TORONTO PARAPAN-AMERICAN GAMES: Dr.H.L.FRANKEL OBE FRCPC was Physician Advisor to Neurosurgeon Sir..L.GUTTMANN KBE FRS

Dr Hans Ludwig Frankel, OBE, MB, FRCP

Guttmann Lecturer 2012

Few are more qualified to honour Sir Ludwig Guttmann than Dr Hans Ludwig Frankel, his understudy and colleague for more than 22 years, 1958-1980 (Guttmann’s death)).  Dr Frankel was called on frequently over the years to pay tribute to his Mentor.  On the occasion of Dr Guttmann’s 70^th birthday, Dr Frankel was asked and delivered his famous paper defining the Frankel Grades (Frankel 1969), the most frequently cited outcome measure for the study of spinal cord injury in the literature today (Ditunno 2010). Dr Frankel was one of the successors to Sir Ludwig at Stoke Mandeville Hospital and continued the tradition of dedicated care, learning and research at this institution so dear to its Founder.  Dr Frankel has also continued Sir Ludwig’s work at the British Paraplegic Sports Society (now WheelPower), IMSoP (now ISCoS) and the journal Paraplegia (now Spinal Cord), all founded by Guttmann.

Who other than Hans Frankel could have described his Mentor with such profound respect as on the occasion of his “100^th Birthday” in 1999?
“Those who never met Guttmann wonder how he achieved so much. He was a small man of immense energy and when he became animated he seemed to grow in size and almost filled the room. He was both loved and feared and inspired great loyalty in his followers.”

John F Ditunno, Jr. MD
Professor of Rehabilitation Medicine, Jefferson Medical College
Philadelphia, USA

JUNE 19 (Fri) MULTIPLE MYELOMA(Plasma cell cancer) Toronto VAUGHAN ESTATE SUNNYBROOK HOSP SCOTTSDALE MAYO CLINIC Prof Keith STEWART

Princess Margaret Cancer Centre and the Department of Medicine, University of Toronto
FOR INFORMATION
Continuing Professional Development
Faculty of Medicine, University of Toronto
416.978.2719 | 1.888.512.8173 | info-MED1507@cpdtoronto.ca
www.cpd.utoronto.ca/myeloma

Keith Stewart, M.B., Ch.B.(Aberdeen) FRCP(Can) MBA(Ivey)

Location

Scottsdale, Arizona

Contact

stewart.keith@mayo.edu Clinical Profile

SUMMARY

Keith Stewart, M.B., Ch.B., conducts translational research in multiple myeloma. This includes both basic and clinical research to identify novel targets for therapy in multiple myeloma.
Dr. Stewart's research is supported by the National Cancer Institute, Multiple Myeloma Research Foundation, and Leukemia & Lymphoma Society, as well as by partnerships with the pharmaceutical industry for clinical trials.

Focus areas

Dr. Stewart's research can be divided into three broad categories:

• Study of the cancer genome. Recently, Dr. Stewart and his colleagues have focused on the use of high-throughput druggable genome RNAi screening in the presence or absence of therapeutic agents such as bortezomib and lenalidomide. This work will lead to the identification of targets that, when suppressed, sensitize myeloma cells to the effects of chemotherapy. Most recently, they have also begun whole-genome sequencing of myeloma cells in patients who have become resistant to chemotherapy drugs in an attempt to identify mechanisms of resistance. Their first whole human genome sequence was completed in June 2009.
• Cancer drug development. Dr. Stewart and his team have performed high-throughput screens of small molecules to identify inhibitors of myeloma targets. With these screens, they have been successful in identifying a number of small molecules that resulted in cell death when applied to myeloma cells. They have employed a medicinal chemistry approach to the development of analogues for these molecules and will pursue these into preclinical testing and subsequently into clinical trials.
• Clinical trials. These include early investigational phase I studies and large international randomized phase III trials. Novel agents being studied include carfilzomib, pomalidomide, aurora kinase, heat shock protein 90, CDK5 and FGFR3 inhibitors.

Significance to patient care

Dr. Stewart and his colleagues are conducting research that has direct relevance to patient care, as they are discovering markers for prognosis and drug responsiveness, understanding what makes patients resistant to drugs, and applying this knowledge in the clinic with clinical trials exploring novel therapeutics in multiple myeloma, amyloidosis and other blood cancers.

Treatment of relapsed multiple myeloma.

Stewart AK, Palumbo A.

• Carfilzomib, lenalidomide, and dexamethasone for relapsed multiple myeloma. [N Engl J Med. 2015]

(KYPROLIS + REVLIMID + dexamethasone)

UK DAILY MAIL: PRIVATE SUITE @ MASS GENERAL

+3

On the mend: The photo shows Kerry in his room at Massachusetts General Hospital in Boston. He has his right leg propped up and is talking on the phone with national security adviser Susan Rice

Read more: http://www.dailymail.co.uk/news/article-3117748/John-Kerry-tweets-photo-breaking-leg-French-Alps-cycling-accident.html#ixzz3ceXibLpX
Follow us: @MailOnline on Twitter | DailyMail on Facebook

Private Hospital suites not available in Toronto although many condos selling at $1-mill+ and professional
homes start @ $1.5-mill.

