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Infectious diseases are among the most common conditions for which patients seek medical care, and potentially the most serious. Fortunately, since the discovery of penicillin over 70 years ago, antibiotics have made the treatment of serious infections highly successful. Nevertheless, physicians and advanced practioners such as nurse practitioners and physician's assistants must use caution in administering antimicrobial medications, both to ensure effectiveness and to prevent side effects. Careful prescribing will help minimize the legal risks resulting from antibiotic treatment.
Over the past two decades, there has been a growing trend for the care of the hospitalized patient to be assumed by physicians who care only for patients in the inpatient setting, and who do not have an outpatient medical practice. These physicians have come to be known as "hospitalists", and their area of practice as "hospital medicine". Hospitalists are a departure from the old style of practice, in which the primary care physician (PCP) cared for their seriously ill patients in the hospital while still maintaining a busy outpatient practice. Because of the increasing complexity of modern medicine, and due to a variety of economic pressures, the trend now is for physicians in primary care specialties to focus their practice on either outpatient or inpatient care, but not both.
Congestive heart failure can be simply described as the inability of the heart to meet the metabolic demands of the body. The heart functions as a pump to deliver oxygen and nutrients to the tissues. Failure of the pump to deliver nutrition to the tissues stimulates a number of compensatory responses in an effort to improve tissue perfusion. These responses result in the clinical symptoms and signs associated with the heart failure syndromes-shortness of breath, rapid heartbeat, and fluid retention.
Acute respiratory distress syndrome (ARDS) was first described in 1967 by Ashbaugh, who described a syndrome of severe respiratory failure associated with pulmonary infiltrates, similar to infant hyaline membrane disease.
Anterior Cruciate Ligament Injury (ACLI) is most often a result of low-velocity, noncontact, deceleration injuries and contact injuries with a rotational component. Contact sports also may produce injury to the anterior cruciate ligament (ACL) secondary to twisting, valgus stress, or hyperextension all directly related to contact or collision.
Some of the most abstract medical occurrences that may also prove to be legally challenging are transient disorders of awareness. The very nature of their transient occurrence often results in an absence of objective laboratory or examination abnormalities. Since these conditions result in an alteration of the patient's awareness, there may also be inadequate historical information to assist in diagnosis. Yet, these disorders can have very significant consequences that range from a loss of one's driving privileges or job to the participation in a criminal event. The two most common causes of altered awareness are seizures and reduced blood flow to the brain.
There are many wrist and hand symptoms related to the multiple tunnels that tendons, nerves, and blood vessels pass through. Wherever there is a "crease" in one's wrist, palm, or fingers on the flexor/volar side, there is a tunnel that these structures must pass through. These tunnels are usually soft transverse tissue bands that keep the tendons from bowstringing as they pass from forearm to fingers, as we use our hands in grasp and function.
Almost every American from eighteen to eighty years of age has heard enough about LASIK to understand on a basic level what it is and how it works. On average approximately 1,000,000 LASIK procedures are performed annually in the United States. The vast majority of these procedures are successful, but unwanted side effects and/or suboptimal results can occur in a small percentage of patients. Below is a discussion of the essential elements in the pre-operative evaluation of a patient being considered for LASIK.
There is an epidemic of diabetes in the United States. In the last ten years, the number of American diagnosed with diabetes has increased 40 percent. The number has risen from 4.9% to 6.9%. It is estimated that the number will increase buy another 16.5% by 2050. A woman born in 2000 has a 39% risk of developing diabeteso. The epidemic of obesity is responsible for the current epidemic of diabetes in pregnancy. The incidence of diabetes complicating pregnancy has increased 40% between 1989 and 2004.
Crude Oil has been pouring into the Gulf of Mexico and is causing numerous and significant health issues for children, pregnant mothers, and adults. Exposure occurs via inhalation, ingestion (of liquid droplets in the air), and direct skin contact. Some of the health effects will be long-term sequelae and may last a lifetime or affect future generations. Crude oil is a known teratogen and can cause birth defects and changes in fetal development. The target organs for crude oil are the hematopoietic (blood forming) system, lymphatic system, nervous system, and reproductive system. The Benzene component is a known carcinogen.
Persistent neuropsychiatric impairment following head injury is a significant public health problem. From 400,000 to 500,000 are hospitalized in the United States every year from head injury; many more people are injured and do not require admission. Head injury is the third most likely cause of dementia, after infection and alcoholism, in people younger than 50 years.
