Archive for October, 2010

Wrapping-up Breast Cancer Awareness Month – It’s a Year-Long Battle – Don’t Forget!

Friday, October 29th, 2010

This year we saw the NFL and White House go pink in honor of Breast Cancer Awareness month.  As the 25th year of Breast Cancer Awareness month comes to close, it’s incredible to look back and see how far we have come over the past 25 years in promoting awareness and early detection as well as in the advances in treatment of this disease.

Cases of breast cancer are documented throughout history with the earliest reports dating back to Ancient Egypt in 1600 BC.  However, it wasn’t until the 17th Century in Europe that an understanding of the disease began to take place.  It was during this time that the first surgeries to remove the breast tumor, breast muscle and lymph nodes were performed to eradicate the disease from the body.  In 1882, William Stewart Halsted performed the first mastectomy, the Halstead Radical Mastectomy, which remained a popular treatment up until the 1970’s.  While this form of surgical treatment is rarely used today, there are three variations of Halstead’s procedure performed to remove breast tumors: partial mastectomy (also called lumpectomy), modified radical mastectomy, and the rarely used total simple mastectomy.

The movement to increase breast cancer research and awareness did not take off until the 20th century.  It was in 1952 that the American Cancer Society created the Reach to Recovery program, a group of women who would travel to hospitals to support patients who had mastectomies performed. This program remains in effect today.

By the 1970’s, breast cancer advocacy began to increase rapidly as more non-profit organizations and governmental organizations formed to increase knowledge and awareness as well as to sponsor research to aid in eradication of the disease. Over the last two decades, major breakthroughs in detection and treatment modalities have been made.

The first step to early detection was the development of modern mammography in 1969, when the first x-ray units dedicated to breast imaging were available. By 1976, mammography as a screening device became standard practice.  Mammograms are the best radiographic method available today as they can detect tumors that are too small to be felt. To increase early detection the Mammography Quality Standards Act was passed by Congress in 1992 to ensure that all women have equal access to quality mammography for detection of breast cancer in its earliest and most treatable stages as well as to improve the quality of mammography facilities. When breast cancer is detected, modern treatment typically involves a combination of surgery and medical treatment with chemotherapy, radiation therapy and/or hormone therapy.  Advances in such treatments have resulted in increased five year survival rates.  Patients who get treatment in the early stages of breast cancer have a five year survival rate of 80% or better. Despite treatment advances, the most important thing for breast cancer survival is early detection through monthly self-checks and yearly mammogram examinations in women over the age of 40.  Lastly, advances in reconstructive surgery have helped women to feel more comfortable with their body image as well as restore confidence in their sexuality.

Despite these advances, every 69 seconds someone’s mother, sister, daughter or friend loses their life to breast cancer somewhere in the world.  While major advances in breast cancer detection and treatment have reduced the mortality rate from the disease, we still have a long way to go.

As Breast Cancer Awareness month comes to a close, we should take a moment to honor and remember those that have battled the disease by reminding ourselves and encouraging our loved ones to perform monthly self-checks and to obtain a yearly mammogram.

Breast cancer is not a one month a year disease. We need to encourage all women to fight breast cancer twelve months a year.

Body Snatchers, Walking Corpses, Werewolves – Halloween Costumes Come to Life!

Friday, October 29th, 2010

Halloween is almost here, and as Sunday night draws closer, I know what I will be looking out for – body snatchers, walking corpses and werewolves!  As Diane Mapes describes, it turns out these mythical characters are not confined to books or movies, they could actually come to your door for Trick-or-Treating….    

Imagine waking up tomorrow morning and not recognizing your husband or children but instead believe they are identical imposters who have taken over your home.  That is exactly what happened in 2007 to a woman in Nebraska.  The story may sound fantastical, but it is in fact true as the case report in the Journal of Clinical Psychology reveals – this patient had Capgras Syndrome. Capgras Syndrome, named for French psychiatrist Joseph Capgras who first described the delusion in 1923, is a rare psychiatric disorder in which a patient believes friends and/or family members are not who they say they are but are actually identical-looking imposters.   In Capgras Symdrome there is a disconnect between the visual and emotional centers of the brain believed to be caused by head injury or an existing psychiatric or neurological disorder.