UK DAILY MAIL TORONTO AUGUST 14 (Fri.) SEX FOR DISABLED Buddies in Bad Times Theatre.

'People in wheelchairs are having great sex - better sex than a lot of people are having'

• A theatre in the Canadian city will host the 125-person event in August
• Ticket price includes interpreter for the deaf and hydraulic lifts
• Organizer Stella Palikarova has spinal muscular atrophy
• She was fed up with people assuming she had no libido
• Co-organizer: 'A wheelchair can become just a big sex toy' 

By Imogen Calderwood For Mailonline

Read more: http://www.dailymail.co.uk/news/article-3115264/People-wheelchairs-having-great-sex-better-sex-lot-people-having-Toronto-host-massive-world-orgy-disabled-people.html#ixzz3cZ3Gf8ad
Follow us: @MailOnline on Twitter | DailyMail on Facebook

COMMENT: Dr.A.Franklin
In 1974 Zoologist Dr."Tuppy"OWENS PhD founded the OUTSIDERS CLUB.: a regiistered UK charity. (vide Wiki.)

"GREY AREAS" STEINECKE MACIURA LEBLANC LAWYERS

"GREY AREAS": a review of selected Court cases: free on-line.
(SML ONLY PROSECUTES MDs DOES NOT DEFEND MDs ).

rsteinecke@sml-law.com
416 625-6897
401 Bay street,suite 2308 (near Queen St.West)

CMAJ & OMA (4 in-house lawyers) provide no legal commentaries on Cases relevant to physicians.

Richard Steinecke practises law exclusively in the area of professional regulation. He is the editor and writer of the widely read Grey Areas newsletter commenting on recent developments in professional regulation. Because of its comprehensive nature, courts and tribunals have cited his book “A Complete Guide to the Regulated Health Professions Act” well over dozen times even in cases dealing with non-health professions. The book is updated twice a year.

Today he spends most of his professional life teaching, writing, speaking, training and consulting on professional regulation issues. A life-long learner, Richard reads every Canadian common law court decision on professional regulation he can find and has a Certificate in Risk Management from the University of Toronto.

• Richard Steinecke has been published in the May 2015 edition of HEALTH LAW IN CANADA.. His article entitled “Applying Risk Management Principles to the Complaints System of Regulators” can be found at pages 98.- 105 .

Applying Risk Management Principles
to the Complaints System of Regulators

 Richard STEINECKE

Introduction:

Risk management has become a popular tool to
assist organizations identify and address challenges.
There are some barriers to applying risk
management processes to regulators. Risk management
is most prominent in the business world,
where the primary goal of the organization is to enhance
profits. In the business world, even considerations
such as reputational damage and fairness to
employees can be measured in terms of its impact
on the organization’s net revenue. The goals of
regulators are more difficult to define and measure.
In addition, regulators work in a very legalistic environment.
They have a specified legal mandate,
express and implicit statutory authority, and a
common law duty to act with procedural fairness.
Many of a regulator’s legal obligations are contained
outside of their home statute (e.g., human
rights codes, the Canadian Charter of Rights and
Freedoms, case law). As a result, the risk focus of
regulators often shifts to legal risks. An overreliance
on obtaining and following legal advice
can obscure, and even make regulators vulnerable
to, other very important sources of risk.
.

"CLAIMS CANADA" Can Independent Adjusters Assn..April/May 2015 "LEAKAGE" pp12-19 CRAIG HARRIS.

"LEAKAGE" = ..DIFFERENCE BETWEEN WHAT AN INSURER SHOULD PAY IN CLAIMS UNDER THE CONTRACTUAL POLICY AND WHAT IT ACTUALLY ENDS UP PAYING.. LEAKAGE OF AN AVERAGE INSURER IS TYPICALLY 8-12 PER CENT.

"LEAKAGE" INCLUDES  FRAUD

Comment by Dr.A.Franklin. In past 45y of OHIP cannot recall a media reported Ont.Govt prosecution against an Ontario resident for OHIP fraud. The only one I remember was settled out of Court. An Ontario resident lent his card (no photo at that time) to an Overseas relative of same gender and approx same age who had heart operation and died. When Ontarian next visited his MD was informed that he`was dead. Case settled out of Court for less than $60,000 billed by OHIP..

Other causes of OHIP (Ont Health Ins.Plan) "leakage:".

No verification of signature. on card by Clinics & Hospitals.

Many No-photo cards still legally in use.

No photo required on over 65y. cards; so elderly do not have to travel to OHIP offices with cameras

"Lost" OHIP:paid drugs for Welfare & Seniors.

"Spilled" medication on floor etc..

