More Costly Prescription Drugs in 2009 for Medicare Part D Recipients

Each year from November 15th through December 31st, Medicare Part D beneficiaries are able to make enrollment changes in their health and prescription drug coverage, which is known as open enrollment. This year, many of these beneficiaries have been notified by their insurers that either their co-pays or deductibles will be going up, and in some cases, subscribers will see an increase in both costs. Worse, some plans that were previously offered in the past will no longer be available in 2009, causing subscribers to select new policies all together. Many insurance companies have been focusing their advertising on these Medicare Part D recipients, knowing that they may be shopping around for a new policy during this time. It is possible for these recipients to research available policies and calculate possible costs by visiting www.medicare.gov.

The Part D prescription drug plan was only added to Medicare in 2006 to provide coverage to social security recipients that could not otherwise afford prescription drug benefits. However, with rising costs, some people that require costly prescription drugs on a regular basis may be motivated to research other policies, since their co-pays and deductibles are likely to go up in 2009. People subscribing to Medicare Part D’s largest plan, AARP’s MedicareRx Preferred plan, are likely to see their premiums go up to $34.92 per month, an increase of almost 20 percent. Subscribers to Medicare Part D’s third largest plan, Humana, may see an increase in their premiums of more than 50 percent, with co-pays for generic prescriptions going up to $7 and co-pays for preferred drugs going up to $40, increases of 75 and 60 percent, respectively.

The U.S. Government has no influence over the premiums set by insurance companies, although these insurers are required to be approved by the Centers for Medicare and Medicaid Services (CMS) before making plans available. People enrolled in Medicare’s prescription drug plan deserve quality benefits and should not have to worry that they cannot afford to purchase the prescription drugs they need. When insurers raise costs and begin to cut benefits, it is more likely that beneficiaries will have to make compromises to be able to afford coverage. If you or a loved one has received unacceptable medical care and has questions regarding a possible medical malpractice case, please contact Silberstein, Awad & Miklos. Our firm serves clients with Nassau and Suffolk County medical malpractice, Brooklyn medical malpractice, Bronx medical malpractice and Queens medical malpractice cases. Silberstein, Awad & Miklos also serve clients located in Staten Island and Westchester County.

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Increase in Heart Failure Cases in U.S.

When a person’s heart experiences a shortage of oxygen, resulting from an enlarged heart’s inability to pump blood to the organs adequately enough, that person is experiencing heart failure. About 660,000 patients are diagnosed with heart failure each year, some of which result in death when left untreated. In the past 30 years, the number of senior citizens presenting to the nation’s hospitals with heart failure has more than doubled, an increase that researchers expect to continue unless something is done. In addition to that, as the baby boomers reach 65 and join the senior citizen category, there will more likely than not be an increase in the number of heart failure cases, simply because there will be more seniors. These statistics were compiled from the medical records or more than 2 million seniors (65+) in the U.S. between 1980 and 2006. Researchers compared the discharged information of these patients with census population data, reporting that in 1980, there were 348,866 heart failure cases, which rose a staggering 131 percent to 807,082 in 2006. In addition, the risk of being hospitalized for heart failure doubled in seniors age 75 to 84 when compared with those age 65 to 74. In people over age 85, that risk of heart failure hospitalization was fourfold that of the 65 to 74 group.

The study was led by an associate professor of Epidemiology and Biostatistics of the Drexel University School of Public Health in Philadelphia and was presented at a meeting of the American Heart Association in New Orleans. The study noted that as heart failure hospitalization rates have increased over the past three decades, hospitalization rates for stroke and coronary artery disease have been declining since the mid-eighties. As for the cost associated with hospitalizations and other treatments for heart failure, the American Heart Association estimated this year alone, that figure will reach nearly $35 billion in the U.S.

High blood pressure, heart attack, stroke, obesity and diabetes may all increase a person’s chances of heart failure, so it is crucial to treat these health problems promptly and completely. Other factors, including smoking, poor diet and lack of exercise may all increase a person’s risk of heart failure. In most cases, doctors are able to treat heart failure by administering drugs that expand the arteries and veins, allowing the heart to pump blood to the organs more easily. Doctors may also use beta-blockers, which slow a person’s heart rate, control their blood pressure and open up vessels to improve blood flow. Another treatment for heart failure which is used less often by doctors is CRT (cardiac resynchronization therapy). This treatment helps the heart get back into its appropriate rhythm with the help of a pacemaker, which coordinates the beating of the right and left ventricles of the heart.

Heart failure is a potentially deadly health problem, especially if left untreated or if treated incorrectly by a doctor or hospital. If you or a loved one has medical malpractice questions in New York, please contact Silberstein, Awad & Miklos, serving clients with Nassau and Suffolk County medical malpractice, Brooklyn medical malpractice, Bronx medical malpractice and Queens medical malpractice cases. Silberstein, Awad & Miklos also serve clients located in Staten Island and Westchester County.

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The 2008 National Poll on Children’s Health

The C.S. Mott Children’s Hospital at the University of Michigan began conducting their National Poll on Children’s Health (NPCH) in 2007 in order to measure what Americans thought were the most important health issues facing children in the U.S. When conducting the surveys, the NPCH uses responses from about 2,000 adults in the country, that may or may not have children of their own. The survey uses a web-based system by Knowledge Networks, which selects a different sample for each poll to resemble the U.S. population. NPCH selects the top twelve issues that the people surveyed believed were the most concerning regarding children’s health. The survey allows people to choose from 20 issues, with depression, suicide, driving accidents, school violence, asthma, autism, eating disorders and neighborhood safety not making the top 12 list.

The first poll in 2007 revealed that smoking, drug abuse and obesity (in that order) were the most significant health issues for children. In the most recent poll conducted in 2008, childhood obesity jumped to number one, knocking drug abuse and smoking down to the second and third spots. The concern for obesity in children has grown as a result of the decrease in physical activity and the lack of healthy foods in the diets of many children. The results were listed in order of importance as follows:

1. Childhood obesity
2. Drug abuse
3. Smoking
4. Bullying
5. Internet safety
6. Child abuse and neglect
7. Teenage pregnancy
8. Alcohol abuse
9. Attention deficit/hyperactivity disorder
10. Sexually transmitted infection
11. Harmful chemicals in environment
12. Less physical activity

The poll also yielded some interesting results when it came to the different categories of Americans surveyed and what they felt were the most important issues. In adults that were not parents of children, the most important issues were drug abuse, smoking, internet safety and sexually transmitted infections. Teen pregnancy was the biggest concern for Black adults, while Hispanic and white adults rated this issue as a less of a concern. Hispanic adults believed that the top two concerns among children were smoking and drug abuse. When it came to household income, the survey revealed that people with higher incomes did not see drug abuse as one of the most important issues, while low-income households rated obesity and internet safety as less important.

Still, with obesity as the number one concern in the 2008 poll, it is important for parents, schools and health care systems in the U.S. to do their part and make sure kids start eating healthier and getting adequate exercise. Also, with drug abuse and smoking still ranking high on the list, it is vital to address these issues to keep children safe and healthy. If your child has been hurt by a hospital, at school or at daycare, please contact Silberstein, Awad & Miklos, serving clients in Nassau and Suffolk County, Brooklyn, Bronx and Queens. Silberstein, Awad & Miklos also serve clients located in Staten Island and Westchester County.

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Medicare’s New Nursing Home Rating System

Medicare recently developed a new rating system for nursing homes, allowing the public to view ratings for over 16,000 nursing homes throughout the United States using the Nursing Home Compare feature on their website. Medicare’s ratings were determined by health inspections, staffing, quality measures and the number of beds available based on complaint investigations, inspection records and other data collected this past year. The data also revealed some other interesting information, allowing Medicare to compare not-for-profit nursing homes with those that operate for profit. Of the for profit nursing homes, 27 percent received a one-star rating, overall, with just 9 percent received the highest five-star rating. As for the not-for-profit homes, only 13 percent received a one-star rating, while 19 percent received the five-star rating. One reason for the significant difference in ratings between the for-profit and not-for-profit nursing homes may be that the for-profit homes usually have fewer staff members, making them less able to reach higher standards of quality and care.

The Nursing Home Compare part of Medicare’s website allows people in search of a nursing home to care for their parent or loved one to see when the home was certified, whether they accept Medicare and Medicaid, how many beds they have and the date and results of their last health and fire safety inspections. It is important for people in search of a nursing home to do additional research and not just this website as their main source of information. Visiting possible nursing homes and asking others that may know of a suitable home may also be helpful in choosing the right place for a parent or loved one.

Sadly, not all nursing homes offer the best quality of care, which sometimes results in harm to their elderly patients. If you suspect a problem in the nursing home of a loved one, please call or e-mail us. Our New York negligent security lawyers know how to help families whose loved ones have suffered injury, pain, damage or emotional trauma because of nursing home negligence. We can help you remedy the situation and get you or your loved one the compensation you deserve. Proudly serving those in the Nassau County, Suffolk County, Brooklyn, & Bronx, New York area.

