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Archive for July, 2013

Doing Eric Merola a favor…

Believe it or not, I’m going to do Eric Merola (who doesn’t particularly like me, to the point of thinking, apparently, that I’m a white supremacist who doesn’t like evidence but does like to eat puppies) a favor. Having been away at TAM and otherwise occupied hanging out with fellow skeptics and, more stressfully, getting ready to give a talk in front of as many as 1,000 people on Saturday, somehow I missed this. Well, actually, I didn’t miss it, but somehow I forgot to post it, even though it would have only take a few minutes. Then when I got home I still forgot to post it. Now there are only three days left (four, counting today) for me to do it; so I’d better get to it. My having forgotten to do this is particularly amazing given the subject of my main stage talk at TAM, our old buddy Stanislaw Burzynski. I’m even doing it as an extra “bonus” post on a day that I don’t usually post on SBM.

I wonder if Merola will appreciate the favor I’ve done him?

Eric Merola, as you recall, is a filmmaker who was responsible for two propaganda films about Stanislaw Burzynski, the dubious cancer doctor who has used “antineoplastons” to treat cancer without having published any decent clinical trial evidence that they do what he claims. Back in 2010, Merola released the first of a not-so-dynamic duo of films, the first of which was called Burzynski The Movie: Cancer Is A Serious Business (or B1, as I like to call it). The movie didn’t do much for a year or more, but then über-quack Joe Mercola promoted it, and somehow Eric Merola landed an interview with Dr. Oz on his radio show. The sequel, the slightly less pretentiously titled Burzynski: Cancer Is A Serious Business, Part 2 (or B2, as I like to call it), was then released June 1 on various pay-per-view modes. As has been pointed out, it’s no better than the first, and it features direct attacks on the skeptics who had the temerity to criticized Burzynski and Merola over the last couple of years.
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Posted in: Cancer, Science and the Media

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Researching SBM Online

The internet is a fabulous resource of information. It is one of those technological innovations for which you soon can no longer imagine how you lived without it. I certainly cannot imagine a project like science-based medicine prior to the web.

The web, however, is also a tremendous source of misinformation, opinion, and ideology. Also the volume of information, good and bad, can be overwhelming. We therefore are frequently asked the meta-question of how we conduct our research into specific topics, or how can the average layperson do their own research online.

Efficiently and effectively researching a complex topic is complex. It is a skill that needs to be developed, and it is especially difficult without having detailed knowledge of the specific topic ahead of time. Therefore there is no simple answer to this question, but I can offer some tips.

There are two main resources I use when searching a topic, Google and PubMed. They each have their strengths and weaknesses. For the average user, Google (or whichever general search engine you prefer) is likely going to be your first stop.

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Posted in: Critical Thinking, Science and Medicine

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The Business of Baby and the Monkey Business of Margulis

A correspondent asked for my opinion of a new book by journalist Jennifer Margulis that is apparently getting a lot of attention in some circles: The Business of Baby: What Doctors Don’t Tell You, What Corporations Try to Sell You, and How to Put Your Pregnancy, Childbirth, and Baby Before Their Bottom Line. I got a copy from the library and read it. It was a painful experience. One of the customer reviews on the Amazon website accurately sums up my own reaction:

There is a great need for an incisive look at all sides of modern maternity care in the United States, because — let’s face it — we all know it’s not perfect. This, however, is not that book.

The author is a strong advocate of home birth, water birth, midwives, “embracing the pain to make you stronger,” “parents know better than doctors,” natural = good, and very early potty training. She thinks bathing a newborn is harmful. She questions the need for well baby checkups: she thinks they are mainly a gimmick to sell vaccines. She questions the (science-based) practice of giving newborns vitamin K and prophylactic eye drops. She is against the use of chemicals in general. She reports that Johnson’s Baby Wash contains “a host of unpronounceable chemicals, some of which are known toxins…and carcinogens.” She doesn’t seem to have grasped the basic principle of toxicology that the poison is in the dose. She is against formula, which she says is killing babies, and against disposable diapers because they contain chemicals and petroleum and because they can cause your child to become infertile. Her only evidence for “infertility” is one study showing that disposable diapers raise scrotal temperatures. Indeed, plastic underpants are probably warm.
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Posted in: Book & movie reviews, Obstetrics & gynecology, Vaccines

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Do clinical trials work? It depends on what you mean by “work”

Introduction

(Skip to the next section if you want to miss the self-referential blather about TAM.)

