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Biomedical subjects

Sue Evans

Publications and source records attributed to Sue Evans.

4 recordsLinked to original sources
PubMed2006

Evidence-based medicine and naturopathy.

Evidence-based medicine (EBM) has been advocated as a new paradigm in orthodox medicine and as a methodology for natural medicines, which are often accused of lacking an adequate scientific basis. This paper presents the voices of tradition-sensitive naturopathic practitioners in response to what they perceive as an ideologic assault by EBM advocates on the validity and integrity of natural medicine practice. Those natural medicine practices, which have tradition-based paradigms articulating vitalistic and holistic principles, may have significant problems in relating to the idea of EBM as developed in biomedical contexts. The paper questions the appropriateness of imposing a methodology that appears to minimize or bypass the philosophic and methodological foundations of natural medicine, and that itself seems primarily driven by political considerations.

Attitude of Health Personnel↗
PubMed2005

Two distinct subgroups of tirofiban-induced thrombocytopenia exist due to drug dependent antibodies that cause platelet activation and increased ischaemic events.

Tirofiban-associated thrombocytopenia is due to drug-dependent antibodies (DDAbs) directed against the GPIIb/IIIa complex which can bind after drug-induced conformational changes to the receptor complex. In such cases a higher incidence of myocardial infarction and mortality has been reported raising the possibility of platelet activation. We followed consecutive cases treated with tirofiban to determine the incidence of thrombocytopenia and confirmed that this was due to tirofiban-dependent antibodies. We then tested if these antibodies could cause platelet activation in vitro and correlated this with clinical outcome. In 871 treated patients, severe thrombocytopenia was observed in 11 cases, an incidence of 1.26%. Tirofiban dependent antibodies were confirmed in all cases using a flow cytometric assay. There were two distinct presentations of thrombocytopenia, one occurring acutely, and the second a delayed thrombocytopenia occurring after several days of tirofiban exposure and in keeping with a primary immune response. The effects of DDAbs on platelet activation was analysed by measuring P-selectin (CD62p) and annexin V, in the presence or absence of tirofiban, by flow cytometry. In addition, platelet activation was sought using the serotonin release assay. In six cases there was evidence of platelet activation and this was significantly associated with further coronary ischaemic events experienced at the time of acute thrombocytopenia. Tirofiban-induced thrombocytopenia due to DDAbs is a common occurrence and can lead to platelet activation and increased thrombotic events.

Acute Disease↗
PubMed2003

Global herbal medicine: a critique.

Herbal medicine finds itself at a crossroads. If it continues to become mainstreamed in a commodity-driven health industry, its focus will change from craft-based tradition to globalized industry. On the other hand, if the fundamental importance of tradition to indigenous and nonindigenous medicine is respected, ecologic and cultural issues arise. Central here are the issues associated with control of both land and culture. Many indigenous cultures and their local ecologies are currently threatened by globalization. Historically, successful large corporations have neither respected the environment nor easily acknowledged indigenous claims to land and intellectual property, so no easy resolution of these conflicts seems likely. Our case study of Mapuche medicine allows us to explore the social and cultural conflicts that many practising herbalists experience. We argue that because of the basic contradictions involved, the protection of cultures and ecologies that underpin the discipline must be made a clear priority. We argue that local cultural traditions are clearly at odds with a globalizing herbal industry.

Biotechnology↗