Swedish Inquiry Finds Top Surgeon, Paolo Macchiarini, Failed to Followup Transplant Patients – NYTimes.com
An investigation in Sweden into a surgeon who is a pioneer in the field of regenerative medicine has found that he committed scientific misconduct by omitting or falsifying information about the conditions of three patients in medical journals.
Dr. Bengt Gerdin, the independent investigator who looked into accusations against the surgeon, Dr. Paolo Macchiarini, said that in several journal papers, including one in The Lancet in 2011, Dr. Macchiarini had “omitted some data and also fabricated or falsified some data regarding the postoperative state of patients” on whom he had performed experimental groundbreaking operations.
The substance of the accusation was that the surgeon had failed to do followup on several patients into whom he had transplanted prosthetic tracheas of plastic treated with stem cells and regeneration drugs. At the same time, he had reported the followup examinations as if he had really performed them. Two of the patients have died, and the third has been stuck in intensive care for almost three years.
The investigation started last fall after four doctors who treated the patients complained that their conditions had never been as good as represented in the papers published about them. Each patient had suffered a severely damaged trachea which, in an experimental operation, Dr. Macchiarini replaced with a plastic trachea implanted with stem cells. The trachea was treated with drugs that promoted regrowth, and, it was hoped, eventually a new trachea.
There have been both tremendous interest and numerous attempts recently to create new organs, to take the place of damaged ones, with stem cells in a plastic scaffolding that supports regrowth and eventual replacement. Animal experiments have so far been very encouraging. The results of Dr. Macchiarini’s surgeries were the subject of several scientific articles, including a positive report in The Lancet in 2011.
There are also complaints that Dr. Macchiarini failed to obtain adequate informed consent from the involved patients for the operations, and that there had not been appropriate ethical review of the procedures. These accusations will be taken up at another level, according to Dr. Gerdin.
There has been some delay because the report by Dr. Gerdin was published only in Swedish, based on the work that Dr. Macchiarini had done at the Karolinska Institute in Stockholm. Some principals have delayed their response until the report is translated into English. The accused doctor has denied all the allegations and blamed other doctors for the problems.
Recently Jeb Bush, the younger brother of ex-president George W. Bush and son of ex-president George H.W. Bush, made a stir in the news by saying that he would have still invaded Iraq “knowing what we know now.” Jeb was forced to dial back on this mis-statement at least twice, but still he failed to tell the truth.
The fact is that we did not invade Iraq based on a mistake. We invaded based on a blatant lie. George W. Bush and his vice president Dick Cheney were dissatisfied with the information that UN weapons inspector Hans Blix was providing, namely that Iraq no longer had any weapons of mass destruction. He was even more dissatisfied when his own CIA told him the same thing. So he set up his own “intelligence” unit within the CIA, operated by Douglas Feith, to cook up stories about “hidden” weapons of mass destruction and ties to al-Qaeda, stories that turned out to be lies.
Even the story that Saddam Hussein tried to have George W. Bush’s father George H.W. Bush assassinated was a lie. The entire incident was made up, yet believed by the media and still believed by many who should know better.
Even if the invasion of Iraq was justified based on the cruelty and brutality of Saddam Hussein, our mismanagement of the country after our successful invasion was not justifiable. We disbanded the Iraqi army and sent its soldiers home with nothing to do and nothing to support them. We destroyed the infrastructure of Iraq during the invasion unnecessarily and we failed to properly rebuild it. We disbursed billions of dollars for rebuilding projects that were misused and diverted into the pockets of crooks in Iraq as well as in the United States. We spent billions of dollars on private security forces who were so trigger happy that some of them were tried for murder in the US because of the public outcry in Iraq. We turned Hussein over to his enemies for a rigged show trial instead of sending him to the United Nations for an International War Crimes Tribunal, partly because that Tribunal could have indicted our own generals and administrators in Iraq. We created secret prisons that tortured and murdered innocent Iraqis. We set up a system of blood money payments to people for turning in their neighbors to be secretly tortured and murdered by an Iraqi secret police that we created and trained.
