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Defensive Medicine

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5001. Highlights of the Digital Imaging Network-Picture Archiving and Communications System project (Full text)

international standards, Digital imaging and Communications in Medicine (DICOM) and Health Level 7 (HL7). The DIN-PACS is required to communicate in a bidirectional manner with the Department of Defense standard hospital information system called the Composite Health Care System (CHCS) through an HL7 compliant interface. The DIN-PACS model and its published specifications stress functionality and performance rather than system architecture to allow industry to propose optimal approaches for implementation (...) Highlights of the Digital Imaging Network-Picture Archiving and Communications System project The Department of Defense issued its requirements for a Digital imaging Network-Picture Archiving and Communications System (DIN-PACS) in a Request for Proposals to industry in January, 1997. The DIN-PACS shall be an open systems network of digital devices designed for the effective acquisition, transmission, display and management of diagnostic imaging studies. This network is primarily based on two

1997 Journal of Digital Imaging PubMed abstract

5002. Large-scale PACS implementation (Full text)

Large-scale PACS implementation The transition to filmless radiology is a much more formidable task than making the request for proposal to purchase a (Picture Archiving and Communications System) PACS. The Department of Defense and the Veterans Administration have been pioneers in the transformation of medical diagnostic imaging to the electronic environment. Many civilian sites are expected to implement large-scale PACS in the next five to ten years. This presentation will related (...) the empirical insights gleaned at our institution from a large-scale PACS implementation. Our PACS integration was introduced into a fully operational department (not a new hospital) in which work flow had to continue with minimal impact. Impediments to user acceptance will be addressed. The critical components of this enormous task will be discussed. The topics covered during this session will include issues such as phased implementation, DICOM (digital imaging and communications in medicine) standard

1998 Journal of Digital Imaging PubMed abstract

5003. Anthrax: A possible case history. (Full text)

Anthrax: A possible case history. 10458965 1999 11 04 2009 05 21 1080-6040 5 4 1999 Jul-Aug Emerging infectious diseases Emerging Infect. Dis. Anthrax: A possible case history. 556-60 Inglesby T V TV Johns Hopkins School of Medicine, Baltimore, Maryland, USA. tvi@welchlink.welch.jhu.edu eng Journal Article United States Emerg Infect Dis 9508155 1080-6040 IM Anthrax epidemiology etiology prevention & control Biological Warfare Civil Defense Humans Violence 1999 8 25 1999 8 25 0 1 1999 8 25 0 0

1999 Emerging Infectious Diseases PubMed abstract

5004. Applying lessons learned from anthrax case history to other scenarios. (Full text)

Applying lessons learned from anthrax case history to other scenarios. 10458966 1999 11 04 2009 05 21 1080-6040 5 4 1999 Jul-Aug Emerging infectious diseases Emerging Infect. Dis. Applying lessons learned from anthrax case history to other scenarios. 561-3 Bartlett J G JG Johns Hopkins School of Medicine, Baltimore, Maryland, USA. biodefen@jhsph.edu eng Journal Article United States Emerg Infect Dis 9508155 1080-6040 IM Anthrax epidemiology etiology prevention & control Biological Warfare Civil (...) Defense Humans United States epidemiology 1999 8 25 1999 8 25 0 1 1999 8 25 0 0 ppublish 10458966 PMC2627743 10.3201/eid0504.990420

1999 Emerging Infectious Diseases PubMed abstract

5005. Common object request broker architecture (CORBA)-based security services for the Virtual Radiology Environment (Full text)

Common object request broker architecture (CORBA)-based security services for the Virtual Radiology Environment The US Army Great Plains Regional Medical Command (GPRMC) has a requirement to conform to Department of Defense (DoD) and Army security policies for the Virtual Radiology Environment (VRE) Project. Within the DoD, security policy is defined as the set of laws, rules, and practices that regulate how an organization manages, protects, and distributes sensitive information. Security (...) policy in the DoD is described by the Trusted Computer System Evaluation Criteria (TCSEC), Army Regulation (AR) 380-19, Defense Information Infrastructure Common Operating Environment (DII COE), Military Health Services System Automated Information Systems Security Policy Manual, and National Computer Security Center-TG-005, "Trusted Network Interpretation." These documents were used to develop a security policy that defines information protection requirements that are made with respect to those laws

