Electrical stimulation of the sympathetic nerves, which originate in the superior cervical ganglia, induces as much as 30% reduction in the net rate of cerebrospinal fluid (CSF) production, while sympathectomy results in a pronounced increase, about 30% above control, in the CSF formation. There is strong reason to believe that the choroid plexus is under the influence of a considerable sympathetic inhibitory tone under steady-state conditions.
http://ukpmc.ac.uk/abstract/MED/6276421
"Lumbar sympathectomy/Sympathectomy and Hydrocephalus sharing one common finding"
http://en.diagnosispro.com/disease_comparison-for/lumbar-sympathectomy-versus-hydrocephalus/16143-22570.html
DiagnosisPro is a medical expert system.[1] It provides exhaustive diagnostic possibilities for 11,000 diseases and 30,000 findings.[2] It is supposed to give the most appropriate differential however this is not always the case.[3] Between Oct 2008 and Oct 2009 the site averaged 61,000 visits per month. [4]
http://en.diagnosispro.com/disease_comparison-for/lumbar-sympathectomy-versus-hydrocephalus/16143-22570.html
Hydrocephalus also known as "water in the brain," is a medical condition in which there is an abnormal accumulation of cerebrospinal fluid (CSF)
http://en.wikipedia.org/wiki/Hydrocephalus
DiagnosisPro is a medical expert system.[1] It provides exhaustive diagnostic possibilities for 11,000 diseases and 30,000 findings.[2] It is supposed to give the most appropriate differential however this is not always the case.[3] Between Oct 2008 and Oct 2009 the site averaged 61,000 visits per month. [4]
http://en.diagnosispro.com/disease_comparison-for/lumbar-sympathectomy-versus-hydrocephalus/16143-22570.html
Hydrocephalus also known as "water in the brain," is a medical condition in which there is an abnormal accumulation of cerebrospinal fluid (CSF)
http://en.wikipedia.org/wiki/Hydrocephalus
Ischemic spinal cord injury has been reported after sympathectomy
it had been marketed intensively to surgeons on the basis of ''compelling'' but misleading claims
MICHELE STEGER is one of thousands of Australians whose ordeal with failing and poisonous hip implants was described by a Senate committee this week as ''intolerable and unacceptable''.
Not only had the product failed at rate several times higher than normal, the ill-functioning metal joint had spread toxic levels of chromium and cobalt into the tissue of her hip.
The Senate community affairs references committee said it believed ''insufficient information has been provided to consumers regarding concerns with the device. This is regrettable''.
Regret understates Mrs Steger's reaction when she learned in October 2010 that a previous implant that had caused her so much grief officially had been withdrawn from use 10 months previously.
The first hint she got that her DePuy ASR implant had been recalled in December 2009 came neither from her surgeon nor even health authorities.
Not only had the product failed at rate several times higher than normal, the ill-functioning metal joint had spread toxic levels of chromium and cobalt into the tissue of her hip.
The Senate community affairs references committee said it believed ''insufficient information has been provided to consumers regarding concerns with the device. This is regrettable''.
Regret understates Mrs Steger's reaction when she learned in October 2010 that a previous implant that had caused her so much grief officially had been withdrawn from use 10 months previously.
The first hint she got that her DePuy ASR implant had been recalled in December 2009 came neither from her surgeon nor even health authorities.
isolated failure of sympathetic sudomotor activity
The main clinical features include symptoms of heat intolerance: feeling hot, flushed, dyspneic, light-headed, and weak when the ambient temperature is high or when exercising. Recent accounts of acquired idiopathic anhidrosis, however, have emphasized the heterogeneous features and sub-types of this condition.
Fitzpatrick's Dermatology In General Medicine, Seventh Edition: Two Volumes
Pub Date: NOV-07
Fitzpatrick's Dermatology In General Medicine, Seventh Edition: Two Volumes
Pub Date: NOV-07
The practice of sympathectomy for treating neuropathic pain is based on very weak evidence. Furthermore, complications of the procedure may be significant.
Cochrane Summariesbeta
Independent high-quality evidence for health care decision making
http://summaries.cochrane.org/CD002918/cervico-thoracic-or-lumbar-sympathectomy-for-neuropathic-pain
Sympathectomy useless, even detrimental
A number of surgical procedures have been developed, which, although well-intentioned, are found unfortunately by further study to prove useless, or even detrimental. It is believed at present that lumbar sympathetic ganglionectomy in the treatment of the post-thrombotic type of ulceration of the lower extremity should be placed in this category.
http://archsurg.ama-assn.org/cgi/content/summary/67/1/2
http://archsurg.ama-assn.org/cgi/content/summary/67/1/2
It has to push us to publish our works, to inform the medical corps, relentlessly and without restraint
7th International Symposium on Sympathetic Surgery 20th-22nd March 2007 Muro Alto (PE), Brazil
Clinical Autonomic Research. New York:Apr 2007. Vol. 17, Iss. 2, p. 126-44 (19 pp.)
