More than 27 million Americans undergo noncardiac surgery annually. Cardiac complications can be a major source of morbidity and mortality in the perioperative period. The focus of the preoperative evaluation for patients with preexisting atrial fibrillation is to (1) assess rate and/or rhythm control; (2) identify patients with valvular disease or heart failure; (3) determine… read more
Atrial fibrillation (AF) patients and treating physicians have to remember that stroke represents a devastating complication from AF. There exists many situations where one can live reasonably well with partially damaged organs; the brain is often not one of these. Sight, memory, speech, cognition, ambulation, and continence are all brain-controlled functions that directly relate to… read more
By; Ray Rollings Over fifty years ago, the distinguished Harvard professor and engineering consultant Karl Terzaghi published a classic paper entitled Consultants, Clients, and Contractors. This paper explored the dynamic and often destructive interactions between these parties in major engineering works. Today, we often see the same destructive conflicts between the parties of which Professor… read more
Epidural steroid injections, both translaminar and transforaminal, are a common therapeutic provided by many pain management practitioners. While this procedure is generally considered safe, there have been reported cases of neurological injuries including spinal cord injury, respiratory arrest, spinal cord infarction, paralysis, and death. The Doctors Company, the nation’s largest physician-owned medical malpractice insurer, reports… read more
Software innovation is growing at an incredible rate in the United States. This means that for many software companies and innovators, so are software patents and software patent litigation. As software programming evolves, the law and legal precedences also change, and the various courts and agencies that apply and interpret them must adapt to a… read more
Assessing Risk Assessing risk is an important issue in both clinical and forensic psychiatry. Whether a clinician is capable of predicting suicide, dangerousness or relapse is a controversial topic as well. It is clear that the future cannot be predicted accurately all the time by even the best clinician. However sometimes, there are logical means… read more
Introduction Over the years, psychiatry has generally not been considered a high-risk medical specialty, at least in regard to the risk of being sued based on a cause of action for medical negligence. The authors in a NEJM article titled Malpractice Risk According to Physician Specialty (8/18/2011) found that only 2.6% of psychiatrists faced a… read more
Introduction In evaluating catastrophic burn victims it is important to objectively assess the extent of scarring, outline a treatment protocol, and predict future disfigurement to determine a prognosis and long-term expenses and medical costs. Incidence of Burn Injuries The American Burn Association reports 450,000 burn related hospital admissions and emergency department visits annually. [1] Minor… read more
Introduction Cataracts are the most common cause of visual loss and blindness in the world. According to the American Society of Cataract and Refractive Surgery approximately 3 million Americans undergo cataract surgery each year. Most of these surgeries are performed without complications. Some patients do suffer significant complications. Definitions A cataract is a clouding of… read more
In dog bite cases it is essential to objectively assess the extent of scarring, outline a treatment protocol and predict future disfigurement in dog bite victims. These parameters are necessary in determining long term expenses and medical costs. Incidence of Dog Bite Injuries Approximately 77.5 million dogs are owned as pets in the United States…. read more