2000 Journal of Digital Imaging PubMed abstract

5006. Public Advocacy and Allocation of Federal Funds for Biomedical Research (Full text)

Public Advocacy and Allocation of Federal Funds for Biomedical Research Members of Congress and officials of the National Institutes of Health face heightened pressure from public advocacy groups seeking more funding for research on specific health conditions. In response, Congress and the Institute of Medicine have urged the NIH to create more opportunities for the public to participate in decision making on allocation of biomedical research resources. The ethical and policy implications (...) of including advocates in the deliberations are explored, leading to the conclusion that public participation could contribute to more defensible decisions under three conditions: public participants are fairly selected and meaningful opinions are solicited; public participants look beyond their narrow constituencies to consider the health needs of the broader public; and NIH officials develop materials to assist participants with their deliberations.

1999 The Milbank quarterly PubMed abstract

5007. The World Trade Center Attack Disaster preparedness: health care is ready, but is the bureaucracy? (Full text)

The World Trade Center Attack Disaster preparedness: health care is ready, but is the bureaucracy? When a disaster occurs, it is for governments to provide the leadership, civil defense, security, evacuation, and public welfare. The medical aspects of a disaster account for less than 10% of resource and personnel expenditure. Hospitals and health care provider teams respond to unexpected occurrences such as explosions, earthquakes, floods, fires, war, or the outbreak of an infectious epidemic (...) . In some geographic locations where natural disasters are common, such as earthquakes in Japan, such disaster practice drills are common. In other locations, disaster drills become pro forma and have no similarity to real or even projected and predicted disasters. The World Trade Center disaster on 11 September 2001 provides new information, and points out new threats, new information systems, new communication opportunities, and new detection methodologies. It is time for leaders of medicine to re

2001 Critical Care PubMed abstract

5008. Doctors and medical negligence. (Full text)

Doctors and medical negligence. 2106979 1990 04 24 2018 11 13 0959-8138 300 6721 1990 Feb 10 BMJ (Clinical research ed.) BMJ Doctors and medical negligence. 343-4 Havard J D JD eng Editorial England BMJ 8900488 0959-8138 AIM IM BMJ. 1990 Mar 17;300(6726):746-7 2322728 Defensive Medicine Humans Malpractice legislation & jurisprudence Medical Staff, Hospital legislation & jurisprudence State Medicine United Kingdom 1990 2 10 1990 2 10 0 1 1990 2 10 0 0 ppublish 2106979 PMC1662128 Br Med J. 1954

1990 BMJ : British Medical Journal PubMed abstract

5009. Resources, the family and voluntary euthanasia. (Full text)

people do not wish for further longevity after they have become too disabled to be of service to their families, and would prefer to see limited resources being used for the young. In the USA, loss of autonomy of patients and their families owing to the practice of defensive medicine has resulted in the development of the 'living will', a legal document in which people can specify in advance what treatment they wish to accept in the event of life threatening illness. It is to be hoped that improved

1990 The British Journal of General Practice PubMed abstract

5010. [Prevention of acute respiratory infections in healthy young adults by using oral immunomodulators]. (Abstract)

[Prevention of acute respiratory infections in healthy young adults by using oral immunomodulators]. It is a general experience at army posts that right after the joining up period the number of airway infections suddenly increases. The upper and lower airway infections are especially facilitated by the confinement of military barracks, and the high number of smokers among soldiers. In the winter of 1995/96 at an army post of the Hungarian National Defense Forces authors treated 68 healthy (...) , young recruits, aged between 18-23 preventively with an immunomodulant which contains lyophilized bacterial extracts, and placebo. The aim was to try this medicine on healthy adults to prevent or influence acute respiratory infections. In one third of the nine-month long follow-up period, a blind study was carried out, and two thirds of it were spent with a double blind one. The number of airway infections and off duty days was reduced by more than 40% in the group which was treated

