Louise Field, 27, died after ETS surgery (1/3) | VerySweatyBetty.com: "A ‘fit and healthy’ young woman was left brain dead after a pioneering operation to reduce her excessive sweating went catastrophically wrong, a medical panel has heard. Louise Field, 27, suffered severe brain damage when doctors accidentally punctured her lung and pumped gas into her stomach, the General Medical Council heard. She died two days later. Vascular surgeon Dr Michael Ormiston and anaesthetist Dr Wasfy Yanny face a catalogue of charges arising from the bungled operation at a Bupa Hospital in Harpenden, Hertfordshire.
Dr Ormiston, who had carried out the operation a handful of times, first punctured the keen sportswoman’s lung with a needle then pumped carbon dioxide into her stomach. Dr Yanny failed to take action when Ms Field’s oxygen levels dropped dangerously low and should have realised this damaged the patient’s brain, the hearing was told. Ms Field had
Louise Field
chosen to undergo an operation to reduce heavy sweating on her hands and feet, the GMC heard.
Sarah Plaschkes, for the GMC, told the hearing: ‘She was born on February 18, 1975, and was to die tragically on March 22, 2002, aged just 27. ‘She was fit and healthy and played a lot of sport however she was embarrassed by excessive sweating of the hands and feet."
'via Blog this'
"He knows the procedure is controversial because of the unpredictability of side-effects"
Information about surgery for sweaty hands: "surgeon "knows the procedure is controversial because of the unpredictability of side-effects"
"Ferrar believes much of the controversy lies in surgeons, mainly in America, who perform the surgery on anyone who asks for it, rather than the severe end of the spectrum.
"In America there are so many that have been operated on when it hasn't been necessary, or the surgeon has given the patient false expectations, that there are support groups for people who've had complications or adverse effects. The people that come to me are almost self-selecting; they've tried everything else."
The youngest patient he has performed an endoscopic thoracic sympathectomy on was 8 years old, with most being in puberty (when the condition tends to arise). Or they are in their 20s when they are beginning relationships and jobs."
Publication info: Waikato Times [Hamilton, New Zealand] 07 Apr 2012: 22."
"Ferrar believes much of the controversy lies in surgeons, mainly in America, who perform the surgery on anyone who asks for it, rather than the severe end of the spectrum.
"In America there are so many that have been operated on when it hasn't been necessary, or the surgeon has given the patient false expectations, that there are support groups for people who've had complications or adverse effects. The people that come to me are almost self-selecting; they've tried everything else."
The youngest patient he has performed an endoscopic thoracic sympathectomy on was 8 years old, with most being in puberty (when the condition tends to arise). Or they are in their 20s when they are beginning relationships and jobs."
Publication info: Waikato Times [Hamilton, New Zealand] 07 Apr 2012: 22."
Sympathectomy is by no means a benign procedure, and sympathectomy for sweating can induce pain and allodynia
"Sympathectomy is by no means a benign procedure, and sympathectomy for sweating can induce pain and allodynia at the border zone which is sometimes associated with pronounced increase in sweating in that area." (p. 534) Surgical Disorders of the Peripheral Nerves by Rolfe Birch Springer, Jan 21, 2011 - Medical - 512 pages original article published in Ann R Coll Surg Engl 2002; 84:181-184"
Patients who undergo sympathotomy for hyperhidrosis will commonly report "clinically bothersome" compensatory hyperhidrosis.
J Thorac Cardiovasc Surg. 2014 Apr;147(4):1160-1163.e1. doi: 10.1016/j.jtcvs.2013.12.016. Epub 2014 Jan 2.
"The custom of a majority is no guarantee of safety and is seldom a guide to best medical practice." in Legal Forum
Cameron`s claim that there has been only one death attributable to synchronous bilateral thoracoscopic sympathectomy is implausible. Surgeons and anaesthetists are reticent in publicizing such events and Civil Law Reports of settled cases are an inadequate measure of the current running total. The custom of a majority is no guarantee of safety and is seldom a guide to best medical practice.
