Iatrogenic disease in paediatrics.
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The occurrence and pattern of disorders attributed to diagnosis and treatment were assessed comparatively by autopsy findings obtained in Moscow and Leningrad. The analysis suggested high frequency rate for iatrogenic diseases promoted by surgical interventions and chemotherapy. Some of these can be traced to physician's errors while delivering therapeutic and diagnostic procedures. The authors cover methodological approaches to gaining information, point to a high informative value of autopsy records, argue that iatrogenic diagnosis must be reflected in autopsy protocols and registered all over the country.
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Human prion diseases can be classified as sporadic, hereditary or acquired. The cause of sporadic Creutzfeldt-Jakob disease (CJD) is unknown, hereditary cases are associated with mutations of the prion protein gene (PRNP) and acquired forms are caused by the transmission of infection from human to human or, as a zoonosis, from cattle to human. Although acquired forms of human prion disease are rare, the transmission of a fatal and untreatable neurological disorder has had major implications for public health and public policy.
So much has changed in medicine in the past 20 or 30 years, but some things have remained a constant part of the medical scene--such a patients suffering 'doctor-induced anxieties'. This paper, first written in 1967 in the early days of the Royal Australian College of General Practitioners, looks at the causes of iatrogenic disease and proposes some common sense precepts for young doctors that will spare their patients some melancholic experiences.
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Although many conferences stimulate a great deal of discussion and practical interest at the time, not so many are followed up to try and estimate what, if any, practical results followed the meeting. This the authors of this study have done. (In Britain the 'medical groups' are voluntary groupings of students at medical schools who meet to discuss ethical problems related to their profession). Sixty-five participants (not all of them students) in the conference on iatrogenic disease replied to the questionnaire, and from the answers it was clear that not only the attitudes of those responding had in some cases been changed but in some positive action had resulted, for example, in the matter of prescribing. This analysis may provide an answer to those who criticize conferences as being a waste of time and money, because much more than could be evaluated from the responses to this survey must have affected all the participants.
We made a retrospective study of 419 cases, who had undergone otological surgery for different reasons. In 55 of them we judged, that the pathology, may have been due to the previous surgery carried out in different hospitals. The disease encountered may have been iatrogenic. We have proceeded analyse of the probable cause and to suggest some techniques for dealing with the problem. We have also suggested criteria for the surgery and for the prevention of this occurrence.
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