While some of us may be dressing-up as zombies for Halloween this year, some people may actually believe they are the walking dead!   Cotard Delusion was first described by French neurologist, Jules Cotard, in 1882.  This disorder is related to a disconnect between the region of the brain that recognizes faces, the fusiform gyrus.  Patients do not recognize their own face and come to believe they are dead.  Several cases of the disease have been reported in the literature including this story involving a homeless man who believed he had melted away and was dead.  Cotard Delusion is believed to be related to severe depression.

Jacob Black from the Twilight series is one hot werewolf, but unfortunately the disease that transforms humans into werewolves does not transform them back to their human form (nor do they look nearly as hot as Jacob Black).  Hypertrichosis is a genetic condition that causes excessive hair growth all over the body, including the hands and face – think Michael J. Fox in Teen Wolf – that can affect both men and women.  Additionally, Cushing’s Syndrome, a hormonal disorder causing excessive hair growth and a fatty hump, or Prophyria, a blood disorder causing light sensitivity and excessive hairiness, may also be responsible for these so called human werewolf disorders.

So when you dress-up this weekend, look in the mirror and don’t believe you are seeing yourself, you may want to get that zombie costume off as quickly as you can.

Oh, there’s the door bell, got to run and see who’s at the door… Trick or treat, Everyone!

Who’s Hawking Rx Drugs? Is It Really an Effective Medication or Just Effective Marketing?

Thursday, October 28th, 2010

We have all seen the non-stop drug ads on TV – a pill or injection that will cure whatever it is that ails us. Public advertising, however, is just one way that pharmaceutical companies get their drugs into the market place. Behind the scenes, there is a full-blown marketing campaign that the public never sees in which drug companies hire doctors (tens of thousands of doctors) to spread the word on their drugs, primarily by giving talks to other doctors.  An ongoing investigation by ProPublica reveals that some of these doctors have significant disciplinary actions in their past:

A review of physician licensing records in the 15 most-populous states and three others found sanctions against more than 250 speakers, including some of the highest paid. Their misconduct included inappropriately prescribing drugs, providing poor care or having sex with patients. Some of the doctors had even lost their licenses.  More than 40 have received FDA warnings for research misconduct, lost hospital privileges or been convicted of crimes. And at least 20 more have had two or more malpractice judgments or settlements. This accounting is by no means complete; many state regulators don’t post these actions on their web sites.

There is no doubt that the pharmaceutical industry (sometimes referred to as Big Pharma) is a huge industry.  According to IMS Health,a healthcare information and consulting company, prescription drugs generate $300 billion in sales in the United States alone.  Therefore, the pressure on drug companies to market their products is immense. For the doctors out there, doing free-lance work for drug companies can be a very lucrative side-business, with some physicians earning as much as $1,500 to $2,000 for giving a single talk to a group of doctors. While there is nothing wrong with marketing a legal product, the public must be assured that the marketing is honest and that the drugs in question are being prescribed because they are effective drugs, not simply because the drug companies have an effective marketing campaign.

“Without question the public should care,” said Dr. Joseph Ross, an assistant professor of medicine at Yale School of Medicine who has written about the industry’s influence on physicians. “You would never want your kid learning from a bad teacher. Why would you want your doctor learning from a bad doctor, someone who hasn’t displayed good judgment in the past?”

Big Pharma appears to be turning a relatively blind eye to the situation. As part of its investigation, ProPublica compiled a database of physicians who work for the drug companies, and then cross-checked these doctors’ credentials and state disciplinary records.  The drug companies themselves could have taken this approach in vetting their doctors, but most do not bother to do so. Most companies “rely on self-reporting and checks of federal databases.”  However, it is the state disciplinary records that typically contain the relevant data on doctors who have been disciplined (and even state authorities do not always post such infractions on their websites). Lisa Bero, a pharmacy professor at University of California, San Francisco, questions the way that Big Pharma checks on its doctors:

Did they not do background checks on these people?  Why did they pick them? If they did things in their background that are questionable, what about the information they’re giving to me now?