Jack Collin,
Consultant Surgeon
Oxford
http://www.bmj.com/content/320/7244/1221?tab=responses
Jack Collin,
Consultant Surgeon
Oxford
http://www.bmj.com/content/320/7244/1221?tab=responses
Antiviral drug stockpile a waste of money, says study | smh.com.au
Antiviral drug stockpile a waste of money, says study | smh.com.au: "Governments around the globe may have wasted billions of dollars stockpiling antiviral drugs to use against an influenza pandemic, according to a damning review drawing on previously suppressed data.
Australia was one of several countries to stockpile the drugs known as Tamiflu and Relenza, believing they would reduce hospital admissions and complications of influenza, such as pneumonia, in the event of an outbreak of swine or bird flu.
But a review of data from trials involving more than 24,000 people, published on Thursday by the Cochrane Collaboration and the British Medical Journal, concluded the drugs were of only marginal benefit, shortening the duration of influenza symptoms by just half a day.
The review found no good evidence that the drugs prevented the spread of the virus between people, or any of its serious consequences, such as infections. It found Tamiflu increased the risk of psychiatric disturbances, renal problems, nausea, vomiting and headaches."
'via Blog this'
Australia was one of several countries to stockpile the drugs known as Tamiflu and Relenza, believing they would reduce hospital admissions and complications of influenza, such as pneumonia, in the event of an outbreak of swine or bird flu.
But a review of data from trials involving more than 24,000 people, published on Thursday by the Cochrane Collaboration and the British Medical Journal, concluded the drugs were of only marginal benefit, shortening the duration of influenza symptoms by just half a day.
The review found no good evidence that the drugs prevented the spread of the virus between people, or any of its serious consequences, such as infections. It found Tamiflu increased the risk of psychiatric disturbances, renal problems, nausea, vomiting and headaches."
'via Blog this'
Dr Fabian Baez was accused of sexual misconduct against four female patients - each who was young or psychological vulnerable - by the Health Care Complaints Commission.
A prominent Sydney cosmetic surgeon has been found guilty of professional misconduct for offering a patient with mental illness Botox in exchange for sex.
Dr Fabian Baez was accused of sexual misconduct against four female patients - each who was young or psychological vulnerable - by the Health Care Complaints Commission.
This month the NSW Civil and Administrative Tribunal found Dr Baez had sexual intercourse with one patient on two or three occasions in exchange for the provision of one session of Botox injections.
He had known the patient since late 1999 when as a GP he was treating her for bipolar affective disorder.
The sex occurred at a beauty salon known as Devine Imaging, which Dr Baez was associated with.
The owner of the business, Patricia Devine, gave evidence that she generated about $100,000 of cosmetic business for Dr Baez, including running promotional nights where he was the guest speaker.
In an interview with HCCC investigators, Dr Baez denied having sex with the patient and said he did not remember her, even though saw her 42 times in two years.
"The sexual exploitation of any patient is a matter of grave concern. The exploitation of a patient with known mental health issues is of even greater concern," the tribunal said.
Read more: http://www.smh.com.au/nsw/surgeon-offered-mentally-ill-woman-botox-in-exchange-for-sex-tribunal-finds-20140216-32tg8.html#ixzz2xnVYTKoG
sympathectomy is based on such anecdotal observation and small case studies which have failed to stand up to scientific scrutiny
Clinical trials do exist and their inability to demonstrate effectiveness suggests an obvious conclusion: the argument for sympathectomy, by chemical or surgical means, is based on such anecdotal observation and small case studies which have failed to stand up to scientific scrutiny. To date there are no reproducible, blinded, randomized studies utilizing control populations which have demonstrated a benefit to sympathetic blockade in CRPS.