1997 Orvosi hetilap

5011. Physiopathologie et thérapeutique de l'utérus en période puerpérale chez la vache laitière: revue (Full text)

Physiopathologie et thérapeutique de l'utérus en période puerpérale chez la vache laitière: revue Accurate diagnosis and effective therapeutics of uterine pathologies in cattle represent some of the daily preoccupations for the veterinarians involved in herd health medicine. A rational approach requires a competence based on fundamental and clinical knowledge.The physiological aspects of the uterine involution in cattle are reviewed with emphasis about the in utero bacteriological dynamic (...) and the endocrinological evolution during this period. The pathogenesis of uterine pathologies is discussed following new research results and new knowledge on the mechanisms of uterine defense. The value and limitations of the clinical diagnosis is briefly reviewed. The therapeutics of uterine pathologies is debated in relation with the pathophysiology of the uterine involution and with the rational of the traditional and new concepts of the treatment of the postpartum uterine pathologies.

1987 The Canadian Veterinary Journal PubMed abstract

5012. The Family Physician as Peacemonger: How to Talk to Your Patients about the Threat of Nuclear War (Full text)

The Family Physician as Peacemonger: How to Talk to Your Patients about the Threat of Nuclear War The threat of nuclear war concerns most Canadians. Many family physicians may consider the issue important as a topic of preventive medicine, but feel uncomfortable discussing it. Physicians must first inform themselves and deal with their own feelings and psychological defense mechanisms before they can help their patients through the same stages.

1986 Canadian Family Physician PubMed abstract

5013. The medicolegal climate of clinical practice. (Full text)

The medicolegal climate of clinical practice. 3719480 1986 07 29 2008 11 20 0820-3946 135 1 1986 Jul 01 CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne CMAJ The medicolegal climate of clinical practice. 19-20 Leighton K M KM eng Journal Article Canada CMAJ 9711805 0820-3946 AIM IM Anesthesiology standards Defensive Medicine Humans Jurisprudence Malpractice 1986 7 1 1986 7 1 0 1 1986 7 1 0 0 ppublish 3719480 PMC1491116

1986 CMAJ: Canadian Medical Association Journal PubMed abstract

5014. Don't shoot the messenger. (Full text)

Don't shoot the messenger. 11013788 2000 10 19 2018 11 13 0008-350X 46 2000 Sep Canadian family physician Medecin de famille canadien Can Fam Physician Don't shoot the messenger. 1738-9 Gray J E JE eng Comment Letter Canada Can Fam Physician 0120300 0008-350X IM Can Fam Physician. 2000 Aug;46:1553-4, 1558-60 10955169 Canada Communication Defensive Medicine organization & administration Humans Malpractice legislation & jurisprudence Medical History Taking Physician-Patient Relations Sexual

2000 Canadian Family Physician PubMed abstract

5015. Mobilizing professional communities. (Full text)

Mobilizing professional communities. 11880670 2002 03 22 2017 02 14 0033-3549 116 Suppl 2 2001 Public health reports (Washington, D.C. : 1974) Public Health Rep Mobilizing professional communities. 40-4 Bartlett J G JG Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine and Center for Civilian Biodefense Strategies, Johns Hopkins University, Baltimore, MD 21205, USA. jb@jhmi.edu eng Journal Article United States Public Health Rep 9716844 0033-3549 AIM IM (...) Attitude of Health Personnel Bioterrorism prevention & control Civil Defense Disaster Planning organization & administration Disease Outbreaks prevention & control Health Priorities Humans Persuasive Communication Physician's Role Private Sector Probability Societies, Medical United States epidemiology 2002 3 7 10 0 2002 3 23 10 1 2002 3 7 10 0 ppublish 11880670 PMC1497260 10.1093/phr/116.S2.40