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CT Scans v. Angiograms

In a new study published in the New England Journal of Medicine, doctors from the Johns Hopkins University School of Medicine in Baltimore, Maryland found that the newer CT scans were less accurate than the older angiogram method for finding blockages in blood vessels. The CT scan yields 3-D images of the heart through multiple X-rays in order to see if people with chest pains have a blockage. However, the scans are relatively new and are not necessarily beneficial to the patient. In fact, CT scans, also known as multi-detector computed tomographic andiography, expose patients to significant levels of radiation, which may cause other health problems down the road. One positive aspect of the CT scan is that it is less invasive than the traditional angiogram, in which a tube is inserted into an artery traveling from the leg up to the heart, releasing a dye that illuminates blockages when X-rayed. Still, the scan does require several X-rays to create the 3-D image of the heart, increasing the patient’s exposure to radiation.

The study included 291 patients that had an angiogram, in addition to a CT scan. What doctors at Johns Hopkins found was that the CT scan produced more false negatives for blockages and was less accurate overall when compared to the angiogram results. Another negative is that in some cases, patients that receive a CT scan also require an angiogram to get additional information, which can create a cost issue, with each CT scan costing roughly $700 and each angiogram costing about $1500. Still, some doctors that support the CT scan say that it is useful in figuring out which patients will need additional treatment for their heart, without any invasive tests.

Patients are urged to talk to their doctors in detail about both procedures before deciding which is right for them. With any new test or procedure, it is possible that a doctor will encounter more problems than with one they have performed many times. If you or a loved one has questions regarding surgical, procedural or other hospital mistakes, please contact the medical malpractice attorneys at Silberstein, Awad & Miklos. We serve clients with Nassau and Suffolk County medical malpractice, Brooklyn medical malpractice, Bronx medical malpractice and Queens medical malpractice cases, as well as clients located in Staten Island and Westchester County.

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Treating Breast Cancer with Estrogen

Each year, metastatic breast cancer takes the lives of an estimated 40,000 women. Reachers are constantly exploring new options for treatment of this cancer, and in many cases, drugs being used for an extended period of time by breast cancer patients often become ineffective. One surprising treatment that doctors are now prescribing for women with metastatic breast cancer is estrogen, which is known for aiding in the growth of a tumor. However, in a new study presented at the annual San Antonio Breast Cancer Symposium, it was found that estrogen therapy brought tumor growth to a standstill in 30 percent of the women involved. For some of the women that took part in the study, not only did they see their tumors stop growing, they saw them shrink in size.

The estrogen therapy study included postmenopausal women, with an average age of 59, that had advanced metastatic breast cancer that was also considered estrogen-receptor-positive cancer. These women’s bodies were no longer benefitting from aromatase inhibitor (AI) drugs, which lower estrogen levels. Eventually, the tumors had altered themselves and became resistant to the AI drugs, allowing the cancer to grow without estrogen. Researchers introduced the estrogen to lab-grown breast cancer cells, observing them as their growth slowed down significantly. However, since these types of treatments become uneffective with long-term use, the estrogen therapy did eventually stop working. Fortunately, most women with metastatic breast cancer are able to switch back to the drugs they were previously taking to treat their cancer and prevent growth. Some patients are even able to go back and forth between the estrogen therapy and the AI estrogen-lowering drugs.

For women with metastatic breast cancer that are interested in learning if this estrogen therapy would benefit them, it is necessary to have PET (positron emission tomography) scans done before and after an estrogen treatment test. The PET scans will allow doctors to see whether or not the estrogen therapy will treat the cancer effectively. Anyone looking to find out more about this type of treatment should talk to their doctor and do extensive research before starting treatment.

With all new treatments, there is a greater chance that a doctor or hospital will make a mistake, causing the patient additional problems. If you or a loved one has medical malpractice questions in New York related to breast or any other type of cancer, please contact the attorneys at Silberstein, Awad & Miklos, serving clients with Nassau and Suffolk County medical malpractice, Brooklyn medical malpractice, Bronx medical malpractice and Queens medical malpractice cases. Silberstein, Awad & Miklos also serve clients located in Staten Island and Westchester County.

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Hospital Checklist for Patient Safety

In most cases, doctors, nurses and other hospital employees take every precaution to make sure a patient’s surgery goes smoothly and does cause any additional problems. However, in some cases, mistakes are made due to negligence or lack of communication and complications arise during surgical procedures. Thankfully, a new checklist, which will obligate doctors and nurses to make absolutely sure that every step of a procedure has been completed carefully, will become mandatory in New York’s city-run hospitals at the start of 2009. Six of the 11 city-run hospitals, including Coney Island Hospital, Kings County Hospital, North Central Bronx Hospital, Jacobi Medical Center, Lincoln Hospital and Elmhurst Hospital Center, are the first in the U.S. to use the Surgical Safety Checklist. Those Brooklyn, Bronx and Queens medical centers adopted the new policy this past August in their operating rooms, making a conscious effort to prevent mistakes during surgery and increase communication before, during and after the procedure.

This new checklist, which was introduced to the six initial hospitals by the city’s Health and Hospitals Corporation, includes three categories that prompt surgeons and nurses to check before the induction of anesthesia, before skin incision and before the patient leaves the operating room. The lists include items such as making sure surgical sponges and other instruments are removed before incisions are closed, verifying any patient allergies and having all surgical team members introduce themselves and state their role before the procedure begins.

The Surgical Safety Checklist was created by the World Health Organization and is being used as a part of the patient-safety initiative at the city’s Health and Hospitals Corporation to make hospitals safer and allow less of a possibility for mistakes. So far, the safety guidelines have reduced procedure-caused infections by 55 percent and ventilator-caused infections by 78 percent.

Mistakes do happen and it is almost impossible to reduce all risk, so it is important to know if a doctor or hospital caused additional harm when a patient has had a procedure or treatment. If you or a loved one has any questions, please contact the hospital and physician medical malpractice attorneys at Silberstein, Awad & Miklos, serving clients with Nassau and Suffolk County medical malpractice, Brooklyn medical malpractice, Bronx medical malpractice and Queens medical malpractice cases. Silberstein, Awad & Miklos also serve clients located in Staten Island and Westchester County.

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Larger Window for Stroke Rehabilitation

In the United States, stroke is the third leading cause of death, after heart disease and cancer, and a main cause of long-term disability, according to the Centers for Disease Control and Prevention. Thankfully, new tests done by research scientists have found that people that have suffered a stroke can be rehabilitated for six months or more after the stroke has occurred. In the recent past, it was believed that stroke sufferers only had the three to six month period after their stroke to regain lost functions through rehabilitation. Now, through the use of new robotic technology and fMRI (functional MRI), which assess the small changes in the oxygenation level of the blood that happen as a result of brain activity, researchers found that it is possible to rehabilitate patients for more than six months.

The study included several right-handed patients that had suffered a stroke involving the left side of the brain six or more months earlier, which impaired the use of their right sides, including their hand. The patients were instructed to exercise their hand by squeezing a robotic device for one hour per day for three days for a period of four weeks. Researchers performed fMRI exams on the patients before, during and at the end of four week period, and again after a period of time had passed. The results of the fMRI tests demonstrated that more than six months after a stroke, the brain's cortex was able to regain lost function through these types of exercises, which improved the use of the functions of the hand. In addition, fMRI showed that even after the patients had stopped the exercises, the functions of the cortex continued to increase.

Each year, an estimated 700,000 strokes occur in the U.S., leaving 80 to 90 percent of those that survive with significant weakness on the side of the body affected by the stroke. Of the stroke cases where a person’s hand is affected, about 65 percent are still not able to use their hand in a functional way after six months. With the results of this new study, stroke survivors may be able to continue their rehabilitation more than six months after their stroke to help regain lost function.

This groundbreaking study was presented at the annual Radiological Society of North America’s (RSNA) annual meeting as the fist study to track stroke rehabilitation using fMRI to view images of the brain.

If you or a loved one has been affected by a stroke and has medical malpractice questions, please contact the stroke malpractice attorneys at Silberstein, Awad & Miklos, serving clients with Nassau and Suffolk County medical malpractice, Brooklyn medical malpractice, Bronx medical malpractice and Queens medical malpractice cases. Silberstein, Awad & Miklos also serve clients located in Staten Island and Westchester County.

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Cancer Death and Incidence Rates Drop

The Journal of the National Cancer Institute online recently reported that in the United States, the rates of new diagnoses and deaths from cancer have shown a decrease for the first time since 1998, when reporting began. The report noted that though the death rates for cancer have been dropping in recent years in both men and women, this is the first report that also shows a drop in the incidence of cancer, or newly diagnosed cases. In total, the incidence rate dropped 0.8% each year from 1999 to 2005 for all cancers, in both men and women. Men showed a decrease in both the death rates and new cases for lung cancer, colorectal cancer and prostate cancer, the most common cancers found in males. As for women, it was reported that the incidence and death rates fell for breast cancer and colorectal cancer, the two most common cancers found in females.

