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Re: Should David Bowie have gone public?

Posted in Diabetes at Sat, 13 Feb 2016 03:38:10

Joey Rio

Posts: 985
Joined: 13 Apr 2011

In Response to Re: Should David Bowie have gone public?:[QUOTE]

We seem to be agreeing too much, Sken!  I hope this suggestion asn't another Guardianista's, because no one has a duty to "use their cancer" to do anything, in the public interest or not.

Bowie seemed to me to have devoted his last days as he spent his life, to performance by making his last album, very much in his own way, one that we would all wish to follow.

John

Posted by John D[/QUOTE]

Dear John:

Was David Bowie a Diabetic subject???

If not, what is this post doing at this niche in doc2doc? Is this because he was a celebrity??? If so, please send this post to Odysseus in Australia!!! 

Joey

 

Re: High exercise levels do not require calories?

Posted in General clinical at Fri, 12 Feb 2016 22:09:28

Joey Rio

Posts: 985
Joined: 13 Apr 2011

In Response to Re: High exercise levels do not require calories?:[QUOTE]

Exercise is a good technique to burn calorie, but if you will know that it also keep you far from anxiety, headache and from disease.

Posted by CAUrgentCare[/QUOTE]

Hello CA:

Always great seeing you back here!

Joey

Re: To discharge or not

Posted in Cardiology at Fri, 12 Feb 2016 21:53:48

Joey Rio

Posts: 985
Joined: 13 Apr 2011

In the clinical scenario, albeit not said about the age or diabetes status we may consider this as a high risk patient because of his/her recent past history of CAD, and even with atypical chest pain, suboptimal anti-anginal therapy and negative troponin I would (Suggest=Shared Decision-Making) to admit this person and repeat next morning EKG, and troponin, because when dealing with probability there is always a "grey zone". If EKG&troponin both repeatedly Negative I would propose to discharge this person home.

Never mind about week-end and other peripherals....

 

PS: Dear Heartfelt; Have missed you in the SPRINT trial discussion started here by Pat Lush.

All Best,

Joey

Re: Doctors strike - have your views changed?

Posted in Careers at Fri, 12 Feb 2016 17:45:21

John D

Posts: 3937
Joined: 01 Feb 2010

But Sken, the question is not if doctors should work on Saturdays, at whatever scale of pay, but if more of them should (and Sundays, of course, that IS the Hunt Plan - 24/7 NHS, remember?     Possibly not so bad for consultants in some specialties, much worse for others, but when the shift system means that trainees are resident for part of weekends than a one-in-whatever would indicate, then this will make family life for them even worse, and mean that they will be at work for more days than at present.

John

Re: Is fertility a human right?

Posted in Medical ethics at Fri, 12 Feb 2016 14:19:57

sken

Posts: 1253
Joined: 13 Oct 2009

John D - not the best of essays. Warnock is better. It has always seemed to me that the driving force behind some of those wanting a child reflects their hierarchy of wants and is often not an absolute priority over other wants. As such I see a limited approach to NHS service provision but would allow for a well regulated private sector.

The problem which is beginning to emerge is the clash between fertility as a religious obligation - one might say weapon - and the failure of Society to be unable to accept any idea of formal limitation on family size. Think what is happening in Israel. The Chinese recognised the problem but their attempted solution was inappropriate and overextreme - and has been modified.

Even more naive is the idea that we need more and more young folk to look after the old - every time I hear this there seems to be no understanding that these folk will grow old too. Perhaps we need synths or robotic careers with implants to be sympathetic to the needs of the very elderly beyond that of mere mortals?

Re: Zika and the Rio Games

Posted in General clinical at Fri, 12 Feb 2016 12:15:41

John D

Posts: 3937
Joined: 01 Feb 2010

Thank you, CAUrgentCare!

    For anyone not a foetus, Zika seems to be a flu-like illness, with no (?) common complications.   So the concern is only for the foetus,  What do we know about the association?   This report from CDC http://www.cdc.gov/mmwr/volumes/65/wr/mm6503e2.htm finds that in the past Brazil had "approximately 0.5 cases per 10,000 live births" whihc was thought to be an under-report, with a true rate of 1-2/10K.    In only the second half of 2015, 20/10K have been reported, but that no previous head circumference records were made and there had been no laboratory confirmation of Zika infection in the mothers or infants, so that bias is inevitable.   As usual, and as the BMJ bans, more data is needed.

