Suchergebnisse

Medical professionals must know when young patients have the competence and capacity to consent to medical procedures

Abstract
The aim of the study was to determine the most effective medical treatment of patients with chronic pancreatitis, by using either pancreatin alone or in combination with proton pump inhibitor (PPI) or PPI and non-steroidal anti-inflammatory drug (NSAID). Patients with chronic pancreatitis, who did not require a surgical treatment, received medical treatment for a one–month period: 20 patients received pancreatin monotherapy; 48 patients were given a combination of pancreatin and PPI; 38 patients were treated with a combination of pancreatin, PPI and NSAID (PNP therapy group). In comparison with other groups, patients in the PNP therapy group showed improvement in body mass index, abdominal pain, bowel movements, chronic pancreatitis severity, as well as their quality of life assessment (p < 0.05). The combination of pancreatin, PPI and NSAID was the most effective among those applied in chronic pancreatitis patient treatment. A one–month long course of this therapy was safe and did not cause any significant adverse effects. The combination of pancreatin, PPI and NSAID for treatment of chronic pancreatitis can be recommended, as it is based on pathogenesis of the disease, effective, safe and economically advantageous.

We study how legal and financial incentives affect medical decisions. Using patient-level data from Italy, we identify the effect of a change in medical liability pressure by exploiting the geographical distribution of hospitals across court districts, where some districts increase the predictability of expected damages per injury while others do not. Using a difference-in-differences identification strategy, we show that as certainty of compensation increases, c-sections increase by 6.5 percentage points. There is no statistically significant effect on secondary health outcomes of either mothers or newborns, but the increase is higher for low-risk than high-risk mothers. The increase is driven by hospitals that have lower quality, are governed by inefficient court districts, face lower expected damages, and are paid more per c-section.