Conflicts of interest compromise US public health agency’s mission, say scientists

BMJ ◽  
2016 ◽  
pp. i5723 ◽  
Author(s):  
Jeanne Lenzer
Keyword(s):  
Public Health ◽  
Conflicts Of Interest

scholarly journals Beyond financial conflicts of interest: Institutional oversight of faculty consulting agreements at schools of medicine and public health

PLoS ONE ◽  
2018 ◽  
Vol 13 (10) ◽  
pp. e0203179
Author(s):  
Michelle M. Mello ◽  
Lindsey Murtagh ◽  
Steven Joffe ◽  
Patrick L. Taylor ◽  
Yelena Greenberg ◽  
...  
Keyword(s):  
Public Health ◽  
Conflicts Of Interest ◽  
Financial Conflicts Of Interest ◽  
Institutional Oversight ◽  
Schools Of Medicine

Potentially Fatal Neutropenia Associated with the Use of Cocaine Adulterated with Levamisole.

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3790-3790
Author(s):  
Surbi Shah ◽  
Umesh Goswami ◽  
Koreth Rachel ◽  
David N Williams ◽  
Josy Mathew
Keyword(s):  
Public Health ◽  
Bone Marrow ◽  
Conflicts Of Interest ◽  
Health Hazard ◽  
B Cell Lymphoma ◽  
Mass Spectrometry Analysis ◽  
Gas Chromatography Mass Spectrometry ◽  
Hepatitis C Infection ◽  
Bone Marrow Biopsies ◽  
The Us

Abstract Abstract 3790 Background: Cases of neutropenia associated with the use of cocaine adulterated with levamisole are being increasingly reported and have become a serious public health hazard. As reported by the US Drug Enforcement Administration (DEA) up to 69% of total cocaine seized in the US is adulterated with this veterinary antihelminthic known to cause agranulocytosis in certain susceptible populations. The rationale for selecting levamisole as an adulterant is unclear, but is likely related to the fact that it shares some physico-chemical properties with cocaine and potentiates the activity of dopaminergic (D2) and NMDA receptors in brain thus enhancing its effects. Methods: A case review was performed of adult patients who presented with neutropenia after the use of levamisole adulterated cocaine. Their laboratory results and treatment outcomes were studied to establish an expected course of the illness. Results: Over a one year period, 5 patients (4 female, 1 male) with age range of 45–60 years, presented with neutropenia in the setting of cocaine use. 4 were positive for levimasole in urine (detected by the use of gas chromatography/mass spectrometry analysis within 4–6 hours of presentation). Bone marrow biopsies were performed in 4 cases showed granulocytic hypoplasia with myeloid maturation arrest, lymphocytic hyperplasia and polytypic plasma cells. Antigranulocyte antibodies (AGA) were positive in 3 of the 4 patients tested. One each had positive serology for serum fluorescent antinuclear antibody (FANA), rheumatoid factor (RF) and antineutrophil cytoplasmic antibody (ANCA). Four of the five patients had hepatitis C infection. One patient had marginal zone B cell lymphoma and another was diagnosed with HIV at her first presentation. The median duration of neutropenia was 5–7 days. 2 patients died as a result of their various co-morbidities. Discussion: Use of cocaine adulterated with levamisole can result in profound neutropenia which could be fatal despite aggressive medical therapy. In patients presenting with neutropenia and a history of substance abuse, a high index of suspicion for cocaine adulterated with levamisole is needed and can be confirmed with rapid testing for both substances in patients' urine. Further diagnostic studies including a bone marrow biopsy with characteristic findings as described above and serologic testing for AGA can aid in confirming the diagnosis and ruling out other common causes of neutropenia. The treatment is usually supportive and based on the Infectious Diseases Society of America (IDSA) guidelines for managing neutropenic patients. The role of public health advisories in providing awareness among patients and care givers cannot be overstated, which can lead to early detection and reduced mortality. Disclosures: No relevant conflicts of interest to declare.

Venous Thromboembolism (VTE) In Hospitalized Patients: What Proportion Is Attributable to Malignancy?

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5250-5250
Author(s):  
Frank Akwaa ◽  
Alok Khorana
Keyword(s):  
Public Health ◽  
New York ◽  
Conflicts Of Interest ◽  
Hematologic Malignancy ◽  
Medical Center ◽  
New York State ◽  
Length Of Hospital Stay ◽  
Cost Of Care ◽  
Hospitalized Patients ◽  
Public Health Burden

