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
Friday, December 5, 2008
Wednesday, December 3, 2008
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
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
Monday, December 1, 2008
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
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
Wednesday, November 26, 2008
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
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
Monday, November 24, 2008
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
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
Friday, November 21, 2008
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
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
Wednesday, November 19, 2008
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
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
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