But that didn't help me make up my mind - the Games should continue.    Zika WILL spread to the other parts of the world where transmitting mosguitoes live, the Games might let it do so a bit quicker, that's all.

John 

 

Re: Who goes first?

Posted in General at Fri, 12 Feb 2016 11:31:43

John D

Posts: 3937
Joined: 01 Feb 2010

Joey,

You will be in London this August!  But I'm in Rio at the Olympics!

All of August and into September, for the Paralympics.  Gosh, ships that pass in the night and all that.   If you were to be back home, I wouwld LOVE to meet you!

John

 

Re: "is hydroxycholorouine is used in T2DM?.What are the S/E its dose?"

Posted in Diabetes at Fri, 12 Feb 2016 05:15:43

Joey Rio

Posts: 985
Joined: 13 Apr 2011

In Response to "is hydroxycholorouine is used in T2DM?.What are the S/E its dose?":[QUOTE]

                             TO        DR DIABETES -in a recent conference one of the faculty is presenting the use of hydroxy chlorouine in T2DM..Can you give references for the use of this drug in T2DM.Please focus on this new molecule .

Dr VALLURI RAMARAO DNB(FAM -MED)

Posted by valluri[/QUOTE]

Hello Dr. Valluri:

Apologies for coming so late here. These have been crazy days in Brazil with ZIKA Virus and Carnaval Holidays. And many thanks for your quite interesting and insightful question. Indeed. We Live and We Learn at Doc2Doc! 

HYDROXICHLOROQUINE Is a Patented and Effective Anti-Malarial Drug!

It is In the List of Essential Medicines of the World Health Organization. It is also an anti-rheumatic drug. But I did not know that it had also anti-diabetic properties! It is a pity that such a cheap drug had never been studied in larger or longer-term trials that I´m aware of!

IT IS STILL QUITE EFFECTIVE IN MALARIA!

Just to start with here goes the LINK to Wikipedia: https://en.wikipedia.org/wiki/Hydroxychloroquine

Thanks also Dr. Diabetes and Dr. Chid for your valuable inputs!

All Best,

Joey

 

Re: MRCP Part 1 practice question from Onexamination: spastic paraparesis

Posted in General clinical at Fri, 12 Feb 2016 03:30:08

Dr.Chid

Posts: 798
Joined: 21 Feb 2012

In Response to Re: MRCP Part 1 practice question from Onexamination: spastic paraparesis:[QUOTE]

albunocytologic reversal is occur  Gullian Barre's syndrome  which is rapidly progressive  flaccid paralysis secondary to perpheral nerve affection following upper respiratory tract infection,GI infection.


Posted by TDGS[/QUOTE]

Sir,

Thank you.

 

 

Re: Do you have enough information about the Zika virus?

Posted in BMJ at Thu, 11 Feb 2016 19:20:25

Joey Rio

Posts: 985
Joined: 13 Apr 2011

In Response to Re: Do you have enough information about the Zika virus?:[QUOTE]

Doctors should know what types of mosquitos carry Zika and how else it is spread. They should know signs and symptoms and the period for onset. They should know what other diseases those mosquitos carry and if they have those types of  mosquitos in their jurisdiction. They should be sure to ask symptomatic or worried patients where else patients have been. I suggest contacting local mosquito control authority as well as public health epidemiologist with expertise in vector borne diseases. If physicians fail to order appropriate lab tests, cases will go undetected. We should all me acutely aware of mosquito borne diseases, what types of mosquitos carry which viruses, symptoms, diagnostic tests and treatment to prevent death and suffering. We should admonish patients to protect themselves and their loved ones adequately to minimize exposure and risk. 

Posted by Lsnow[/QUOTE]

I don´t  know who you  are. But I have treated patients with THREE full developed episodes of DENGUE, am not a still in-training junior doctor, and have the knowledge of the mosquitos epidemiology&pathobiology. Having said that, I have the right to expect a better job from WHO authorithies, as well as, the government (Not Only Doctors) authorithies where I live.