In addition to disciplinary actions, ProPublica also raises questions as to these doctors’ credentials, e.g. medical research, academic appointments and professional society involvement, that would make them especially qualified to speak on medical conditions and ways to treat them. The investigation highlights a Las Vegas endocrinologist who has earned over $300,000 from Big Pharma. However, ProPublica contends that it was unable to locate any credentials on this doctor other than his schooling and some 20-year-old research articles. Furthermore, an online brochure from a recent presentation given by this doctor indicated that he was the chief of endocrinology at a local hospital, but “an official there said he hasn’t held that title since 2008.” Such stories only add to the serious questions as to how Big Pharma is selecting its doctors.

Certainly, a lot of good can come from honest marketing of effective new drugs. Especially in out-of-the way places, a talk by a knowledgeable physician can be a great source of information on new treatments available for a certain disease. If a new drug is truly effective, then by all means the word needs to get out on that drug because such drugs allow us to live longer and to live more comfortably with what were once debilitating diseases.  However, the public must demand honest assessment of these drugs. When drug companies allow unscrupulous doctors to hawk their wares, it raises legitimate suspicion as to whether these drugs are so popular because they are truly effective or simply because they had a good marketing blitz.

If you are curious about a specific doctor, ProPublica has a searchable database of doctors who do work for drug companies. Also, ProPublica has published several follow-up and/or related articles which can be found here.

Medical Malpractice – Serious Medical Errors: Failure of the System or Just Plain Ignorance

Wednesday, October 27th, 2010


Social Media Platforms: Are they really for Lawyers or just People who are Lawyers?

Tuesday, October 26th, 2010

Lawyers and social networking platforms really don’t seem to fit together very well – do they? Many lawyers stumble into social networking simply because they attended some seminar or read some article or blog that told them they are behind the eight ball if their firm is not engaging in social network marketing. “Print media advertising is a thing of the past – get on board with the new marketing of the 21st Century – the internet and social media channels!”

It’s exactly this concept of using social media channels only as a marketing tool that leads to what we see today in places like Twitter and Facebook. Just type in #lawyer, #legal or #attorney in your Twitter search bar and see what you get. Here are some really socially-driven and engaging tweets:

  • If you need a lawyer to handle your messy divorce situation, connect with … then the link to the firm’s website’s contact page.
  • Looking for the right lawyer?
  • Have you been in an accident and need a lawyer?
  • Need a bankruptcy lawyer who has over 20 years of experience….?
  • Have you been arrested for drunk driving? We’re here to help!

You get the idea. Is there anything wrong with this? No…but is it really using the concept of social networking properly or just using social network platforms for advertising or marketing? Me thinks the latter.

Why would anyone want to “connect” with a lawyer?

When I was mulling over this topic with my wife, she astutely likened lawyers to undertakers on social networks. Do you really want to have a “conversation” with an undertaker? Sure – if you need one I guess. Maybe that’s where the internet has replaced Yellow Pages or Yellow Book. But would you really go to Facebook or Twitter to find such a “service provider” or would you probably use a search engine like Google, Bing, Yahoo or whatever.

As lawyers, especially in our firm’s fields of medical malpractice and catastrophic personal injury, what do we offer our “communities” by way of product, entertainment, conversation – or just plain fun? Not a whole lot! Let’s face it, we deal with injury, death – catastrophe – plain and simple. We don’t sell a product like a car, cool T-shirts, a new song or any other “fun commodity.” We are a service industry that is laced with ethical restrictions on what we can say and do on Facebook, Twitter or LinkedIn. We really aren’t a fun group in general or at least our professional lives don’t evoke warm and fuzzy feelings with the public.

