He was down in Venezuela with none other than Andrew Wakefield this May.

If a professor thinks his students have discovered something remarkable, it’s his duty to encourage them to get it the widest possible audience, not bury it in the school’s own publications.

That might mean submitting to publications outside his sphere of influence, to a journal with higher circulation and stiffer standards.

“I’m not too sure about the references used to support the hypothesis that non-english speaking countries or journals publish positive studies preferentially. The first study cited compares studies about acupuncture between England on one side and China, Japan, Russia and Taiwan on the other…it might not be too wise to generalize from that kind of study.”

The acupuncture study I cited went on to evaluate studies of conventional treatments. The abstract says “In studies that examined interventions other than acupuncture, 405 of 1100 abstracts met the inclusion criteria. Of trials published in England, 75% gave the test treatment as superior to control. The results for China, Japan, Russia/USSR, and Taiwan were 99%, 89%, 97%, and 95%, respectively. No trial published in China or Russia/USSR found a test treatment to be ineffective.”

Granted, one shouldn’t usually generalize from one study. But my personal experience and reports from credible sources in China make me think that the conclusion is probably valid. In the absence of any other study refuting its findings, I tentatively accept it.

I’m not too sure about the references used to support the hypothesis that non-english speaking countries or journals publish positive studies preferentially. The first study cited compares studies about acupuncture between England on one side and China, Japan, Russia and Taiwan on the other…it might not be too wise to generalize from that kind of study.

Nevertheless I believe, just like you, that that RCTs conducted in ‘developing’ countries are likelier to be positive (even if I don’t have any evidence to support it, is there any?). I also believe that this could be explained by the cost of conducting proper RCTs (according to the regulations to protect patients rights), which is so high that it’s unlikely for non-industry-linked researchers to finance an RCT. Drug companies or medical technology companies pay for positive results to appear and negative ones not to, that’s no mystery.

Anales de la Facultad de Medicina is not considered an obscure journal here, it’s edited at the oldest medical school in the country and one of the most prestigious. I don’t know about it’s peer review process, though. I know that at least 2 peruvian medical journals (Revista Medica Herediana and Revista Peruana de Medicina Experimental y Salud Publica) have due peer-review processes.

I think, as most of you do, that research should not be biased by our personal beliefs. Dr. Maya’s paper does have very biased introduction and has the methodological flaws pointed out by many of you.

I am myself also very disturbed by some anti-vaccine activists acts and opinions. Recently in Peru there have been 2 very important vaccination campaigns. The first one was to vaccinate fertile women to prevent congenital rubella and the other one to vaccinate all children against Hepatitis B Virus (we still have regions with high vertical transmission rates).

Both of these campaigns were attacked through the media by anti-vaccine activists. The negative impact of this on both campaigns is still to be assessed by a scientific manner but I witnessed many parents refusing to vaccinate their children fearing autism. In a country where most HBV infected patients won’t be able to afford inferon or antivirals it’s even more serious to harm vaccination campaigns like these ones.

Misinformation through the media harms the health of populations. Those who misinform should be legally prosecutable for the harm they provoke.

On the bright side, the Peruvian Ministry of Health did not withdraw its vaccination campaigns despite all the media fuss. But this is thanks to politicians that were well informed by serious physicians.

That said, each study should be judged on its own merits. Good research and bad research are done in all countries.

In this case, even if this study’s design and results were impeccable, even if it were done at Johns Hopkins and published in The New England Journal, even if ithe authors were Nobel-prize winning researchers, it would not be acceptable to use it as an argument against thimerosal in vaccines.

I intended no disrespect to Peru or to Spanish-speaking scientists. My disrespect is for those who grasp at straws like this to support an ideological agenda.

I am a bit surprised that some of you point out as arguments against Dr. Maya’s research things like the fact that it’s done in a country like Peru or that it’s written in spanish. That kind of ethnocentric bias resembles a lot Dr. Maya’s anti-vaccine bias.

Peruvian researchers have made significant contributions to many areas of medicine such as infectious diseases (cysticercosis, leishmaniasis, bartonellosis, etc), gastroenterology (h pylori and gastric cancer), high altitude medicine and physiology, among other disciplines.

Pseudoscience is diffused through the media not only in underdeveloped spanish speaking countries like Puerto Rico or Peru but also in well developed countries. (ie. scientology, the “abscence of evidence” for global warming…) The industry bias of many well renowned medical journals from the developed world is not too hard to be detected… So if you have money and influence peer review may not only by-passed in Peru but also in Europe or the US…

So it would be great if the discussion were based a lot more on the critical appraisal of Dr. Maya’s research (like TsuDohNimh’s arguments) than in speculations about what goes on in Peru or Puerto Rico.