DISABILITY MEDICINE, The Official Periodical of the American Board of Independent Examiners,
Vol. 5 No. 3-4 July - December 2005
www.abime.org/documents/
DISABILITY MEDICINE, The Official Periodical of the American Board of Independent Examiners,
Vol. 5 No. 3-4 July - December 2005
www.abime.org/documents/
US scientists were “accomplices after the fact” in Japanese doctors’ war crimes
BioEdge: US scientists were “accomplices after the fact” in Japanese doctors’ war crimes: "A fascinating answer appears in the Cambridge Quarterly of Healthcare Ethics. The broad outline of the story has been well documented, even if it is not widely known. To cut a long story short, the Americans struck a deal with the doctors. They traded immunity from prosecution for access to scientific information from the ghastly Japanese experiments – many of which are too grim to detail here. (If you have the stomach for it, a remorseful doctor describes, at the age of 90, some of his vivisection experiments in an article in the Japan Times.)
A report from US scientists who interviewed the staff of Unit 731 and the surviving records concluded that “Such information could not be obtained in our own laboratories because of scruples [sic] attached to human experimentation"
'via Blog this'
A report from US scientists who interviewed the staff of Unit 731 and the surviving records concluded that “Such information could not be obtained in our own laboratories because of scruples [sic] attached to human experimentation"
'via Blog this'
"We quickly discovered that lay people often lack the (medical) knowledge to make well-considered judgements"
Jane McCredie: Wishing on risks
BioEdge: The scandal of wasted research dollars
BioEdge: The scandal of wasted research dollars: "Twenty years ago, a British statistician complained in the BMJ that much medical research was “seriously flawed through the use of inappropriate designs, unrepresentative samples, small samples, incorrect methods of analysis, and faulty interpretation.”
Today, says the BMJ’s former editor, the influential writer Richard Smith, the only word to be changed in that diagnosis is probably “much”. It should now be “most”. And he complains that the leaders of the medical profession are not interested in changing the situation."
'via Blog this'
Today, says the BMJ’s former editor, the influential writer Richard Smith, the only word to be changed in that diagnosis is probably “much”. It should now be “most”. And he complains that the leaders of the medical profession are not interested in changing the situation."
'via Blog this'
Evidence based medicine is broken
Indeed, the current regulation is handmaiden to the polluters, as this partial list of examples indicates:
• The regulation does not demand that the research agenda be driven strictly by patient needs, not corporate interests.
• It is silent about the adequacy of selection criteria, outcome measures, and statistical significance, three variables that are often used by the polluters to manipulate evidence.
• It says nothing about what should count as scientific and unscientific research. This lacuna allows the latter to take place too, provided, of course, that it labels itself as "scientific".
• The regulation introduces exceptions to the head-to-head rule, exceptions that allow the polluters to test every new drug against placebo or no treatment thereby showing us exactly what they want: efficacy, but not necessarily over the current treatment.[4]
• It does not ban regulators, health care institutions and medical professionals from having financial conflicts of interest. Worse than that, "transparency", the only thing it insists on and quite feebly so, gives both the doctor and the patient nothing but the misleading impression that they can make a truly informed choice.
• The regulation does not ban subject recruitment through financial incentives, a practice capable of introducing outcome bias.
• It does not ban seeding trials, i.e., marketing exercises concealed as scientific research.
• It does not ban manipulative advertising to both doctor and patient inside or outside "scientific" journals.
• It does not ban medicalisation and “me too” drugs.
• It does not regard polluted information, whether it involves misconduct or not, as a sufficient condition for rendering disclosure inadequate. Thus, it lets informed consent degenerate into a legal fiction and the principle of autonomy into a cynical farce.[5]
• Worst of all, it is perfectly ethical: being the codified expression of the collective conscience of our medicine, it naturally purports to be moral.
• It is silent about the adequacy of selection criteria, outcome measures, and statistical significance, three variables that are often used by the polluters to manipulate evidence.
• It says nothing about what should count as scientific and unscientific research. This lacuna allows the latter to take place too, provided, of course, that it labels itself as "scientific".
• The regulation introduces exceptions to the head-to-head rule, exceptions that allow the polluters to test every new drug against placebo or no treatment thereby showing us exactly what they want: efficacy, but not necessarily over the current treatment.[4]
• It does not ban regulators, health care institutions and medical professionals from having financial conflicts of interest. Worse than that, "transparency", the only thing it insists on and quite feebly so, gives both the doctor and the patient nothing but the misleading impression that they can make a truly informed choice.
