bmj.com Rapid Responses for Pickles, 332 (7544) 783-786
Have a look down the bottom, Preparing to treat Pandemic flu.
Friday, April 07, 2006
Thursday, April 06, 2006
TGN1412 Trial Northwick Park Hospital Censored
Press release: Latest findings on clinical trial suspension
I am unimpressed by the fact that the documentation released by the UK MHRA, the body responsible for finding out what went wrong with the experiment that left 6 men in the Northwick Park Hospital Intensive Care unit, has allowed large sections of the Clinical Trial Investigator's Brochure to be censored and withheld from the public. The most charitable interpretation is that it is to protect confidential intellectual property that the company has acquired, although we cannot be sure that it is not withheld in order to hide culpable misjudgements on the part of TeGenaro. In any case, if you have nearly killed 6 men in a clinical trial, you owe it to the world to share all information no matter how much it is worth to you, in order to prevent such tragedies in the future.
In future, the most obvious thing is to leave a 2 hour gap between administstering the drug to each subject. That way, it there is an immediate effect, (as there was in this case) only one person gets it, not the whole lot.
Second, from what I have seen, cytological testing was not done before human testing. TGN1412 must be tested on all manner of cells, to try to pick up one cell group that displays its toxicity, and that test must be run on all future drugs prior to testing on humans.
In the end, this is just one more example of how the interests of corporations take precedence over the interests of the human.
I am unimpressed by the fact that the documentation released by the UK MHRA, the body responsible for finding out what went wrong with the experiment that left 6 men in the Northwick Park Hospital Intensive Care unit, has allowed large sections of the Clinical Trial Investigator's Brochure to be censored and withheld from the public. The most charitable interpretation is that it is to protect confidential intellectual property that the company has acquired, although we cannot be sure that it is not withheld in order to hide culpable misjudgements on the part of TeGenaro. In any case, if you have nearly killed 6 men in a clinical trial, you owe it to the world to share all information no matter how much it is worth to you, in order to prevent such tragedies in the future.
In future, the most obvious thing is to leave a 2 hour gap between administstering the drug to each subject. That way, it there is an immediate effect, (as there was in this case) only one person gets it, not the whole lot.
Second, from what I have seen, cytological testing was not done before human testing. TGN1412 must be tested on all manner of cells, to try to pick up one cell group that displays its toxicity, and that test must be run on all future drugs prior to testing on humans.
In the end, this is just one more example of how the interests of corporations take precedence over the interests of the human.
Avian flu and management science
H5N1 Avian is in Scotland, not a problem for non-poultry farmers, but H5N1 pandemic flu will be a bit of a problem not least for health workers when it emerges. We can probably reduce our chance of falling victim to the pandemic ourselves by wearing masks (it seemed to work for SARS). Trouble is the masks cost about £2 each, and each worker in contact with infected patients or potentially infected patients will need about 2 a day. That's £4 a day for the organisation with the biggest payroll in the world now that the Red Army is history and which is nearly £1,000,000,000 in the red this year.
So I wonder to myself, could the masks be sterilised and reused, thus saving the NHS squillions? I ask a helpful public health physician,and she writes to a manager
Hi J
Had a query from the GPs.. Do you think that masks could be 'sterilised' by being microwaved? They are looking for practical ways to recycle equipment given the likely shortage and cost involved.
Cheers
K
The reply:
An FFP3 mask should be effective for 8 hours they are single use disposable
equipment & therefore cannot be reprocessed. Microwaves are not use (sic) in sterilization as far as I know, so I am not sure how effective this would be.
Best Wishes
J
Infection Control Nurse
K posts back to me with:
Re you mask related query. Not sure it's worth going to the virologists because the wouldn't be allowed to tell us to do anything that contravened health and safety guidance..
to which I reply thus
"I am not sure how effective this would be."
This is true. So the scientific approach would be to say, "Let us see how effective it would be".
The method would be to
1 Pop a mask in to a microwave, give it 3 minutes and see if it melts or explodes.
2 If it survives, spray a known virus onto a mask and pop it in again
3 See if the virus has survived or not.
If the microwave can sterilize the mask, (i.e. kill the virus) we repeat the experiment with Influenza viruses, and find the optimum sterilization time.
If this method works, the NHS could end up saving £millions.
However, I fully accept that this procedure, or any experimental process leading or intended to lead to such a procedure, would be outwith normal operational parameters of the NHS leadership in these matters, and should therefore be deemed utterly impractical and utopian, inasmuch as it is not
contained in the papers and other informational media relating to this subject, and I give my solemn undertaking as an NHS functionary that I will endeavour to cease thinking of it or of any matter related to it, or in any way to think of any operational procedure or matter which is not already
contained in the papers and other informational materials which are handed down to us from the committees and authorities with properly designated and invested powers to be responsible for thinking about these matters.
Regards
Richard
So I wonder to myself, could the masks be sterilised and reused, thus saving the NHS squillions? I ask a helpful public health physician,and she writes to a manager
Hi J
Had a query from the GPs.. Do you think that masks could be 'sterilised' by being microwaved? They are looking for practical ways to recycle equipment given the likely shortage and cost involved.
Cheers
K
The reply:
An FFP3 mask should be effective for 8 hours they are single use disposable
equipment & therefore cannot be reprocessed. Microwaves are not use (sic) in sterilization as far as I know, so I am not sure how effective this would be.
Best Wishes
J
Infection Control Nurse
K posts back to me with:
Re you mask related query. Not sure it's worth going to the virologists because the wouldn't be allowed to tell us to do anything that contravened health and safety guidance..
to which I reply thus
"I am not sure how effective this would be."
This is true. So the scientific approach would be to say, "Let us see how effective it would be".
The method would be to
1 Pop a mask in to a microwave, give it 3 minutes and see if it melts or explodes.
2 If it survives, spray a known virus onto a mask and pop it in again
3 See if the virus has survived or not.
If the microwave can sterilize the mask, (i.e. kill the virus) we repeat the experiment with Influenza viruses, and find the optimum sterilization time.
If this method works, the NHS could end up saving £millions.
However, I fully accept that this procedure, or any experimental process leading or intended to lead to such a procedure, would be outwith normal operational parameters of the NHS leadership in these matters, and should therefore be deemed utterly impractical and utopian, inasmuch as it is not
contained in the papers and other informational media relating to this subject, and I give my solemn undertaking as an NHS functionary that I will endeavour to cease thinking of it or of any matter related to it, or in any way to think of any operational procedure or matter which is not already
contained in the papers and other informational materials which are handed down to us from the committees and authorities with properly designated and invested powers to be responsible for thinking about these matters.
Regards
Richard
Tuesday, April 04, 2006
To the Kidnappers of Tom Fox
If there was a life he begged for, it was yours.
If he wept when you killed him, he wept for you.
If I would have anyone know about Tom, it would be this.
(This poem was made by Beth Pyles, one of the Christian Peacemaker Team in
Iraq, who saw Tom's body (accompanied by the body of a young Iraqi who also died in detention) off from Anaconda Air Base in Balad, Iraq).
If he wept when you killed him, he wept for you.
If I would have anyone know about Tom, it would be this.
(This poem was made by Beth Pyles, one of the Christian Peacemaker Team in
Iraq, who saw Tom's body (accompanied by the body of a young Iraqi who also died in detention) off from Anaconda Air Base in Balad, Iraq).
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