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Archive for November, 2011

Random Flu Thoughts

I normally write the first draft of this blog the weekend before it is due, and this is no exception.  However, I am ill this weekend.  Headache, myalgias., painful cough, but only mildly ill.  The worst part is the interferon induced brain fog; my thoughts flow with all the speed of pudding and I was not appreciably better as the week progressed, although no cracks about how  you can’t any difference in my writing over baseline.

I doubt the cause of my symptoms is influenza.  According to the CDC site and Google flu trends there is little influenza activity in the US at the moment, so it is probably one of the innumerable viruses that can cause a flu-like illness.  I am also not ill enough to think I have influenza, but I could be having a modified course as I was vaccinated a month ago.  Of course, the doctor who treats herself has a fool for a patient and an idiot for a doctor. Flu season approaches, so from my interferon addled brains, flu thoughts.

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Posted in: Public Health, Science and Medicine, Vaccines

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Spinal Fusion: Chiropractic and Subluxation

A spirited exchange about chiropractic arose in response to a recent post proposing “The Cure” for the legalization of implausible and unproven diagnostic methods and treatments. Some comments pointed to the implausibility of the chiropractic “subluxation” and the lack of robust evidence of efficacy/effectiveness for spinal manipulation, as well as the difficulty of understanding what exactly “chiropractic” is, or does, that distinguishes it from other manual therapists.  In response, other comments were posted positing that the Science-Based Medicine blog “is not informed  on contemporary chiropractic practice,” that “the profession does not support [the chiropractic] subluxation as a cause of disease,” that chiropractors who treat the chiropractic subluxation are “on the fringe,”  and that the chiropractic “subluxation” is no longer taught in chiropractic colleges as a clinically relevant concept, but merely as an artifact of chiropractic history.

However, a review of recent chiropractic literature does not appear to support the latter opinions.  The same concerns as raised on SBM are shared by chiropractors themselves and are discussed in articles appearing in peer-reviewed chiropractic journals. Nor is the chiropractic literature as sanguine on the demise of the chiropractic “subluxation” as a clinically relevant condition which is both diagnosable and treatable.

Despite the concerns expressed by chiropractors themselves, the chiropractic literature continues to discuss the chiropractic “subulxation” as if it were a clinically relevant condition subject to diagnosis and amenable to treatment for both non-musculoskeletal and musculoskeletal conditions.  This same view of the “subluxation” is taught in chiropractic colleges in North America and Australia. (more…)

Posted in: Chiropractic

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Potential market for alternative medicine left untouched

A few days ago, I had the good fortune to share lunch and ideas with David Gorski and Kimball Atwood.  Kimball was on his way from a talk at Michigan State to one at Brigham and Women’s, one of the country’s best-known teaching hospitals.  David was planning a future talk for a group in Florida.  These guys have been thinking and writing about alternative medicine for a lot longer than I, and it was great to pick their brains, toss around ideas, and just hang out on a nice fall day.

We were discussing many of the inanities of so-called alternative medicine touted for use in “real” diseases, that is, not just symptomatic care.  There have been, for example, an number of studies out of China in the last few years claiming that acupuncture helps with in-vitro fertilization. All of these studies have been terribly flawed, and the reasons for these flaws are interesting, but irrelevant beside the primary flaw:  the ideas are so implausible as to render any conclusions invalid.   It is very difficult to understand how acupuncture in any of its forms could improve chances of conception, either in vivo or in vitro.

During our visit, Kimball brought up a rather interesting analogy:  if acupuncture could increase fertility, shouldn’t it also be able to decrease it?  We have scads of alternative treatments for the common cold, back pain, headache, multiple sclerosis, diabetes—everything, really.  Why not contraception?  After all, no one likes condoms, and the pill comes with its own baggage.  Nuva rings and IUDs are convenient, but can be annoying to use, or can cause problems in certain patients.   And almost all contraception relies solely on the woman.  The only possible contribution a man can make is condom use or vasectomy.