As I write this, I’m winging my way home from TAM, crammed uncomfortably—very uncomfortably—in a window seat in steerage—I mean, coach). I had been thinking of just rerunning a post and having done with it, sleeping the flight away, to arrive tanned, rested, and ready to continue the battle against pseudoscience and quackery at home, but this seat is just too damned uncomfortable. So I might as well use the three and a half hours or so left on this flight to write something. If this post ends abruptly, it will be because I’ve run out of time and a flight attendant is telling me to shut down my computer in those cloyingly polite but simultaneously imperious voices that they all seem to have.

I had thought of simply recounting the adventures of the SBM crew who did make it out to TAM to give talks at workshops and the main stage and to be on panels, but that seems too easy. Even easier, I could simply post my slides online. But, no, how on earth can I reasonably expect Mark Crislip to post while he’s at TAM if I’m too frikkin’ lazy to follow suit? I’m supposed to lead by example, right, even if what comes out is nearly as riddled with spelling and grammar errors (not to mention the occasional incoherent sentence) as a Mark Crislip post? Example or not, lazy or not, I would be remiss if, before delving into the topic of today’s post, I didn’t praise my fellow SBM bloggers who were with me, namely Steve Novella, Harriet Hall, and Mark Crislip, for their excellent talks and insightful analysis. Ditto Bob Blaskiewicz, with whom I tag-teamed a talk on everybody’s favorite cancer “researcher” and doctor, Stanislaw Burzynski. It’ll be fun to see the reaction of Eric Merola and all the other Burzynski sycophants, toadies, and lackeys when Bob’s and my talks finally hit YouTube. Sadly, we’ll have to wait several weeks for that. (Hmmm. Maybe I will post those slides later this week.)
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Posted in: Cancer, Clinical Trials

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Who you gonna believe, me or you own eyes?

Mrs. Teasdale: Your Excellency, I thought you’d left!

Chicolini: Oh no, I no leave.

Mrs. Teasdale: But I saw you with my own eyes!

Chicolini: Well, who you gonna believe, me or your own eyes?

Duck Soup. Funniest movie ever.

If I could choose a super power, it would be neither flight nor invisibility, but the ability, like Triad, to separate into multiple people so I could accomplish more. I find that my multiple personality disorder is not all that efficient at getting things done. The Goth cowgirl? Lazy.

So sometimes I have to cut corners. As this post goes live I am at TAM helping with panel discussions and workshops and the only way I can get a post up is to cannibalize my lecture. Dr. Gorski will not let me post the slides and be done with it; those managing editors can be so unreasonable. Full sentences. Proper spelling. Good grammar. Sheesh. Some people.

The topic of my presentation is the cognitive errors that lead people to believe in nonsense and is, or was, a brief tour of the flawed ways in which we think and how the brain allows everyone to be under the false impression that fictions are real. (more…)

Posted in: Critical Thinking, Science and Medicine

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Ask the (Science-Based) Pharmacist: What are the benefits of coffee enemas?

How do you like your coffee? Rectally.

How do you like your coffee? Rectally.

It might not occur to you, sipping your morning coffee, that you could derive tremendous health benefits by simply shooting that coffee directly into your rectum. Yet many people believe this. Suzy Cohen, who calls herself, “America’s Pharmacist™” and also “America’s Most Trusted Pharmacist®” is a proponent. Her syndicated column Ask the Pharmacist recently contained this question and response: (more…)

Posted in: Cancer, History, Naturopathy

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Brain Stimulation for the Masses

In the last decade or so there has been increasing research into non-invasive brain stimulation techniques for a variety of conditions. These include transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), random noise stimulation (tRNS), and transcranial magnetic stimulation (TMS). These techniques alter the excitability of neurons in the brain, seem to have an effect on plasticity (the ability to form new connections), and can modulate the activity of brain networks.

Overall the current research is preliminary but encouraging. Many of the details of exactly how to apply this new technology, however, are still being worked out. One recent review summarizes this complexity:

tDCS can be used to manipulate brain excitability via membrane polarisation: cathodal stimulation hyperpolarises, while anodal stimulation depolarises the resting membrane potential, whereby the induced after-effects depend on polarity, duration and intensity of the stimulation. A variety of other parameters influence tDCS effects; co-application of neuropharmacologically active drugs may most impressively prolong or even reverse stimulation effects. Transcranial alternating stimulation (tACS) and random noise stimulation (tRNS) are used to interfere with ongoing neuronal oscillations and also finally produce neuroplastic effects if applied with appropriate parameters.