Pity colleagues, pity for these poor patients!
Gross Michel* Institution: Private Cabinet*; Grone - Switzerland
A desperate 22-year-old man comes to consult and tells me about his idea of committing suicide. Since the age of 9, he suffers from a severe cephalic ephidrosis, with blushing face, intensifying with years, to such an extent that it became unbearable over the last year:
''It is a real Calvary''. His family GP assures him that his troubles are going to disappear as he will get older and ''ut aliquid fieri'' he prescribes sage drops and anxiolytic. As these prescriptions do not improve his situation, his GP sends him to an endocrinologist who performs many exams to exclude an hyperthyreosis, a carcinoıd tumor or a pheochromocytoma. Among the considerable number of blood exams, one appears to be out of normal ranges. The patient goes therefore to an haematologist, who does not find anything
abnormal. A neurologist, then consulted, does not suspect anything in particular, but asks however for some radiology exams, including a brain MRI, as well as a Pet-scan, to exclude an adrenal gland tumor. All these exams being normal, the patient is sent to a behaviour therapist to begin a psychotherapy. Exhausted by the
weight of these useless consultations here and there, our young patient, always seeking for the solution to his problems, decides to turn to an acupuncturist, an osteopath, a healer and a radiesthesist, in vain. He then decides to consult a dermatologist and shares with him a summary of information gathered on Internet, including information from my site. Finally, the patient was referred to me.
Aware of that, the GP warns his colleagues by sending a letter indicating that any therapeutic measure other than psychotherapy is not recommended, considering the surgical alternative as irresponsible. I did by the way, not get any call from any of my colleagues. The patient had successful surgery 2 weeks later
(sympathicotomy T2-3-4-5) This recent history redraws, once again, iatrogenic caricatural wandering to which our patients are too often subjected. It has to push us to publish our works, to inform the medical corps, relentlessly and without restraint. The information could also, throughout the public, reach our colleagues. It is at the end an interesting paradox to note that physicians, whose primary role is to relieve patients, are also the primary actors of a film where patients are maintained in a ''medical jail''.
Clinical Autonomic Research. New York:Apr 2007. Vol. 17, Iss. 2, p. 126-44 (19 pp.)
Pity colleagues, pity for these poor patients!
Gross Michel* Institution: Private Cabinet*; Grone - Switzerland
A desperate 22-year-old man comes to consult and tells me about his idea of committing suicide. Since the age of 9, he suffers from a severe cephalic ephidrosis, with blushing face, intensifying with years, to such an extent that it became unbearable over the last year:
''It is a real Calvary''. His family GP assures him that his troubles are going to disappear as he will get older and ''ut aliquid fieri'' he prescribes sage drops and anxiolytic. As these prescriptions do not improve his situation, his GP sends him to an endocrinologist who performs many exams to exclude an hyperthyreosis, a carcinoıd tumor or a pheochromocytoma. Among the considerable number of blood exams, one appears to be out of normal ranges. The patient goes therefore to an haematologist, who does not find anything
abnormal. A neurologist, then consulted, does not suspect anything in particular, but asks however for some radiology exams, including a brain MRI, as well as a Pet-scan, to exclude an adrenal gland tumor. All these exams being normal, the patient is sent to a behaviour therapist to begin a psychotherapy. Exhausted by the
weight of these useless consultations here and there, our young patient, always seeking for the solution to his problems, decides to turn to an acupuncturist, an osteopath, a healer and a radiesthesist, in vain. He then decides to consult a dermatologist and shares with him a summary of information gathered on Internet, including information from my site. Finally, the patient was referred to me.
Aware of that, the GP warns his colleagues by sending a letter indicating that any therapeutic measure other than psychotherapy is not recommended, considering the surgical alternative as irresponsible. I did by the way, not get any call from any of my colleagues. The patient had successful surgery 2 weeks later
(sympathicotomy T2-3-4-5) This recent history redraws, once again, iatrogenic caricatural wandering to which our patients are too often subjected. It has to push us to publish our works, to inform the medical corps, relentlessly and without restraint. The information could also, throughout the public, reach our colleagues. It is at the end an interesting paradox to note that physicians, whose primary role is to relieve patients, are also the primary actors of a film where patients are maintained in a ''medical jail''.