One not so positive statistic that was reported was the increase of lung cancer deaths and newly diagnosed cases in the South and Midwest. Eighteen states had higher rates of lung cancer deaths and new lung cancer cases, likely due to the lack of smoking bans in these areas. In addition to absence of non-smoking laws, these states have also not raised their excise taxes on cigarettes as many other states have done, giving smokers less of an incentive to quit. However, overall in the U.S., lung cancer deaths have been decreasing in men for the past decade, while the rates for women have stopped rising and are leveling off at this point. Specifically in the state of California, which banned smoking in most workplaces in 1995 and in most bars and casinos in 1996, the number of lung cancer deaths and newly diagnosed cases dropped in women. As for men in California, the report stated that lung cancer deaths fell an average of 2.8% each year from 1996 to 2005.

According to the National Cancer Society, roughly 30% of all cancer-related deaths in the United States are caused by smoking cigarettes, with about 80% of those deaths involving lung cancer. Cigarette smoking can also cause cancer of the larynx, oral cavity and pharynx, esophagus, and bladder, in addition to kidney, pancreatic, cervical, and stomach cancer.

The report was compiled by the American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute and the North American Association of Central Cancer Registries, the leading cancer and medical research organizations.

All forms of cancer are serious and usually require significant amounts of treatment or intricate procedures. If you or a loved one has medical malpractice questions in New York, please contact Silberstein, Awad & Miklos, serving clients with Nassau and Suffolk County medical malpractice, Brooklyn medical malpractice, Bronx medical malpractice and Queens medical malpractice cases. Silberstein, Awad & Miklos also serve clients located in Staten Island and Westchester County.

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How to Find the Best Cardiologist

When a person requires the care of a cardiologist to treat a heart condition or problem, it is important to find a doctor that fits their needs best. Aside from asking your primary care physician for a referral, it may be helpful to ask friends and family for advice on choosing a doctor, or the name of a cardiologist that they have used or know has a good reputation. However, it is also important to make your own evaluation after meeting a doctor for the first time, just to make sure they are a good fit. One way to seek out a good cardiologist is by utilizing the internet and other sources to research the credentials and certifications of your potential doctor. The Physician Profile on the New York State Department of Health website is a good source for researching and finding the right doctor. Most hospitals also offer directories on their websites that allow patients in search of a doctor to look through the credentials, certifications, subspecialties, education, training and possible malpractice information, in addition to other medical history. One credential patients may want to look for when seeking a cardiologist is Fellow of the American College of Cardiology (FACC), which is an elected fellowship for heart specialists based on the achievement, community contribution and peer recommendations of the doctor.

It is also important to choose a cardiologist that is associated with a credible hospital or medical center. Hospitals that have a positive reputation have acquired that reputation because of the care their employees provide, meaning that the best doctors usually work at the best hospitals. So, it may be helpful to search the directories of credible hospitals and medical centers in your area when looking for a cardiologist. Smaller hospitals and practices can also get recognized for the quality of care they provide, so it is important to do the research and not simply select the biggest hospital.

Another critical factor to look at when selecting a cardiologist is the level of experience the doctor has in the field, especially if you are require a specific procedure or treatment. Before scheduling a particular surgery or procedure, make sure the cardiologist you are using has performed the procedure enough times so that you trust their expertise and feel comfortable with the choice you have made. The more times a doctor has done a procedure or administered a particular treatment, the less likely it is that there will be an error or complication.

Women, in particular, need to do extra research when looking for a cardiologist because when a woman has heart disease or experiences a heart attack, their symptoms are not the same as men. Therefore, it is important to find a doctor that has a history of dealing with female patients, making sure that their training and knowledge of women's health is up to date with new developments. Women in search of a cardiologist may want to check out specialists or clinics that are devoted to treating heart disease and other heart-related health issues in women.

Last but definitely not least, patients making a decision about a cardiologist should make sure that they are able to communicate with their chosen doctor, and that the doctor communicates back. It is important that the doctor you choose is able to answer any questions you may have about your treatment, procedure, or general care, and answers these questions clearly and in a way you can understand. Many doctors are only interested in the medical side of things, dismissing the concerns of the patient. It is critical to find a cardiologist that is interested in both the quality of medical care they are administering, as well as addressing any worries or questions the patient may have. Overall, it is important to feel comfortable with the doctor you have chosen and be able to talk to him or her about anything related to your medical care.

Just because a doctor is a good communicator does not necessarily mean that they are experienced in their particular field, so it is important to find a cardiologist that has extensive experience as well as good communication skills. If you or a loved one has medical malpractice questions in New York, please contact Silberstein, Awad & Miklos, serving clients with Nassau and Suffolk County medical malpractice, Brooklyn medical malpractice, Bronx medical malpractice and Queens medical malpractice cases. Silberstein, Awad & Miklos also serve clients located in Staten Island and Westchester County.

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Cutting Back on the Salt

For many people, purchasing food items that are low-fat or fat-free makes them feel like they are making a healthy choice for themselves and their families. However, what most people don’t realize is that many of these fat-free or lower-fat products may actually have a whole lot more salt in them than their full-fat alternatives. Food producers add extra salt to make up for the flavor that is lost when the fat content is reduced or eliminated, so it is important to read the labels and understand what you are buying. Especially for people that are looking to lower their consumption of saturated fats, it is essential that they also keep their sodium intakes in check.

Too much sodium in a person’s diet can lead to hypertension, or high blood pressure, which may eventually result in a heart attack or stroke. However, a healthy level of sodium intake does have benefits, such as stabilizing the body’s fluids. Still, doctors recommend that people keep their blood pressure at a healthy level in order to avoid the harmful effects of hypertension. It is recommended that most people in good health consume about 2,300 milligrams of sodium a day, according to organizations like the USDA and the American Heart Association. However, it is estimated that most people in this country consume daily sodium levels closer to 4,000 milligrams. A major contributor to having higher sodium levels are processed foods, which have high salt contents to help preserve the foods and give more flavor.

It is important to be conscious of sodium at all stages of food purchasing and preparation, as well as with foods that are prepared outside of the home by restaurants and other food vendors. Also, it may be helpful to reduce sodium intake by choosing organic foods, which are sometimes lower in salt than other products. Making sure to prepare meals using fresh meats, fish, poultry, fruits and vegetables, as well as grains and low-fat dairy products may also be beneficial. If a canned vegetable or other type of food is going to be used in preparing meals, try to rinse the products to reduce the sodium content. According to a study published in the Journal of the American Dietetic Association, the more salt a person consumes, the more they crave it. So, by cutting back on the amount of sodium consumed daily, a person’s craving for salt will also be diminished.

A high level of salt in a person's diet may put them at greater risk of having a stroke or heart attack due to elevated blood pressure. If you or a loved one has medical malpractice questions in New York, please contact Silberstein, Awad & Miklos, serving clients with Nassau and Suffolk County medical malpractice, Brooklyn medical malpractice, Bronx medical malpractice and Queens medical malpractice cases. Silberstein, Awad & Miklos also serve clients located in Staten Island and Westchester County.

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Caffeine’s Effects on Pregnancy

In a study published by the British Medical Journal this month, it was reported that women that consume caffeine while pregnant increase their risk of fetal growth restriction, which is characterized by a fetal weight that is below the 10th percentile for gestational age as determined through an ultrasound. The study involved healthy, pregnant women, evaluating caffeine intake during their pregnancy, including their caffeine consumption one month prior to conception. The study found that fetal growth restriction was seen more often in women that consumed higher levels of caffeine, with women consuming more than 300 milligrams of caffeine per day having a 40% higher chance of having a baby with fetal growth restriction when compared with those that consumed less than 100 milligrams a day. Women that consumed 100 to 199 milligrams of caffeine daily had a 20% higher chance, while women that consumed between 200 and 299 milligrams a day had the highest risk, with a 50% higher chance that their baby would have fetal growth restriction.

Researchers believe that caffeine may be to blame for some cases of fetal growth restriction because it is able to enter the placenta, allowing the mother to pass caffeine along to the fetus. In women with faster caffeine clearance (how quickly caffeine is metabolized), it was found that the relationship between caffeine intake and fetal growth restriction was much stronger than in those that metabolize caffeine more slowly. Another factor that increases the risk of fetal growth restriction is smoking, which doubles the risk of the fetus being below the 10th percentile for gestational age. Researchers compared the effect of caffeine on pregnancy with that of alcohol, saying that the two substances have similar ramifications and that women should avoid consuming caffeine one month prior to conception, stop consuming alcohol after conception, and avoid smoking.

Fetal growth restriction may result in reduced birthweight, requiring additional medical care for the infant. If you or a loved one has medical malpractice questions in New York, please contact the malpractice lawyers of Silberstein, Awad & Miklos, serving clients in Nassau and Suffolk Counties and Brooklyn, the Bronx and Queens, Staten Island and Westchester County.

