Logic Versus Science

To comprehend St Thomas Aquinas’ statement that, “A student should address themselves to logic before the other sciences, because it deals with their common procedure”[1] this essay argues that it is necessary to ask the question of whether one’s world view comes before science or whether science forms one’s world view. A world view that comes before science first requires understanding and logic to make a hypothesis which is to be confirmed through scientific experiment. If science forms one’s world view, however, conversely, scientific experiments create our logical thoughts and world view. This essay will analyse St Thomas Aquinas’ statement to argue that he is saying that logic comes before the other sciences

Primary open abductor reconstruction - a 5-10 year study

Background: Gluteal tears are recognised as the source of pain over the greater trochanter. We investigated the outcome of primary open abductor tendon reconstruction with a 5 year follow-up. Methods: 165 consecutive hips underwent an open abductor tendon reconstruction, with all tears confirmed pre-operatively by MRI. Oxford hip scores (OHS) were assessed at the initial visit, and at 5 to 10 years. Results: The average pre-operative OHS was 22 (r: 7y – 34y) and average post-operative OHS was 40 a difference of 18 (p\u3c0.0001). Conclusion: Surgical reconstruction of degenerate abductor tendons should be considered in the presence of an MRI confirmed separation where clinical findings are consistent with the known tendon disruption. Open transosseous reconstruction reliably results in good pain relief at 5 to 10 years

The prevalence of opioid analgesic use in people with chronic noncancer pain : systematic review and meta-analysis of observational studies

Objective To review studies examining the proportion of people with chronic noncancer pain who report consuming opioids and characteristics associated with their use. Design Systematic review. Methods We searched databases from inception to February 8, 2020, and conducted citation tracking. We included observational studies reporting the proportion of adults with chronic noncancer pain who used opioid analgesics. Opioids were categorized as weak (e.g., codeine) or strong (e.g., oxycodone). Study risk of bias was assessed, and Grading of Recommendations Assessment, Development and Evaluations provided a summary of the overall quality. Results were pooled using a random-effects model. Meta-regression determined factors associated with opioid use. Results Sixty studies (N=3,961,739) reported data on opioid use in people with chronic noncancer pain from 1990 to 2017. Of these 46, 77% had moderate risk of bias. Opioid use was reported by 26.8% (95% confidence interval [CI], 23.1–30.8; moderate-quality evidence) of people with chronic noncancer pain. The use of weak opioids (17.3%; 95% CI 11.9–24.4; moderate-quality evidence) was more common than the use of strong opioids (9.8%; 95% CI, 6.8–14.0; low-quality evidence). Meta-regression determined that opioid use was associated with geographic region (P=0.02; lower in Europe than North America), but not sampling year (P=0.77), setting (P=0.06), diagnosis (P=0.34), or disclosure of funding (P=0.77). Conclusions Our review summarized data from over 3.9 million people with chronic noncancer pain reporting their opioid use. Between 1990 and 2017, one-quarter of people with chronic noncancer pain reported taking opioids, and this proportion did not change over time