• The regulation does not ban subject recruitment through financial incentives, a practice capable of introducing outcome bias.
• It does not ban seeding trials, i.e., marketing exercises concealed as scientific research.
• It does not ban manipulative advertising to both doctor and patient inside or outside "scientific" journals.
• It does not ban medicalisation and “me too” drugs.
• It does not regard polluted information, whether it involves misconduct or not, as a sufficient condition for rendering disclosure inadequate. Thus, it lets informed consent degenerate into a legal fiction and the principle of autonomy into a cynical farce.[5]
• Worst of all, it is perfectly ethical: being the codified expression of the collective conscience of our medicine, it naturally purports to be moral.
In light of these examples we should ask ourselves: If the polluters of medical knowledge can tick the ethical box, then what does that say about our ethic?
1 Spence D. Evidence based medicine is broken. BMJ 2014;348:g22.
2 Goldacre B. Bad Pharma. London:Fourth Estate, 2012.
3 Gøtzsche PC. Deadly Medicines and Organised Crime: How big pharma has corrupted healthcare. London:Redcliffe, 2013.
4 WMA Declaration of Helsinki 2013; pt. 33.
5 Epstein M. Legal and institutional fictions in medical ethics: a common, and yet largely overlooked, phenomenon. J Med Ethics 2007;33(6):362-364.
http://www.bmj.com/content/348/bmj.g22/rr/680463
BioEdge: Evidence-based medicine comes under attack
BioEdge: Evidence-based medicine comes under attack: "evidence-based medicine has its critics, as a bilious outbreak of comment and letters in the BMJ demonstrated recently. Early last month a Glasgow GP, Des Spence, said that the system of EBM had been corrupted. “If we don’t tackle the flaws of EBM there will be a disaster, but I fear it will take a disaster before anyone will listen,” he wrote.
How could anyone fault the notion of treatment based on scientifically validated evidence? No one. But the critics of EBM argue heatedly that the standards for the evidence are often low and tainted by commercial or personal interests."
http://www.bioedge.org/index.php/bioethics/bioethics_article/10841
How could anyone fault the notion of treatment based on scientifically validated evidence? No one. But the critics of EBM argue heatedly that the standards for the evidence are often low and tainted by commercial or personal interests."
http://www.bioedge.org/index.php/bioethics/bioethics_article/10841
Health experts with pharma links more likely to talk up risk
"A number of scientists on the World Health Organization’s (WHO) flu advisory committee, which monitors pandemics and provides guidance for governments, for example, have disclosed links with the pharmaceutical industry.
But given that the media can influence demand for pharmaceutical products and perceptions of risk, we set out to examine whether health experts commentating on swine flu more generally were also more likely to have links to drug companies.
Analysing UK newspaper coverage of the swine flu pandemic between April and July 2009 – the period in which the UK government was taking decisions on how best to respond to the emerging pandemic, including providing the public with vaccine and antiviral drugs – we looked for how often scientists were quoted in articles on the pandemic from a wide range of publications.
We then looked at these comments in more detail to see if scientists made an assessment of the risk to the public from swine flu, and if so, we compared these against assessments made by official agencies such as the Department of Health."
"We found that half of the health experts that commentated on the use of antiviral drugs or vaccine had competing interests. And scientists promoting the use of antiviral drugs were eight times more likely to have a competing interest than those that didn’t comment on their use. We also found that health experts with competing interests were six times more likely than those without to predict a higher risk to the public compared to official assessments."
https://theconversation.com/health-experts-with-pharma-links-more-likely-to-talk-up-risk-20108
Making all clinical data public is vital for better medical care
Making all clinical data public is vital for better medical care: "An article published in the journal of the British Medical Association, BMJ, earlier this week illustrates a devastating problem with the “evidence base” in the academic medical literature.
A large proportion of drug trials, particularly those sponsored by pharmaceutical companies, never get published, skewing our picture of drugs' effectiveness and safety."
