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I don't really get what they are getting at. Presumably sharks have fight and flight responses but they don't have any bones. We fight or fly long before these hormones get going. OK the body readjusts its physiology, but loads of factors contribute to that. The fact that adrenalectomised...

Yes, but then the GP became the named person responsible for monitoring all their ill patients anyway when they took the job. If someone actually needs to point that out there is something wrong. (And I agree there is definitely something wrong.)

I just looked at this sites you posted. I agree that are plans should be person directed and involve the patient. But I have always assumed that throughout 40 years of being a doctor. When I hear people use these terms it is always in the context of window dressing, usually be a...

Yes, that was my conclusion. The problem that I see is that in practical terms there is no real way to get 'representative' information so the only real value is in making committee members aware of salient problems that can occur. I think we can be certain that some committee members, and I...

I think we have to consider what NICE can be expected to do and what they should base it on. As I understand it the main function of the committee is to provide evidence-based recommendations for what is though to be useful management for the benefit of health professionals and commissioning...

I tried to find out exactly what that meeting was. Nothing comes up in association with Royal Society of Medicine itself. It appears to be a meeting run by a syringomyelia and Chiari foundation and the UK EDS organisation. It may be that they have used RSM facilities for a private meeting...

No, only the people who are putting out hypothesis about ME as if they were medically knowledgeable. I see no reason to think the cord would suffer with stretching alone in the context of a hyper mobile spine. As Henderson implies, you need also to have some sort of entrapment at a particular...

But a tenfold change can be to 10%. We often say change by an order of magnitude - when it is already assumed which way. They probably mean change to 60% but why not say so? We normally say a 40% decrease.

I don't think this is at all clear. A 0.6 fold change could be a change to 60% or to 166% or even to 160% or 40% as far as I can see. Nobody normally says this. Unless it is some special technical term in a particular area it sounds like half-baked usage.

I think you need to ask a dermatologist. This is not a common rash. I don't think it is of serious concern but it should be checked out by a specialist, not a GP. If you have history of immunological drug therapy that may be relevant.

I agree that our main problem is lack of evidence, so everything is speculation. But we are seeing people speculate without knowing basic anatomy and clinical neurology and saying things that are entirely implausible I am completely unbiased because I am on a pension and have no financial...

I think you are confusing two issues. Henderson is talking about the situation where there is pressure on the cord from disc herniation or osteophytes. that traps the cord at certain points. In this context normal movement of the spine may pull at particular points and cause shear. Everyone in...

I am not sure that I see this proposal as unreasonable. NICE is at least making an attempt to get input from patients. There is a limit to what is practical and also a limit to what can be done without being intrusive or breaching confidentiality relating to children. People have to be asked to...

I don't think it is saying anything particularly unexpected or surprising. Cord damage is likely to be a mixture of pressure and tension. That does not change the way we understand the clinical picture. Also he is talking about cervical myelopathy from narrowing in the lower cervical region...

I cannot se any point in these composite score systems unless it is specified exactly what they are to be used for. Are they to judge a current state, or make diagnosis, or measure a change with time or treatment? You want different measures for each, and for treatments very likely different for...

This is the citation point: Another answer is that the available evidence indicates that specific treatments for FND coupled with careful selection of patients work well: effect sizes are often very large when judged by the standards of drug trials for similarly disabling neurological disorders...

Oh but he does - if you look at the citations. Basically he is echoing Wessely's concern that all his patients will be sent off to cheap services instead of what ought to happen - imply an expensive multidisciplinary team and get them to decide to send the patient to trudge Chalder (or her...

Yes, those sorts of things sound interesting. Failure of habituation at a low electrophysiological level would be very interesting.

You need to multiply that be the number needed to treat though, and the amount of benefit in terms of Quality Adjusted Living Death Years

That would be the Darkning Process then?