Think Before You Sue the Doctor

August 18, 2007

A lawyer writing in the Michigan Law Review has assessed the outcomes of medical malpractice suits, with some interesting conclusions.

1. Contrary to popular opinion, the jury is more likely to sympathize with the physician than with the patient, other things being equal.
2. Juries can usually recognize a weak case, agreeing with the legal experts 80% to 90% of the time.
3. Plaintiffs win 10% to 20% of the cases that independent reviewers feel they should lose, and 20% to 30% of the cases rated as toss-ups.
4. Physicians win roughly half of the cases that independent expert reviewers believe they should lose, based on strong evidence of negligence.

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Serum Uric Acid and Parkinson’s Disease

August 12, 2007

Robert W. Griffith, MD

Here’s another ‘re-discovery’. In 1996 Honolulu scientists reported that, in a population of 8000 men, those with above average serum uric acid levels had a 40% reduction in their likelihood of later contracting Parkinson’s disease. This was reported in the American Journal of Epidemiology . The scientists suggested that the antioxidant properties of uric acid might protect against oxidative damage and nerve cell death in Parkinson ‘s. And they advised further research.

Eleven years later (last June, in fact) the same journal reported data from the Health Professionals Follow-up Study, which comprised 18,000 men screened in1993-1995 and followed until 2000. 84 cases of Parkinson’s disease were matched with two controls by age, race, and time of blood collection. Then the participants were divided into quarters (quartiles) based on their serum uric acid. After corrections for age, smoking, and caffeine, those in the highest quartile were found to have a 55% lower likelihood of developing the disease than those in the lowest quartile. The principal investigator stated “”the data are very compelling, and if they are confirmed, urate could become the first biomarker of Parkinson’s disease”. Do we really need another study (in ten years’ time!) to re-discover this relationship?

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FDA Okays Stomach Drugs Prilosec And Nexium, For Now

August 11, 2007

The US Food and Drug Administration (FDA) said yesterday that a preliminary review of new data on the safety of two stomach drugs made by AstraZeneca, Prilosec (generic name omeprazole) and Nexium (generic name esomeprazole) suggests that long term use of these medications does not lead to heart attacks and other heart related events. The agency said for the time being, until a final decision and recommendation is made in three months’s time, health professionals and patients should not change their current practice in the use of these drugs.

Prilosec and Nexium are proton pump inhibitors (PPIs) used to control stomach acid. They are taken by patients with a range of gastrointestinal conditions such as ulcers and gastroesophageal reflux disease (GERD). Some GERD conditions erode the lining of the food pipe (esophagus) and PPIs help to heal the erosions or stop them getting worse. Prilosec and Nexium are available in the US by prescription, although Prilosec is also dispensed over the counter for heartburn.

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