Lessons learned and a long time for the awakening:

At my age (just check out the profile picture and take a guess – no, I’m not in my 40′s or 50′s), I was not into this whole social networking gig about a year ago. I was one of those who heard that if you were going to compete in the marketplace, you better have a Twitter account and a Facebook page. So in I ventured, not having a clue what I was doing. I used a logo, did my blog, posted it through Twitter and Facebook, and it pretty much ended there. I couldn’t figure out why all this great content was not spurring constant, passionate conversations with my Fans and Followers. I watched what was happening on others pages and tweets. Why weren’t my peeps engaging me on Twitter nor my fans filling my Facebook page with zesty comments?

It took a long, long time – but the light finally went on. People have enough bad news in their everyday lives. They want to have fun, engage, meet and communicate with other people, who may have something to bring to the table. They don’t need lawyers in their everyday lives – or at least hopefully they don’t.

When and how did this epiphany occur? I was sitting at my computer on father’s day and just had the urge to write a blog in honor of my father, who died over 18 years ago. It had zero to do with the law, but it had everything to do with just wanting people to know something about him and my relationship with him. I wrestled with the concept of putting this on the firm’s blog. Was this a place to post such a piece? Well – since I didn’t have any other forum, it just hit the “publish” button on my WordPress screen. Away it went – and the comments came pouring in. Wow – there really were people out there reading what I wrote!

Don’t get me wrong, our blog is not devoted to personal pieces. What this experience taught me, however, is that if I was ever going to have any communication with my fans and tweeps, I should try being a person who’s a lawyer, not a lawyer trying to engage or market my friends and followers.

So what have I learned and where do I go from here?

There’s no doubt that if I just want to meet new people (network) and engage in conversations with many people I would never in this lifetime have met were it not for communities such as Facebook and Twitter, I could use my personal profile page and a Twitter name other than NashLawFirm. Do I have personal connections and engagements on my personal Facebook page? I sure do. A lot of what takes place there is not meant for my Fan Page (interesting choice of words, Mark Zuckerberg).

So the question remains – why should our firm be on Facebook or Twitter? As they say, “the jury’s still out” for the full answer to that one. Does anyone really understand how this phenomenon called social media developed, exploded or where it’s going? I don’t think so. Businesses simply know they better be there, or they’ll be left in the dust in this competitive world. So – here we are – Facebook-posting and tweeting with the best of them.

But what’s different now? What has time and experience taught me? Answer: I’m still learning and figuring it out. That being said, since we are lawyers with a niche practice, since being on social media platforms really is a method for marketing who we are and what we do, since it is a method to publish content to the world, since it is a way to share some knowledge and information with our followers and friends, and since consistently adding new content to our website is apparently good for search engine optimization, here we are!

All that being said, Facebook, Twitter and LinkedIn (yes, I hyperlinked them in case you want to become part of our family- a word I purposely chose), I have really learned that there’s a world of fascinating, friendly, engaging people out there whom I never would have met were it not for such social media platforms. So many people have knowledge, information and advice that they are willing to freely share, it’s simply amazing. So many people just like to connect, banter and chat- it’s been eye-opening and – quite frankly – fun!

Do we have fun with our Facebook and Twitter communities of fans and friends? We do now, and I love it. Do we share information about the law, medicine, product safety, important trends in law and medicine, and the like? We sure do – that’s what we offer our communities on Facebook and Twitter. Do I engage in some personal fun and banter with my more “vocal“ friends and fans? You bet I do – and those, quite frankly, are some of the more fun-filled times I spend on Facebook and Twitter.

So – here’s to my new friends and tweeps – thanks! You’ve made my life richer. I will try to figure out how to best give back to you what you give to me and the other folks in our firm. Sorry it took so long to figure it out…but I believe we’re on the right path now. Let’s continue to have fun, learn some things from each other and just have an interesting place to meet. Yes, meet! That’s what social networking really provides – an interesting and fun place to meet new friends, share some thoughts and sometimes laughs and get to know each other a little better.

Actavis issues voluntary recall of fentanyl transdermal system C-11 patches.

Monday, October 25th, 2010

Eighteen lots of fentanyl transdermal system C-11 patches have been recalled by Actavis. The fear leading to the recall relates to concerns that the active ingredient could release into the patient’s system at “an accelerated rate,” potentially leading to hypoventilation, respiratory depression and stoppage of breathing.