Retrograde Changes in the Nervous System Following Unilateral Sympathectomy
In consequence of right-sided smpathectomy at the level of C5 it was found that in the sheep the cervical sympathetic trunk contains nerve fibres which proceed from cells situated in the first four segments of the thoracic part of the spinal cord and in the stellate ganglion. These fibres are about 85 per cent of all fibres of the sympathetic trunk. The remaining 15 per cent proceed from nerve cells situated nasally of the anterior cervical ganglion.
http://onlinelibrary.wiley.com/doi/10.1111/j.1439-0442.1967.tb00255.x/abstract
http://onlinelibrary.wiley.com/doi/10.1111/j.1439-0442.1967.tb00255.x/abstract
Telaranta's patient commits suicide after elective surgery for sweaty hands
One of Dr. Telaranta’s patients who had made a complaint began to experience strong reactions of anxiety which did not go away even after corrective surgery. Later the patient committed suicide.
Surgery involving the clamping of sympathetic nerve trunks to prevent excessive perspiration and blushing appears to be of questionable value.
Complications have been reported, ranging from phantom perspiration to blood clots in the brain.
The Finnish Office for Health Care Technology Assessment (FinOHTA), which is part of the National Research and Development Centre for Welfare and Health (STAKES) recently conducted a survey on the various effects of hyperhidrosis surgery at the request of the Finnish Medical Association.
Finnish surgeon Timo Telaranta has performed about 2,000 such operations at private clinics in Helsinki and Oulu in the past ten years.
The National Authority for Medicolegal Affairs has issued three warnings to Telaranta and the Provincial Government of Southern Finland has issued one.
Many doctors have serious reservations about the idea of treating complaints such as excessive perspiration, blushing, and performance anxiety by severing people’s nerves.
http://www.hs.fi/english/article/1101979734791
Surgery involving the clamping of sympathetic nerve trunks to prevent excessive perspiration and blushing appears to be of questionable value.
Complications have been reported, ranging from phantom perspiration to blood clots in the brain.
The Finnish Office for Health Care Technology Assessment (FinOHTA), which is part of the National Research and Development Centre for Welfare and Health (STAKES) recently conducted a survey on the various effects of hyperhidrosis surgery at the request of the Finnish Medical Association.
Finnish surgeon Timo Telaranta has performed about 2,000 such operations at private clinics in Helsinki and Oulu in the past ten years.
The National Authority for Medicolegal Affairs has issued three warnings to Telaranta and the Provincial Government of Southern Finland has issued one.
Many doctors have serious reservations about the idea of treating complaints such as excessive perspiration, blushing, and performance anxiety by severing people’s nerves.
http://www.hs.fi/english/article/1101979734791
Peer review and the corruption of science
Peer review is the process that decides whether your work gets published in an academic journal. It doesn't work very well any more, mainly as a result of the enormous number of papers that are being published (an estimated 1.3 million papers in 23,750 journals in 2006). There simply aren't enough competent people to do the job. The overwhelming effect of the huge (and unpaid) effort that is put into reviewing papers is to maintain a status hierarchy of journals. Any paper, however bad, can now get published in a journal that claims to be peer-reviewed.
The blame for this sad situation lies with the people who have imposed a publish-or-perish culture, namely research funders and senior people in universities. To have "written" 800 papers is regarded as something to boast about rather than being rather shameful. University PR departments encourage exaggerated claims, and hard-pressed authors go along with them.
Not long ago, Imperial College's medicine department were told that their "productivity" target for publications was to "publish three papers per annum including one in a prestigious journal with an impact factor of at least five.″ The effect of instructions like that is to reduce the quality of science and to demoralise the victims of this sort of mismanagement.
The only people who benefit from the intense pressure to publish are those in the publishing industry. Hardly a day passes without a new journal starting. My email inbox is full of invitations to publish in a weird variety of journals. They'll take just about anything. The US National Library of Medicine indexes 39 journals that deal with alternative medicine. They are all "peer-reviewed", but rarely publish anything worth reading. The peer review for a journal on homeopathy is, presumably, done largely by other believers in magic. If that were not the case, these journals would soon vanish.
But it isn't only quack journals that have failures in peer review. In June, the British Journal of General Practice published a paper, "Acupuncture for 'frequent attenders' with medically unexplained symptoms: a randomised controlled trial (CACTUS study)". It has lots of numbers, but the result is very easy to see. All you have to do is look at their Figure.
http://www.guardian.co.uk...rish-peer-review-science
The blame for this sad situation lies with the people who have imposed a publish-or-perish culture, namely research funders and senior people in universities. To have "written" 800 papers is regarded as something to boast about rather than being rather shameful. University PR departments encourage exaggerated claims, and hard-pressed authors go along with them.
Not long ago, Imperial College's medicine department were told that their "productivity" target for publications was to "publish three papers per annum including one in a prestigious journal with an impact factor of at least five.″ The effect of instructions like that is to reduce the quality of science and to demoralise the victims of this sort of mismanagement.
