March 15, 2014- By Steven E. Greer, MD
In 2009, Atul Gawande, MD, MPH and his large international team published in the New England Journal of Medicine (NEJM) an observational study that showed a significant reduction of death and “complications” after non-cardiac surgery. The World Health Organization (WHO) created the checklist used in the NEJM paper. After this non-randomized, non-controlled, observational study was published, entire nations adopted the surgical checklist system.
Now, in 2014, a population study drawing from Ontario surgical patient data, published in the NEJM, showed no significant benefit from the widespread adoption of the same WHO surgical safety checklist that Dr. Gawande popularized. This study was also observational, but it was stronger than the 2009 Gawande study in that it included the entire population within a region.
What went wrong? Read more »
Anesthesiology, Biostatistics, Cardiac surgery, Critical care, General Surgery, Harvard affiliates, HHS, Infectious Disease, NEJM, NICE (UK), Op-Ed, Orthopedic surgery/sports, Plastic Surgery, Policy, Preventive Medicine, Spine surgery, Trauma, Vascular Surgery | apples49 | 
November 8, 2014 10:24 pm | 
Comments (0)
Interviewed by Steven Greer, MD
A recent New York Times article concluded that MRI’s are overused when diagnosing sports injuries and lead to unnecessary surgeries. One sports surgeon, and skeptic of MRI’s, scanned 31 healthy baseball pitchers and found “abnormal shoulder cartilage in 90 percent of them and abnormal rotator cuff tendons in 87 percent.” The article went on the explain the financial incentives to the fee-for-service system that pays for the MRI’s and procedures. In many cases, doctors own the MRI’s and receive even greater profit.
Related to this, the New England Journal of Medicine published a landmark study in 2008 by lead author Robert Litchfield, MD, from Ontario. The paper concluded that routine knee arthroscopy was of no benefit for osteoarthritis.
June 26, 2008
Tiger Woods is in the news for yet another scandal. This time, The New York Times has published a report linking him to a Canadian sports medicine doctor who administers banned substances to athletes in order to speed their recovery from surgery. According to the story, Mr. Woods’ sports agents at IMG referred him to this doctor after his knee was recovering too slowly from surgery in 2008.
To be fair to Mr. Woods, the article does not say that he took HGH or steroids, but rather a platelet derived growth factor, Actovegin, to help with ligament and tendon healing. Giving this product a drug name makes it seem more sinister than it actually is. Actovegin is simply bovine platelet-rich fluid made from centrifuged blood. The theory is to collect the growth factors known to speed healing found in platelets. Small centrifuge machines made for the operating room that spin the patient’s own blood are available in the U.S. now and sold by Johnson and Johnson as the Symphony device. Regranex is an actual drug containing Platelet Derived Growth Factor (PDGF), also sold by JNJ.
The HCC interviewed knee surgeon, Sharon Hame, MD, of UCLA, to discuss Tiger Woods specific type of knee surgery and his prospects for a full recovery and ability to beat Jack Nicklaus’ record of 18 majors.
Interviewed by Steven Greer, MD
W. Dalton Dietrich, Ph.D., Scientific Director of the Miami Project to Cure Paralysis discusses two therapies to treat acute spinal cord injury (SCI). First, he discusses the trial recently allowed to proceed by the FDA, funded by company Geron, to use stem cells to treat SCI. It will be the first human trial of its kind in the U.S. In the second part of the interview, he discusses the pioneering work from Miami that uses hypothermia to treat acute SCI.
September 14, 2010
Lee Kaplan, MD, Chief of Sports Medicine at The University of Miami Health System and team doctor for the Miami Hurricanes football team discusses the state-of-the-art methods for surgically repairing torn knee meniscus injuries and for repairing torn ACL’s.
Clifton Page, MD, internists for the Miami Hurricanes football team, discusses the new guidelines for handling the return to play for athletes who have suffered a concussion, testing for sickle cell, and for monitoring heat exhaustion. (See Op-Ed How to Eliminate Head Injury in Football)
Hematology, Internal medicine, Neurology, Neurosurgery, Ohio State University, Orthopedic surgery, Orthopedic surgery/sports, Policy, Spine surgery, Univ Miami | apples49 | August 19, 2011 8:01 am | Comments (0)
September 10, 2008
The New England Journal of Medicine has an important landmark study comparing the use of knee arthroscopy and physical therapy for Osteoarthritis pain. This study was designed to answer controversies of previous negative trials.