For more information, you can find the manufacturer’s voluntary recall notification information on the FDA’s website.

Tort Reform or Just Plain Medical Care Reform: the debate continues as thousands are injured annually in US hospitals

Monday, October 25th, 2010


Wall Street Journal, September 28, 2010, diagnostic errors kill 40,000 to 80,000 patients annually based on autopsy studies over past 4 decades.

American Medical News, August 23, 2010, an estimated 1.5 million medical errors cost the US economy $19.5 billion in 2008., October 19, 2010, the Colorado Physician Insurance Company found between 2002 and 2008, 25 surgeries were performed on the wrong patient, and another 107 surgeries were performed on the wrong body part. One-fourth, approximately 6 patients suffered significant injury. There was 1 death.

News from the National Academies, October 21, 2006, medication errors injure 1.5 million people annually. 400,000 injuries occur in hospitals; 800,000 occur in longterm care; and 530,000 occur in Medicare outpatient clinics. Estimates were conservative.  Treatment of hospital injuries cost more then $43.5 billion annually. Lost wages, productivity, or additional healthcare costs were not included.

HealthGrades, April 2008, published 3 years of Medicare data from 2004-2006 in their 5th Annual Patient Safety in Hospitals Study. They found 1.12 million patient safety incidents occurred representing a 3% incident rate; and 270,491 in hospital deaths were directly attributable to an incident. The incident rate was unchanged from the 4 previous annual reports.  The incidents accounted for $8.8 billion in excess cost.

HealthGrades, April 2009, also reported improved data in the 6th Annual Patient Safety in Hospitals Study.  Inpatient Medicare admissions from 2005 to 2007 were studied. Only 913,215 patient safety incidents occurred with an associated $6.9 billion in excess costs. Instead of a 1 in 5 chance of dying from a safety incident in 2004-2008; patients’ odds improved to 1 in 10 chance of dying from an incident by 2007.

Institute of Medicine of the National Academy of Sciences, 2000, estimated medical errors kill up to 98,000 US hospital patients each year.


I decided to write about patient injuries in American hospitals 2010 because – frankly – my career in healthcare quality assurance and risk management was launched as a direct result of a landmark study released in 1978.  Don Harper Mills, M.D. published a study known as the California Medical Insurance Feasibility Study (CMIFS). In 1978, no one knew how many people were actually being injured in hospitals. There was a crisis of available liability insurance for physicians and hospitals, and as a result, compensation alternatives were being considered. In order to fund compensation alternatives for patient victims, actual injury data was needed.

Dr. Mills and his colleagues manually reviewed 20,864 hospital patient medical records from 23 representative California hospitals for the year 1974. They found 970 patients were directly injured by a medical mistake. This was 4.5% of the entire records sampling.  What shook the healthcare industry to the core in 1978 was the following:

When expanding the study sample size to the full statewide population, the data showed there were:

  • 6.5% minor permanent injuries – 9,100 patients;
  • 3.8%  major permanent injuries – 5,300 patients; and
  • 9.7% suffered death – 13,600 patients.

If all of these patients were to be fully compensated under full disclosure and/or no fault insurance plans, the state would not have been able to fund the approach. Insurance companies and states across the country began looking at closed medical malpractice claims, statewide data, medical records that showed the same trends were a national and not just a “California” problem.

Throughout the early 1980’s, we saw state and federal regulations mandating hospitals implement physician peer review and quality assurance programs. Medical malpractice insurance companies and brokers sent consultants into hospitals to begin teaching staff how to set up systems for monitoring care and correcting/improving systems.

The American Society of Healthcare Risk Management was born creating national and state-based initiatives to reduce injuries. The American College of Surgeons published their first Patient Safety Manual for medical staff leadership.

Initiatives from the Joint Commission for the Accreditation of Healthcare Organizations continued into the 1980’s and 1990’s with expanded quality improvement standards.

