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Disease is Never Fatal (Health)
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Ishmael


In: Toronto
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Mick Harper wrote:
Policy in Britain is irrelevant if Darwinism is correct.


But that's just it. Darwinism isn't correct and it's the Darwin paradigm that's leading everyone to intuit that super-bugs are evolving as a result of exposure to antibiotics.

Microorganisms are populations of genes. There are no new mutations occurring that enable these populations to survive exposure to antibiotics. All that is happening is that existing individual organisms within given populations have an immunity. The antibodies kill off most but not all of their brothers organisms, meaning that the population makeup changes to favour the resistant strains while exposure to the toxin continues and shortly thereafter.

However, once the germ population is no longer in the presence of the antibiotic, the population distribution returns to normal, because that "normal" happens to be the gene distribution best adapted for the general environment.
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Mick Harper
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In: London
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I entirely agree with all this of course but I take issue with the implied optimism of your last paragraph. We can assume that the non-resistant strains are indeed superior to the resistant ones (since they were dominant before the advent of antibiotics) and that in a post-antibiotic environment they will once again become prevalent.

But how will this help us? We will merely return to the days when all strains (resistant and non-resistant) kill us in our zillions. If we don't want to return to this situation I can see no alternative to developing new antibiotics to take care of the resistant strains while our present ones continue to deal with the non-resistant ones.

What is your solution to this situation?
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Grant



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What is your solution to this situation?


Worldwide ban on penicillin for five years. The bugs would return to their pre-penicillin state and then the drugs will work again.
We could then ban another antibiotic for five years etc etc.
It would be like fields lying fallow in the olden days.

(Not my original idea by the way. I saw it years ago somewhere)
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Grant



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Oops sorry! Just noticed that Ishmael said the same thing a few pages back!
Now he's going to accuse me of nicking his ideas again
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Mick Harper
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Whoever said it, it's complete mullarkey. In the first place what World Authority is going to enforce a worldwide ban? Everyone and his dog can make penicillin and since it's still effective for most people in most places it will be universally made and universally sought out. Me, I'll order mine over the internet.

But OK so some World Policeman manages to enforce the ban. So what? Forget the millions who might die from treatable diseases during the five years, what will happen to penicillin itself? Yes, sure, it will be marginally more effective but since the resistant strains are still hanging around in the wings they will start to return as soon as the ban is over. Now what? Another five year moratorium?

The point about the fallow system is that you deal with a large problem (soil exhaustion, pests) by accepting a less large solution, a twenty-five per cent cut or whatever in output. It's called an investment strategy. 'Investing' in antibiotic moratoriums is just a bad play.
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Ishmael


In: Toronto
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Grant wrote:
Oops sorry! Just noticed that Ishmael said the same thing a few pages back!
Now he's going to accuse me of nicking his ideas again


I didn't say the same thing. Because it's not necessary to ban antibiotics world wide---just ban them within the key space. You allow an individual field to lie fallow--you don't provoke a famine to save next year's crop!
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Ishmael


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Mick Harper wrote:
...but since the resistant strains are still hanging around in the wings they will start to return as soon as the ban is over.


First. It's not a world-wide ban. You just stop using a hospital as a hospital for a short time. Allowing the bacteria within the building to reset.

Second. There are no "resistant strains." This is an artifact of darwinistic thinking. Nothing has "evolved". Antibiotics have the effect of selecting out existent individuals for survival but even then, they don't transform the entire population---they only alter the percentages. Once the poison is removed, the population returns to its normal state.
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Boreades


In: finity and beyond
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For AEL hypochondriacs and contrarians alike, some heartening news.

No less than 12 doctors at the famous Mayo Clinic have been busy analysing how often published and authoritarian medical advice turns out to be rubbish.

A Decade of Reversal: An Analysis of 146 Contradicted Medical Practices

Results

We reviewed 2044 original articles, 1344 of which concerned a medical practice. Of these, 981 articles (73.0%) examined a new medical practice, whereas 363 (27.0%) tested an established practice. A total of 947 studies (70.5%) had positive findings, whereas 397 (29.5%) reached a negative conclusion. A total of 756 articles addressing a medical practice constituted replacement, 165 were back to the drawing board, 146 were medical reversals, 138 were reaffirmations, and 139 were inconclusive. Of the 363 articles testing standard of care, 146 (40.2%) reversed that practice, whereas 138 (38.0%) reaffirmed it.
Conclusion

The reversal of established medical practice is common and occurs across all classes of medical practice. This investigation sheds light on low-value practices and patterns of medical research.


http://www.mayoclinicproceedings.org/article/S0025-6196(13)00405-9/abstract
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Boreades


In: finity and beyond
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Don't try this at home.