Where is the alternative medicine community?  They are usually pretty keen on getting involved in common medical problems.  Undesired pregnancy is a common problem.  Where are the studies on acupuncture for contraception?  Homeopathy?  Chiropractic?

How would these treatments look?  Acupuncture could perhaps stimulate the qi involved with spermatogenesis, causing a feedback inhibition, right?  Homeopathy, well, if a lot of sperm heading to the egg are the cause of pregnancy, then a little bit of sperm should do the trick I’d think.  You could even put them in a lozenge. And with vertebral subluxations able to cause all manner of medical problems, shouldn’t a good chiropractor be able to shove around a vertebra, impeding sperm production or release?  Contraception is big business.  Where are these guys?

Let me very clear that I am a traditionalist when it comes to contraception, preferring those methods that have been proven safe and effective.  I don’t give medical advice online, but I might make an exception here.

Speaking of implausible, after looking at some of Kimball’s slides, I wanted to do this just for giggles.

Common cuts of beef vs. Reflexology chart

Common cuts of beef


Posted in: Science and Medicine

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Return of an old foe

In 2000, a panel of experts was brought together by the Centers for Disease Control and Prevention (CDC). They came to discuss whether measles was still endemic in the United States, that is whether it still existed in the general background of US infectious diseases. They concluded that measles had been eradicated in the US, and that the occasional cases imported from abroad were stopped by a wall of vaccinated Americans.

Welcome to the future. The US is in the middle of its largest measles outbreak since 1996. Most of the cases originated abroad, brought back by unvaccinated travelers, either American residents or foreign visitors. This has so far led to 12 outbreaks (that is, a cluster of three or more connected cases) mostly among the unvaccinated. Of the 139 cases who were US residents rather than foreign visitors, twelve had documentation of adequate immunization.

The surprise isn’t that a few cases should slip through the wall of vaccination, but that the wall has so many chinks in it. The number of measles cases being imported, and the falling vaccination rates of Americans may reach the point soon where we no longer need to import our measles as it will once again become endemic.

Measles isn’t just a curious disease that we learned about in medical school (“cough, coryza, conjunctivits”); it’s a serious disease that leads to pneumonia in 1 in 20 children, and brain inflammation in 1 in 1000. Outside the US, it causes hundreds of thousands of deaths yearly.

We must increase our efforts to vaccinate all US residents properly (including undocumented residents). If measles does take hold once again in the U.S., the blame will fall squarely on our health care system’s failure to deliver vaccine, and on those who for whatever reason delay or avoid vaccination altogether.

It used to be that Americans viewed public health battles with excitement, a battle against fear itself, against the fear of children choking to death from whooping cough, or becoming paralyzed by polio. Now, as we sit behind our crumbling shield of vaccination, we have become complacent. If we fail to act, our complacency will be replaced by very real fears, especially for our children.

Posted in: Vaccines

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Steven Fowkes (Part 2 of 2): Nutrients for Better Mental Performance

Last week, in part 1, I covered Steven Fowkes’ “cures” for Alzheimer’s and herpes. In part 2, I will cover a video where he goes further afield. It is titled “Nutrients for Better Mental Performance,” but he also discusses sleep, depression, hangovers, and a lot of other topics.

Some of what he says are simple truisms: mental performance is affected by everything related to health such as sleep, food, vitamins, minerals, detoxification, nutrients, amino acids, hormone replacement, pharmaceuticals and herbs. Metabolism is the key to brain function: 3% of the body uses 20% of the energy. Macronutrients, micronutrients, exercise, water, and breathing are important too.

We knew that.

Which nutrients promote optimal brain function? All of them: any deficiency will affect the brain. Fowkes goes beyond the evidence to claim that some nutrients are needed at super-physiological levels; Mother Nature is not optimal. Some supplements appear to work but the effects are not sustainable. It’s not about parts, but about how things work together. (more…)

Posted in: Neuroscience/Mental Health, Nutrition

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