2001 Public Health Reports PubMed abstract

5016. Reducing the bioweapons threat: international collaboration efforts. (Full text)

Reducing the bioweapons threat: international collaboration efforts. 11880663 2002 03 22 2017 02 14 0033-3549 116 Suppl 2 2001 Public health reports (Washington, D.C. : 1974) Public Health Rep Reducing the bioweapons threat: international collaboration efforts. 17-8 Eitzen E M EM Jr Division of Operational Medicine, USAMRIID, Fort Detrick, MD 21702-5011, USA. edward.eitzen@amedd.army.mil eng Journal Article United States Public Health Rep 9716844 0033-3549 AIM IM Biological Warfare prevention (...) & control Bioterrorism prevention & control Civil Defense organization & administration Disaster Planning organization & administration Global Health Humans International Cooperation Public Health United States 2002 3 7 10 0 2002 3 23 10 1 2002 3 7 10 0 ppublish 11880663 PMC1497269 10.1093/phr/116.S2.17

2001 Public Health Reports PubMed abstract

5017. Analysis of cord blood gas at delivery: questionnaire study of practice in the United Kingdom (Full text)

Blood Gas Analysis Cerebral Palsy diagnosis Defensive Medicine Female Fetal Blood chemistry Humans Infant, Newborn Practice Patterns, Physicians' Pregnancy Surveys and Questionnaires United Kingdom 2001 9 29 10 0 2001 11 3 10 1 2001 9 29 10 0 ppublish 11576980 PMC56891 Obstet Gynecol. 1991 Dec;78(6):1103-7 1945216 BMJ. 1999 Oct 16;319(7216):1054-9 10521205 Br J Obstet Gynaecol. 1994 Dec;101(12):1054-63 7826958

2001 BMJ : British Medical Journal PubMed abstract

5018. Training room management of medical conditions: infectious diseases. (Abstract)

Training room management of medical conditions: infectious diseases. Management of infectious diseases in athletes encompasses a wide range of pathogens, clinical presentations, and treatment options. Certain athletic activities and training regimens may predispose athletes to increased risk of contracting infectious diseases, some of which may limit athletic participation and pose the threat of significant morbidity. The sports medicine physician plays an important role as a first line (...) of defense in preventing, recognizing, and appropriately treating infectious diseases in athletes.

2005 Clinics in Sports Medicine

5019. It is easier to confuse a jury than convince a judge: the crisis in medical malpractice. (Abstract)

It is easier to confuse a jury than convince a judge: the crisis in medical malpractice. A study of cervical spine malpractice cases was conducted. Identifying tort reform models may help to resolve a crisis in medical malpractice.To identify tort reform models that may help to resolve a crisis in medical malpractice.Medical malpractice faces a crisis. Insurance rates are exorbitant, yet many injured patients go uncompensated. Physicians practice defensive medicine for fear of suits (...) %). All of the six plaintiff verdicts (average, $4.42 million) and four of the nine settlements (average, $1.6 million) involving surgery that resulted in new postoperative quadriplegia appeared to be appropriate. However, the author could discern "no fault" in cases five defendants had settled, and the surgeons did not deserve to lose. On the other hand, the author found "fault" in five defense verdicts rendered to three newly quadriplegic patients and two with new postoperative root injuries

2002 Spine

5020. Do house officers learn from their mistakes? (Full text)

Do house officers learn from their mistakes? Mistakes are inevitable in medicine. To learn how medical mistakes relate to subsequent changes in practice, we surveyed 254 internal medicine house officers. One hundred and fourteen house officers (45%) completed an anonymous questionnaire describing their most significant mistake and their response to it. Mistakes included errors in diagnosis (33%), prescribing (29%), evaluation (21%), and communication (5%) and procedural complications (11 (...) %). Patients had serious adverse outcomes in 90% of the cases, including death in 31% of cases. Only 54% of house officers discussed the mistake with their attending physicians, and only 24% told the patients or families. House officers who accepted responsibility for the mistake and discussed it were more likely to report constructive changes in practice. Residents were less likely to make constructive changes if they attributed the mistake to job overload. They were more likely to report defensive

2003 Quality and Safety in Health Care PubMed abstract

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