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Large-scale adverse events deserve disclosure, study says

Hospitals, physician practices and other health care organizations should disclose adverse events that affect numerous patients, even when most patients may not be harmed, a new study shows. These large-scale adverse events -- usually involving poor infection-control practices or defective equipment -- are ones in which some patients may experience harm while most escape unfavorable consequences, said the study, published Sept. 1 in The New England Journal of Medicine. "We think disclosure should occur in virtually every case," said study lead author Denise M. Dudzinski, PhD, associate professor in the Dept. of Bioethics and Humanities at the University of Washington School of Medicine. "There are some cases in which the risk of harm is higher, and there's a greater obligation to disclose, because of the high likelihood that some patients will need treatment." There also may be "a higher obligation to disclose if the case involved a breakdown that was a deviation from standard ...

20-state health reform lawsuit likely to go forward

A federal judge says he is likely to rule that a 20-state lawsuit against the national health reform has legal grounds to go to trial. Attorneys for the federal government asked U.S. District Judge Roger Vinson of the Northern District of Florida to dismiss a lawsuit filed by a coalition of 20 states. They argued that the lawsuit is premature because states cannot prove they will be harmed by the health reform law's requirement for individuals to have health insurance, which takes effect in 2014. The states' complaint asks the court to block the individual insurance requirement because they argue that Congress does not have the constitutional authority to penalize citizens for not having health insurance. After hearing arguments from both sides on Sept. 14, Vinson said he would rule on the motion to dismiss the lawsuit as soon as Oct. 14, said Ryan Wiggins, spokeswoman for Florida Attorney General Bill McCollum, one of the attorneys arguing the states' case. She said McCollum doe ...

Diet and exercise counseling may help prevent recurrent strokes

Treating patients with metabolic syndrome and counseling them on diet, exercise and weight loss might help prevent a recurrent stroke or a transient ischemic attack, according to new recommendations by the American Heart Assn. and the American Stroke Assn. The secondary stroke prevention guidelines were published online Oct. 21 in the AHA's journal Stroke. The recommendations, updated from 2006, aim to prevent recurrent incidents in stroke survivors and patients who had transient ischemic attacks. Suggestions for metabolic syndrome are among the key updates for primary care physicians, said AHA President Ralph Sacco, MD. Metabolic syndrome is characterized by a group of risk factors, including abdominal obesity, elevated blood pressure and insulin resistance. The syndrome increases patients' risk for vascular disease and affects about half of those who have an ischemic stroke, according to the guidelines. "We want clinicians to begin to recognize [metabolic syndrome], to know ...