after sympathectomy "the extremity will be more apt to have disturbance of circulation and is left unprotected from fluctuation in circulation"

1. Sympathectomy is analogous to the act of killing the messenger. The sympathetic nervous system has the critical job of properly controlling and preserving the circulation in different parts of the body, especially in the extremities. By paralyzing the system, the extremity will be more apt to have disturbance of circulation and is left unprotected from fluctuation in circulation.

Sympathectomy is similar to permanently removing the central heat and air-conditioning system and never replacing it because of malfunction.

Sympathectomy permanently damages the temperature regulatory system. The reason sympathectomy does not cause side effects other than ineffective control of pain as well as impotence and orthostatic hypotension is because it is invariably partial and incomplete.H. Hooshmand, M.D.: Chronic Pain

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9780849386671

Chronic Pain: Reflex Sympathetic Dystrophy Prevention and Management

Hooshang Hooshmand

ISBN 10: 0849386675 / 0-8493-8667-5 

ISBN 13: 9780849386671

Publisher: CRC Pr I Llc

Publication Date: 1993

Binding: Hardcover

German doctors shaken by corruption allegations

BioEdge: German doctors shaken by corruption allegations: "The German Medical Association has investigated nearly 1,000 cases of corrupt doctors over the past few years, according to its president, Frank Ulrich Montgomery.

Dr Montgomery told Der Spiegel that more than half of the case involved alleged bribes from an Israeli pharmaceutical company, Ratiopharm. The doctors were paid for prescribing its drugs to their patients. This was “clearly prohibited”, says Dr Montgomery.

“The Medical Association punished 163 Ratiopharm doctors after state prosecutors made the files available to us,” said Montgomery. He wants the government to pass legislation which would permit the Medical Association itself to conduct searches and confiscate files.

However, this is opposed by health insurance companies. “Corruption is not a minor offence which doctors can regulate amongst themselves,” said an industry spokesman."

'via Blog this'

Doctor earning $1m and huge debts: the state of our hospitals

Doctor earning $1m and huge debts: the state of our hospitals: "A MILLION-DOLLAR doctor, thousands of unpaid bills and debts that exceed assets: that's the financial shape of NSW hospitals says the Auditor-General.

Six employees earned more than half a million dollars over the past three years, and one was paid more than $1 million in overtime and call-backs over three years.

The Auditor-General, Peter Achterstraat, said he found it astounding that one person could earn so much overtime."

'via Blog this'

Register all trials, report all results – it's long overdue

Register all trials, report all results – it's long overdue: "If researchers go to the effort of getting funds, recruiting patients, and following them up, you would think that they would be keen to publish the results. So it’s surprising that our best estimates show around half of all completed clinical trials have never been published in academic journals. And the half we have is biased towards trials with positive results."

'via Blog this'

Perks put patients at risk - claim

Perks put patients at risk - claim: "A SENIOR Geelong Hospital anaesthetist has been accused of putting patients at risk by prescribing a drug he was effectively being paid by a pharmaceutical company to use.

A Fair Work Australia hearing was on Tuesday told Dr Mark Colson reported colleague Dr Simon Tomlinson to the ombudsman in 2007 for accepting business-class flights from Pfizer for him and his family to attend a conference in New York.

Deputy director of anaesthesia at Geelong Hospital Dr Colin Gordon said Dr Colson also alleged the hospital had the highest prescription rate of a drug called parecoxib because of Dr Tomlinson's dealings with Pfizer and that this was ''harming patients and potentially causing patients to die''."

'via Blog this'

Mass donor organ fraud shakes Germany | World news | The Guardian

Mass donor organ fraud shakes Germany | World news | The Guardian: "German medical authorities are calling for an extensive overhaul of the country's organ transplant programme after transplant centres across Germany were placed under criminal investigation over allegations that they had systematically manipulated donor waiting lists.

Scores of patients are believed to have been given priority access to donor organs after doctors falsified the severity of their illnesses to ensure they received treatment ahead of other patients in Europe.

The revelations have led to accusations of widespread corruption and dishonesty in the system, and shattered public trust. Since the scandal emerged last year as a handful of cases that were initially believed to be isolated incidents, the number of Germans willing to donate organs has plummeted."