'via Blog this'
A large proportion of drug trials, particularly those sponsored by pharmaceutical companies, never get published, skewing our picture of drugs' effectiveness and safety."
'via Blog this'
Any sensible person or scientist knows that the drug laws are not based on the science of drugs
David Nutt: 'I was sacked, I was angry, I was right': "Any sensible person or scientist knows that the drug laws are not based on the science of drugs. And it’s a collusion among scientists, politicians, and to some extent the public, to ignore that. It is anti-establishment, but also not, in that it’s such an obvious thing. It’s like the emperor’s new clothes – someone needed to speak up."
'via Blog this'
'via Blog this'
Medical Students Examine Unconscious Patients Without Consent | Fox News
Medical Students Examine Unconscious Patients Without Consent | Fox News: "Australian and UK medical students carried out intrusive procedures on unconscious and anesthetized patients without first gaining consent, news.com.au reported Friday.
The unauthorized examinations included genital, rectal and breast exams, according to Australian women's magazine Madison, and raised serious questions about the ethics of future doctors.
The research, to be published in international medical journal Medical Education, describes -- among others -- a student with "no qualms" about performing an anal examination on a female patient because she did not think the woman's consent was relevant.
Another case is of a man who was subjected to rectal examinations from a "queue" of medical students after he was anesthetized for surgery.
The author of the study, Professor Charlotte Rees, voiced concerns about senior medical staff ordering students to perform unauthorized procedures, leaving the students torn between the strong ethics of consent in society and the weak ethics of some medical staff."
'via Blog this'
The unauthorized examinations included genital, rectal and breast exams, according to Australian women's magazine Madison, and raised serious questions about the ethics of future doctors.
The research, to be published in international medical journal Medical Education, describes -- among others -- a student with "no qualms" about performing an anal examination on a female patient because she did not think the woman's consent was relevant.
Another case is of a man who was subjected to rectal examinations from a "queue" of medical students after he was anesthetized for surgery.
The author of the study, Professor Charlotte Rees, voiced concerns about senior medical staff ordering students to perform unauthorized procedures, leaving the students torn between the strong ethics of consent in society and the weak ethics of some medical staff."
'via Blog this'
Epidemiology of medical error | BMJ
Epidemiology of medical error | BMJ: "The Harvard and Australian studies into medical error remain the only studies that provide population level data on the rates of injuries to patients in hospitals and they identified a substantial amount of medical error
In the United States medical error results in 44 000–98 000 unnecessary deaths each year and 1 000 000 excess injuries"
http://www.bmj.com/content/320/7237/774
In the United States medical error results in 44 000–98 000 unnecessary deaths each year and 1 000 000 excess injuries"
http://www.bmj.com/content/320/7237/774
Pharma giant fined billions for fraud
GLOBAL healthcare giant Johnson & Johnson will pay more than $2.3 billion to settle allegations that it fraudulently promoted drugs and used kickbacks to promote sales.
In one of the largest healthcare fraud settlements in US history, J&J's criminal and civil fine covers allegations the company marketed risperidone (Risperdal) and other prescription drugs for uses not approved as safe and effective by the Food and Drug Administration (FDA).
The settlement further covers kickbacks J&J allegedly paid to physicians and pharmacies for prescribing and promoting those drugs, the US Justice Department said yesterday.
The settlement further covers kickbacks J&J allegedly paid to physicians and pharmacies for prescribing and promoting those drugs, the US Justice Department said yesterday.