As a result of our mismanagement of the government of Iraq, a revolutionary terror group that calls itself the Islamic caliphate of Syria and Mesopotamia has arisen to overrun the Sunni parts of Iraq and threaten the Shia and Kurdish parts. The shortsighted lies of people like Paul Wolfowitz who claimed that the invasion would cost less than a hundred billion dollars and take less than a hundred thousand soldiers have been shown up, and the the realities that General Shinseki warned about and was fired for have been proven true. The results have been over a trillion dollars spent and 2.5 million soldiers, including those who spent two or three or more deployments in Iraq and Afghanistan. The results have been unknown hundreds of thousands of dead Iraqis and the destruction of a once viable country.
In the face of these facts, the claim by Jeb Bush that “mistakes were made” has to be one of the grossest understatements of the twenty-first century so far. The possibility that Jeb Bush might become president has to be the most depressing thought of the election of 2016.
A new report states that there has been a loss of 42.1% of honeybees this last year, worse than last year, and the second worst since die-off records have been kept, in 2010. Colony collapse disorder has claimed the lives of more and more honeybees every year, troubling agriculturalists and honeybee keepers. For the first time, summer losses exceeded winter losses.
Normally, honeybee keepers expect to lose ten percent of their bees every year. About ten years ago, losses began to increase, for unknown reasons. Mass deaths have been less in the last few years, but remain very high.
A variety of possible causes have been suggested: the varroa mite, which affects small backyard bee keepers more than commercial growers; neonicotinoid insecticides, which are deadly to bees; and the loss of millions of acres of wildflowers due to intensive farming practices.
The honeybee is in no danger of extinction, but these large losses are causing difficulty in pollinating a large number of commercial crops, which depend on honeybees.
Most importantly, the lack of a clear cause for these massive die-offs of entire colonies is worrying to entomologists and farmers alike.
For more information, check out http://www.nytimes.com/2015/05/14/us/honeybees-mysterious-die-off-appears-to-worsen.html and http://qz.com/107970/scientists-discover-whats-killing-the-bees-and-its-worse-than-you-thought/ which blames the die-off on a combination of multiple insecticides and fungicides.
The latter article mentions that it takes 60% of the honeybee population to pollinate just one crop, almonds; and California grows 80% of the world’s almonds.
Here is a controversial subject: the economy, what is often called a “market economy”, that is, a system in which things are priced by reference to an open market of the top bid by any potential buyer (also known formally as an “auction economy”), which is supposed to be either good (if you are a Republican) or bad (if you are a “left-wing Democrat” although few Democrats would endorse this point of view.)
Thus, a market economy is considered the ideal state of affairs by Republicans, while at the same time there is a strict moral code prohibiting pornography, homosexuality, abortion, and so on.
At the same time, Republicans view Democrats as “secretly opposed” to a market economy, and they are far more equitable in their moral views, tolerating homosexuals, abortions, etc. Democrats would say that they were not opposed to a market economy but would like to have it regulated and abuses prohibited. Republicans shudder at the concept of “regulation.”
What is a “market economy” and how does it supposedly work? First, there is supposed to be a public market in which people offer their products and services for sale and others buy what they wish to and can pay for.
In addition, it appears that, ideally, government would place no restrictions on individual’s ability to corner stock markets, take over corporations, consolidate into monopolies, suppress minimum wages, avoid medical insurance, give out enormous salaries to top executives, and so on. There are many fraudulent enterprises who currently find ways around ordinary taxes by claiming to be religions, and favored corporations such as Halliburton still enjoy privileged access to government construction contracts.
The Democrats and Barack Obama especially have attacked this ideal situation that the Republicans had under Bush. They have instituted an attempt at universal health insurance and some companies have been forced to raise their minimum wages even though the labor market is very soft.
Many of the Democratic reforms are now in the hands of the Supreme Court. It remains to be seen whether the Court will be able to block these changes that the Democrats want. For one thing, the Court could destroy the foundations of the Affordable Care Act (“Obamacare”) by a case it is currently considering and will promulgate this summer. There are numerous other cases in which initiatives of the Obama administration are being attacked by Republican plaintiffs who expect the Supreme Court to derail Obama’s plans. Decisions to come out this summer will tell the tale.
Is coffee associated with the risk of death from all causes? There have been two meta-analyses published within the last year or so. The first reviewed 20 studies, including almost a million people, and the second included 17 studies containing more than a million people. Both found that drinking coffee was associated with a significantly reduced chance of death. I can’t think of any other product that has this much positive epidemiologic evidence going for it.