In 1911, Hammond and Sutton of Philadelphia performed the first human-to-human kidney transplant with transient success. Since then the techniques and indications have evolved. The first wholly successful human transplant took place on December 23, 1954, in Boston, Massachusetts. Surgeon Joseph Murray performed a kidney transplant between identical twin brothers. Although this and subsequent twin transplants did little to solve the problem of rejection, these procedures contributed to proving the value of the procedure and to the solution of many technical problems.
Neonatal emergencies are not uncommon problems. They appear either at the time of birth, during the in-hospital post-birth period, or at home within several weeks of discharge. In all instances they present significant diagnostic and treatment challenges to the clinician, and must be taken seriously.
Cardiovascular disease (CVD) is the leading cause of death in the United States, accounting for approximately 500,000 deaths each year. More women in the United States die of heart disease than of any other cause, and one form of heart disease, myocardial infarction, is responsible for the majority of these deaths. In every year since 1984 it has claimed the lives of more women than men.
A large number of reports have been produced on HP and its pathogenetic potential. In fact, although peptic ulcer disease is the most studied disease related to HP infection, this bacterium is seemingly involved in the pathogenesis of several extragastric diseases, such as mucosa-associated lymphoid tissue lymphomas (MALTomas), coronaritis, gastroesophageal reflux disease, iron deficiency anemia, skin disease, and rheumatological conditions.
Abdominal aortic aneurysm (AAA) is a relatively common, potentially life-threatening condition. It has a wide spectrum of presentations and should be considered in the differential diagnosis for a number of symptoms.
Acetaminophen is the most widely used pharmaceutical analgesic and antipyretic agent in the United States and the world; it is contained in more than 100 products. As such, acetaminophen is one of the most common pharmaceuticals associated with both intentional and accidental poisoning. Acetaminophen-induced hepatotoxicity is well recognized.
Salicylates are ubiquitous agents found in hundreds of over-the-counter (OTC) medications and in numerous prescription drugs including topical preparations used for the treatment of pain, warts, and acne.
Peptic ulcer disease (PUD) is one of the most common diseases affecting the GI tract. It causes inflammatory injuries in either the gastric or duodenal mucosa, with extension beyond the submucosa into the muscularis mucosa.
Among suicidal patients who had taken antidepressants, fluoxetine (Prosac) was associated with the lowest risk for causing suicidal tendencies and venlafaxine (Effexor) with the highest risk, according to the results of a cohort study published in the December 2006 issue of the Archives of General Psychiatry.
David Friedler, LMHC, MPH Is an expert in the regulatory standard of care in Nursing Facilities, Psychiatric, Alcohol/Substance Use Rehabilitation Facilities as well as Group Homes for the disabled. He has worked in clinical and administrative roles in these environments over four decades. He has extensive experience with survey compliance, Federal and State regulation, JCAHO and CARF accreditation, OSHA compliance and policy and procedure development.
Areas of Expertise:
Long Term Care
Drug and Alcohol Rehabilitation
Behavioral Health / Psychiatric Care in Drug Treatment Facilities
Elite Medical Experts works with attorneys to provide 100% Board-Certified physicians and surgeons practicing at the professorial level at the nation's leading universities. From Stanford to Yale, and from every medical and surgical specialty, Elite secures full-time practicing high-level experts from the nation’s most respected medical institutions. Each specialist is truly unique – a Board Certified professor with a dedicated clinical practice, extensive publications, and top-tier credentials from a major U.S. medical center.
Complex Consulting at the Intersection of Medicine & Business Elite Medical Experts also consults on complex strategic and tactical issues for enterprises of any size, and has extensive experience securing top-tier Professors of Medicine and Surgery for a range of complex consulting engagements. Elite Medical Experts is mission-critical to:
Television, Film, Print News, and Other Media
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To learn how you can align with nationally recognized thought leaders from myriad areas of expertise, call Elite today and ask for our Director of Complex Consulting:
Dr. Burton Bentley II, M.D., FAAEM CEO, Elite Medical Experts, LLC.
Past President of the Boston Society of Neurology, Neurosurgery, and Psychiatry
Clinical experience in both inpatient and outpatient care. Board Certified. Fellowship training and extensive experience in Behavioral Neurology – that branch of neurology that focuses on brain conditions, including dementia, that change a person's behavior or intellect. Has treated 1,000+ patients with dementia (usually due to Alzheimer's Disease). Former Director of Neurology at Head Injury rehabilitation facility.