The audience of doc2doc is a highly connected one. With all my respect, maybe you should take another look at the results of the above poll.

Sincerely,

Joey

 

Re: Your first rotation as a junior doctor

Posted in Student BMJ at Thu, 11 Feb 2016 17:39:20

Poltor

Posts: 303
Joined: 29 May 2013

My experience was similar to that of Sken.

First job:  I was available 24/7 with a half-day off per week and 1 week-end in 3 off.

I was doing General Medicine, Paediatrics and 1 night per week on Casualty - also 1 week-end in 3 on Casualty (My opposite number doing Gen Med and Geriatrics) covered while I was on Casualty and vice- versa.

The set-up was 2 Consultants for General Medicine and Geriatrics, 1 consultant for Paediatrics, 1 registrar and the 2 House Physicians.

Loved every minute of it.

Second job:  Orthopaedics at my teaching hospital with 3 consultants, a tutor, a senior registrar and a junior registrar with the luxury of an attached student on the 'firm'.

Enjoyed every minute of that too.

Dates - February 1964 to January 1965.

Re: Cardiology Quiz

Posted in Cardiology at Thu, 11 Feb 2016 17:33:46

TDGS

Posts: 2
Joined: 11 Feb 2016

subarachinoid hemorrage is the most likely diagnosis.

it is good if we do cardiac enzyme to rule out ischemia

Re: Junior doctors’ strike February 2016: Live blog

Posted in BMJ at Thu, 11 Feb 2016 13:48:31

Johann Malawana

Posts: 6
Joined: 15 Oct 2015

Junior doctors cannot and will not accept a contract that is bad for the future of patient care, the profession and the NHS as a whole, says BMA

(issued Thursday 11 Feb 2016)

Commenting on the announcement by the Government to impose a new contract on junior doctors in England, Dr Johann Malawana, BMA junior doctor committee chair, said:
“The decision to impose a contract is a sign of total failure on the Government’s part. Instead of working with the BMA to reach an agreement that is in the best interests of patients, junior doctors and the NHS as a whole the Government has walked away, rejecting a fair and affordable offer put forward by the BMA. Instead it wants to impose a flawed contract on a generation of junior doctors who have lost all trust in the Health Secretary.

“Junior doctors already work around the clock, seven days a week and they do so under their existing contract. If the Government want more seven-day services then, quite simply, it needs more doctors, nurses and diagnostic staff, and the extra investment needed to deliver it. Rather than addressing these issues, the Health Secretary is ploughing ahead with proposals that are fundamentally unfair.

“This is clearly a political fight for the Government rather than an attempt to come to a reasonable solution for all junior doctors. If it succeeds with its bullying approach of imposing a contract on junior doctors that has been roundly rejected by the profession it will no doubt seek to do the same for other NHS staff.

“It is notable that the rest of the UK has chosen a different, constructive path on junior doctors’ contracts with only the Health Secretary in England choosing imposition over agreement.

“The Government’s shambolic handling of this process from start to finish has totally alienated a generation of junior doctors – the hospital doctors and GPs of the future, and there is a real risk that some will vote with their feet.

“Our message to the Government is clear: junior doctors cannot and will not accept a contract that is bad for the future of patient care, the profession and the NHS as a whole, and we will consider all options open to us.”

Ends

Hunt’s full statement copied below.

