Pulsed radiofrequency applied to the suprascapular nerve in painful cuff tear arthropathy.

The purpose of this study was to assess the efficacy of pulsed radiofrequency (PRF) applied to the suprascapular nerve for pain relief in medically unfit patients with painful cuff tear arthropathy. Twelve patients with chronic shoulder pain due to cuff tear arthropathy were recruited. The mean age was 68 years (range, 60-83 years).

A multicentre randomized controlled trial of epidural corticosteroid injections for sciatica: the WEST study.

Objective: To determine the effectiveness and predictors of response to lumbar epidural corticosteroid injections (ESI) in patients with sciatica. We performed a 12-month, multicentre, double-blind, randomized, placebo-controlled, parallel-group trial in four secondary pain-care clinics in the Wessex Region.

Methods: Two hundred and twenty-eight patients with a clinical diagnosis of unilateral sciatica of 1-18 months' duration were randomized to either three lumbar ESIs of triamcinolone acetonide or interligamentous saline injections at intervals of 3 weeks.

Phantom limb pain--a complication of lower extremity wound management.

Amputation is one treatment option for patients with critical limb ischemia, diabetic foot wounds, and occasionally, even venous leg ulcers. Amputation of the whole limb or part of it or the digits can cause complications including pain. Post-amputation pain, and especially phantom limb pain (PLP), is a poorly understood phenomenon.

The old faith and the new science: the Nuremberg Code and human experimentation ethics in Britain, 1946-73.

This article explores the impact of the Nuremberg Code on post-Second World War research ethics in Britain. Against the background of the Nuremberg Medical Trial, the Code received international endorsement, but how much did its ethical percepts influence actual research? This paper shows that, despite British involvement in the formulation of the Code, the experience of war-time and changing career structures were more influential in shaping the approach of investigators to their subjects. Where medical debates ensued, primarily over controversial research practices at the British Postgraduate Medical School, Hammersmith Hospital, they were set in the context of a much older division between 'bedside' and 'scientific' medicine.

Understanding the organisational context for adverse events in the health services: the role of cultural censorship.

This paper responds to the current emphasis on organisational learning in the NHS as a means of improving healthcare systems and making hospitals safer places for patients. Conspiracies of silence have been identified as obstacles to organisational learning, covering error and hampering communication. In this paper we question the usefulness of the term and suggest that "cultural censorship", a concept developed by the anthropologist Robin Sherriff, provides a much needed insight into cultures of silence within the NHS.