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Medicine
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errors Revealed magician of the scalpel than 100 years ago, similar to those of today

notes a neurosurgeon from the late nineteenth century and the beginning of last century

(Reuters) - The problem of medical errors is not as new as it seems. A survey sifting through the notes of the famous American neurosurgeon Harvey Williams Cushing, written in the late nineteenth century and the beginning of last century, has revealed an abundant documentation of its surgical mishaps. But the depth of his suggestions to prevent future errors, according to modern researchers, in some cases are strikingly similar to those that still occur in hospitals around the world. A team of Johns Hopkins University, whose hospital The surgeon worked for years, says on the 'Archives of Surgery' as it may have played an important stimulus for the progress of medical care and neurosurgery in the age of Cushing. And its discovery may have the same positive effect today. "To acknowledge medical errors is obviously something that the white coats are considered to be of crucial importance for the advancement of science long ago," said Katherine Latimer, lead author of the research. Latimer and his colleagues scoured the archives of the Johns Hopkins locating the notes for 878 patients with Cushing. The notes, which were transferred to microfilm decades ago, covering the early career of the great surgeon, dal 1896 al 1912. Ma la decifrazione degli appunti è stata resa complessa dalla grafia poco comprensibile dello specialista, da abbreviazioni e dai fitti commenti di altri medici. Così i ricercatori hanno selezionato 30 casi, in cui alcuni errori sono chiaramente delineati da Cushing. I casi appartengono a categorie di errori simili a quelli che affliggono oggi i medici, spiegano gli autori, classificando 11 degli episodi 'nel mirino' come errori di giudizio: in cui, in pratica, Cushing ha fatto la scelta sbagliata durante un intervento chirurgico. Un esempio fra tutto, l'operazione eseguita sul lato sbagliato del cervello di un paziente. Diciassette casi, poi, sono stati identificati come "errore umano", in cui Cushing ha rivelato un comportamento clumsy or careless, such as the fall of an instrument in a surgical wound. Three episodes were considered related to equipment or instruments. Latimer and his colleagues were stupid amount of documentation from the "honest and transparent" through which analyzes the Cushing's conduct. The notes acknowledge the errors that may have led to death or put in balance the success of interventions. And this at a time when the malpractice litigation was already becoming a growing concern for physicians, at least in the U.S.. Not so much (at least at the time) as a matter of sanctions for the same reputation as the 'white coats'. It was an era of great medical advances: the mortality of patients operati per tumori cerebrali è scesa dal 50% al 13% nel corso della carriera del celebre neurochirurgo. Progressi frutto non solo delle tecnologie più avanzate, ma anche del fatto che per la prima volta è stata tenuta una attenta documentazione degli errori, che hanno aiutato lo stesso Cushing e altri chirurghi a sviluppare metodi per evitarli, dicono i ricercatori. "Le persone sono esseri umani e faranno" sempre "degli errori medici", dice Latimer, "vigilare sulle proprie debolezze è fondamentale per migliorare". Un atteggiamento che deve essere rinnovato "anche oggi". Anche perché, spiega Alfredo Quinones, associato di neurochirurgia presso la Johns Hopkins University School of Medicine e autore anziano dello studio, gli errori doctors still have a huge impact on patients and their families. "Recognize and report can help us significantly improve the medicine."