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Apart from anything Garner has behaved in a totally unprofessional way. As a physician you do not malign members of the public, however pathological you may think their behaviour is. In fact the more pathological you think their behaviour is the more you should have sympathy and treat them...

It looks to me as if the climate of opinion and the policy making of specialties is at present so awful that there isn't a lot of point in hoping for a home. As Kitty says, we need a change in leadership. Maybe we have to wait for a science lead to raise physicians' interest.

There is a very important confusion going on here. Nobody will be suggesting that Garner did not experience what he experienced. What is suggested is that Garner's belief in the reason for his recovery is likely to be baseless because it does not fit even the facts in his case.

Hi @Friendswithme. I disagree with your analysis. (You are probably aware that I am a professor of medicine.) Paul Garner's behaviour has been absolutely terrible. The level of hypocrisy is astonishing. He is supposed to be an expert on evidence quality in medicine yet is prepared to tag his...

I think you might need to go to an Ann Summers shop.

Another thing that intrigues me is that Fox and Garner are Liverpool and so is Kell. Is there some local infighting involved in all this?

The thought of being intellectually inspired by Sharpe is intriguing. Almost medically unexplainable.

Maybe that is a different preparation. Their methods are not well described. But platelet aggregates would be spun out by centrifugation. Then the aggregation. would be ex vivo - however you try to play it. Why should they look bigger. I have sent years doing fluorescence microscopy. Things...

I think their argument is naive and simplistic. Thrombosis and embolisation depend both on fibrin polymerisation and platelet aggregation, and can be contributed to by bacterial material as in endocarditis and even immunoglobulin in various forms of thrombotic vasculopathy like visual loss in...

I agree. And to be honest this is a very good rate of funding in an area where there are no solid leads. Any other areas that get more like 20% funded will have well established avenues and tenured MRC fellows extending ongoing work. Putting it bluntly the figures do not such any bias - if...

Why? At least some of the bits stuff they showed were much bigger than platelets and would need to be to be of any interest in embolisation. Isn't platelet poor plasma plasma that has been spun hard enough to get rid of most of the platelets. Platelet Poor Plasma Centrifuge tube to obtain...

It is a pity that they have not recruited some haematologists. The main objection to the story is that the lumps in the pictures cannot have been there in the patients because they would have been centrifuged out. Whether or not you call them clots is probably less important. It intrigues me...

I continue to be very confused by what is going on in individual cases. It is uncomfortable to refer to details online but I am not sure how else to get things clearer. I wonder if the real issue is the refusal to set up PEG, if TPN is already in place and home TPN is not an option. But TPN can...

There are two problems with the NICE guideline. One is that it does not intend to cover service provision, just treatment modalities. The other is that it caved in and di make some recommendations for service provision that aren't very good. Charles Shepherd wanted consultant led clinics. That...

Ah, but was he a Barts man? Did he train at Barts?

Not so sure after listening to my old music teacher who survived a Japanese death pit with a smashed femur. I suspect Japanese soldiers were a bit like Bart's men. Peter Denton White was almost but not quite a Barts man, being at QMC. It was said that; You can always tell a Barts man. But you...

Clearly muscle isn't exposed to light but yes we have detailed studies of muscle changes for 48 hrs after exercise. The UCL muscle unit did biopsies after exercise. But there is a very stereotyped resolution time frame. PEM doesn't do that I am told. And of course on 2 day CPET normal people do...

I have no doubt that fatigue after car travel is due to continuous muscle contractions - if the trip is long enough I specifically have neck ache and the neck muscles are going to be working the hardest unless you have an aeroplane pillow. But that is something quite other than the sleepiness...

Nobody is going to fund 'we intend to make a whole load of measurements and hope someone else can figure out what it means. More seriously, the design of the sensors is going to need careful thought in relation to what is going to be analysed.

I think it may have to come from completely objective evidence from actimetry. Not just measures of periods of exertion but measures of subsequent reduction in activity. You might say that this would never show anything - but that is what Sarah Tyson has said, probably because it doesn't suit...