https://www.gov.uk/…/jeremy-hunt-updates-parliament-on-the-…

Secretary of State
Mr Speaker, nearly 3 years ago to the day the government first sat down with the British Medical Association (BMA) to negotiate on a new contract for junior doctors. Both sides agreed that the current arrangements, drawn up in 1999, were not fit for purpose and that the system of paying for unsocial hours in particular was unfair.
Under the existing contract doctors can receive the same pay for working quite different amounts of unsocial hours; doctors not working nights can be paid the same as those who do; and if 1 doctor works just 1 hour over the maximum shift length it can trigger a 66% pay rise for all doctors on that rota.
Despite the patent unfairness of the contract, progress in reforming it has been slow, with the BMA walking away from discussions without notice before the general election. Following the election, which the government won with a clear manifesto commitment to a 7-day NHS, the BMA Junior Doctors Committee refused point blank to discuss reforms, instead choosing to ballot for industrial action. Talks did finally start with the ACAS process in November but since then we have had 2 damaging strikes with around 6,000 operations cancelled.
In January I asked Sir David Dalton, Chief Executive of Salford Royal, to lead the negotiating team. Under his outstanding leadership, for which the whole House will be immensely grateful, progress has been made on almost 100 different points of discussion, with agreement secured with the BMA on approximately 90% of them. Sadly, despite this progress and willingness from the government to be flexible on the issue of Saturday pay, Sir David wrote to me yesterday advising that a negotiated solution is not realistically possible.
Along with other senior NHS leaders and supported by NHS Employers, NHS England, NHS Improvement, the NHS Confederation and NHS Providers, he has asked me to end the uncertainty for the service by proceeding with the introduction of a new contract that he and his colleagues consider both safer for patients and fair and reasonable for junior doctors. I have therefore today decided to do that.
Tired doctors risk patient safety, so in the new contract the maximum number of hours that can be worked in 1 week will be reduced from 91 to 72; the maximum number of consecutive nights will be reduced from 7 to 4; the maximum number of consecutive long days will be reduced from 7 to 5; and no doctor will ever be rostered on consecutive weekends. Sir David Dalton believes these changes will bring substantial improvements both to patient safety and doctor wellbeing.
We will also introduce a new Guardian role within every Trust, who will have the authority to impose fines for breaches to agreed working hours based on excess hours worked. These fines will be invested in educational resources and facilities for trainees.
The new contract will give additional pay to those working Saturday evenings from 5pm, nights from 9pm to 7am, and all day on Sunday. Plain time hours will now be extended from 7am to 5pm on Saturdays. However, I said the government was willing to be flexible on Saturday premium pay and we have been: those working 1 in 4 or more Saturdays will receive a pay premium of 30%, that is higher on average than that available to nurses, midwives, paramedics and most other clinical staff. It is also a higher premium than that available to fire officers, police officers or those in many other walks of life.
Nonetheless it does represent a reduction compared to current rates, necessary to ensure hospitals can afford additional weekend rostering. So because we do not want take home pay to go down for junior doctors, after updated modelling I can tell the House these changes will allow an increase in basic salary of not 11% as previously thought but 13.5%. Three-quarters of doctors will see a take home pay rise and no trainee working within contracted hours will have their pay cut.
Mr Speaker, our strong preference was for a negotiated solution. Our door remained open for 3 years, and we demonstrated time and again our willingness to negotiate with the BMA on the concerns that they raised. However, the definition of a negotiation is a discussion where both sides demonstrate flexibility and compromise on their original objectives, and the BMA ultimately proved unwilling to do this.
In such a situation any government must do what is right for both patients and doctors. We have now had 8 independent studies in the last 5 years identifying higher mortality rates at weekends as a key challenge to be addressed. Six of those say staffing levels are a factor that needs to be investigated. Professor Sir Bruce Keogh describes the status quo as ‘an avoidable weekend effect which if addressed could save lives’ and has set out the 10 clinical standards necessary to remedy this. Today we are taking one important step necessary to make this possible.
While I understand that this process has generated considerable dismay among junior doctors, I believe that the new contract we are introducing - shaped by Sir David Dalton, and with over 90% of the measures agreed by the BMA through negotiation - is one that in time can command the confidence of both the workforce and their employers.
I do believe, however, that the process of negotiation has uncovered some wider and more deep-seated issues relating to junior doctors’ morale, wellbeing and quality of life which need to be addressed.
These issues include inflexibility around leave, lack of notice about placements that can be a long way away from home, separation from spouses and families, and sometimes inadequate support from employers, professional bodies and senior clinicians. I have therefore asked Professor Dame Sue Bailey, President of the Academy of Medical Royal Colleges, alongside other senior clinicians to lead a review into measures outside the contract that can be taken to improve the morale of the junior doctor workforce. Further details of this review will be set out soon.
Mr Speaker, no government or health secretary could responsibly ignore the evidence that hospital mortality rates are higher at the weekend, or the overwhelming consensus that the standard of weekend services is too low, with insufficient senior clinical decision-makers. The lessons of Mid Staffs, Morecambe Bay, and Basildon in the last decade is that patients suffer when governments drag their feet on high hospital mortality rates – and this government is determined our NHS should offer the safest, highest quality care in the world.
We have committed an extra £10billion to the NHS this Parliament, but with that extra funding must come reform to deliver safer services across all 7 days. That is not just about changing doctors’ contracts: we will also need better weekend support services such as physiotherapy, pharmacy and diagnostic scans; better 7-day social care services to facilitate weekend discharging; and better primary care access to help tackle avoidable weekend admissions. Today we are taking a decisive step forward to help deliver our manifesto commitment, and I commend this statement to the House.