'via Blog this'

Dollars for Docs - ProPublica

Dollars for Docs - ProPublica: "Drug companies have long kept secret details of the payments they make to doctors and other health professionals for promoting their drugs. But 12 companies have begun publicizing the information, some because of legal settlements. ProPublica pulled their disclosures into a database so patients can search for their doctor. Accepting payments isn’t necessarily wrong, but it can raise ethical issues."

'via Blog this'

in the absence of autonomic arousal, behavior that appears emotional will not be experienced as emotional

"In the presence of a barking dog, for example, the sympathectomized cats manifested almost all of the signs of feline rage. Finally, Cannon notes the report of Dana (1921) that a patient with a spinal-cord lesion and almost totally without visceral sensation still manifested emotionality.
For either the Jamesian or the present formulation such data are crucial, since both views demand visceral arousal as a necessary condition for emotional arousal. When faced with this evidence, James's defenders (e.g., Wenger, 1950; Mandler, 1962) have consistently made the point that the apparently emotional behavior manifested by sympathectomizied animals and men is well-learned behavior, acquired long before sympathectomy. There is a dual implication in this position: first, that sympathetic arousal facilitates the acquisition of emotional behavior, and second, that sympathectomized subjects act but do not feel emotional. There is a small but growing evidence supporting these contentions. Wynne and Solomon (1955) have demonstrated that sympathectomized dogs acquire an avoidance response considerably more slowly than control dogs. Further, on extinction trials most of their 13 sympathectomized animals extinguished quickly, whereas not a single one of the 30 control dogs gave any indication of extinction over 200 trials. Of particular interest are two dogs who were sympathectomized after they had acquired the avoidance response. On extinction trials these two animals behaved precisely like the control dogs - giving no indication of extinction. Thus, when deprived of visceral innervation, animals are quite slow in acquiring emotionally-linked avoidance responses and in general, quick to extinguish such responses." (p. 163)

"A line of thought stimulated by the Wynne and Solomon (1955) and the Hohmann (1962) studies may indeed be the answer to Cannon's observations that there can be emotional behavior without visceral activity. From the evidence of these studies, it would appear, first, that autonomic arousal greatly facilitates the acquisition of emotional behavior but it is not necessary for its maintenance if the behavior is acquired prior to sympathectomy; and second, that in the absence of autonomic arousal, behavior that appears emotional will not be experienced as emotional." (p. 167)

Psychobiological Approaches to Social Behavior

P. Herbert Leiderman, David Shapiro, Harvard Medical School. Dept. of Psychiatry, United States. Office of Naval Research - 1964 - 203 pages

Controversial Surgery for Addiction Burns Away Brain’s Pleasure Center | TIME.com

Controversial Surgery for Addiction Burns Away Brain’s Pleasure Center | TIME.com: "How far should doctors go in attempting to cure addiction? In China, some physicians are taking the most extreme measures. By destroying parts of the brain’s “pleasure centers” in heroin addicts and alcoholics, these neurosurgeons hope to stop drug cravings. But damaging the brain region involved in addictive desires risks permanently ending the entire spectrum of natural longings and emotions, including the ability to feel joy.

In 2004, the Ministry of Health in China banned this procedure due to lack of data on long term outcomes and growing outrage in Western media over ethical issues about whether the patients were fully aware of the risks.

However, some doctors were allowed to continue to perform it for research purposes—and recently, a Western medical journal even published a new study of the results. In 2007, The Wall Street Journal detailed the practice of a physician who claimed he performed 1000 such procedures to treat mental illnesses such as depression, schizophrenia and epilepsy, after the ban in 2004; the surgery for addiction has also since been done on at least that many people."

'via Blog this'

The hidden world of medical racism in the United States

The hidden world of medical racism in the United States: "The idea that discredited, repugnant ideas about racial differences might play a role in medical diagnoses and treatment today is one that doctors ought to find profoundly disturbing. The racially biased treatment of patients is a grievous violation of medical ethics and a direct threat to the dignity of the profession.

But over the past two decades, American medical literature has published hundreds of peer-reviewed studies that point to racially-motivated decisions by physicians that may do serious medical harm. The principal result of these studies has simply been more studies of the same kind."