Unlike UK where patient is registered with one GP or one Clinic,. in Ontario patients can WALK-IN to a variety of GPs and ask for medication; (=multiple doctoring).

Demand for antibiotics with threat of CPSO complaint if MD non-compliant.

Supplementary food money grant (NOT food stamps) for those on welfare with conditions such as constipation now stopped due to widespread fraud. MDs threatened with complaint to CPSO if they did not comply with often absurd demands.

Methadone clinics.



...

TORONTO STAR June 4, GTA section pp 1 & 4 Staff reporter JACQUES GALLANT U.Tor Neurology(St.Michael's Hosp.) Prof. Paul O'CONNOR MD(Tor.1979) FRCPC(1985)

Neuroscience Research Program

Paul W. O'Connor

MD, University of Toronto; FRCPC (neurology), University of Toronto; Diplomate, American Board of Psychiatry and Neurology; M.Sc. (clinical epidemiology), University of Toronto

Affiliations

Director, Multiple Sclerosis (MS) Clinic and MS Research and the Evoked Potentials Laboratory, St. Michael's Hospital
Scientist in the Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital
Staff, Neurology, St. Michael's Hospital
Professor of Medicine, Neurology, University of Toronto
National Scientific and Clinical Advisor, Multiple Sclerosis Society of Canada
Core faculty, Clinical Epidemiology and Health Care Research Program, University of Toronto
Coordinator, MS Program, University of Toronto
Associate Member, Graduate Department of Community Health, University of Toronto
Associate Member, Institute of Medical Science, University of Toronto

USA NATIONAL MS SOCIETY
In addition to its physical symptoms, MS may have profound emotional consequences. At first, it may be difficult to adjust to the diagnosis of a disorder that is unpredictable, has a fluctuating course, and carries a risk of progressing over time to some level of physical disability. Lack of knowledge about the disease adds to the anxieties commonly experienced by people who are newly diagnosed. In addition to these emotional reactions to the disease, demyelination and damage to nerve fibers in the brain can also result in emotional changes. Some of the medications used in MS — such as corticosteroids — can also have significant effects on the emotions. Some of the emotional changes observed in MS include the following:

• Major depressive episodes as well as less severe depressive symptoms
• Grieving for losses related to the disease
• Stress and reactions to stressful situations
• Generalized distress and anxiety
• Emotional lability or mood swings
• Pseudobulbar Affect - uncontrollable laughing and/or crying
• Inappropriate behavior such as sexual aggressiveness

A very small proportion of people with MS exhibit inappropriate behavior such as sexual disinhibition. This type of behavior is thought to result in part from MS-related damage to the normal inhibitory functions of the brain. These behaviors may also reflect very poor judgment related to cognitive dysfunction caused by MS. Such behavior is generally beyond the control of the individual and is not a sign of moral weakness or sociopathic tendencies.


The treatment of these problems is complex. The person with MS may require some form of psychiatric medication, perhaps along with psychotherapy. Family members will probably need supportive counseling since these behaviors are often shocking and disruptive. In some cases, the affected individual may require supervision to prevent the manifestation of the behaviors in question


TOR. STAR(TODAY): In 2003 patient complained about alleged conversation which included sexual references. Also she met Prof O'Connor at a MS Charity event.  The CPSO recommended a "boundaries" course which Prof O'connor completed. The case was not sent the Discipline committee. Patient appealed to HSARB (Health Services Appeal Review Board Tribunal which TWICE returned case back to CPSO for consideration. This is the third time the HSARB has`referred`case to CPSO for  consideration to refer to Discipline committee. The Tor Star printed a picture of Prof.O'Connor,.CMPA-paid lawyer Ms Keary GRACE. of  Toronto branch of McCarthy Tetrault.

Ms Grace has appeared before courts of all levels in Ontario. She has appeared as counsel before various administrative boards and tribunals. She has extensive experience with professional liability and regulatory matters, having acted as counsel for physicians in a wide variety of cases. Ms Grace acts as a Designated Representative for unrepresented minors at refugee hearings on a pro bono basis. Ms Grace received her Bachelor of Social Sciences from the University of Ottawa in 1987 and her LL.B. from Osgoode Hall Law School in 2001. She was awarded the S.J. Birnbaum Scholarship from the Law Society of Upper Canada (Bar Admission Course).Ms Grace was admitted to the Ontario Bar in 2002.  She is a member of the Canadian Bar Association, Ontario Bar Association and The Advocates’ Society.

COMMENT Dr.A.Franklin
Chaperone imperative in Ontario when in consultation with a patient.. Also recording conversation important Discipline committee usually has no hard evidence but only probability. Case of Toronto 400 Walmer Rd @ St Clair, Psychiatrist SZATMARI, an arthritic and respiratory cripple who could hardly move with a walker and spoke with difficulty. Dr.Szatmani was brought before the Discipline Committee on accusation by an "actress" that he molested her. After seeing Dr Szatmari the Case was dismissed.. Dr Szatmari died a few months later.