 
Health Secretary announces introduction of new junior doctors’ contract.
GOV.UK
 
 

 

Re: Mixing politics with medicine.

Posted in General at Thu, 11 Feb 2016 11:15:05

Joey Rio

Posts: 985
Joined: 13 Apr 2011

It would be Great having Kirked brought here into this debate with us. Could you please invite him John?

Sincerely,

Joey

"We have assumed the challenge to unionize" (...)

Posted in News & media at Thu, 11 Feb 2016 11:05:47

Jorge Ramirez

Posts: 49
Joined: 09 Jan 2015

A few weeks ago I wrote some posts about labour conditions for doctors in Colombia as well as the attention of doctors in this country to the events taking place in the UK.

http://bit.ly/1mulzYm

http://bit.ly/1mulBzH

http://bit.ly/1mulEeP

Last year, several doctors trade unions in Colombia obtained legal approval. General practitioners created SIMUC (Sindicato Médicos Unidos de Colombia) on April 2015, on the meanwhile, each one of the medical specialities had created their own union. I believe that one of the most remarkable aspects to highlight about these newly created doctors unions in Colombia is the fluent communication between Colombian doctors to do written and spoken statements, individually and collectively, about the current situation of the health care system in our country. For example:

"Trade unions of general practitioners and specialists from Colombia: Open Letter

The labour unions of general practitioners and specialists from Colombia due to the serious and bothersome situation deteriorating our health care system, publicly denounce the following issues:

1. The purpose of the health care system is to cover the entire population with services provided under the principles of quality and opportuneness has not yielded the expected results.

2. The well-known limited flow of financial resources on behalf of the national government and health insurance companies (EPS – Health Promoting Entities) have limited payment of obligations to all the stakeholders in our national health care system. As a result, several hospital services such as emergency units and surgical rooms are now closed, many beds in hospitalization rooms have been lost. It is unnerving, disturbing and inappropriate the complete closure of pediatric services by hospitals and clinics (IPS) as well as by the EPS. This situation has happened without any anticipation of the consequences secondary to the improvisation by governmental authorities at local (i.e., cities, municipalities, and departments) and national level (i.e., health ministry).

3. Closure of hospitals, clinics, and health insurers have caused a widespread deterioration in the delivery of medical services, adversely affecting the well-being and the overall health status of our patients, even to the point of causing death in some unfortunate cases by provision of health care services with are untimely, ineffective, and delivered in shoddy installations with an insufficient number of well-trained of medical professionals necessary to do the job consisting on the primary, secondary, and tertiary prevention of human illnesses.

4. The overcrowding of installed capacity causes uncontrollable events resulting in a high psychosocial risk factor to do our medical profession, doctors are not only exposed to lawsuits or investigations of any kind (e.g., civil, criminal, ethical nature, disciplinary, etc) but also to physical and verbal abuses by grievers. Faced with this situation the EPS and IPS have not taken any corrective measures to guarantee their employees and contractors with the least guarantees of safety and well-being at the workplace, it can even be interpreted as setting up a form of labor deprotection steps, this situation have not been yet acknowledged by the ministry of labour without any intervention on behalf of healthcare workers across the country."

(Translation of points 5-8 of the letter in a consequent post - original letter in Spanish here: 
https://sindicatomedicocolombiano.wordpress.com/(...)/carta-abierta/)

Here is a video in Spanish with English subtitles showing the president of SIMUC speaking at the clinic of Champagnat - Saludcoop Cali, Colombia. 

https://www.youtube.com/watch?v=JWyTKsqlRd4&feature=youtu.be

It will be very interesting to exchange ideas about some obscure situations that doctors face every day (e.g., violence, unemployment, reprisals from whistleblowing, etc) and how unions can effectively protect us.