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Pregnancy Weight Gain May Cause Health Risks

In a study published in Obstetrics and Gynecology, it was found that women that gain an excessive amount of weight while pregnant put their newborns and themselves at risk during and after the birth. Mothers that take “eating for two” literally and consume twice as much as when they were not pregnant tend to gain too much weight during their pregnancy, making it more difficult to drop the weight after the baby is born. Women that put on more than 40 pounds during their pregnancy are more likely to give birth to a larger baby, which can result in the need for a cesarean section, or tearing and bleeding if the baby is delivered vaginally. Larger babies also run the risk of breaking their collar bone during the delivery. In addition to the problems that may occur during the birth, larger babies are also prone to obesity and type 2 diabetes later on in life.

The study, which was conducted by researchers at the Kaiser Permanente Center for Health Research in Portland, Oregon, looked at the weight of the mother and the baby at birth. Of the 41,540 pregnancies and births examined in Washington, Oregon and Hawaii, 20% of women that gained over 40 pounds during their pregnancy gave birth to larger babies, while less than 12% of women that gained less than 40 pounds had larger babies. The study also tested the mother for gestational diabetes, which increases a mother’s risk of having a bigger baby. About 29.3% of the pregnant women that gained more than 40 pounds and had gestational diabetes gave birth to heavier babies, compared with the 9.3% of women that gained less than 40 pounds and did not have gestational diabetes.

Revisions are currently being made to guidelines set in the early 1990s by the Institute of Medicine for pregnant women. The guidelines recommend that underweight women with a BMI (body mass index) below 19.8 gain 28 to 40 pounds during pregnancy, normal weight women with a BMI of 19.8 to 26.0 gain 25 to 35 pounds, and overweight women with a BMI above 26.0 gain 15 to 25 pounds. Gaining too little weight while pregnant may also result in health problems for the mother and child, so staying within a healthy range is important. Doctors should discuss weight gain with pregnant patients in order to keep them within a healthy range.

Though the mother’s weight may cause complications when giving birth, the doctors or nurses that provided care or performed the delivery may be to blame if problems occur. If you or a loved one has medical malpractice questions in New York, please contact the malpractice lawyers of Silberstein, Awad & Miklos, serving clients in Nassau and Suffolk Counties and Brooklyn, the Bronx and Queens, Staten Island and Westchester County.

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The 12 Best Children’s Hospitals for 2008

Hospitals that treat sick children make an extraordinary commitment to those children and their families that they will provide the best care possible. These facilities and their teams specialize in treating the physical and emotional needs that these children face when dealing with their diseases and sicknesses. In order to best treat their patients, these hospitals utilize the most cutting-edge equipment and technology. U.S. News and World Report began ranking hospitals in 1990, basing its ratings on hospital reputation, outcome of patient care and care-related measures, which includes volume, nursing and credentialing processes. The recent announcement of the top 12 children’s hospitals in the United States were in the category of general pediatrics, and were ranked as follows:

1. Children’s Hospital of Philadelphia
2. Children’s Hospital Boston
3. Cincinnati Children’s Hospital
4. Johns Hopkins Children’s Center
5. Rainbow Babies and Children’s Hospital
6. Texas Children’s Hospital
7. Children’s Hospital, Denver
8. Children’s Hospital, Seattle
9. Children’s Hospital, Los Angeles
10. Children’s Hospital, Pittsburgh
11. New York Presbyterian Medical Center
12. Lucille Packard Children’s Hospital at Stanford

The hospital that received the number one ranking, Children’s Hospital of Philadelphia, also ranked first in the specialties of neonatal care, cancer facilities and respiratory disorders. Children’s Hospital Boston, which received the second best rating, was ranked first in the areas of heart conditions, heart surgeries and digestive disorders. Johns Hopkins Children’s Center received the top ranking in the specialties of neurology and neurosurgery, while ranking fourth overall.

This ranking information is useful to the medical facilities because it allows them to see what areas they are in need of improvement and where they are achieving excellence. The data is also helpful to the families of sick kids all over the county because they are able to see where the best children’s hospitals are while also being able to find out what hospitals rank highest in the specialty of care their child requires.

Unfortunately, not every child is able to get to such reputable hospitals to receive the treatment they need. If you or a loved one has medical malpractice questions in New York, please contact the malpractice lawyers of Silberstein, Awad & Miklos, serving clients in Nassau and Suffolk Counties and Brooklyn, the Bronx and Queens, Staten Island and Westchester County.

Call toll free 1-877-ASK4SAM and visit www.ask4sam.net

Cholesterol Drug Crestor May Benefit Healthy People

In a recent study published in The New England Journal of Medicine and funded by the makers of Crestor, AstraZeneca, it was found that the drug may be beneficial to people with healthy cholesterol levels by helping to reducing their risk of heart disease. Crestor, which is a statin, is normally prescribed to people that need help lowering their cholesterol. In the U.S., an estimated 36 million people qualify for a prescription to some type of statin drug, a number which will grow significantly because of this study’s findings.

According to the study published earlier this month, statins have proven effective in the 7,000 men and 5,000 women included in the trials who all had good cholesterol levels. The participants, coming from 26 different countries, had an average LDL level (bad cholesterol) of 108 and an average HDL level (good cholesterol) of 49. All of the participants, however, had an elevated hs-CRP (high-sensitivity C-reactive protein), suggesting inflammation that can lead to coronary heart disease. The study participants took either a 20 milligram dose of Crestor (chemical name rosuvastatin calcium) or a placebo pill. In less than 2 years, the risk of stroke, heart attack and death dropped by nearly half (44%) in those that took Crestor, when compared with those taking the dummy pill. In addition to that, those that were taking the statin drug also saw a 50 percent drop in their LDL level (bad cholesterol) and a 37 percent drop in their hs-CRP levels.

Authors of the study estimate that 250,000 heart attacks, strokes, cardiac deaths and hospitalizations could possibly be avoided if these new candidates took statins over the next 5 years to lower their hs-CRP levels, and their overall risk. If changes are made to the current guidelines for statin prescriptions, people with good cholesterol levels would need to have a blood test done to see if their hs-CRP levels were high. If their levels were high enough for concern, these candidates would be able to begin taking the statin drugs and start lowering their risk of these serious health problems. More research still needs to be conducted before the guidelines will be changed, though this study did reveal some very useful information.

Coronary heart disease is the number one killer of men and women in the United States. If you or a loved one has medical malpractice questions in New York, please contact the malpractice lawyers of Silberstein, Awad & Miklos, serving clients in Nassau and Suffolk Counties and Brooklyn, the Bronx and Queens, Staten Island and Westchester County.

Call us toll-free 1-877-ASK4SAM and visit www.ask4sam.net

Medical Residents Need More Rest to Increase Safety

In a report released this past Tuesday by the Institute of Medicine (IOM), a new rule was implemented, allowing doctors-in-training to take an undisturbed five-hour break to rest after the first 16 hours of a 30 hour shift. A regulation implemented five years ago by the Accreditation Council for Graduate Medical Education put a cap on the number of hours these new doctors, allowing a maximum of 80 hours to be worked per week, with a maximum shift of 30 hours. Before this cap was enforced, some residents were working a 110 hour work week, on average. In a government requested study by the IOM, it was found that hospitals often demand longer shifts and longer work weeks, disregarding the limits put on medical residents’ work hours. Also, the fact that if a patient is in need of medical attention, a doctor can not just leave when their shift is over, tacking on additional hours to their already lengthy days. These extended work hours cause exhaustion in these young doctors, which leads to medical errors. In a separate study done in this field, it was found that residents make more mistakes during longer shifts. Still, it is hardly possible to determine if the time caps had any effect on the safety of patients, since it is reliant on so many components.

The Institute of Medicine is struggling to come up with a way to balance the education of these resident doctors and the safety of the patients they are treating, allowing them enough time to learn their specialty while not depriving them of much needed sleep. These young doctors, straight out of med school, work as residents for three to seven years, learning and training to be the best they can in their chosen area of medicine. In order to reduce the number of errors made by medical residents, the IOM suggests that more practiced physicians supervise the young doctors them more closely and that hospitals increase the number of involuntary days off and hours off between lengthy shifts. Also, the Institute recommends that a longer overlap of residents’ shifts, which would make it easier to pass patients off to the next doctor.

Any mistake made by a doctor or hospital, whether it be due to lack of sleep or lack of care, is not the fault of the patient. If you or a loved one has medical malpractice questions in New York, please contact the malpractice lawyers of Silberstein, Awad & Miklos, serving clients in Nassau and Suffolk Counties and Brooklyn, the Bronx and Queens, Staten Island and Westchester County.

Call us toll-free at 1-877-ASK4SAM and visit www.ask4sam.net

Fan May Reduce Risk of SIDS

SIDS, or sudden infant death syndrome, is the name given to the unforeseen, unexplained death of an infant under the age of one year. SIDS deaths cannot be attributed to any other cause and it is currently the leading cause of death for infants from one month to one year old . In a recent study published in the Archives of Pediatrics & Adolescent Medicine involving 500 infants from 11 counties in California, it was found that a fan may help in reducing the risk of SIDS by circulating air and allowing the infant to get sufficient oxygen. It is believed that a cause for SIDS may be brain abnormalities, which can restrict an infant’s ability to gasp and wake up when they are not getting enough oxygen.

