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Biomedical subjects

R A Spector

Publications and source records attributed to R A Spector.

4 recordsLinked to original sources

Malpractice claims analysis yields widely applicable principles.

We received 50 claims of medical negligence in pediatric cardiology. From the analysis, patterns were identified and recommendations for improvement were found that apply generally to healthcare. Less than half (38%) of the claims were found to be medically meritorious. The impression of substandard care was often (7/50) created by an erroneous attribution of cause of death at autopsy. Both structured learning for caregivers and education of the public will reduce the frequency of malpractice forms-both valid and frivolous. Caregivers should document more effectively. The current tort system neither deters nor compensates as it was intended. The assignment of blame to a single individual is usually not in concert with the reality of modern medicine. Good health care is not a passive behavior; active participation by the public is required.

Cardiac Surgical Procedures↗

Cervical approaches to the surgery of cervicothoracic neoplasia.

Seven cases are presented to illustrate four cervical surgical approaches to the upper mediastinum and thorax. These surgical approaches are described and illustrated, and we have termed these the retrosternal, retroclavicular, posterior, and lateral approaches. Two cases of thymic cyst, one of recurrent metastatic pretracheal adenopathy, a case of tracheal stenosis, a foreign body of the left subclavian artery, a large Zenker's diverticulum, and a neoglottic reconstruction are presented to illustrate the surgical anatomy, dissection technique, and postoperative complications.

Adolescent↗

Alveolar soft part sarcoma of the head and neck.

The twelfth case (in 25 years of literature) of alveolar soft part sarcoma of the head and neck is presented. It represents the seventh case to occur in the base of tongue and the second to be associated with pregnancy. The average age of onset is in the second decade with a 2:1 female preponderance and a marked tendency to right-sided occurrence. Treatment with surgery and/or radiotherapy is not curative. Local recurrence is common as are distant metastases, usually to lung, brain or bone. Theoretically, chemotherapy may offer better control of disease but few agents have shown dramatic response. The characteristics of the tumors are discussed and various chemotherapeutic agents are reviewed.

Adolescent↗