 

Re: "market is flooded with gliptins we need to know the various aspects of this molecule.which gliptin is uniformly indicated"?

Posted in Diabetes at Thu, 11 Feb 2016 04:31:38

Joey Rio

Posts: 985
Joined: 13 Apr 2011

Well, let´s day more on a clinical practice long-term scenario...........outside of clinical trials, the gliptins still are at least to me a bit suspicious regarding pancreatitis and heart failure.

Let´s beware that that are no trials out of pharmaceutical companies support.

In summary, even Sitagliptin, the most studied one, is not completely trustworthy to me in the longrun!

All Best,

Joey

Re: Should UK junior doctors strike over new contract plans?

Posted in Careers at Thu, 11 Feb 2016 01:25:43

d0ctor

Posts: 1
Joined: 11 Feb 2016

It is true that politicians do not care about doctors career or patients safety. What doctors must understand is that a poorly managed Healthcare will eventually kill more patients and degrade more doctors. 

Inaction will guarantee a slow, painful and miserable future for doctors. 

Strikes will bring drastic resolution and meaningful working criteria. 

Politicians are not as powerful as they bluff. The electoral process is of no use to doctors who are "always happy " with the status quo.

If doctors fail to understand the above concept, nobody but doctors will be to blame for the ensuing misery and degrading Healthcare. Take a leaf from doctors around the world for once.

What your patient is thinking: Help make miscarriage less devastating

Posted in General clinical at Tue, 09 Feb 2016 13:12:28

Sabreena

Posts: 1530
Joined: 07 Sep 2009

In the latest What your patient is thinking piece from The BMJ, an anonymous author describes how it felt being told she'd had a miscarriage during her 12 week scan, waiting for the doctor in a waiting room full of expectant mothers, and responding to the doctor's curiosty about her job.

"Finally, after about four hours (it was a busy day) a young doctor led me into her office to talk through my options for how to end the pregnancy. I was trying to remain calm and not show how dreadful I was feeling so I smiled at her. She asked me what I did for a living. I was a radio producer, I told her. “Oh, that’s interesting”, she said, “is it hard to get your ideas made into programmes?” I tried to answer, but my mouth was dry and I was on the brink of tears. What I really wanted at that moment was someone who would reassure me, perhaps ask me if I wanted a hug."

Advice from the author: It matters where you wait;  a word of sympathy or silence is more welcome than small talk.

The author's experience occurred 13 years ago. Is communication/support following miscarriage different now?

As this is based on a patient-authored piece, The BMJ will be inviting patients to comment here. Please bear this in mind when responding.

Re: Just why does the Guardian fail to get the message?

Posted in Diabetes at Tue, 09 Feb 2016 10:56:16

sken

Posts: 1253
Joined: 13 Oct 2009

PS “We’re ruining the NHS because we’re not being clear enough about what it’s for. Meeting popular demand does n’t  solve problems. It simply stokes more demand – and not all demand is reasonable”

Margaret McCartney  BMJ

One might add that politicians look to meeting public demand but newspapers also have a responsibility to lead  informed debate ?

And to-day we have : one-to-one sun exposure risk advice for everyone. Just as an extra service for underworked GPs to provide.... 

Re: Clinical question of the week: Gout in a patient with heart failure

Posted in General clinical at Tue, 09 Feb 2016 06:10:02

Dr.Chid

Posts: 798
Joined: 21 Feb 2012

http://www.bpac.org.nz/BPJ/2007/September/docs/bpj8_gout_pages_9-18.pdf

Are CQC inspections too stressful? Should they be abolished?

Posted in Careers at Mon, 08 Feb 2016 14:40:58

Sabreena

Posts: 1530
Joined: 07 Sep 2009

GPs at the BMA’s conference of local medical committees in London last week called on the BMA to campaign for the abolition of general practice inspection in England by the Care Quality Commission (CQC).