PD: There’s a comprehensive academic review about Thimerosal and autism written by a peruvian pediatrician. Which was also published in spanish in the Acta Medica Peruana, here’s the link:
http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1728-59172007000100012&lng=es&nrm=is

Javier Villafuerte Galvez, peruvian medical student

I do have some composites that are 18 years old. The dentist apparently did not cure them completely. I had a bad case of glossitis for weeks until the dentist went over the composites again with the UV gun. These predated the blue light cured composites. Mercury free is not necessarily toxin free.

Giving an equivalent dose at days 7, 9, and 11 for the hamster pup (trying to match 2, 4, and 6 month infants) doesn’t give the animal time to clear the first dose before the second one is given. The infants have a couple of months; the hamsters have 48 hours.

Like rats and mice, hamsters are born naked and blind. Their eyes don’t even open until day 13 or 14 …. so these “experiments” were done on extremely immature animals.

I see no mention of equal numbers of sexes in the groups, and hamster females are larger than the males by about 10%, even before weaning.

I see no mention of the light levels or the care conditions. Hamsters are photo-period sensitive, and changing light levels will make them gain or lose weight.

LOL! You mean the scientific community that needs vaccines to be safe and effective. http://www.whale.to/vaccine/vaccine_autism_proven.html

A bit of google-fu found this website:
http://members3.boardhost.com/AUTISMO/msg/1181658890.html

Which shows that he apparently ‘treats’ autistic children. (website also has the address of his office and his phone number). Some more googling shows that he is lobbying the government of Peru to stop using vaccines that contain ‘toxic levels of mercury’.

More googling finds this website for a forum on “Biomedical Treatments for Autism” in Venezuela, where Dr. Maya is a guest speaker:
http://www.greatplainslaboratory.com/Conference/VENEZUELA-2008/

So it does look like this guy is out to make a quick buck off those who believe autism is caused by mercury.

Shameless link to my blog: doazic.wordpress.com

“Some things deserve special mention just because they go off the deep end. Virginia Gomez deserves an honorary mention for achievement in the field of insanity. As you can see in her horrifying website this is a person who dabbles in every field of pseudoscience, woo and superstition imaginable. I first became aware of Virginia through her radio program on WKAQ 580, a Spanish language station in Puerto Rico.

Last week the program hit a new low, when her guest, (a psychologist who I have been unable to identify), recommended trepanation as a treatment for autism. This bears repeating, her guest recommended trepanation as a treatment for autistic children. In keeping with her practice of agreeing with anything her guests say regardless of lack of plausibility of corroborating evidence, she promptly told the caller to look into trepanation as treatment.” http://doazic.wordpress.com/

There is even an International Trepanation Advocacy Group that believes that making a opening in the skull favorably alters movement of blood through the brain and improves brain functions. http://www.trepan.com/index_.php

Has anyone else heard anything like this being done before? At what point can we call child services on these people?

I don’t remember the last time I went to the dentist, because it’s been that long. But I do remember that it was about the time when composites were starting to come in as the filling material of choice. My dentist, being slightly behind the times, stuck four little blobs of mercury amalgam in my teeth.

They’ve been with me for at least 16 years (since that last visit I’ve managed to avoid cavities and so haven’t been back since). My boyfriend, who has both amalgams and composites, has had to get his composites replaced almost every year, while his amalgams remain intact.

Moral of the story: stick to the mercury!

In all seriousness–I think people are clinging to the pseudo-autism-thimserol link because they don’t want to acknowledge a far likelier culprit: TV. I’m about halfway convinced that the correlation between TV and autism rates is real, but I haven’t heard of any long-term studies or anything beyond the Cornell epidemiological survey that first uncovered this link. Like I said, I’m not entirely convinced–correlations are not causations–but it’s intriguing and (I think) worth exploring. The theory (which is far more sound than anything the anti-vax idiots can come up with) is that watching lots of brightly-colored two-dimensional images when the brain is still developing can lead to changes in how the visual cortex develops, which correspond to the differences in the visual cortices of autistic kids. Like I said, intriguing. But real? TBD.

I’ve read elsewhere that studies out of China are essentially all positive, but can’t put my hands on the source at the moment. Maybe other readers can help.

I also found this on bias in Chinese genetic epidemiology studies: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0020334&ct=1

“Studies in non-English speaking countries are statistically more likely to be positive (i.e., there is a greater chance that published reports are false positives).”

Do you have a cite? I mean, it wouldn’t surprise me if articles published in non-English-only journals were sub-par.

It also appears to me that this “research” is the med school equivalent of a freshman’s essay for a lit class. They were all bounded together and a student from the art department designed a cover.