Medical Observer
5tov 2013
MORE than 25% of large randomised clinical trials registered with ClinicalTrials.gov have not published
MORE than 25% of large randomised clinical trials registered with ClinicalTrials.gov have not published any results in medical literature or in the registry database, according to research published in the BMJ. The researchers examined 585 registered trials with at least 500 participants and which had been completed by 2009. They found 171 trials with a total of almost 300 000 participants had not been published. Industry-sponsored trials were the most likely to remain unpublished. Of unpublished trials, 78% had no results available in ClinicalTrials.gov. For trials where the recruitment status was listed as “completed”, 26% (132/513) remained unpublished, and 29 trials were described as “active, not recruiting”; with 10 of these unpublished. The BMJ authors said trial investigators and sponsors had an ethical obligation to study participants to publish trial results. “The lack of availability of results from these trials contributes to publication bias and also constitutes a failure to honor the ethical contract that is the basis for exposing study participants to the risks inherent in trial participation”, they wrote. “Additional safeguards are needed to ensure timely public dissemination of trial data.”
http://www.bmj.com/content/347/bmj.f6104
http://www.bmj.com/content/347/bmj.f6104
Scientists voice fears over ethics of drug trials remaining unpublished
Almost a third of large clinical trials in the US still not published five years after being finished, scientists write in BMJ
http://www.theguardian.com/science/2013/oct/29/scientists-fears-over-unpublished-drug-trials
http://www.theguardian.com/science/2013/oct/29/scientists-fears-over-unpublished-drug-trials
there are three main conditions which could impair the autonomy of a patient's medical decision: insufficient information, irrational beliefs/desires, and influence of different framing effects
http://onlinelibrary.wiley.com/doi/10.1111/j.1467-8519.2012.01973.x/abstract
Only 56% would recommend thoracoscopic sympathectomy to others with hyperhydrosis
http://www.ncbi.nlm.nih.gov/pubmed/21539945
List of predatory publishers - 2013
http://scholarlyoa.com/2012/12/06/bealls-list-of-predatory-publishers-2013/
corruption is the greatest moral challenge facing medicine today
Bioethical debate tends to focus on controversial medical procedures, such as genetic modification, IVF, euthanasia and abortion. The latest issue of the Indian Journal of Medical Ethics questions this, arguing that corruption is the greatest moral challenge facing medicine today.
In the lead article, Dr Subrata Chattopadhyay asserts that, "undermining the moral vision -- and nobility -- of the art of healing, corruption is arguably the most serious ethical crisis in medicine today". Chattopadhyay says that corruption in medicine is common everywhere, though he focuses his home country of India.The corruption of disgraced former WMA president Ketan Desai is, it seems, indicative of endemic misconduct.
Other articles in the issue include a summary of corruption cases in several of the major pharmaceutical companies of Europe and the US and the declining ethical standards of the Indian Medical Council.
"return of sweating in the hands is common occurrence in patients followed up for sufficient length of time"
Annals of the Royal College of Surgeons of England (1989) vol. 7.1
Transthoracic sympathectomy for palmar hyperhidrosis in children under 16 years of age
N W LAW BSc FRCS Surgical Registrar
H ELLIS CBE DM MCh FRCS Professor ofSurgery Professorial Surgical Unit, Westminster Hospital, London
Transthoracic sympathectomy for palmar hyperhidrosis in children under 16 years of age
N W LAW BSc FRCS Surgical Registrar
H ELLIS CBE DM MCh FRCS Professor ofSurgery Professorial Surgical Unit, Westminster Hospital, London
Unravelling madness
Unravelling madness
4:00 AM Saturday Apr 4, 2009
Richard Bentall believes that patients should be given the choice to have drug treatment, rather than be coerced into it. Photo / Simon Baker
In 1993 Richard Bentall went a bit mad.
He voluntarily took an antipsychotic drug and at first thought he'd get through unscathed.
"For the first hour I didn't feel too bad. I thought maybe this is okay. I can get away with this. I felt a bit light-headed."
Then somebody asked him to fill in a form. "I looked at this test and I couldn't have filled it in to save my life. It would have been easier to climb Mt Everest."
That was the least of his troubles. Bentall, an expert on psychosis from the University of Bangor in Wales who is in New Zealand under the University of Auckland Hood Fellowship programme, developed akathisia - unpleasant sensations of inner restlessness and an inability to sit still.
"It was accompanied by a feeling that I couldn't do anything, which is really distressing. I felt profoundly depressed. They tried to persuade me to do these cognitive tests on the computer and I just started crying."