Highly experienced expert witness. Has reviewed over 250 cases and testified in dozens of depositions and trials. Expert-witness assignments have involved death, catastrophic injury, personal injury, medical malpractice, testamentary capacity, and criminal cases. Experience includes spine injury, head trauma, seizure disorder, epilepsy, headaches, post-concussion syndrome, Parkinson's Disease, anoxia, hypoxic encephalopathy.
Testimonial – "I found Dr. Cranberg to be very thorough, resourceful, and exceedingly well prepared. He was very precise at his deposition and stood up well against a very seasoned lawyer. He knew the medical records better than either the defense lawyer or I did. The case settled; so I cannot tell you how he did before a jury, but I had complete confidence that he would have presented well. He was very easy to work with and was very accessible. He bills fairly. I would not hesitate to use him again." - Charles J. Muchmore, Esq.; Burch & Cracchiolo, PA (Phoenix, AZ)
Cathy Ciolek, DPT, FAPTA, Cathy Ciolek, DPT, FAPTA, President of Living Well With Dementia, LLC, has over 30 years of experience as a Geriatric Physical Therapist. Dr. Ciolek is board certified as a Geriatric Clinical Specialist, a Certified Dementia Practitioner (CDP), and Certified Alzheimer’s Disease and Dementia Care Trainer (CADDCT) by the National Council of Certified Dementia Practitioners.
Consulting Services: Consultation for individuals, care partners, and facilities to address challenging issues that impact well-being and quality of life for people with dementia. Examples include:
People with frequent Falls and developing Falls Assessment Process and Teams
Behavioral Expressions of Unmet Needs
Inappropriate Medications and Anti-psychotic Medication Reduction
Alarm Use Reduction
Culture Change and Change Management
Background Experience: Dr. Ciolek previously served as Regional Director for the Pennsylvania Restraint Reduction Initiative (PARRI), providing education and consultation for issues related to well-being (falls, engagement, medication reduction) to nursing homes throughout the Commonwealth of Pennsylvania via a CMS grant.
Prior to that, Dr. Ciolek served as assistant professor and director of clinical education for the University of Delaware, Department of Physical Therapy. She has practiced as a physical therapist in outpatient, SNF, home health and CCRC facilities over the course of her career. She is a former Instructor/ Guest Lecturer/Lab Instructor at multiple universities including: Drexel University, Temple University, AT Still University/Arizona School of Health Sciences, Widener University, and Rocky Mountain University.
Dr. Ciolek speaks and delivers seminars throughout the nation on topics including dementia, exercise for aging adults, falls and fall risk mitigation, and Person-Centered Care. She is also a noted author on geriatric issues with books entitled, “Cognitive Issues in the Older Adult," “Restraint Assessment,” and “The Older Adult With Multiple Comorbidities.”
Geriatric Physical Therapy Thought Leader
President, Academy of Geriatric Physical Therapy (APTA Geriatrics)
Past President, Delaware Physical Therapy Association (APTA Delaware)
American Physical Therapy Association
Awards and Accolades
Catherine Worthingham Fellow of the American Physical Therapy Association
Elliott M. Stein, MD is Board Certified by the American Board of Psychiatry and Neurology in General Psychiatry (October, 1979), and in Geriatric Psychiatry (April, 1991; Re-Certified, December, 2001, and in April, 2011). Caring for the elderly for over 40 years, Dr. Stein has received numerous honors and awards for his contribution to his field. Dr. Stein is a Clinical Professor in the Department of Psychiatry at the University of California, San Francisco, School of Medicine. He is a Distinguished Life Fellow of the American Psychiatric Association and a Distinguished Fellow of the American Association for Geriatric Psychiatry.
For 33 years, Dr. Stein was in the Private Practice of Geriatric Psychiatry in Miami and Miami Beach, Florida. His experience includes working with the elderly in various settings, including having been Medical Director for the Community Mental Health Center of Miami Beach, Medical Director of an Inpatient Geriatric Psychiatry program, and Medical Director of an Inpatient Mood Disorder program, as well as consulting at Nursing Homes, Assisted Living and other facilities. Dr. Stein was the Director of Psychiatry at the Jewish Home of San Francisco from 2010-2020, and the Medical Director of their Geriatric Psychiatry Hospital. He has treated older individuals, typically people who have complex combination of psychiatric and medical problems.
Dr. Stein has been a Member of the Task Force on Testamentary Capacity and Undue Influence, for the International PsychoGeriatric Association. He is also the author/co-author of teaching and professional materials, including books and book chapters, and articles in the professional literature.