'via Blog this'

Remove industry bias from clinical trials before it's too late

Remove industry bias from clinical trials before it's too late: "A study published today shows that clinical trials with industry sponsorship report greater benefits and fewer harmful side effects. In the discussion, the authors note that most reviews and guidelines don’t report the funding sources for the included trials."

'via Blog this'

BioEdge: Leveson Inquiry recommends reform of science reporting

BioEdge: Leveson Inquiry recommends reform of science reporting: "Remember patients: don't call something a "cure" that is not a cure."

'via Blog this'

BioEdge: The ultimate hot potato: female genital mutilation is not as bad as it seems

BioEdge: The ultimate hot potato: female genital mutilation is not as bad as it seems: "The authors’ aim is to "move the coverage of the topic from an over-heated, ideologically charged, and one-sided story about 'mutilation,' morbidity, and patriarchal oppression to a real, evidence-based policy debate governed by the standards of critical reason and fact checking."

The claims and counter-claims are too long to list. But the authors – about 15 of them, mostly from Western countries – make the following points about female genital mutilation (or “female genital surgery”, as they call it)"

Provocatively, the authors argue that women and girls who have undergone genital mutilation should not be stigmatized or taught to expect sexual dysfunction. This might cause “psychological mutilation", potentially compromising the development of a normal and healthy psychosexual life.

Bad Science

Bad Science: "This morning at 11:30, Dr Sarah Wollaston MP will ask questions in parliament about the ongoing scandal of missing trial data. This is widely recognised as a problem by academics and doctors, but governments, regulators, and journalists have neglected the problem, while industry simply denies it. Watch the questions live here or watch it later here.
As an example, we spent £500m stockpiling Tamiflu in the UK, but the company Roche are still withholding vitally important information about the trials on whether it works from Cochrane, the international academic collaboration who make gold standard reviews of evidence for doctors, patients, and governments."

'via Blog this'

Irving Kirsch, P.h.D: Antidepressants: The Emperor's New Drugs?

Irving Kirsch, P.h.D: Antidepressants: The Emperor's New Drugs?: "It turned out that 75 percent of the antidepressant effect was also produced by placebos - sugar pills with no active ingredients that are used to control the effects of hope and expectation in clinical trials. In other words, most of the improvement seen in patients given antidepressants was a placebo effect."

'via Blog this'

Peer review: Bad Pharma by Ben Goldacre

Peer review: Bad Pharma by Ben Goldacre: "In Bad Pharma he repeats this trick, but the headline news is infinitely more disturbing: contemporary medicine is acutely sick and in desperate need of therapy. Usually, it’s naturopaths who run this argument, portraying what they see as contemporary medicine’s de-humanising reductionism.

Goldacre’s perspective is very different: medicine’s evidence base has been undermined by an unscrupulous alliance of the pharmaceutical industry and regulators, which leads to the routine suppression of negative studies revealing many drugs to be either ineffective or less effective than those they seek to replace.

This suppression has been wilful and many academics (the industry’s “key opinion leaders”) have acted as willing partners in the enterprise, putting their names to ghostwritten articles reporting positive trials, while failing to publish negative trials.

Since there’s so much missing data, we can’t really say whether the therapies we use work or not. "

'via Blog this'

Limited heart rate variability, autonomic nervous system imbalance implicated in the aetiology of CFS

The Conversation: "The stress-response neural systems of chronic fatigue syndrome (CFS) patients remain on high alert even when they sleep, signalling that it’s not safe to relax, researchers have found.

Researchers also discovered that reduced heart rate variability, or changes in heart beat timing, are the best predictors of cognitive disturbances, such as concentration difficulties commonly reported by CFS sufferers. This adds to the growing body of evidence linking autonomic nervous system imbalance to this disorder.

The findings could lead to new ways to improve cognitive difficulties in people with CFS, which remains a poorly understood condition."

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0049518  

ETS result in limited (reduced) heart rate variability and alters the ANS (sympathetic and parasympathetic balance). This article might provide some insight into the cases where ETS resulted in a variety of unwelcome and detrimental side-effects, including fatigue, altered cognitive function ('brain fog'), etc.

Tamiflu effectiveness questioned as drug company refuses to release data

Tamiflu effectiveness questioned as drug company refuses to release data: "Public health researchers have stepped up their campaign to access clinical trial data about influenza drug Tamiflu, amid concerns about its effectiveness.