In a Guiness-Book-Of-Records kind-of-way, you might have thought that Harold Shipman's record was hard to beat.

The (Shipman) inquiry identified 218 victims and estimated his total victim count at 250


But it looks like someone(s) in Gosport is having a good try at beating the record. Also using diamorphine.

Last week’s monstrously belated report on the Hampshire hospital’s treatment of its patients in the 1990s revealed that at least 450, and probably more than 650, had been killed — sorry, had had their lives shortened — as a result of a policy of attaching them to syringe drivers pumping diamorphine. Diamorphine is medically indicated only when the patient is either in the severest pain or terminally ill, because its notable side effect, when large doses are consistently administered, is respiratory failure. Injections of diamorphine — in 30mg doses — were Dr Harold Shipman’s chosen method of dispatching his patients. But the numbers at Gosport exceed the tally of Britain’s most prolific mass murderer.


You might have assumed that unusually high levels of prescribing of diamorphine would be be easy to detect, given that all NHS prescribing is computer-based. Certainly should cause a red-flag of some kind. But strangely still not the case.

Oh, by the way, AEL-inmates might the ones at highest risk.

The ones most likely to get the treatment appeared to be not the sickest, but the most “difficult”. As the stepson of one of the victims remarked: “If a nurse didn’t like you, you were a goner.” This was clear from the testimony of Pauline Spilka, an auxiliary nurse. After the local newspaper in 2001 reported the complaints by relatives of Gladys Richards, (whose life had been “shortened”), Spilka went to the police. In an interview with Detective Chief Inspector Ray Burt of the Hampshire constabulary, Spilka said: “It appeared to me then and more so now that euthanasia was practised by the nursing staff. I cannot offer an explanation as to why I did not challenge what I saw at that time . . . I feel incredibly guilty.”

Spilka was especially troubled by the fate of an 80-year-old patient (his name is redacted) whom she described as “mentally alert and capable of long conversations . . . able to walk . . . and to wash himself”. He was, however, “difficult”. She told the policeman that this patient was “always making demands” and that “I remember having a conversation with one of the other auxiliaries [Marion] . . . we agreed that if he wasn’t careful he would ‘talk himself onto a syringe driver’.”

So it came to pass: “One day I left work after my shift and he was his normal self. Upon returning to work the following day, I was shocked to find him on a syringe driver and unconscious. I was so shocked and angered by this that Marion and I went to confront the ward manager.” They were told to put a sock in it. Nursing auxiliaries are at the bottom of the chain, without any medical qualifications. What was their word worth, against that of the formidable (and formidably well connected) Dr Jane Barton.
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Mick Harper
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There was a lot of (very) careful ignoral going on with the media reporting as well. The moving light was clearly this Dr Jane Barton whose present whereabouts were always described as 'unknown' -- though whether unknown to the authorities or just to the media was never made clear. [Corrections, please, if this has changed -- I don't read or watch the tabloids.]

Also left vague--and presumably for legal reasons--was the question of intent. If Barton was a Shipman then she was extremely masterly and may never get convicted. Of course manslaughter-by-gross-negligence was canvassed, and if so there will be dozens in the frame. Except possibly Barton herself who can claim clinical judgement. The others can't, they were just following orders which is not a defence if the orders were unreasonable, and everyone seemed to know they were!

Oh, by the way, AEL-inmates might the ones at highest risk

This is One Flew Over The Cuckoo's Nest syndrome. But the whole thing is of consuming interest to AE-ists nonetheless. Truly, orthodoxy is quite, quite mad.
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Boreades


In: finity and beyond
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It's the patients' own fault.

Her husband, Tim Barton, told The Sunday Times in 2002 that she had been under a huge amount of pressure and was severely overworked. “Instead of trying to find a new Harold Shipman, it might be more constructive to ask why a part-time GP was looking after 48 beds,” he said.

“No one has seen any of the letters she sent saying, ‘You cannot keep sending me this number of patients, I cannot cope with this number’.”


Usually, high numbers of patients is blamed on the patients that stay the longest (the selfish bed-blockers). Presumably removing the bed-blockers via diamorphine would be a novel form of ward load management? Not in the manual, or on the training course, but with all that "excessive and increasing burden", maybe some innovation was required. Perhaps "The Management" that kept quiet were fairly happy with the results?

She is married to retired Royal Navy Commodore, Tim Barton, who has previously defended her role in what happened. The couple live in a £700,000 detached home in Gosport, but there was no sign of them on Wednesday, with neighbours claiming they had gone to Menorca. A neighbour said: 'She doesn't have many friends around here. I only know her from seeing her across the street. She's friendly."
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