Volunteers were given either 5mg of the antipsychotic droperidol, 1mg of lorazepam, a type of tranquillizer, or a placebo.
"The experiment completely failed," says Bentall. "Because first, it's absolutely mind-bogglingly obvious to anybody after an hour whether or not they are taking an antipsychotic or a placebo - the side effects are so marked. There is no such thing as a placebo antipsychotic in that sense."
But it was the fact that most of the healthy volunteers who took the antipsychotic became so unwell, let alone do the cognitive tests, that meant the study couldn't continue. One psychiatrist became suicidal and had to be put under observation.
In his controversial book Let Them Eat Prozac Healy wrote about what the volunteers experienced. "It was not like anything that had happened to them before... Highly personal memories of previous unhappy times - broken relationships or loneliness - seemed to be flooding back. And if they previously held themselves responsible for these unhappy times, they seemed to hold themselves responsible for feeling the way they did now as well."
Story of antipsychotics is one of myth and misrepresentation
The way antipsychotics have been misrepresented, their benefits inflated, their dangers minimised, illustrates how what is presented as neutral and objective “science” may in fact conceal a whole array of political and commercial interests. The psychiatric profession wanted to present a new image to society and politicians wished to replace costly mental institutions with cheaper community care.
All of this has helped transform antipsychotic drugs from dreaded chemical straight-jackets to modern-day soothers, lining the coffers of the pharmaceutical industry along the way. It’s time we woke up.
"Serious effects have been obscured because the frank descriptions provided by early clinicians were replaced by a vision of the drugs as a cleverly targeted, sophisticated and essentially benign treatment. And despite no convincing evidence to support the theory, the view emerged that they work by reversing an underlying “chemical imbalance” or other such abnormality rather than by inducing an abnormal or altered state."
Neuralgia due to sympathectomy
Depending on the skill of the surgeon and difficulty encountered performing various intraoperative maneuvers, the incidence of complications following sympathectomy should be the same as that following any other extraperitoneal or extrapleural operation. However, a frequent complication following sympathectomy, and one which is apparently unrelated to operative technique, is that of postsympathectomy neuralgia.
This neuralgia is characterized by aching thigh pain after lumbar sympathectomy or aching shoulder and arm pain after cervical sympathectomy. The pain is intense in severity, sudden in onset and disappearance, and not related to any major neurologic manifestations.
Recently we have reviewed the files of the Vascular Surgical Service at the West Roxbury Veteran's Hospital and the literature on this condition. This report is a presentation of our findings.
Incidence Pain following sympathectomy has been described as "an all too common complaint."8 Reports have varied in incidence from 2.1% to "practically every case."
http://archsurg.jamanetwork.com/article.aspx?articleid=560162
"No primary data can be located, and no evidence has been found that the study described in the article was conducted."
The Australian understands a whistleblower lodged a complaint about the study, whose lead author was former UQ professor Bruce Murdoch, an internationally renowned expert on speech and language disorders.
UQ vice-chancellor Peter Hoj said the university had asked the European Journal of Neurology to retract the paper, and it had agreed, on the grounds "no primary data can be located, and no evidence has been found that the study described in the article was conducted".
Professor Murdoch had run the university's Centre for Neurogenic Communication Disorders Research. He is no longer employed at UQ and could not be contacted last night.
There has been no finding of misconduct against anybody. The investigation is continuing.
Mr Hoj said the retraction meant the global scientific community would be alerted that the study could not be relied on for further research.
The study, Treatment of articulatory dysfunction in Parkinson's disease using repetitive transcranial magnetic stimulation, was published online by the journal in October 2011. Professor Murdoch was lead author, with a researcher from the Speech Science Laboratory at the University of Hong Kong also cited.
http://www.theaustralian.com.au/higher-education/uq-pulls-study-on-lack-of-evidence/story-e6frgcjx-1226710106648
If the TGA and AAT were not able to protect the public, “doctors and pharmacists should take matters into their own hands
TWO leading pharmacologists have called for a boycott on prescribing dextropropoxyphene after its manufacturer successfully appealed the drug’s removal from the Australian Register of Therapeutic Goods.