Professor Peter Gøtzsche, leader of the Nordic Cochrane Centre in Copenhagen, has called for drug company Roche, which manufacturers Tamiflu, to be sued over its refusal to share data with independent researchers.

Meanwhile, questions are being raised about whether Tamiflu works in the way its manufacturers claim, or acts like paracetamol instead.

Tamiflu, or oseltamivir, is supposed to reduce complications from flu, such as pneumonia, and reduce the rate of hospitalisation and death during outbreaks of the illness.

The drug was stockpiled in Australia, Europe and the US following the swine flu outbreak of 2009. The British Medical Journal claims it has made billions of pounds for Roche."

'via Blog this'

Doctor pleads guilty to abortion clinic infections

Doctor pleads guilty to abortion clinic infections: "He made admissions to the Medical Practitioners Board in 1995 that he had abused fentanyl and pethidine, obtained by forging prescriptions.

He was charged by police with several counts of failing to give notice that a patient was drug-dependent and obtaining a drug of dependence by forging prescriptions.

He was convicted over the charges, received community-based orders and two months’ jail, which was wholly suspended for 18 months.

In July 1996 he was also charged with multiple counts of aiding and abetting another person to forge a prescription for drugs, and for being in possession of a drug of dependence, using a drug of dependence and introducing a drug into the body of another. He was again convicted and released on a community-based order for 18 months.

He was ordered to undergo assessment for a drug addiction, submit to medical, psychological and/or psychiatric treatment and be drug-tested as part of his conditions.

The medical board suspended him in 1996 before he returned to work at Box Hill Hospital the following year.

He tested positive for hepatitis C — a disease of which the health department must be notified — in 1997."

GMC suspends 'rogue surgeon' accused of unnecessary breast operations | Society | The Guardian

GMC suspends 'rogue surgeon' accused of unnecessary breast operations | Society | The Guardian: "
An alleged "rogue surgeon" has been suspended by the General Medical Council after it emerged he might have performed "unnecessary or inappropriate" breast operations on more than 1,000 women in Britain.

Ian Stuart Paterson, a breast cancer specialist who worked at NHS and private hospitals in the Midlands from 1994 until last month, is suspected of misdiagnosing at least 450 of the women with breast cancer when they were in fact healthy, and then performing unnecessary "lumpectomy" surgery."

We need a different national conversation about ADHD

We need a different national conversation about ADHD: "That’s why Australia needs to start a broader conversation about ADHD. And if we do, we might uncover a deep contradiction in our past response.

While we laud the qualities of activity, alertness and resistance to authority in our grandparents as foundations of the ANZAC tradition, we consider these same qualities in our children as something to be treated with medication.

It leads to the question – if Ginger Meggs were around today, would he be ADHD?"

'via Blog this'

The drugs don't work: a modern medical scandal | Ben Goldacre

The drugs don't work: a modern medical scandal | Ben Goldacre | Business | The Guardian: "The doctors prescribing the drugs don't know they don't do what they're meant to. Nor do their patients. The manufacturers know full well, but they're not telling."

'via Blog this'

These observations further emphasize our ignorance of the mechanisms responsible for primary hyperhidrosis and of the effect of sympathetic ablation

"These observations further emphasize our ignorance of the mechanisms responsible for primary hyperhidrosis and of the effect of sympathetic ablation on the function of the remaining sympathetic system."  

"Only investigators who deviate from accepted standards innovate and thus advance science. Obviously, such deviations may also result in disasters;"  

Statement made by the former President of the International Society of Sympathetic Surgery,  and ETS surgeon, Moshe Hashmonai (Invited Commentary)   Endoscopic Lumbar Sympathectomy Following Thoracic Sympathectomy in Patients with Palmoplantar Hyperhidrosis    

World J Surg (2011) 35:54–55 DOI 10.1007/s00268-010-0809-5

Ben Goldacre: 'It's appalling … like phone hacking or MPs' expenses' | Business | The Observer

Ben Goldacre: 'It's appalling … like phone hacking or MPs' expenses' | Business | The Observer: "The point of my book is that it's possible for good people in badly designed systems to perpetrate acts of great evil completely unthinkingly. I don't think any of the people I write about would punch an old lady in the face, but they would inflict the same level of harm when they are abstracted away from the outcomes of their actions.

