Single-Payer On The Way?
Publication Date: December 1, 2012 | Daily News Record, Open Forum
President Obama’s re-election means that the Affordable Care Act will come to fruition. Even though fissures in the act are apparent, some believe that “ObamaCare” will eventually lead to a single-payer health system.
Although some have clamored for universal health care, few understand the long-term consequences of single-payer systems. Canada’s system offers a compelling example of government-run inefficiency. Its system is enshrined in The Canada Health Act, which was enacted into law Continue reading →
Media Falsely Depict “Diversity”
Publication Date: February 3, 2012 | Daily News Record, Open Forum
Diversity. Multiculturalism. Tolerance. These words are bandied about in conversations and communication, and as such, have become part of the modern lexicon. Hardly a day goes by when we don’t read about, or speak of, diversity in the workplace, multicultural classrooms, or the need for religious tolerance.
The societal benefits of multiculturalism are praised by politicians, and lauded by community leaders. The need for understanding of cultural diversity is the clarion call of colleges and universities. Most institutions of higher education offer an array of classes related to this theme. International festivals and celebrations of diversity are ubiquitous. Continue reading →
Principles and Practice of Brachytherapy: Using Afterloading Systems
Publication Date: August 15, 2001 | ISBN-10: 0340742097 | ISBN-13: 978-0340742099 | Edition: 1
This authoritative new reference provides a comprehensive review of current practice in afterloading brachytherapy. It covers the scientific principles of brachytherapy and its applications in clinical practice. The first two sections of the book cover Physics and Radiobiology, while the third section is devoted to the clinical application of the technique in relation to specific tumor sites. Each chapter is authored by acknowledged experts in these fields. The design and provision of a brachytherapy service, quality assurance and cost implications are also discussed. Continue reading →
The Health Care Quality Improvement Act of 1986 and the National Practitioner Data Bank: The Controversy Over Practitioner Privacy Versus Public Access
Publication Date: April 1996 | Bulletin of the Medical Library Association
During the 1970s and 1980s the substantial rise in the number of medical malpractice lawsuits created a situation often characterized as a “malpractice crisis” . In fact, more medical malpractice suits were filed in the decade ending in 1987 than in “the entire previous history of American tort law” . Claim frequency per 100 physicians rose at least 10% each year during this period, from 13.5 claims in 1982 to 17.2 in 1986 . The Department of Health, Education and Welfare, in an early attempt to study this problem, established the Commission on Medical Malpractice in 1973 . Continue reading →
Palladium-103: A new radioactive source in the treatment of unresectable carcinoma of the pancreas: A phase I–II study
Publication Date: April 1996, Volume 61, Issue 4, pages 300–305 | Journal of Surgical Oncology
Palladium-103 (Pd-103) is introduced in brachytherapy procedures because of its favorable physical properties, including its low energy, rapid dose fall-off, short half-life, and total cumulative dose delivery at a higher dose rate than iodine-125 (I-125) isotope. Intraoperative brachytherapy using I-125 pellets was reported to provide significant palliation and meaningful prolongation of life in highly selected patients with unresectable carcinoma of the pancreas. After considering some of the advantages of Pd-103 over I-125, we designed a phase I-II clinical trial to assess the feasibility of intraoperative Pd-103 in unresectable carcinoma of the pancreas to study the related morbidity when combined with chemotherapy and external beam radiation, and to evaluate the impact on palliation and local control rates. Between December 1989 and December 1993, 15 patients with biopsy-proven unresectable adenocarcinoma of the pancreas were treated with interstitial Pd-103 implants during laparotomy. In 13 patients the lesion was located in the head of the pancreas, in one patient in the uncinate process, and in one patient in the body of the pancreas. The stage distribution was as follows: T1 = 2; T2 = 6, and T3 = 7. In addition, all patients underwent biliary and gastric bypass. The mean number of Pd-103 pellets was 45; the mean total activity to obtain a matched peripheral dose (MPD) of 11,000 cGy was 68.9 mCi. The mean tumor volume encompassing the MPD was 16.5 cc. All patients received postoperative external beam radiation (4,500 cGy over 4 1/2 weeks) and chemotherapy (5-fluorouracil and mitomycin C). This combined treatment, consisting of intraoperative brachytherapy using Pd-103 and postoperative external beam radiation with chemotherapy, was well tolerated in all patients. There were no treatment-related mortalities, and no serious complications, such as bleeding or fistula formation. Pain relief was obtained within 3–6 weeks in 10 out of 12 patients presenting with pain. Survival ranged from 6 to 24 months (median 10 months). The study suggests that Pd-103 can be considered an alternative to I-125 for interstitial brachytherapy for unresectable carcinoma of the pancreas. Symptom relief appeared to occur faster and complications are significantly less. However, this study did not show any improvement in the median survival rate over I-125 due to the advanced stage cancer in the majority of patients in the study. © 1996 Wiley-Liss, Inc. Continue reading →