Experts have several recommendations for lowering the risk of sudden infant death syndrome, including putting babies to sleep on their backs and using a firm mattress. They also recommend that parents keep toys and pillows out of the crib when infants are sleeping, as well as making sure infants do not get too warm. The newest recommendation that suggests using a fan while infants sleep still requires more research. However, the study found that SIDS was reduced by 72 percent when a fan was used, with only 3 percent of infant deaths occurring while a fan was in use. The use of a fan was also found to especially reduce the risk of SIDS in infants sleeping in poor conditions.

The study was funded by grants from the National Institute of Health and is the first of its kind to look at the use of a fan to reduce the risk of SIDS.

SIDS may be the cause of the sudden, unexpected death of an infant, though a proper investigation should always take place in order to rule out other causes of death, especially if the infant is under the care of a hospital or daycare center. If you or a loved one has medical malpractice questions in New York, please contact the medical malpractice attorneys at Silberstein, Awad & Miklos serving clients in Nassau and Suffolk Counties and Brooklyn, the Bronx and Queens, Staten Island and Westchester County.

Call toll-free 1-877-ASK4SAM

Increased Breast Cancer Risk for Bigger Baby Girls

In a recent study conducted by the London School of Hygiene and Tropical Medicine and published in the online edition of PLoS Medicine, a link was found between the size of a baby girl at birth and her risk of developing breast cancer as a woman. The London School utilized results of 32 studies, comparing the birth measurement data and breast cancer risk. The study analyzed more than 22,000 breast cancer cases in over 600,000 women, finding that weight, length and head circumference at birth were all significant factors in a woman’s risk of developing breast cancer. The chance of developing breast cancer was 12 percent higher in women that weighed 8.8 pounds or more at birth, when compared to those that weighed between 6.6 and 7.69 pounds. Women that measured 20 inches long at birth had a 17 percent greater risk of developing breast cancer when compared with women that measured 19.29 inches long. As for head circumference, those with a measurement of 13.7 inches or more had a 11 percent greater risk when compared with those who had a measurement of 12.9 inches at birth.

One possible reason for the increased breast cancer risk in larger girl babies may be the higher levels of the estrogen hormone estradiol found in the mother. These increased levels of estrogen may alter the breast development of the baby, making her more susceptible to cancer. Another reason may be overactive stem cells or other growth hormones. Additional research needs to be done on the connection, since very little is known about the connection between breast cancer development and the prenatal environment.

As for the women that were born with larger than average measurements, the American Cancer Society’s director of breast and gynecological cancer, Debbie Saslow, says that there is no reason to worry or consider themselves at a high risk for developing breast cancer, since this study is only for research purposes. Also, expecting women should not make any alterations or do anything differently in an attempt to have a smaller baby.

Breast cancer is the second most common form of cancer, only after non-melanoma skin cancer. Certain factors increase a woman’s risk of developing breast cancer, including smoking, drinking alcohol, poor diet and lack of exercise. Statistics from the American Cancer Society reveal that 1 in 8 women will develop invasive breast cancer at some point in their lives, equaling about 182,460 new cases in the U.S. in this year alone. An estimated 40,480 women in the United States will die from invasive breast cancer in 2008.

Breast cancer treatment is most effective when the cancer is caught early on. If you or someone you love has been harmed by a delay in diagnosing or treating breast cancer, our medical negligence attorneys can help. Your initial consultation is FREE and there is NO FEE to you unless we recover money. Please call Silberstein, Awad & Miklos today, or submit an instant inquiry now and we will respond within 24 hours.

Call toll-free 1-877-ASK4SAM

Vitamin D and Breast Cancer

A recent study published in the Journal of the National Cancer Institute reported some unfavorable results from research done on the effect of vitamin D on breast cancer. The supplement was not found to be beneficial to the half of the women involved in the study that were given 400 IU of vitamin D and 1,000 mg of calcium. The vitamin D and calcium segment of the Women’s Health Initiative (WHI) study included 2,134 women, half of which were given vitamin D and calcium for 7 years, while the other half were given nothing. Of the women that took the supplements for the seven year period, 528 developed breast cancer. In the group that did not take either vitamin D or calcium, 546 women developed breast cancer during the time frame. The similarity between these two rates gave way to the disappointing outcome that vitamin D does not help prevent breast cancer.

Experts have questioned whether or not the dose of vitamin D used in the WHI study was high enough to yield accurate results, being that doctors now recommended up to 2,000 IU daily for adults. The 400 IU used in the study is too low to raise blood levels, which does not allow for there to be much of an impact as a result of taking the supplement. One small problem the study encountered involved the inability to tell half of these women to stop taking their regular doses of calcium and vitamin D to prevent bone fracture. About 15 percent of the women included in the half that were to be taking no calcium or vitamin D continued with their usual supplement dosages, possibly causing inaccuracies in the results. Experts also believe that the study may have been too short to determine the real advantages of vitamin D. Since it takes a long period of time for breast cancer to develop, the women in the study that developed breast cancer may have already started to develop the cancer before the 7 year study began (breast cancer may take up to 20 years to develop). If cancer of the breast had already started to develop before the study even began, the vitamin D and calcium supplements would have had little effect on the cancer.

More research is in the works studying the effects of vitamin D and calcium on breast cancer. One earlier study and other animal-related studies did suggest that vitamin D helped prevent breast cancer, giving experts more of a reason to continue their research on the supplements and their effect on breast cancer.

The Women’s Health Initiative took place over several years and involved 36,000 women and studied various health issues, including cancer, fracture risk, heart disease, hormone therapy and other complications.

Breast cancer treatment is most effective when the cancer is caught early on. If you or someone you love has been harmed by a delay in diagnosing or treating breast cancer, our medical negligence attorneys can help. Your initial consultation is FREE and there is NO FEE to you unless we recover money. Please call Silberstein, Awad & Miklos today, or submit an instant inquiry now and we will respond within 24 hours.

Joseph Miklos
Silberstein, Awad & Miklos, P.C.
600 Old Country Road
Garden City, New York 11530
Call Toll-free 1-877-ASK 4 SAM
www.ask4sam.net

Choosing the Right Weight Loss Surgery

In the United States, along with many other countries throughout the world, obesity is a major problem that continues to grow each year among all ages, genders, ethnic groups and both smokers and non-smokers. The obesity rate in the U.S. was 15 percent or more in every state in the year 2000, except for Colorado, with twenty-two states having rates of 20 percent. Doctors recommend that obese patients lose the weight in an attempt to avoid health risks such as high blood pressure, high cholesterol, diabetes and various cancers. An estimated 42 percent of men and 38 percent of women that are obese are reported to have high blood pressure, while 22 percent of obese men and 27 percent of obese women have high cholesterol. In addition to that, about 70 percent of all diabetes risk is resulting from obesity. Higher death rates were seen in cancers of the esophagus, colon, rectum, liver, gallbladder, pancreas, kidney, stomach, prostate, breast, uterus, cervix and ovaries in people that were overweight. The risk of death from any cause, especially heart problems, in overweight people was found to be 50 to 100 percent higher than the risk for people with a normal body weight. Also, the more overweight a person is, the shorter their life expectancy. Extremely obese young white males (20-30) may lose up to 13 years of their life, while women in that range may lose up to 8 years. As for African Americans in that category, men can lose up to 20 years and women up to 5 years. People that are only moderately obese can still shorten their life expectancy by 2 to 5 years, making weight loss extremely important even for slightly overweight individuals.

Conclusions reached in 1991 by the National Institute of Health reported that about 95 percent of individuals who start a weight loss regimen regained their lost weight within 2 years of reaching their lowest weight. These results prompted the recommendation of two forms of bariatric surgery, vertical banded gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGB), for extremely obese individuals or those facing life-threatening health risks because of their weight. Those eligible for bariatric surgery must have already attempted normal weight loss methods with no success and be completely educated about the procedure and its results. The American Society for Metabolic and Bariatric Surgery recommends that patients not only be well informed about their surgery, but also understand what variations to expect in their lifestyle as well as the need for extensive follow-up to their procedure. It is also important that a patient be evaluated before making a decision on which procedure to use, in order to best fit the choice to their needs. Doctors should administer a physical exam and assess the medical and dietary history of a patient, as well as their psychologic status, before considering them as a candidate. Patients should also be given extensive information on each bariatric surgery option so they can make an educated choice and have a successful procedure.

Laparoscopic procedures:

The most preferred bariatric surgeries are performed laparoscopically, or in a minimally invasive way. These methods have a lower death rate because they avoid thh sizable incision in the abdomen required of other surgeries. In the United States, Roux-en-Y gastric bypass, adjustable gastric band, biliopancreatic diversion with duodenal switch and sleeve gastrectomy are the most routinely performed procedures.