Despite years of bad press, coffee persists as the most popular beverage for adults. Frequently it is prepared with large quantities of sugar, cream, vanilla, and other flavorings which raise the calorie count from a negligible five calories per serving to 500=750 calories in as much as 24 ounces of liquid. Starbucks, for example, with a white chocolate macchiato in venti size, has 580 calories. These high calorie beverages are obviously not good for the health. But plain coffee has many advantages.
A number of meta-analyses of very large groups of people have shown reduced risk for stroke, cardiovascular disease, heart failure, Parkinsonism, liver and breast cancer, cirrhosis, type 2 diabetes, and improved response to treatment for hepatitis C.
None of these studies are of the double-blind, randomized, case-control or crossover variety that can provide ironclad evidence of causation, but the association of coffee with reduced mortality is so strong that there must be some logical explanation, for example: drinking coffee must be good for you.
There are of course some people who do not react well to coffee, in some cases because of a missing enzyme for the metabolism of caffeine. There are also those who do not like the taste. For the rest, there is no harm and possibly considerable benefit from drinking a few cups of coffee (without sugar) each day.
In the summer after my junior year, I still needed a course to make up for the courses I had missed during the term I was out of school, in the fall of my sophomore year. I didn’t have to take anything specific, I just needed a course. I chose to take first-year Russian, my second choice after rejecting first-year Chinese, for reasons which were discussed in previous posts (see “First Bicycle”, “Ma Mei-ling”, and others.)
I moved in to an apartment in the Yard for the summer; it was normally a two or three person set of rooms, with a big living room and two bedrooms plus a bathroom. I rented a refrigerator because I intended to eat my meals in the rooms instead of using the dining hall to save money. I didn’t get a phone because it was too expensive; the phone company required a large deposit for short-term phone hook-ups, and in those days the phone company was AT&T, known as “Ma Bell”, a monopoly.
One other thing I bought for the summer was a high-velocity window fan, a special model that cost me $30, an exorbitant price in 1973, but worth it in my opinion because it really was a high velocity fan. I remember the name on the fan: Patton, and I saw in later years that the same company made the same model, as well as larger ones, for a long time. The fan required occasional oiling with a 30 weight oil, which I found in 2 ounce squirt bottles at the hardware store.
This fan was a lifesaver because the rooms were on the top floor and it got very hot in the afternoons. I could turn the fan on high and sit in front of it to catch the breeze, and the air it brought in from outside was tolerably cool.
The first day of class, I found about sixteen other students in small classroom with the instructor, a young, bearded Russian, slender and Romantic, with long thin fingers and a long, hooked nose. Like most Russians in the US, he was anti-communist, but he didn’t admit to any Royalist tendencies. He was patient and low key, which was helpful because we spent four hours every morning drilling intensely and repetitively, and the atmosphere sometimes became tense with frustration.
The first week we concentrated on the alphabet, and by the end of the week we were expected to know how to write Russian in longhand. The Russian alphabet has several more letters than the English alphabet, and the familiar letters don’t look exactly like the equivalent English letters. In the evenings I studied for several hours to fix in my mind the necessary writing skills.
We also started on memorizing words and pronunciations in the first week, wasting no time, for we had only a few weeks to learn a year’s worth of introductory Russian.
The rooms were big and empty, with only three beds, study desks, and chairs– no other furniture at all except for the two small refrigerators, the one I rented and the one that just happened to be there. The kids who handled the rental refrigerators knew I had two, but they didn’t care; apparently they had some extras that weren’t needed. The rental service was under the control of the school housing department and they used students to do the lower level work, as part of their work-study program.
I had been offered the choice of taking out a National Defense Student Loan or joining the work-study program; I chose the loans because I didn’t think I’d be able to study and work at the same time. The work-study program used students to clean the bathrooms and halls of all the student houses, to do various menial tasks around the University, to serve food in the cafeteria, and so on. It turned out that by the time I had to start repaying the loan, when I began my residency, I was making enough money so that the $50 a month didn’t matter much.
I had just bought a classic book entitled “Light on Yoga”, by BKS Iyengar, which illustrated and described all the yoga poses. I used the book to introduce myself to yoga; the way the book was organized made this easy by starting with the simplest poses and progressing pose by pose. The illustrations and instructions were clear and complete, and I had no difficulty in replicating the poses, or at least the simple ones.