This great computer age has allowed more sophisticated and widespread comparison of insurance, state and national data than ever before. The data tragically continues to reveal dismal results despite decades of government, state, regulatory, and social pressures for hospitals, physicians, and healthcare professionals to improve.


While the AMA continues to whine about being sued too often and the tragic impact on physicians, as you see the data show that for decades, patients continued to be significantly injured. A study by Harvard researchers, who reviewed 1452 medical malpractice closed claims in 2006, reported 75% had legal awards consistent with their merit. Two reports by Dartmouth economists in 2005 and RAND in 2004 found awards were consistent with the rising costs of medical care and average awards grew less than real income. The more costly medical care was responsible for more then half the jury awards. A study of American insurance data between 2001 and 2004 showed malpractice awards per doctor were stable or fell, and premium increases were not connected to awards.

In 2009, the Canadian Medical Association Journal reported there was no evidence US doctors were experiencing increasing numbers of lawsuits during 2001-2004.  Over 15 years, states had reported physician insurance premium rates were flat or declined relative to economic and population changes.  The article cited opinions that the problem was not litigation; the problem was malpractice.  However, the AMA is persistent in claiming financial relief is needed. One means they propose is to limit of non-economic damages for pain and suffering nationally to $250,000.

Very recently, American Medical News ( issued a summary of 20 new grants issued by the Dept. of Health and Human Services at a cost of $25 million. The grants are to find ways to cut medical errors and improve communication between doctors and patients.  Highlights were:

  • New patient safety programs that include data designed to link with medical liability claims.
  • New York won $3 million to expand and test a judge-directed negotiation program for surgery and obstetrical injured patients.
  • The University of Washington in Seattle won $2.97 million to train physicians, nurses, and pharmacists to communicate.
  • Ohio State University of College of Medicine won $186,214 to establish a statewide database on pregnancy-related deaths for study towards improving outcomes.
  • South Dakota and Sanford Health won $299,995 to develop a state model for collecting medical error data and to design a patient complaint reporting system.

Ironically, the Wall Street Journal article (September 28, 2010) reported physicians were learning from reviewing closed lawsuit claims data. As a result, “Some doctors are using electronic alerts and reminders to order tests, follow-up lab data, and communicate with referral specialists.”


This June’s Archives of Internal Medicine reported 91% of doctors practice defensive medicine and order too many tests adding huge unnecessary costs to the healthcare system.  The Wall Street Journal article reported a better solution is to  improve larger system failures and prevent errors. Kaiser Permanente uses medical malpractice data for education, but also focuses resources on technology to reduce patient injuries, i.e. close tracking and follow-up of patients with abnormal testing results. The VA is doing the same through an electronic medical record system. This is encouraging.

The insurance company representing Harvard University affiliated hospitals and doctors uses lawsuit data to focus on improvement strategies. Again, from my perspective having worked in the past for a large insurance broker, a statewide project funded by an insurance company, and a medical malpractice insurance company, this is NOTHING NEW.  Out of 456 high severity cases resulting in serious harm to patients, most were diagnostic errors. The insurance executive for the Harvard account is hoping to spur changes in systems and procedures and reduce this finding.

I am hoping he will see results. I trust the headlines will continue to print those results and trends for us to follow.

We can only hope that the coming years will see a dramatic reduction in these preventable medical injuries.

How Much Do You Really Know About Prostate Cancer? Facts you should know!

Monday, October 25th, 2010

According to the American Cancer Society, about 217,730 men will be diagnosed with prostate cancer this year. Another 32,050 men are expected to die from prostate cancer in 2010.  Prostate cancer is the second leading cause of cancer-related deaths among men.

Prostate cancer refers to carcinoma of the prostate gland. The prostate is about the size of a walnut, and it is an integral part of the male reproductive system. This gland secretes and stores an alkaline fluid that makes up about 25-30% of the semen. This alkaline fluid is what prolongs the life of the spermatozoa once secreted. The prostate gland wraps around the urethra, which conducts the urine out of the bladder.  Men diagnosed with prostate cancer experience difficulties with urination as the gland swells up, thus constricting the urethra.