Roux-en-Y gastric bypass:

Laparoscopic RYGB is the most widely performed bariatric procedure for weight loss in the United States due to its familiarity among doctors. This surgery restricts the amount of food consumed by the patient, while reducing the number of calories the body can absorb from that food. During RYGB, doctors create a tiny pouch at the top of the stomach which reduces the amount of food a person can consume. The procedure also requires the gastrointestinal tract to be reconstructed so that food can leave both the pouch and the existing stomach. People that have this procedure develop a decrease in appetite because their body is telling them that they are fuller, sooner. This causes the person to consume less food at each meal, resulting in substantial weight loss. Patients must also monitor their eating habits, making sure that food is completely chewed, eaten slowly and they must not eat more than they can now fit to avoid nausea or vomiting.

This procedure comes with advantages and disadvantages that may influence a patient’s decision. One benefit of this procedure is that results are seen almost immediately, continuing for 18 to 24 months after the surgery is performed. This procedure is also permanent, meaning that a patient will not regain the weight lost years after the surgery. RYGB also reduces the health risks that were increased due to obesity, such as high blood pressure, obstructive sleep apnea, diabetes and hyperlipidemia, or high lipid levels in the blood, such as cholesterol. Some of the disadvantages of RYGB include the risk of leaks in any of the impacted areas, internal hernias and a longer follow-up time when compared to other procedures.

For more information, visit www.obesityhelp.com

Adjustable gastric band:

Following RYGB, the second most common laparoscopic surgery in the United States is the adjustable gastric band. The operation was approved by the Food and Drug Administration (FDA) in June of 2001, after becoming the most prominent weight loss operation in places like Latin America, Europe and Australia. In the U.S., two types of laparoscopic gastric bands are now available, Ethicon Endo-Surgery’s Realize Personal Banding Solution and Allergan’s Lap-Band adjustable banding system. Both of these products involve minimally invasive surgery with short operating times and hospital says, as well as an extremely minimal risk of death and reduced risk of pain and incisional hernias. Negatives of the procedure include decrease in the stomach’s tolerance of certain foods, reflux and pain, which should be discussed with a doctor if experienced.

Similar to the RYGB procedure, the gastric band creates a small pouch in the stomach, about the size of an egg. This operation employs an inflatable silicon band to create the pouch, decreasing the amount of food the person can consume, resulting in weight loss. The diameter of the band can be adjusted, which in turn changes the size of pouch, allowing for more or less to be consumed. Adjustments to the gastric band can be made whenever needed, allowing for an increase in weight loss when desired. Unlike RYGB, this procedure does not lower the number of calories the body is able to absorb, nor is it permanent. The laparoscopic adjustable gastric band procedure, or LAGB, has varying results, occurring over the course of 18 months to 3 years.

For more information, visit www.realizeband.com and www.lapband.com


Biliopancreatic diversion with duodenal switch:

This laparoscopic procedure, known as BPD, alters the way in which a person absorbs foods by shrinking the stomach. The operation creates a diversion around part of the small intestine, preventing the body from absorbing as many calories as before. A modification made to this procedure involving the duodenal switch (BPD/DS) allows the pylorus, or the valve at the opening of the stomach, to stay intact, while the roughly half of the stomach is removed permanently. As in the original BPD procedure, the stomach is then connected to the last 8 feet of the small intestine, with the rest of the small intestine connecting to the small bowel where food meets the digestive enzymes.

BPD/DS is completely irreversible, due to the removal of part of the stomach. Also, there is a risk that patients may experience long-term nutritional insufficiencies since their bodies are no longer able to absorb the same amount of nutrients via the small intestine. However, there are also important advantages of this procedure, including the prevention of dumping syndrome (click here for more info), where the undigested stomach contents are promptly emptied into the small intestine too rapidly, causing abdominal cramps and nausea. This is avoided because the pylorus valve is left intact in the at the outlet of the stomach. Another advantage is that patients can consume larger meal portions that with a gastric band because the remaining stomach is larger than that of the created pouch in other procedures.

For more information, visit www.duodenalswitch.com

Sleeve gastrectomy:

The laparoscopic sleeve gastrectomy represents approximately 2 percent of weight loss operations performed in the United States. This relatively new operation which shrinks the stomach down to 25 percent of its original size, reducing the body’s allowed food intake. As in the BPD/DS procedure, the pylorus remains intact, eliminating dumping syndrome. Also, the procedure normally lasts for less than an hour, although patients are required to stay in the hospital overnight. Normal recovery time is about 2 weeks or less, allowing the patient to resume work and normal activities after that time period. The procedure also avoids the malabsorbiton that may occur in the BPD/DS procedure, allowing patients to normally absorb nutrients in the small intestine. However, there is a risk of blood clots with this procedure and the operation is irreversible.

For more information, visit www.advancedobesitysurgery.com

All of these surgeries may have serious complications if performed incorrectly or carelessly by a doctor. If you or a loved one has medical malpractice questions in New York, please contact the malpractice lawyers of Silberstein, Awad & Miklos, serving clients in Nassau and Suffolk Counties and Brooklyn, the Bronx and Queens, Staten Island and Westchester County.

Fight for justice against FRIVOLOUS DEFENSES and DECEPTIVE DEFENSES.

Joseph Miklos
Silberstein, Awad & Miklos, P.C.
600 Old Country Road
Garden City, New York 11530
Call Toll-free 1-877-ASK 4 SAM
www.ask4sam.net

Rate of Diabetes is Up...and Growing

In a government phone survey that retrieved data from over 260,000 adults in the country, it was found that the rate of new diabetes cases has almost doubled in the past decade. The government also reported that the highest levels of diabetes were found in the South, particularly in West Virginia, with roughly 13 out of every 1,000 having been diagnosed with diabetes. Other Southern states with the highest rates were South Carolina, Alabama, Georgia, Texas and Tennessee, which all had a rate of at least 11 out of every 1,000 people contacted. The lowest rate of diabetes was in Minnesota, in which about 5 out of every 1,000 people surveyed had been diagnosed with the disease. Hawaii and Wyoming were also reported as having some of the lowest rates of diabetes, after Minnesota.

In 90% of the cases found, people had been diagnosed with Type 2 diabetes, which is commonly associated with obesity. Not surprisingly, the South is also noted for having high rates of obesity and heart disease. Also, higher rates of Type 2 diabetes are often found in older people and blacks, which are highly concentrated in the South, as well as in Hispanics, which Texas has a high concentration of. The survey only collected data on people that already know they have the disease, and did not provide data on those that have not yet been diagnosed. In the U.S. an estimated 1 in 4 diabetics have yet to be diagnosed with the disease. Moreover, the amount of undiagnosed cases is more likely than not higher in the South or in places where health care is limited.

The study, which was conducted by the U.S. Centers for Disease Control and Prevention, included 40 states and determined that an estimated 1.6 million new diabetes diagnoses were made last year in people age twenty and over. That rate reflects the increase from 5 per every 1,000 adults having been diagnosed with diabetes in the 1990s to the current rate of 9 per every 1,000 adults.

Diabetes causes serious complications including heart attack, stroke, kidney disease and other health issues that require the care of a doctor. If you or a loved one has medical malpractice questions in New York, please contact the malpractice lawyers of Silberstein, Awad & Miklos, serving clients in Nassau and Suffolk Counties and Brooklyn, the Bronx and Queens, Staten Island and Westchester County.

Call Silberstein, Awad & Miklos Toll-free at 1-877-ASK 4 SAM

SIDS - Still a risk to infants

SIDS, or sudden infant death syndrome, is a name given to natural infant deaths that occur suddenly during sleep and with no medical cause, with highest rates occurring in infants between 2 and 4 months old. The rate of SIDS has been significantly reduced in the past fourteen years thanks to the Back to Sleep campaign led by the American Academy of Pediatrics, which has cut the rate of SIDS related deaths in half. According to the National Centers for Health Statistics, SIDS occurs in about .05 percent of infants, or one SIDS case for every 2,000 babies born. But, even though these statistics have been reduced, infants are still dying from the unexplained syndrome. There are other classifications now given to cases where healthy infants die unexpectedly during sleep, which may be a reason why the SIDS rate has decreased and the rates of these other cases has increased. A situation known as code-shifting occurs when examiners give other unrelated reasons for why an infant has died, and classifies the case as something other than SIDS, causing the official numbers of SIDS related deaths to be lower than they actually are. Another reason why fewer cases have been reported as SIDS may be that in order for a death to be diagnosed as SIDS, an extensive investigation must take place, requiring funds that are simply unavailable to some areas. The lack of an investigation may result in a code-shift where cases that are in fact SIDS related are classified as something else. Many SIDS cases may have also been misdiagnosed due to the complicated forms that medical examiner’s were required to fill out regarding the death. The forms have recently been updated, although they still prove unclear, leading to missed SIDS cases.