The living room was perfect for yoga practice, being practically empty of furniture and having large windows all across one wall that let in the sunlight. I used my closed cell foam sleeping mat, the one I had gotten for camping, to sit on and lie down on.
In silence, I repeated the repertoire of poses, ending with the cool down pose of just lying flat on the floor with my hands at my sides. I didn’t have anything to listen to music with, not even a radio, and I didn’t realize at the time how much the silence could affect me.
The only visitor I had was a friend from my club, the Spee Club, a club devoted to a more oddball set of students, or at least they seemed more simpatico to me. This friend was a dealer, but not a very good one; he spent too much time drinking to be very successful at pushing drugs. I didn’t buy anything from him because I didn’t have any money, but he was generous with samples and seemed to think that I was a cool guy to associate with.
One evening he showed up at my rooms with a package in a brown paper shopping bag. He asked me if I would mind keeping this bag in my closet for a few days. I didn’t have to ask him what was in the bag. He explained that he was staying at the club and he didn’t want to take a chance on being discovered by the club steward, who was a nosy and conservative local who couldn’t be trusted. My friend was already suspect to the workers at the club; he had been warned after being discovered smoking pot on the roof.
I didn’t mind holding his product for him, and indeed felt touched that he had confidence in me. It was only later that I realized he was just using me, a convenient stooge on whom no suspicion was likely to fall.
I began to feel lonely, a single student who did nothing but go to class in the morning and study all evening. I usually took a nap in the afternoon with the fan blowing on me, and I couldn’t sleep at night so I took to studying late, which eventually made me drowsy. I would wake up at four or five AM and I couldn’t go back to sleep, so I started doing yoga early in the morning, at dawn.
The Russian quickly became an interesting problem, and I found it easy memorizing the daily words– some twenty or thirty a day– with pronunciation being hardly more difficult, aided by the native Russian, Moscow accent of the instructor. Writing in long hand, in Russian, was graceful and flowing, better than English it seemed.
I went to the bookstore and bought the biggest Russian-English dictionary I could find. It was in two volumes, the first English to Russian and the second Russian to English; each volume was about four inches thick. There was no reason to need such a big dictionary, but I liked to have books that represented the knowledge implied by the classes I took.
When it came time to write the final examination, I was fully prepared. The exam consisted of a series of English sentences that were to be translated into Russian. It was straightforward for me. I ended with an A-. The only reason I didn’t get a straight A was, first, there were two students who were better than I, and second, I got sick and missed a day of class.
More on how I got sick next time.
The big news from Baltimore is that the recently elected District Attorney has indicted six police officers for the arrest and death of Freddie Gray. Her logic is impeccable: running from the police is not a crime; the knife he was arrested for having in his possession was a legal knife; and he was clearly injured, according to the autopsy, in the police van. This, at the very least, justified the indictment for false arrest.
The autopsy showed that he had a fatal, large force injury in the back of his head that was shaped like a bolt in the bulkhead of the van. This blunt injury caused a fracture of the spinal column and partial transection of the spinal cord; in addition, he had a crushed larynx that may have been caused by the same injury.
There is evidence, from what the police officers testify (all but the van driver have testified) that they initially looked in on him for complaints of pain and difficulty breathing, but merely set him back up on the seat. Thereafter, he was looked at and spoken to several times, but was unresponsive. This suggests that he was injured early on during the van ride. This also forms the basis for charges of involuntary manslaughter.
It is irrelevant to say that Freddie Gray was, while not currently wanted by the police, a known lawbreaker who had been arrested several times. That is no excuse for stopping someone without probable cause. There is equally no excuse for arresting a man for possessing a legal knife when the size and style of legal knifes should be well known to a beat officer.
Then, the fact that the new District Attorney is a 35 year old black woman is irrelevant as well; it may as well be said that she is a fifth generation police officer.
Then there is the attitude of the indicted police officers themselves: (With the awareness that, although they have been arrested, someone has posted their $250 thousand bail, they have seen the judge, and they have been released and are free to come and go as they please, at least to a limited extent.)
““They came, they did their job, they regret that someone was killed. But in their hearts and in their minds, they think that they did the right thing. And they hurt behind the backlash of it more than anything, and being left out there with no support,” the relative of one of the six officers involved with Gray’s arrest told WBAL.”
That’s alright. The first stage in Mourning is Denial.