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THE PULSE

a DEADLY link GROWING UP IN THE SOUTHEAST

The Southeast has a higher rate of stroke than the rest of the United States, but it is only partly explained by known risk factors like high blood pressure and obesity. Now researchers have found another risk factor: living in the Southeast as a teenager. Writing online for Neurology, investigators studied a group of 24,545 people, average age 65, for almost six years, recording their medical histories and time spent living in the area sometimes called the Stroke Belt. As they controlled for more and more known risk factors, including age, gender, race, blood pressure, socioeconomic level, smoking and diabetes, the association of stroke with living in the region began to weaken. But one association remained statistically significant: Living in the region between ages 13 and 18 increased the risk for stroke by 17 percent. "We don't know what it is about the Stroke Belt," said the lead author, Virginia J. Howard, a professor of epidemiology at the University of Alabama at Birmingham. "We need to do more research."

Linking obesity, prostate cancer

A new study adds to evidence that obese men may have an increased risk for prostate cancer. Researchers studied biopsies of 6,692 cancer-free men, 11 percent of whom had precancerous lesions. They selected 494 who went on to develop cancer and matched them with 494 who did not. Their results were published online by Cancer Epidemiology, Biomarkers & Prevention. After 14 years of followup, they found that being overweight or obese increased the risk of prostate cancer by 57 percent. The association held for all kinds of tumors. Lead author Andrew Rundle, an associate professor of epidemiology at Columbia University in New York, said the study may help in deciding what kind of clinical followup is required with obese men.

Malpractice begins in a bad diagnosis

What kind of medical error accounts for most malpractice payments? Making errors in diagnosis. Using the National Practitioner Data Bank, which records actions taken by state licensing authorities against health care practitioners, researchers found that 28.6 percent of malpractice payments are for diagnostic mistakes. Errors related to treatment and surgery were second and third most common, and all other errors combined - obstetric, medication, monitoring, anesthesia and the rest - accounted for only 20 percent of malpractice payments. The BMJ Quality and Safety study, published online, found more than 100,000 payments for diagnostic error from 1986 to 2010. Diagnostic blunders accounted for 33.8 percent of the disabilities and almost 40 percent of the deaths that resulted in malpractice payments.

The senior author, Dr. David E. Newman-Toker, an associate professor of neurology at Johns Hopkins, said that "this is a major health problem. You can't get the treatment right if you don't get the diagnosis right."

New York Times

Saturday in Personal Best

A Tampa family welcomes visitors to their organic garden of eating.

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