It is important that parents carefully follow the safe-sleep recommendations, which include putting infants to sleep on their backs, keeping soft toys and bedding out of the crib during sleep, never letting infants sleep in a bed with adults and keeping them away from secondhand smoke. Research has shown that African-American, Native American and premature infants are at a greater risk of dying of SIDS, along with any infant exposed to dangerous sleeping conditions or secondhand smoke. Babies that are put to sleep on their stomachs or sides are twice as likely to die from SIDS infants that are placed on their backs. There is a greater chance that an infant will not be able to inhale as much oxygen when sleeping on their stomach because the carbon dioxide that has been exhaled is re-inhaled instead of fresh air. For babies that do not get enough oxygen because of their sleeping position and do not wake up to change position when this happens, there is a possibility that SIDS will occur. When an infant’s brain-stem is abnormal, serotonin production, which assists in the regulation of arousal and breathing, is not properly being produced. According to researchers at Children’s Hospital Boston, this may cause an infant to remain sleeping even when there is a decrease in oxygen, creating a risk for SIDS. When an infant reaches 6 months, their risk of SIDS is significantly lowered, and vanishes completely at age 1, due to the fact that development occurs to the point where even abnormal brain-stems can produce serotonin normally, taking away the risk of a SIDS related death.

Researchers are also exploring other reasons why SIDS may occur, including MCADD, or medium chain acyl-CoA degydrogenase deficiency, a metabolic disorder where an infant does not process fatty acids, causing heart function to cease. QT syndrome, a heart disorder causing a sporadic recurrences of hurried heart beat sometimes resulting in heart attack, is also being explored as a cause of SIDS. Both QT syndrome and MCADD are treatable if they are discovered in a blood test.

It was also found that if an infant is placed in daycare before they have reached 4 months may be at a greater risk of SIDS. Research shows that approximately 20 percent of SIDS related deaths occurred while the infant was not under the care of parents. The chance of SIDS is multiplied by 18 if an infant that is routinely put to sleep on its back is placed on its stomach, making it critical that parents make sure that their infants, if placed in a daycare program, are being put to sleep using the safe-sleep guidelines both in daycare and at home.

SIDS may be to blame for the sudden, unexpected death of an infant, however a proper investigation should take place in order to rule out any other cause of death, especially if the infant is under the care of a hospital or daycare center. If you or a loved one has medical malpractice questions in New York, please contact the medical malpractice attorneys at Silberstein, Awad & Miklos serving clients in Nassau and Suffolk Counties and Brooklyn, the Bronx and Queens, Staten Island and Westchester County.

Call Toll-free 1- 877- ASK 4 SAM

Vitamins C and E Supplements Not So Beneficial to Heart

In a study funded by the National Institutes of Health and numerous vitamin manufacturers, it was found that vitamins C and E have no effect on heart disease. In fact, some researchers believe that not only does vitamin C not help prevent heart attacks, but the supplement may also promote cancer, which is a very scary thought considering that millions of Americans take these pills to reap their potential benefits. As for vitamin E, it was found that the risk of bleeding strokes was increased in people that take the pills, especially in males that smoke cigarette, on top of the fact that the supplement does not prevent heart disease.

The Physicians Health Study, which began in 1997, is one of the largest studies ever conducted on vitamins C and E. It utilized 14,641 male doctors that were age 50 or over, 5 percent of whom had previously had heart disease. Researchers divided the men into four separate groups, with one group taking vitamin C, one vitamin E, one taking both and one taking a dummy pill. At the conclusion of the study 8 years later, it was found that there were no difference between the four groups regarding heart-related deaths, heart attack or stroke rates. Surprisingly, the study did reveal that in the group of men taking the vitamin E supplement, there was a 74 percent greater risk for bleeding stroke. Although this new evidence suggests that these vitamins are not beneficial to the heart, and have several negative effects, an estimated 12 percent of Americans still take the supplements.

In a separate study involving over 12,000 heart attack survivors conducted at the University of Oxford in England, it was found that the B-12 and B-9 (folic acid) vitamins also had no positive effect on heart disease. The results of the original study can be found online at the Journal of the American Medical Association website.

The potential risks involved in taking these supplements are serious and may require medical care. If you or a loved one has medical malpractice questions in New York, please contact the medical malpractice attorneys at Silberstein, Awad & Miklos serving clients in Nassau and Suffolk Counties and Brooklyn, the Bronx and Queens, Staten Island and Westchester County.

Call Toll-free 1- 877- ASK 4 SAM

More harm than good in prostate screening over 75

New evidence shows that routine prostate screening may do more damage than good for elderly men. Methods used to treat prostate cancer in this age group is known to cause other health issues such as erectile dysfunction and bowel and bladder control problems, while benefits of such treatments are minimal to none.

These recommendations were made by the U.S. Preventive Services Task Force, which concluded in 2002 that there is no substantial evidence suggesting men of any age should receive prostate screening. There has been much argumentation regarding the significance of these blood tests, which are often inaccurate, and require a biopsy for a positive confirmation. Also, there is no way of identifying how fast or slow a tumor is growing from these tests.

With this new information regarding prostate screening, doctors are encouraged to speak to their 50+ male patients (such tests should not be necessary before age 50) about the possible harms of the tests, as well as the potential benefits. Patients will then have the information needed to weigh their options and make a choice about prostate screening.

Although most prostate cancer tumors grow so sluggishly they are not considered life threatening, it is still the most common cancer among men in this country. After lung cancer, prostate cancer is the second leading cause of deaths in men.

Since there is a favorable chance that a man will survive prostate cancer, doctors will sometimes recommend a more passive approach, known as “watchful waiting”. In these cases, doctors will track the disease and only treat their patients only if the cancer worsens. One study also found that it is not a huge risk to leave early-stage prostate cancer untreated for a period of time in older men.

If you or a loved one has medical malpractice questions in New York, please contact the malpractice lawyers of Silberstein, Awad & Miklos, serving clients in Nassau and Suffolk Counties and Brooklyn, the Bronx and Queens, Staten Island and Westchester County.

Fight for justice against FRIVOLOUS DEFENSES and DECEPTIVE DEFENSES.

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Joseph Miklos
Silberstein, Awad & Miklos, P.C.
600 Old Country Road
Garden City, New York 11530
Call Toll-free 1-877-ASK 4 SAM
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More Sleep Equals Lowered Risk of Heart Attack

In a recent study conducted by Dr. Imre Jansky of the Karolinska Institute, and other Swedish researchers, it was found that more sleep may lower the risk of a heart attack. The researchers analyzed heart attack records from the past two decades (1987 - 2006) and found that on the day after clocks are set back one hour in the fall, heart attack rates dropped. What’s more, in the few days following the clocks going forward an hour in the spring, heart attack rates increased. To make the comparison, researchers looked at heart attack rates for the few days following the changing of the clocks (either forward or back), and then at the rates on the same days of the week two weeks before and two weeks after the change. They found that when clocks are set forward, heart attack rates increase by 6% on the following Monday, 10% on Tuesday and 6% on Wednesday, with a 5% increase over the entire week. However, when clocks are set back, heart attack rates fell by 5% on the following Monday, although they remained the same through the rest of the week. The increased risk of a heart attack on a Monday was normally blamed on the resumed activity and stress that comes with the start of a new week. However, this study may hint that the real cause is the loss of sleep people get on Sunday nights as a result of getting to bed later and waking up earlier on Monday for work.

This study, which was published in the New England Journal of Medicine, reveals that losing or gaining sleep can increase or decrease the risk of a heart attack, which supports the fact that sleep affects our cardiovascular health. The amount of sleep a person gets each night can cause changes in blood pressure, blood clotting, blood sugar, inflammation, cholesterol, and blood vessels. Doctors suggest that people gradually adjust to the time change in the spring by going to bed earlier and waking up earlier, which will make it easier to deal with the hour loss.

In a separate study conducted by American researchers, it was found that the time change in the fall was to blame for an increase in pedestrian deaths during evening rush hour because drivers have trouble adjusting to earlier darkness. In the spring when daylight is extended with the change of the clocks, there was a lowered risk for pedestrian deaths.

Heart attacks require the immediate care of a doctor or hospital. If you or a loved one has questions about the quality of the medical care you received please call Silberstein, Awad & Miklos' medical malpractice attorneys for answers. Together we will continue our fight against FRIVOLOUS DEFENSES and DECEPTIVE DEFENSES.
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Treatment helpful up to 4 1/2 hours after stroke

In the third European Cooperative Acute Stroke Study, which was sponsored by German pharmaceutical giant Boehringer Ingelheim, it was found that tPA (tissue plasminogen activator) treatment may still be moderately beneficial when given three to four and a half hours after an acute ischemic stroke. When compared with the patients that were given the tPA drug within a three hour window, trial patients that received the drug up to four and half hours after an ischemic stroke were equally as likely to suffer symptomatic intracerebral hemorrhages and had no increased risk of death. However, authors of the study, which was published in the New England Journal of Medicine, still stress the importance of treating a stroke as soon as symptoms arise.

At this point in time, tPA is the only drug approved for treating ischemic strokes, though its use for treatment is currently only allowed within the three hour window. This new study, however, may expand that window to include up to four and a half hours, though more extensive research is still needed before approval. In another study published in The Lancet, conclusions from the Safe Implementation of Treatments in Stroke International Stroke Thrombolysis Registry provided additional evidence that there is no substantial difference between treating ischemic stroke before the three hour limit and treating within the three to four and a half hours window. If the approved window of time was increased from three hours to four and a half hours, doctors would be able to help a larger percentage of patients who have suffered a stroke.