This is made easier, I think, because in general, most drugs do work better than nothing: it's just that we may be misled into using, for example, an expensive new drug where an older, cheaper one is more effective.

Overall, the problem is we don't have a competent regulatory framework that prevents things from going horribly wrong. If companies are allowed to hide the results of clinical trials then they will, and that will distort clinical practice."

'via Blog this'

Parents can't sue vaccine manufacturers - SFGate

Parents can't sue vaccine manufacturers - SFGate: "Parents whose children are harmed or killed by allegedly defective vaccines can't sue the manufacturers for damages in state court and must instead accept no-fault compensation from a national tribunal for vaccination injuries, a federal appeals court ruled Tuesday.

The Ninth U.S. Circuit Court of Appeals upheld dismissal of a suit by a Las Vegas couple whose baby son suffered seizures and died after an immunization shot, saying such suits were precluded by a 1986 federal law.

The law established a "vaccine court" where those who claimed injuries from vaccination must file their claims. If a hearing officer determined that the harm was consistent with the vaccine's known side effects, the victim would be awarded compensation without having to prove that the manufacturer caused the harm or acted negligently."

'via Blog this'

Arthroscopy to treat osteoarthritis of the knee? | Medical Journal of Australia

Arthroscopy to treat osteoarthritis of the knee? | Medical Journal of Australia: "Changing clinician beliefs and behaviour in response to credible evidence of lack of treatment efficacy remains highly challenging"

'via Blog this'

The antidepressant reboxetine: A “headdesk” moment in science

The antidepressant reboxetine: A “headdesk” moment in science | Guest Blog, Scientific American Blog Network: "For psychiatry and behavioral pharmacology, one of those moments came a few weeks ago with the findings of a meta-analysis published in the British Medical Journal (Eyding et al., 2010). The meta-analysis showed that an antidepressant, reboxetine (marketed by Pfizer in Europe, but not in the U.S., under the names Edronax, Norebox, Prolift, Solvex, Davedax or Vestra) doesn’t work. Not only does it not work, it really doesn’t work, and it turns out that Pfizer hadn’t published data on the putative antidepressant from 74% of their patients. "

'via Blog this'

New symptoms for ADHD diagnosis

New symptoms for ADHD diagnosis: "In a published ''pros and cons'' list about the additional symptoms, the committee said they were "not empirically derived" and had potential to decrease the accuracy of the criteria.

Melissa Raven, a psychiatric epidemiologist and policy analyst at Flinders University, in Adelaide, said that was an "absolutely damning statement".

"They have identified some problems then proceeded blithely on," she said.

Allen Frances, the chairman of the taskforce that produced the present edition of the DSM, said when they increased the number of symptoms they produced an ''epidemic'' of ADHD. They thought it would increase by 15 per cent, but it actually increased by 200 per cent."

'via Blog this'

'Miracle' drugs put thousands at risk

'Miracle' drugs put thousands at risk: "THOUSANDS of Australians could be taken off cholesterol-lowering medications because of mounting evidence they increase the risk of diabetes and dementia.

Australian health authorities are reviewing their advice after US regulators announced statins will now carry warnings they could increase the risk of diabetes and cognitive impairment.

Statins are the most commonly prescribed drugs in Australia, with about 2 million people thought to be taking them to reduce their heart disease risk."

'via Blog this'

Madness is undergoing a redesign

Madness is undergoing a redesign: "You know how sometimes you just go a little bit crazy when you have your period? Well, it turns out PMS is about to become a mental illness.

Madness is currently undergoing a redesign, with the Diagnostic and Statistical Manual of Mental Disorders, often called the ‘Psychiatrist’s Bible’ being updated.

Basically, a big group of grey-haired psychiatrists have been getting together to decide what qualifies someone as being mentally ill.

There are a whole heap of proposed changes that have the potential to change how we think about our bodies and behaviours. Rape is set to become a mental disorder, and wanting to have sex all the time is being considered for inclusion."

'via Blog this'

Does doctor still know best? | Australian cardiologists

Does doctor still know best? | Australian cardiologists: "Are Professor MacMahon and the other cardiovascular researchers and clinicians who have called the article “sensationalist” and “hysterical” saying that it is hysterical or sensationalist to suggest that people at low-risk of heart disease should reconsider their use of statins? I would say that position is mainstream, and a conservative approach.