Considering the prevalence of this cancer in the male population, each man should take time to familiarize himself with the signs and symptoms of this disease and how it is diagnosed.  Some of the symptoms of prostate cancer include:

  • Urinary hesitation
  • Urinary dribbling
  • Urinary retention
  • Pain with urination
  • Pain with ejaculation
  • Lower back pain
  • Pain with bowel movements
  • Urinary leakage
  • Bloody urine
  • Anemia
  • Lethargy
  • Weight loss

If you happen to experience some or all of  the above symptoms, make sure to talk to your doctor about the possibility of prostate cancer.  You should ask your physician to explain to you the various diagnostic tests, which could help make an early diagnosis.  These include:

  • PCA test – Prostate-Specific Antigen blood test is designed to examine the level of a substance produced by the prostate gland (i.e., the antigen). An elevated PCA level could be indicative of prostate cancer.
  • AMACR - α-Methylacyl Coenzyme A Racemase (AMACR) is a protein, which tends to be more expressed in patients with prostate cancer.
  • Urine analysis
  • Prostate fluid testing
  • Prostate biopsy

Sure, many men will avoid getting ongoing healthcare and avoid going to their doctors regularly – until it’s too late. If you have any of the symptoms listed above, do yourself a favor and contact your doctor for an appointment.

Science Confirms What Women Have Known for Years – We Really Are the Stronger Sex!

Saturday, October 23rd, 2010

Guess the "study" is right!

A new study from Johns Hopkins University led by assistant professor of surgery, Dr. Adil Haider has shown that women have an increased ability and tenacity to survive trauma when compared to men who have suffered a traumatic injury.

Haider and collegues collected data on over 48,000 patients who had suffered a severe traumatic injury.  Only patients whose blood pressure was extremely low – which is considered a sign of traumatic injury - were included in the study.  Male and female participants were placed in three groups – under 12, between 13 and 64 and those over 65.  After taking into account such variables as age, severity of injury, type of injury and manner of injury, women demonstrated a 14% higher rate of survival of traumatic injury than men.  While other variables may have caused the increased rate of survival, Haider suggests that female sex hormones like estrogen are a likely factor in women’s survival.  In some cases, female sex hormones enhance the immune system.  However, it is unclear whether the improved odds of survival are a result of the prescence of female sex hormones or the result of a decrease in the amount of male sex hormones like testosterone that serves as a protector.

Whatever the cause of the improved odds its nice to have science show us who is really capable of survival!

Editorial Comment: Geez…this is what I have to deal with….! (Brian Nash)

Warning to Women of Menopausal Age: HRT Linked to Increase in Death from Breast Cancer

Friday, October 22nd, 2010

One day after Pfizer wins the latest lawsuit regarding HRT in Arkansas, a new study published in the October 20, 2010 issue of the Journal of the American Medical Association found a link between prolonged use of HRT and the risk of not only developing breast cancer but of dying from the disease.

This new study began with data from the Women’s Health Initiative, a randomized-controlled study of post-menopausal women that abruptly ended in 2002, when a definitive increase in the incidence of breast cancer was discovered in women taking the combined HRT of estrogen-plus-progestin.  Since the end of that study, researchers continued to follow the participants and found that women taking the combined HRT were more likely to have an invasive breast cancer, more likely to have breast cancer that spread to the lymph nodes, and more likely to die from breast cancer than participants in the placebo group.

Estrogen-plus-progestin pills like Prempro increase breast density making tumors difficult to identify on mammograms which delays the diagnosis and inevitably the treatment for the disease. The researchers conclude that women taking HRT should use the lowest dose for the shortest amount of time to reduce their risk of developing breast cancer.

The Today Show’s Dr. Nancy Snyderman discusses the study’s conclusions on the Today website with a warning to women of menopausal age to consider the risks of HRT and to discuss with their physicians the possibility of taking the lowest dose for the shortest amount of time.

It is important to note that the study findings only apply to hormone replacement therapy with estrogen-plus-progestin pills or combined hormone therapy, not to estrogen-only therapy.

Contributing Author: Rachel A. Leyko