Abstract Abstract 5250 Background: VTE is a public health burden in hospitalized patients, affecting the length of hospital stay and overall cost of care. Recent studies suggest increasing incidence of VTE among cancer patients, but contemporary data regarding proportion of VTE attributable to cancer and non-cancer populations are lacking. Methods: Hospital-acquired VTE is a reportable event to New York State and we studied all reported VTE events among patients hospitalized at the University of Rochester Medical Center from January 2003 through April 2009. We utilized electronic medical records to identify additional information including demographics and diagnosis of malignancy. Results: We identified 2031 patients with 2185 documented VTE events during the study period. Of these, 1102 (54.3%) were men and 929 (45.7%) were women. VTE events included deep vein thrombosis (DVT) (N=1428, 65 %), pulmonary embolism (PE) (N=757, 34.6%), and concurrent DVT and PE (N=153, 7 %). Of the 2031 hospitalized patients with VTE, 492 (24.2%) had a concurrent diagnosis of cancer and 1539 (75.8%) did not. Of 492 cancer-related VTE, 167 (34%) were associated with hematologic malignancies, and 324 (66%) with solid tumors. The proportion of cancer-associated VTE varied by year, ranging from 21% to 31%. Conclusions: Approximately one-fourth of all VTE in hospitalized patients occurred in patients with cancer, including a substantial proportion with hematologic malignancy. Public health efforts to reduce hospital-associated VTE should focus on improving compliance with thromboprophylaxis for this population. Disclosures: No relevant conflicts of interest to declare.

Curing Financial Conflicts of Interest in Psychiatric Professional Organizations

2014 ◽  
Author(s):  
Omar Sultan Haque ◽  
Alicia Lu ◽  
Daniel Wu ◽  
Lisa Cosgrove ◽  
Harold J. Bursztajn
Keyword(s):  
Public Health ◽  
Conflicts Of Interest ◽  
Evidence Base ◽  
Diagnosis And Treatment ◽  
Professional Organizations ◽  
Psychiatric Research ◽  
Sponsored Research ◽  
Normative Framework ◽  
Financial Conflicts Of Interest ◽  
Organized Psychiatry

Most of the attention to the problem of financial conflicts of interest (FCOI) in psychiatry has centered on the actions of individuals. But what if the problem is much larger, and has infected entire organizations? Using the conceptual, and normative framework of “institutional corruption,” we describe how organized psychiatry has developed values, norms, and practices that have undermined its public health mission. Specifically, we argue that institutionalized FCOI have distorted the evidence base upon which psychiatric research, diagnosis, and treatment depends. We argue that current strategies such as simple transparency of commercial ties and “managing” FCOI are insufficient and vulnerable to gamesmanship. Following the IOM’s most recent (2011) recommendations for preventing bias when there are academic–industry relationships, we offer ideas for responding to the ethical and intellectual crisis in psychiatry, and emphasize the importance of training practitioners to think critically when assessing the evidence base of industry-sponsored research.

scholarly journals Public-Private Partnerships With Unhealthy Commodity Industries: Are They Undermining Real Progress in Non-Communicable Disease Prevention? Competing Frames in Global Health Governance: An Analysis of Stakeholder Influence on the Political Declaration on Non-communicable Diseases

2021 ◽  
Author(s):  
Chiara Rinaldi
Keyword(s):  
Public Health ◽  
Disease Prevention ◽  
Conflicts Of Interest ◽  
Communicable Disease ◽  
Public Private Partnerships ◽  
Health Governance ◽  
Stakeholder Influence ◽  
Public Health Promotion ◽  
Public Health Strategies ◽  
Non Communicable Disease

Public-private partnerships (PPPs) and whole-of-society approaches are increasingly common in public health promotion and non-communicable disease prevention, despite a lack of evidence in favour of their effectiveness in improving health outcomes. While PPPs may have advantages, they also give industry actors more influence over the design and implementation of public health strategies and interventions. Partnering with unhealthy commodity industries in particular – including the alcohol and ultra-processed food and beverages industries – can pose significant risks to public health due to these industries’ deep-rooted conflicts of interest. In this commentary, I reiterate Suzuki et al.’s message about the importance of assessing and managing conflicts of interest before engaging with non-state actors through PPPs or other forms of engagement.

Purveyors of the Commercial Determinants of Health Have No Place at Any Policy Table Comment on "Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool"

2020 ◽  
Author(s):  
Ronald Labonté
Keyword(s):  
Public Health ◽  
Global Governance ◽  
Policy Development ◽  
Conflicts Of Interest ◽  
Nutrition Policy ◽  
Determinants Of Health ◽  
World Health ◽  
Governmental Organization ◽  
Good Citizen ◽  
Health Organization

With public health attention on the commercial determinants of health showing little sign of abatement, how to manage conflicts of interest (COI) in regulatory policy discussions with corporate actors responsible for these determinants is gaining critical traction. The contribution by Ralston et al explores how COI management has itself become a terrain of contestation in their analysis of submissions on a draft World Health Organization (WHO) tool to manage COI conflicts in development of nutrition policy. The authors identify two camps in conflict with one another: a corporate side emphasizing their individual good intents and contributions, and an non-governmental organization (NGO) side maintaining inherent structural conflicts that require careful proscribing. The study concludes that the draft tool does a reasonable job in ensuring COI are avoided and policy development sheltered from corporate self-interests, introducing novel improvements in global governance for health. At the same time, the tool appears to adhere to a belief that private economic (corporate) and public good (citizen) conflicts can indeed be managed. I question this assumption and posit that public health needs to be much bolder in its critique of the nature of power, influence, and self-interests that pervade and risk dominating our stakeholder models of global governance.

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