International Journal of Risk & Safety in Medicine - Volume 6, issue 1
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The International Journal of Risk and Safety in Medicine is concerned with rendering the practice of medicine as safe as it can be; that involves promoting the highest possible quality of care, but also examining how those risks which are inevitable can be contained and managed.
This is not exclusively a drugs journal. Recently it was decided to include in the subtitle of the journal three items to better indicate the scope of the journal, i.e. patient safety, pharmacovigilance and liability and the Editorial Board was adjusted accordingly. For each of these sections an Associate Editor was invited. We especially want to emphasize patient safety. Our journal wants to publish high quality interdisciplinary papers related to patient safety, not the ones for domain specialists. For quite some time we have also been devoting some pages in every issue to what we simply call WHO news. This affinity with WHO underlines both the International character of the journal and the subject matter we want to cover. Basic research, reports of clinical experience and overviews will all be considered for publication, but since major reviews of the literature are often written at the invitation of the Editorial Board it is generally advisable to consult with the Editor in advance. Submission of news items will be appreciated, as will be the contribution of letters on topics which have been dealt with in the journal.
Abstract: The objective of the study was to determine the effect of chronic lead exposure on pregnancy and the newborn. Cord blood was assayed for blood lead levels (PbB) in a randomly selected group of 82 Maltese newborns. Twenty-eight (34.1%) neonates had a PbB level greater than 200 μg/l. Two trends appeared with increasing blood lead levels suggesting a decrease in newborn birth weight (r=−0.1445, P=0.207) and an increase in the duration of the first stage of spontaneous labour (r=0.1385, P=0.3043). There appeared to be no mean differences in maternal third trimester haemoglobin, duration of gestation, and previous pregnancy loss in…infants with high PbB levels compared to infants with low PbB. Through its properties of inhibiting enzymatic function and its competitiveness with other minerals, calcium and zinc, chronic sub-toxic lead exposure during pregnancy may cause adverse effects on the neonate and pregnancy.
Abstract: The author focuses on the healing effects of a sterile CaOH paste when used in pulp capping treatment and draws the conclusion that this substance is even more strongly indicated when treating the apical part of the root in endodontical practice. CaOH is a bactericide — pH modified to around 12 — and useful also as an inlay in the root canal, even in teeth with gangrene. The author recommends a root filling method with sterile CaOHin the apical part of the root — stimulating healing and growth of regenerating tissue — which is covered with a plug of a…biocompatible material, e.g. sterile silicon in an injectable form, or by a two-component root canal sealing paste. This is considered as a far more biological method than that commonly practised which involves use of chloroform and gutta-percha points which may contain traces of heavy metals.
Keywords: Root filling, Health consequences, CaOH paste
Abstract: Cardiologists and cardiothoracic surgeons apply invasive procedures in increasing numbers of patients. Several studies reveal a high rate of adverse outcome and mortality, which is not related to a different composition of the patient groups or their risk profiles for complications. The answer to the question whether invasive treatment is safe enough depends on what is regarded as an acceptable risk of failure and whether failure can be reasonably prevented. The prospect of an economic reward for meeting safety standards by institutions and physicians in terms of business income or reduction of the litigation pressure, is essential. Also, adequate disclosure…of risks to patients may add to their sense of safety.
Abstract: Introduction: General practitioners make mistakes and errors, just like everyone else. In order to prevent these ‘incidents’, a model for a Committee of Investigation of Incidents in General Practice has been developed in consultation with members of the profession. GPs can report incidents to this Committee, which will analyse the incidents and try to find ways to prevent them in the future. The Committee then informs the GP concerned of its conclusions and, if necessary, all GPs. Method: After interviews with 20 experts and a Delphi procedure with 20 GPs, a survey was conducted among 600 GPs. Results:…The survey shows that 83% of the respondents think that such a Committee should be set up. It is expected that this will improve the status of general practice (69%) and that it can make a considerable contribution to the prevention of incidents in general practice (71%). An overwhelming majority said that it will report incidents (89 Discussion: It is to be expected that in practice psychological defence mechanisms will have a negative influence on the actual reporting by GPs. Conclusion: GPs advocate the setting up of a Committee of Investigation of Incidents in General Practice.
Abstract: The increase of litigation against doctors in Britain has drawn attention to the serious deficiencies in the current machinery of litigation as a means of providing a remedy to the iatrogenically damaged individual; nor is the process sufficiently effective, efficient or fair. Consideration of alternative means of dealing with medical injury, as they have been developed in New Zealand and Sweden, lead to the conclusion that serious consideration should be given to the introduction in Britain of a no-fault compensation scheme despite some of its inherent deficiencies.
Keywords: Medical injury, Litigation, United Kingdom, No-fault compensation