September Pearls

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September 29, 2013

 1. Preventable Adverse Events (PAE) at U.S. hospital are the third leading cause of death behind heart disease and cancer.

 A new study in the Journal of Patient Safety, conducted by John James of the advocacy group Patient Safety America, estimates that PAEs cause as many as 440,000 patient deaths a year in U.S. hospitals, far more than the estimate from the Institute of Medicine (IOM) which estimated about 98,000 PAE deaths in the country each year.  HHS, on the other hand, estimated in 2010 that PAEs were responsible for 180,000 deaths a year in Medicare beneficiaries alone.

“ All evidence points to the need for much more patient involvement in identifying harmful events and participating in rigorous follow-up investigations to identify root causes,” James wrote in his study, concluding that perhaps “ it is time for a national patient bill of rights for hospitalized patients.”                                                                            

2. The Antibiotics Resistance Crisis: The CDC reported that more than two million Americans become ill with antibiotic-resistant infections each year, resulting in at least 23,000 deaths, costing the U.S economy about $20 billion a year, with loss of productivity as high as $35 billion.

Antibiotic resistance is caused by frequent and sometimes unnecessary use of antibiotics or incomplete use of an antibiotic course of treatment.  As patients, we should resist the temptation of asking for antibiotics whenever we have cold like symptoms.  As physicians, our goal is to treat infections appropriately, explain to our patients the danger of antibiotic resistance and try to avoid overprescribing antibiotics.

3. Exposure to different chemicals in the environment can harm reproductive health.

The American College of ObGyn (ACOG) and the American Society for Reproductive Medicine urged physicians to be aware of their patients’ exposure to environmental chemicals and to advise patients of how to avoid these exposures.  Many chemicals such as mercury in certain fish could harm brain development.  Some pesticides have been linked to childhood cancer, while other chemicals have been linked to infertility, birth defects, and miscarriages.   Pesticides in adult men have been linked to sterility and prostate cancer. The specialists behind this report support stricter environmental policies to better identify and reduce exposure to chemicals that are proven to pose a risk.

What should the consumers do?  Avoid processed food, wash your fresh fruits and vegetables thoroughly, avoid certain “bottom feeding” fish such as Sharks, tilefish, King Mackerel, Swordfish etc…, and limit white or albacore tuna to the FDA recommended 6 ounces per week maximum, especially for pregnant women.                                                                                                              

4. Working Longer, Lower Dementia Risk.                                                                                   

The study, conducted by Carole Dufouil, director of research in neuro-epidemiology at the Bordeaux (France) School of Public Health’s National Institute for Health and Research, showed a lower rate of Alzheimer’s and other forms of dementia in people who retired later.  There were 429,000 participants and result showed a 14% lower rate of Alzheimer’s diagnosis in those who retired at 65 instead of 60.  The researcher believed by working longer, older people continue to keep their brain stimulated.  This study was presented at the Alzheimer’s Association International Conference in Boston in July 2013.

Author’s note: Sometimes it’s difficult to determine cause and effect – Perhaps people retired earlier because they sensed they weren’t functioning 100%, and soon after were diagnosed with dementia.  Those who were symptom-free worked longer and were not diagnosed with dementia until many years later.  It might seem from looking at the results that early retirement caused the dementia, when in fact early dementia led to early retirement.   In any case, keep up as much brain exercise as possible to delay memory loss!  For more about this, see Nutrition and the Brain, Part 3.

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