The only people who benefit from the intense pressure to publish are those in the publishing industry. Hardly a day passes without a new journal starting. My email inbox is full of invitations to publish in a weird variety of journals. They'll take just about anything. The US National Library of Medicine indexes 39 journals that deal with alternative medicine. They are all "peer-reviewed", but rarely publish anything worth reading. The peer review for a journal on homeopathy is, presumably, done largely by other believers in magic. If that were not the case, these journals would soon vanish.
But it isn't only quack journals that have failures in peer review. In June, the British Journal of General Practice published a paper, "Acupuncture for 'frequent attenders' with medically unexplained symptoms: a randomised controlled trial (CACTUS study)". It has lots of numbers, but the result is very easy to see. All you have to do is look at their Figure.
http://www.guardian.co.uk...rish-peer-review-science
Access to medical records for patients is still unresolved
The recognised requirement for informed consent to treatment has also had a direct bearing on this new era of cooperation. [33] PIAC's report, Whose Health Records, refers to court decisions over the past ten years in Australia which have made the medical professions `more accountable and led to greater recognition of consumer rights'. PIAC cites the High Court's judgment in 1992 in Rogers v Whitaker for a doctor's obligation to `provide a consumer with sufficient information to allow them to give informed consent to treatment'. [34] Such landmark decisions have in many ways changed the doctor-patient relationship, although provision of access to medical records in private general and specialist medical practice has remained legally unresolved.
Members of the Royal Australian College of General Practitioners (RACGP) responded to this issue in a recent survey conducted by the RACGP. Their survey canvassed a range of issues including patient access to medical records. 76 per cent of respondents indicated that they agreed that legislation which presently does not allow patients to have access to their medical records should not be changed.
Medical practitioners therefore may state the principle that access to medical records and privacy of medical records is one simply of communication, education and cooperation. In practice, fears of possible litigation as well as strongly-held views on medical records being the sole property of the medical practitioner, often prevents patients gaining automatic access to their records.
The final report of the Professional Indemnity Review (PIR) also noted that doctors feared litigation. PIR pointed to doctors' fears that patients might `lose confidence in the health care system and the advice of health care professionals' if patients were more aware of the `unknowns and risks' which might be revealed in medical and health records. [43]
http://www.aph.gov.au/senate/committee/clac_ctte/completed_inquiries/1996-99/medical/report/c02.htm
Members of the Royal Australian College of General Practitioners (RACGP) responded to this issue in a recent survey conducted by the RACGP. Their survey canvassed a range of issues including patient access to medical records. 76 per cent of respondents indicated that they agreed that legislation which presently does not allow patients to have access to their medical records should not be changed.
Medical practitioners therefore may state the principle that access to medical records and privacy of medical records is one simply of communication, education and cooperation. In practice, fears of possible litigation as well as strongly-held views on medical records being the sole property of the medical practitioner, often prevents patients gaining automatic access to their records.
The final report of the Professional Indemnity Review (PIR) also noted that doctors feared litigation. PIR pointed to doctors' fears that patients might `lose confidence in the health care system and the advice of health care professionals' if patients were more aware of the `unknowns and risks' which might be revealed in medical and health records. [43]
http://www.aph.gov.au/senate/committee/clac_ctte/completed_inquiries/1996-99/medical/report/c02.htm
ONE in 15 medical practitioners registered to work in NSW has a criminal past
ONE in 15 medical practitioners registered to work in NSW has a criminal past, new figures reveal.
The first look into the criminal histories of 13,000 doctors, dentists, psychologists, nurses and pharmacists - many of whom were graduates and foreign medical professionals registering for the first time - has led to calls for further background checks.
There are 156,000 people working in NSW who have not been checked by police under the new system, which does not take into account driving infringements.
But eyebrows have been raised by the findings of the Australian Health Practitioner Regulation Agency, the national body established last year to replace a patchwork of more than 80 medical boards around Australia.
Of the 13,421 medicos checked by NSW police at the request of the agency, 936 - or 7 per cent - were found to have ''disclosable court outcomes'' such as convictions for theft, fraud and sexual offences. The figure was slightly higher than the national average of 6 per cent.
The first look into the criminal histories of 13,000 doctors, dentists, psychologists, nurses and pharmacists - many of whom were graduates and foreign medical professionals registering for the first time - has led to calls for further background checks.
There are 156,000 people working in NSW who have not been checked by police under the new system, which does not take into account driving infringements.
Advertisement: Story continues below
The Minister for Health, Jillian Skinner, and the Australian Medical Association insist the industry is ''weeding out'' unsuitable people.But eyebrows have been raised by the findings of the Australian Health Practitioner Regulation Agency, the national body established last year to replace a patchwork of more than 80 medical boards around Australia.
Of the 13,421 medicos checked by NSW police at the request of the agency, 936 - or 7 per cent - were found to have ''disclosable court outcomes'' such as convictions for theft, fraud and sexual offences. The figure was slightly higher than the national average of 6 per cent.
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