 

 

This piece from The BMJ reports that GPs are “living in a climate of fear because of inspections.” And that “80% of practices in a survey found preparing for CQC inspections very stressful,” and “80% of GPs said that they were more likely to want to leave the profession as a result.”

 

 

Re: UK response to Assange judgement is depressing

Posted in Careers at Sun, 07 Feb 2016 17:40:09

Maxim

Posts: 559
Joined: 14 Dec 2010

I can't see how this can end.  Both the UK and Sweden are bound to consider extradition to the US (Mysteriously it doesn't seem to apply in the other direction, at least for the UK).  The US is never likely to drop its wish to get Assange there, in which event he will undoubtedly disappear for a very long time.

I'm not quite sure why the US hasn't simply asked the UK to extradite Assange there.  Perhaps the three countries involved have calculated that public opprobrium would be less in Sweden if he could first be charged and perhaps convicted there for rape.  Sweden is reportedly not allowed to say it wouldn't extradite Assange.  Neither presumably is the UK although I've read that extradition from Sweden would require permission from the UK as well.  I guess that could be hushed up or made opaque.

Extradition and rendition seem different to me only insofar as the latter is unlawful and the Government, of the country from which the person is kidnapped, can pretend they didn't know anything about it.  Ring any bells?

It's all too easy for Governments to say they support whistleblowing whilst making exception for anything that might embarrass politicians or expose lies.  I don't know, and would never be allowed to know, whether Wikileaks has been of net benefit or harm to the public but it seems to me what we need is the sort of perfect lie-detecting software that would be applied to all public pronouncements by politicians.  The sort of device for which its inventor had to be murdered in the 'entirely fictional' drama 'London Spy'.

Re: New to doc2doc? Introduce yourself here...

Posted in General at Sat, 06 Feb 2016 23:49:26

John D

Posts: 3937
Joined: 01 Feb 2010

However academic or esoteric, I'm sure you will find something of interest here, Daverk.

Welcome to D2D, and please start by telling us of your research?

John

 

Re: When your blood is not right

Posted in General clinical at Sat, 06 Feb 2016 22:13:03

autodidact

Posts: 4
Joined: 26 Jan 2016

If I may take a stab at this one with my IT troubleshooting skills... (a type of "woodoo" sometimes)

- Both abnormalities are connected to the patient's bone marrow - erythrocytes and leukocytes. I am tempted to believe that the problem is in her bone marrow, rather than iron levels.

- Family history of cancer, and her own history of fibroadenoma. While this is not widely accepted yet, there is a growing body of evidence that cancers are connected to presence of some viruses such as EBV, and other (herpes) viruses. Considering how viruses work, dare I say that viruses may even be recognized some day as the most common cause of cancers?

- Her symptoms seemingly came out of nowhere. Or did they? She already did have other symptoms such as allergies and probably other things that are not mentioned here as they could be considered sub-clinical in nature (e.g. fatigue, poor memory or concentration, prone to infections etc).

All this leads me to believe that the patient suffers from an infection, which has very likely reached her bone marrow. It could very well be the same infection that caused other health troubles in her family. I would like to know where her family is from, and then I would compare her family's history to geographical distribution of some of these infections that are easily missed such as EBV, or one of the mycobacteria, or even fungal infections.

In my view, barring some environmental factor such as chronic exposure to heavy metals or some other toxins, she most likely suffers from a chronic, and until recently - subclinical infection (maybe even co-infections).

ps. One piece of the puzzle may be an infection that is "hungry" for iron, as in many infections, iron is an important virulence factor... Perhaps the connection is not as direct as one would like to think, but a competition for iron may influence her body's ability to absorb it and/or use it.

Re: Patient perspectives - registering trials

Posted in General at Sat, 06 Feb 2016 02:59:18

Jorge Ramirez

Posts: 49
Joined: 09 Jan 2015

Dear Kirked,

Perhaps you might be interested in this information.  

- Over 50% of trials (registered at ClinicalTrials.gov, EudraCT, etc) -> not published.

- Unregistered trials: a lot.

Kind regards, 

Jorge

http://www.bmj.com/content/347/bmj.f1881/rr/762606

http://www.bmj.com/content/348/bmj.g1888/rr/763197