International Journal of Risk & Safety in Medicine - Volume 13, issue 2-3
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The International Journal of Risk and Safety in Medicine is concerned with rendering the practice of medicine as safe as it can be; that involves promoting the highest possible quality of care, but also examining how those risks which are inevitable can be contained and managed.
This is not exclusively a drugs journal. Recently it was decided to include in the subtitle of the journal three items to better indicate the scope of the journal, i.e. patient safety, pharmacovigilance and liability and the Editorial Board was adjusted accordingly. For each of these sections an Associate Editor was invited. We especially want to emphasize patient safety. Our journal wants to publish high quality interdisciplinary papers related to patient safety, not the ones for domain specialists. For quite some time we have also been devoting some pages in every issue to what we simply call WHO news. This affinity with WHO underlines both the International character of the journal and the subject matter we want to cover. Basic research, reports of clinical experience and overviews will all be considered for publication, but since major reviews of the literature are often written at the invitation of the Editorial Board it is generally advisable to consult with the Editor in advance. Submission of news items will be appreciated, as will be the contribution of letters on topics which have been dealt with in the journal.
Abstract: The antianxiety drug buspirone is favored for anxious patients with Alzheimer's disease (AD) because it is less sedating that the benzodiazepine tranquilizers, which may worsen cognitive impairment. But how safe is buspirone for AD patients? A review of medical research finds several prominent similarities between AD pathology and buspirone pharmacology, raising concerns that buspirone could significantly augment cognitive decline in AD.
Abstract: A high prevalence of human T‐cell lymphotrophic virus type I (HTLV‐I) infection has been identified in Israel among the Mashhadi Jewish community originating from northern Iran. In the present study we screened and examined Iranian‐born psychiatric outpatients for the presence of HTLV‐I infection. The presence of HTLV‐I antibodies was determined by the gelatin particle agglutination test, and simultaneously by the Western blot method. Screening of 50 (26 males, 24 females) Iranian‐born Israeli Jewish psychiatric outpatients showed 2% (one of 50) prevalence of HTLV‐I seropositivity. This low rate of HTLV‐I virus carriers in the study population indicates that there is no…association between HTLV‐I infection and psychiatric morbidity in non‐Mashhadi Iranian‐born Jewish psychiatric patients.
Abstract: Background: The treatment of subtrochanteric and unstable pertrochanteric fractures by operative methods is technically demanding and presents a surgical challenge to the orthopedic surgeon. Fixation failure rates of 5–33% have been reported. However, outstanding results (98% healing) have recently been reported in a large series of 90 fractures treated by one surgeon using an intramedullary Gamma nail. In our department, these fractures are treated by many different surgeons with different levels of surgical training. The aim of this study was therefore to assess our experience with intramedullary fixation of peritrochanteric fractures. Methods: Between January 1998 and December 1999, a…total of 37 peritrochanteric fractures were treated with intramedullary fixations. There were 25 women and 12 men. The average age of the patients was 79 years. The 37 operations were performed by 18 different surgeons! (9 registrars and 9 senior registrars or consultants). Results: Two patients were lost to follow‐up. The overall 6 months fixation failure rate was 8/37=22%. The fixation failure rate among survivors at 6 months was 8/20=40%. The 6 months mortality rate was 17/37=46%. Conclusions: It may be wise to refer patients requiring intramedullary peritrochanteric surgery to a specialist.
Keywords: Peritrochanteric fractures, hip, subtrochanteric, intramedullary nail
Abstract: This paper discusses unresolved key problems in social sciences research and publishing. Researcher bias can lead to the publication of studies with highly questionable conclusions, which can impact adversely on important social topics (e.g., the influence of heredity on intelligence, criminality). Outright fraud occurs in science, and social sciences in particular . To help counter the prevailing publication bias in research, four editorial suggestions for scientific reporting are proposed: (1) Before the work starts, investigators would be required to submit a written description of their research methodology. An international social sciences evaluation registry would be created to monitor research activity.…(2) The Editor's decision about whether to publish a research study would be based on a paper that omitted the results and conclusions sections. These sections would be included in the published paper after an editorial decision was made. (3) With these appropriate scientific safeguards, researchers would also be required to provide raw data to other interested scientists, especially when the study is socially important, or is difficult to replicate. (4) Journal Editors who greenlight socially relevant studies would provide extra publishing space to people whose views differ significantly from the principal investigators. Bias and distortion cannot be completely eliminated from the scientific publication process. Adoption of these four proposals, however, would reduce scientific reporting problems such as data dredging and the dissemination of unsupported conclusions, and would also help to reduce fraud. Such adoption would eventually lead to the publication of improved scientific research in the social sciences.
Abstract: An international meeting with wide multidisciplinary participation was convened to define the case for direct reporting by consumers of suspected, supposed or proven adverse reactions to medicines; the meeting was structured to provide participants with the tools and the inspiration needed to establish systems that capitalise on user experiences. Participants included experts from the medical and pharmaceutical professions, drug regulatory authorities, the consumer movement and the World Health Organization. The participants examined experience with such schemes in various countries to date, and the role of such approaches in complementing existing professional‐based systems for the reporting of supposed adverse drug…reactions.
Abstract: One third of the world's population lacks access to essential drugs. In the most impoverished parts of Africa and of Asia more than half the population do not have access to such drugs (WHO, 1999). Many effective remedies are and have been for many years out of reach of the people in developing countries. Because of globalization and new international trade rules the situation may even get worse in the near future. Globalization demands for new approaches to protect and further the basic human right to access to health care.
Abstract: Patent rights establish a price level for medicines that makes them unaffordable for the majority of the people in the world. This paper presents some main consequences of the influence of patents on the markets for drugs, and provides some economic arguments that might be useful in the discussion of patent rights. Patents for essential medicines have unacceptable social short run effects. Arguments that in the long run they provide incentives to promote invention seem uncertain and poorly justified. A system of compulsory licensing inside the WTO TRIPS agreement will work better. The paper is not the result of original…research by the author, but it attempts to assist in understanding certain of the economic arguments which are advanced in favour of patent rights, and to consider how such rights influence consumers of medicines.