Word: carotid
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...goat from the garage. The animal moves reluctantly, like a stubborn dog. As the chanting congregation beseeches the deity Chango to accept the animal, a santero, or priest, holds the animal's head firmly, stretching the neck with one hand. With a sharp knife he easily slices through the carotid artery. The animal struggles feebly. Seconds later, the goat's head is lying on the floor as blood gushes into each of the vessels...
Rand studies have found that in some regions of the country as many as 44% of coronary bypass surgeries and 64% of artery-clearing carotid endarterectomies were either unnecessary or highly questionable. In a separate review for the Philadelphia Professional Standards Review Organization, Dr. Allan Greenspan found that about 25% of heart-pacemaker implants performed in the Philadelphia region were inappropriate. Many doctors challenge such findings, arguing that it is better to err on the safe side...
...that such standards be viewed as guidelines, rather than rules that might impinge upon a doctor's best sense of what a patient needs. "Judgment is an important factor in medicine," says Dr. Robert Heyssel, president of the Johns Hopkins Hospital. "Doctors disagree all the time about whether a carotid endarterectomy or a coronary bypass will offer a patient the best shot at recovery. There are no absolutes around these things...
...depth of feeling on both sides of the old Iron Curtain in favor of merging the two Germanys -- and with that his strategy backfired. His effectiveness as a campaigner was also undermined by near tragedy: in April a deranged woman plunged a knife into his neck, just missing the carotid artery. The assassination attempt forced Lafontaine into a two-month convalescence; he abandoned shaking hands and signing autographs and gave his campaign speeches surrounded by a phalanx of bodyguards...
...bought better care or increased access. Instead, it has fueled a profoundly wasteful and inefficient system. "Thirty percent of what we do in health care is of no apparent benefit," says Marion Ein Lewin, of the National Academy of Sciences' Institute of Medicine. A Rand Corp. review of carotid endarterectomies, operations aimed at clearing blocked neck arteries, found nearly a third of the procedures "inappropriate." Similar questions have been raised about heart bypass operations and pacemakers. The next Administration must put a premium on value and coordinate a nationwide re-examination of diagnostic and surgical procedures to curtail the exorbitant...