It’s also worth pointing out that sometimes, as in the case of this Medical Observer article, the criticisms are made without the speakers declaring their links to pharmaceutical companies that produce lipid-lowering medications."

'via Blog this'

Thousands of children put at risk by asthma medication

Thousands of children put at risk by asthma medication:

'via Blog this'

A significant admission from an ETS surgeon, President of the ISSS:

"General represents the ESB (whether as ETS as ETSC or ELS) a substantial interference in regulatory processes of the body represent the decision for this operation requires that previously conservative treatments were made. An ESB is therefore at the end of a treatment history, and never at the beginning."

http://www.dhhz.de/index....;subPage=&section=32

it is an automatic translation (google) from german, so you have to look at what the 'gist' of what he is saying: ETS, ESB = "a substantial interference in regulatory processes of the body"

The drugs don't work: a modern medical scandal | Ben Goldacre | Business | The Guardian

The drugs don't work: a modern medical scandal | Ben Goldacre | Business | The Guardian: "
Drugs are tested by the people who manufacture them, in poorly designed trials, on hopelessly small numbers of weird, unrepresentative patients, and analysed using techniques that are flawed by design, in such a way that they exaggerate the benefits of treatments. Unsurprisingly, these trials tend to produce results that favour the manufacturer. When trials throw up results that companies don't like, they are perfectly entitled to hide them from doctors and patients, so we only ever see a distorted picture of any drug's true effects. Regulators see most of the trial data, but only from early on in a drug's life, and even then they don't give this data to doctors or patients, or even to other parts of government. This distorted evidence is then communicated and applied in a distorted fashion."

'via Blog this'

The drugs don't work: a modern medical scandal | Ben Goldacre | Business | The Guardian

The drugs don't work: a modern medical scandal | Ben Goldacre | Business | The Guardian: "Drugs are tested by their manufacturers, in poorly designed trials, on hopelessly small numbers of weird, unrepresentative patients, and analysed using techniques that exaggerate the benefits."

'via Blog this'

Ending over-diagnosis: how to help without harming

Ending over-diagnosis: how to help without harming: "Over-diagnosis is a significant problem that’s already common in some areas of medicine, such as screening and some mental health conditions. It is a problem now but a bigger threat for the future: better imaging technologies, more biomarkers, more genetic tests and so on, will gradually expand the amount of over-diagnosis that’s possible."

'via Blog this'

Senate Committees – Parliament of Australia

Senate Committees – Parliament of Australia: "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. "

'via Blog this'

False positives: fraud and misconduct are threatening scientific research | Science | The Guardian

False positives: fraud and misconduct are threatening scientific research | Science | The Guardian: "Publishing his results in the journal PLoS One, he found that an average of 1.97% of scientists admitted to having "fabricated, falsified or modified data or results at least once – a serious form of misconduct by any standard – and up to 33.7% admitted other questionable research practices. In surveys asking about the behaviour of colleagues, admission rates were 14.12% for falsification, and up to 72% for other questionable research practices.""

'via Blog this'

Private doctors criticised on births

Private doctors criticised on births: "TENS of thousands of Australian women with low risk of birth complications are undergoing unnecessary medical interventions in private hospitals in a trend that a leading midwifery expert has described as ''horrifying''.

In a landmark study of nearly 700,000 women in NSW hospitals, those giving birth privately were found to have a 20 per cent lower chance of having their first child through normal vaginal delivery.

''The fact that these procedures which were initially life saving are now so commonplace and do not appear to be associated with improved [baby] death rates demands close review,'' found the study, to be published today in the British Medical Journal's open journal.

''The findings … suggest a two-tier system exists in Australia without any obvious benefit for women and babies and a level of medical overservicing which is difficult to defend.''

The leader of the study, Hannah Dahlen, said the women examined between 2000 and 2008 were aged 20 to 34, were not pre-term or overdue and carried babies of normal weight."

'via Blog this'

Sympathectomy controversial for the treatment of RSD

What Is Reflex Sympathetic Dystrophy Syndrome (RSD)?

Complex Regional Pain Syndrome

By Carol Eustice, About.com Guide

Updated June 06, 2012

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

http://arthritis.about.com/od/rsd/a/rsd.htm