If the TGA and AAT were not able to protect the public, “doctors and pharmacists should take matters into their own hands and stop using this dangerous and useless drug”, Professor Henry said.
Dextropropoxyphene, an opioid, was approved for mild-to-moderate pain more than 30 years ago. Since then evidence has accumulated that it is no more efficacious than paracetamol.
A “For Debate” article in the MJA said the drug also carried a significant risk of sudden death from cardiotoxicity in patients with renal impairment, drug interactions and accidental or deliberate overdose. (1)
If the TGA and AAT were not able to protect the public, “doctors and pharmacists should take matters into their own hands and stop using this dangerous and useless drug”, Professor Henry said.
Doctors urged to boycott dextro
financial interests may unduly influence professionals’ judgments
widespread relationships with industry have created significant risks that… financial interests may unduly influence professionals’ judgments.
“conflicts of interest” threaten the integrity of research, the objectivity of education, the quality of patient care, and public trust in medicine.
“conflicts of interest” threaten the integrity of research, the objectivity of education, the quality of patient care, and public trust in medicine.
Conflict of Interest in Medical Research, Education, and Practice
- Released:
- April 21, 2009
- Type:
- Consensus Report
- Topics:
- Biomedical and Health Research, Education
- Activity:
- Conflict of Interest in Medical Research, Education, and Practice
- Board:
- Board on Health Sciences Policy
Trials of skin cancer drug DZ13 suspended pending investigation at UNSW
http://www.abc.net.au/news/2013-08-12/trials-of-skin-cancer-drug-dz13-suspended-amid-misconduct-claims/4881622
the Australian and New Zealand Clinical Trials Registry will not be signing up
A GLOBAL campaign to publish all clinical trial results within a year of trial registration has been ramped up, but the Australian and New Zealand Clinical Trials Registry will not be signing up — at least, not yet.
Organisations already signed up include the UK Medical Research Council, the Cochrane Collaboration and the World Association of Medical Editors.
MJA InSight Cate Swannell
Monday, 12 August, 2013
It's an unfair fight for patients in medical malpractice suits
physicians’ groups and hospitals hide errors and abuses behind the confidentiality provisions of the peer review process. This approach leaves the public guessing where the worst risks of medical treatment are hidden.
http://www.pressdemocrat.com/csp/mediapool/sites/PressDemocrat/News/story.csp?cid=2213058&sid=555&fid=181#page=1
These are the reasons a viable system of medical negligence (malpractice) litigation is necessary to protect the public. The threat of being held financially responsible for diagnostic and treatment errors is the only economic incentive that causes the medical establishment to police its own ranks.
I have been an attorney in Sonoma County for 38 years and have represented both sides (physicians and patients) in medical negligence cases. Without question, California law today unfairly favors doctors and their insurance companies at the expense of patients.
http://www.pressdemocrat.com/csp/mediapool/sites/PressDemocrat/News/story.csp?cid=2213058&sid=555&fid=181#page=1
Endoscopic sympathectomy is not minimally invasive - doing the operation through a smaller incision is not necessarily less invasive
The term ‘‘minimally invasive surgery’’ was initially applied to coelioscopic procedures such as laparoscopic cholecystectomy and hernia repair, thoracoscopic sympathectomy, and arthroscopy, but has since been abandoned, because doing the same operation through a smaller incision is not necessarily less invasive. The term ‘‘minimally invasive parathyroidectomy’’ does not fully convey the nature of the techniques, and, as previously debated in the wider field of minimal-access surgery, carries connotations of increased safety that are not necessarily supported by the existing data [12].
Surg Clin N Am 84 (2004) 717–734
F. Fausto Palazzo, MS, FRCS(Gen),
Leigh W. Delbridge, MD, FACS*
Department of Surgery, Royal North Shore Hospital, Sydney 2065, NSW, Australia
Leigh W. Delbridge, MD, FACS*
Department of Surgery, Royal North Shore Hospital, Sydney 2065, NSW, Australia
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