate absolute fracture rates and the time to treatment effects," he said. After about 16 months, the reduction in hip fracture rates by 20% was seen in people who took vitamin D (10ug; 400 IU) and calcium (1000 mg) together, regardless of age, gender and fracture history. Fracture rate in other bones was reduced by 10%. "Vitamin D on its own is not very effective, even if the dose is doubled," said Professor Abrahamsen, a consultant physician at the hospital. "In people over fifty, the combination of vitamin D with calcium, however, seems to work equally well in people with or without a history of bone fractures - this is important new knowledge," he said. The impact of calcium plus vitamin D on fracture however is somewhat more modest than that seen for other osteoporosis interventions. People with a high risk of fracture will benefit more from being treated with specific osteoporosis drug therapies such as bisphosphonates, together with oral vitamin D and calcium. Professor Tahir Masud from Nottingham University Hospital and a UK collaborator said, "Previous data have shown that there is a high degree of vitamin insufficiency in the older population in the UK. Many older people at high risk of fracture do not receive vitamin D and calcium supplements." The study cannot separate the beneficial effects of daily vitamin D from daily calcium, but the results suggest that vitamin D by injection every three months given to many elderly patients does not make a big impact on fracture rates. "We cannot yet recommend that all adult, healthy people should take oral vitamin D and calcium supplements to prevent bone fracture in later life, but our findings indicate that vitamin D supplements taken daily with calcium is a simple and cheap way of reducing the risk of bone fractures in people in late middle age and onwards, " said Professor Abrahamsen. The European Calcified Tissue Society


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