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Posted in: Neuroscience/Mental Health

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The Bendectin Controversy Redux?

When I read that a new study had shown that antihistamines were harmful for patients with morning sickness, I cringed and thought “Here we go again.”

Hyperemesis gravidarum (HG) is a serious complication of pregnancy. Simple morning sickness is more common and less serious. When I started out in medicine, we routinely treated morning sickness with Bendectin. It was a safe and effective remedy, a combination of the antihistamine doxylamine and a B vitamin, pyridoxine. Unfortunately the manufacturer, Merrill Dow Pharmaceuticals, was bombarded with numerous lawsuits claiming that Bendectin caused birth defects. There was a clear scientific consensus that the evidence did not show that Bendectin caused birth defects and there was plentiful evidence of its safety. The lawyers prevailed over the science, and in 1983, Dow voluntarily took Bendectin off the market to avoid further litigation expenses. After the drug’s withdrawal, the rate of birth defects did not decrease, but the rate of hospitalization for hyperemesis gravidarum doubled. (more…)

Posted in: Legal, Obstetrics & gynecology, Pharmaceuticals

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A Trilogy of (Acupuncture) Terror

A Trilogy of (Acupuncture) Terror

TAM is fast approaching, and I’ve been frantically trying to get my talks together. The theme this year is “Fighting the Fakers,” and one of my talks will be for the Science-Based Medicine Workshop on Thursday, in which I will attempt in a mere 15 minutes to explain what Science-Based Medicine is and how it can be used to combat the infiltration of quackademic medicine into medical academia. Then, the second talk will be a tag-team spectacular with Bob Blaskiewicz about Stanislaw Burzynski as an example of how some cranks skirt the edges of science-based medicine. That doesn’t make them any less dangerous (if anything, it makes them more dangerous), but it does make them not as easy to identify as someone like, say, Hulda Clark.

Trilogy_of_Terror_Poster

Unfortunately, between working on these talks, revising some papers, and having an unusually busy weekend on call, I wasn’t sure what I was going to come up with for the edification of you, our readers. Fortunately, right on the 4th of July holiday, there was an article that gave me my idea, particularly given that I had noticed a couple of studies on the very subject of the article in the week leading up to the long holiday in the US (at least for people not on call). As a result, I’m half tempted to refer to this article as a trilogy of acupuncture terror.

Oh, wait. I just did. (more…)

Posted in: Acupuncture

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Infant and Toddler Swimming Programs: Are They Safe and Effective?

It’s now officially summertime, but people have been hitting the pools and beaches for weeks in many parts of the nation. In fact it has been well into the 90’s for over two month here in Baton Rouge, which is what I blame for the early exit of LSU from the College World Series. Our boys just weren’t used to that cold and dry northern weather.

Not surprisingly, the media has already been busy reporting on some of the many tragic drowning incidents that have occurred thus far, and Facebook profiles have been full of commentary from worried parents. And, as usual, there are businesses offering infant and toddler swimming lessons costing hundreds and even thousands of dollars per course, some of which come with claims of decreasing the risk of drowning in the young participants.

At what age can a child begin swimming lessons? According to Jan Emler of Emler Swim School, teaching a child to swim can start “As soon as the umbilical cord falls off.” Emler, like more reputable proponents of infant and toddler swimming programs, doesn’t actually put newborns into swimming pools for lessons (I’ll leave water birthing enthusiasts out of this discussion). For the most part these programs only cover bath time activities to help younger babies grow comfortable being in the water. Truly teaching infants and toddlers behaviors aimed at reducing the likelihood of drowning in the event of falling into a body of water doesn’t usually start until 6 months of age. There are exceptions.

But when should these lessons start, are they safe and do they work? Or do they actually put children at risk of injury and the parent at risk of having a false sense of security? Until their updated 2010 policy statement on the prevention of drowning, the American Academy of Pediatrics came down firmly against initiating swimming lessons in children less than 4 years of age for a number of very good reasons. Why did they soften their stance and does their change of opinion support the claims that are being made by infant and toddler swimming programs?  First some background information.
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Posted in: Basic Science, Public Health

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