The European Cooperative Acute Stroke Study 3 was a causal trial which used both the intravenous tPA drug and a placebo, a substance with no pharmacological effect. Researchers utilized 821 stroke patients that arrived for treatment three to four and half hours after stroke symptoms were first experienced. Ten percent of those patients were treated between three and three and a half hours, 50 percent between 3 and a half and four hours, and 40 percent between four and four and a half hours. The study concluded that a greater number of patients had a positive outcome after ninety days when treated with the tPA drug rather than the placebo. Further research is still required before doctors will be permitted to treat ischemic stroke patients with tPA beyond the three hour window, though the most recent study results point in that direction.

If you or a loved one has questions about the quality of the medical care you received please call Silberstein, Awad & Miklos' medical malpractice attorneys for answers. Together we will continue our fight against FRIVOLOUS DEFENSES and DECEPTIVE DEFENSES.

Call Toll-free 1- 877- ASK 4 SAM

Joseph Miklos
Silberstein, Awad & Miklos, P.C.
600 Old Country Road
Garden City, New York 11530
www.ask4sam.net

Green Tea proven beneficial to your heart

Green Tea proven beneficial to your heart


A new green tea study conducted at the Athens Medical School in Greece has shown that the flavonoids in the tea, which act as antioxidants and reduce inflammation, keep blood vessels pliable. So what does this mean for your heart? Flexible, relaxed arteries (blood vessels) can more easily tolerate a person’s constantly changing blood pressure. The cells found within these blood vessels can now easily secrete the material needed to relax the vessels, allowing unrestricted blood flow. The antioxidants found in green tea may also prevent clots, which may ultimately lead to heart attacks.

In a study done in Greece, it was found that subjects who drank green tea had a greater dilation of arteries in the heart when compared to subjects who drank hot water or diluted caffeine. This proved that the results were not due to the small amounts of caffeine found in green tea, because those who drank the diluted caffeine beverage did not show any additional dilation of heart arteries. What is more interesting, those who consumed the green tea beverage still exhibited more dilated arteries after two weeks compared to when they began the study. This study demonstrates that drinking green tea is beneficial, even over time.

Some doctors are not completely convinced, however, that green tea is all it is cracked up to be, since other elements such as vitamins E and C can also aid heart function. One doctor, though he agrees that green tea does have its benefits, feels that people should not assume that by drinking the tea alone, they will be preventing a heart attack or stroke. However, it probably wouldn’t hurt to include it in your heart-healthy diet, along with the other dietary recommendations made by the American Heart Association .

If you or a loved one has medical malpractice questions in New York, please contact the medical malpractice attorneys at the Law Offices of Silberstein, Awad & Miklos, serving clients in Nassau and Suffolk Counties and Brooklyn, the Bronx and Queens, Staten Island and Westchester County

This may be considered a legal advertisement.

Joseph Miklos
Silberstein, Awad & Miklos
600 Old Country Road
Garden City, New York 11523
phone 877 ask 4 sam
www. Ask4sam.com

Drug companies in hot water

Drug companies in hot water

Pharmaceutical giant Merck & Co. was recently accused of paying academic scientists to take credit for reports that were actually written by Merck employees. Merck’s painkiller Vioxx, which was pulled from the market in 2004 due to stroke and heart risks, is the subject of the two articles at hand. Merck is said to have downplayed the number of deaths in two studies involving Vioxx, and its failure to prevent and/or treat Alzheimer’s disease.

Merck & Co. stands by their statements that these accusations are deceiving and completely false. In addition to that, it was revealed that five of the six authors of the accusing articles were consultants paid by individuals that had sued Merck over problems concerning Vioxx. Merck claims that these reports are prejudiced because all authors were influenced by people who had previously challenged Merck in court, or testified about the risks of Vioxx before the Senate.

Although these accusations are aimed strongly at Merck, other pharmaceutical companies have been identified for claiming that academic scientists had more of a role in the writing of research articles about their drugs. All companies are urged to identify what function each member involved performed in writing such research articles.

When a drug study is initiated, it is necessary to perform the necessary research, evaluate the results, and finally, prepare these results so that they can be printed in a medical publication. If a pharmaceutical company does not want to be accused of releasing altered reports, it is also necessary for them to employ independent scientists for each of those steps, rather than utilizing their own.

One incident which has Merck in hot water involves the failure on their part to report data found after two studies in an accurate and timely manner. In the study, patients that took the drug Vioxx had a higher death rate than those who were given a dummy pill. Merck failed to report the number of deaths resulting from taking Vioxx accurately. Merck denies these claims, stating that the previously mentioned deaths were not a result of the patient taking Vioxx.

In an Alzheimer study published by Merck, the list of authors included several academic scientists who were never before mentioned during the study, when in fact the principal contributors to the study were scientists employed by Merck. Once again, however, Merck denied the claims, stating that all parties listed were personally involved in the studies. Merck did state that they sometimes have external companies brought in to write up studies, but only scientists who read and edit the documents are listed as authors. In an attempt to correct these problems, medical journals are creating stricter rules and policies regarding the articles they publish.

If you or a loved one has medical malpractice questions in New York, please contact the Malpractice Law Offices of Silberstein, Awad & Miklos, serving clients in Nassau and Suffolk Counties and Brooklyn, the Bronx and Queens, Staten Island and Westchester County.

Fight for justice against FRIVOLOUS DEFENSES and DECEPTIVE DEFENSES.

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Joseph Miklos
Silberstein, Awad & Miklos
600 Old Country Road
Garden City, New York 11523
Call Toll-free 1– 877- ASK 4 SAM
www. Ask4sam.com

intraventricular hemorrhage

New treatment for intraventricular hemorrhage

Dramatic improvements in the rate of death and disability have been reported in the treatment of intraventricular hemorrhage with the use of a catheter-based clot lysis using low-dose tissue plasminogen activation (tpa).

At the 17th European stroke conference results were presented for the study of clot lysis: evaluating accelerated resolution of intracranial hemorrhage. Administration of 1 mg TPA every eight hours for a maximum of four days reduced expected mortality by approximately 70% and resulted in dramatic improvements and functional outcomes. The mortality rate was 15% at 30 days. Usually a 30 day mortality rate was about 80 to 85%. Over the long run of 180 days more than 40% of the patients recovered well enough to live independently and 10% were completely normal with no deficits.

The study required daily CAT scans and careful monitoring of the drug. While the results are encouraging further trials of the protocol are being planned. Hopefully this will become the new standard of care for intraventricular hemorrhage.

If you or a loved one has medical malpractice questions in New York, please contact the Malpractice Law Offices of Silberstein, Awad & Miklos, serving clients in Nassau and Suffolk Counties and Brooklyn, the Bronx and Queens, Staten Island and Westchester County.

Fight for justice against FRIVOLOUS DEFENSES and DECEPTIVE DEFENSES.

This may be considered a legal advertisement.

Joseph Miklos
Silberstein, Awad & Miklos
600 Old Country Road
Garden City, New York 11523
Call Toll-free 1– 877- ASK 4 SAM
www. Ask4sam.com

Botox

Botox, a popular anti-wrinkle drug has been linked to serious side effects including death. A popular drug used to treat wrinkles and a version called Botox cosmetic and a competitor called Myobloc interfere with nerve impulses to muscles causing them to relax.

The drugs have been shown to spread beyond the site of injection throughout the body affecting the muscles used for breathing and swallowing. When the muscles used for ancillary bodily functions are paralyzed or weakened death can result.

These types of drugs are best known for minimizing wrinkles by affecting the facial muscles. However, the toxin is also used for other muscles spasm conditions such as neck spasms or cervical dystonia.

All of the deaths to date have involved children mostly with cerebral palsy. The drug was being used to treat leg spasticity. The use of the drug by physicians in this condition is considered off label use in that it has not been approved for that use by the FDA.

People taking these class of drugs in the form of injections should be advised that they can suffer symptoms of botulism toxicity including difficulty swallowing or breathing, slurred speech, muscle weakness or difficulty holding up their head.

Up until now, the Botox warnings from the manufacturer have been related to side effects suffered by people with neuromuscular disease. The FDA has now indicated that the side effects may be applicable to a wider range of patients. As we speak this story is still being written. Care and common sense must be exercised by all those who receive Botox injections. Physician monitoring and communication is essential.


If you or a loved one has medical malpractice questions in New York, please contact the Malpractice Law Offices of Silberstein, Awad & Miklos, serving clients in Nassau and Suffolk Counties and Brooklyn, the Bronx and Queens, Staten Island and Westchester County.
Together we will continue our fight against FRIVOLOUS DEFENSES and DECEPTIVE DEFENSES.
Call Toll-free 1- 877- ASK 4 SAM


This may be considered a legal advertisement.

Joseph Miklos