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Military Medicine in Iraq

 Doctors get a lot of flak these days without ever going near a battle zone. They are bombarded with accusations of not caring about their patients, of being shills for Big Pharma, of being motivated by money, of killing patients with medical errors and drug side effects. In addition, they are bombarded with claims that non-scientific medical systems (so-called alternative medicine, from chiropractic to Ayurveda) offer greater benefits to patients. 

It was a delight to read a new book   about a doctor who was exposed to real flak in Iraq. His story is a wonderful reminder of how effective modern medicine is and it is an eye-opener about the selfless dedication of doctors who put themselves in harm’s way; who accept lower incomes, separation from families, and poor living conditions; who care desperately about their patients; and who magnanimously apply the same skills to treating friend and foe. 

The title is Coppola: A Pediatric Surgeon in Iraq. The author, Chris Coppola, is an Air Force pediatric surgeon who was twice deployed to Balad Air Base, 50 miles north of Baghdad, as a trauma surgeon. In his first night on call, he treats the five worst gunshot injuries he has ever seen – and they are all in the same patient! Despite serious damage to liver, colon, small intestine, pancreas, duodenum, vena cava and spine, the patient, a 22 year old Iraqi policeman, recovers. As the foreword of the book explains, the survival rate for troops injured in the field was 20% in WWI, 40% in WWII, 66% in Viet Nam, and is now an astounding 97% in Iraq. Lessons learned in war are translated to civilian trauma care and we all benefit from the knowledge however much we may deplore the war. 

No subluxations were adjusted, no qi manipulated, no acupuncture points stimulated, no homeopathic or herbal medicines given. Beside numbers like these, alternative medicine looks pretty puny and irrelevant. And the Air Force’s initiative to train doctors in battlefield acupuncture looks frankly delusional.  (more…)

Posted in: Book & movie reviews

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The Montagnier “Homeopathy” Study

A recent study is being cited as support for homeopathy. For instance, the Homeopathy World Community website says

Luc Montagnier Foundation Proves Homeopathy Works.

Dana Ullman cites it in the comments to this blog

And I assume that you all have seen the new research by Nobel Prize-winning virologist Luc Montagnier that provides significant support to homeopathy. 

Nope. Sorry, guys. It doesn’t. In fact, its findings are inconsistent with homeopathic theory.

The study has nothing whatsoever to say about homeopathy. Its abstract concludes:

This opens the way to the development of highly sensitive detection system for chronic bacterial infections in human and animal diseases.

Homeopaths are grasping at straws when they cite this study. It involved dilution and agitation: that’s the only possible hint of anything homeopathic and it is nothing but a false analogy. (more…)

Posted in: Homeopathy

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Resveratrol: Of Mice and Men

We would all like to live longer. The most promising longevity research indicates that severe calorie restriction might extend life span, but such a diet is difficult to follow. Resveratrol, a phytochemical found in red wine, has been evaluated as a possible way out of the dilemma. When given to obese mice on a high calorie diet, it produced a number of changes associated with improved health, such as increased insulin sensitivity, and it increased survival. Perhaps by taking resveratrol you could eat as much as you want and get fat without suffering the usual consequences. Perhaps you could get the longevity benefits of severe calorie restriction without restricting calories.

In addition to fat mice, resveratrol also extends the life of Saccharomyces cerevisiae, Caenorhabditis elegans and Drosophila melanogaster (yeast, nematodes, and fruit flies). But a study in non-obese mice found no increase in survival (although it did find several signs of improved health). Besides the anti-aging claims, there is also some evidence from in vitro and animal studies that it might have cardiovascular effects and anti-cancer effects. (more…)

Posted in: Herbs & Supplements

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“Obesity Linked to Stupidity”- an Example of Stupid Reporting

A news story on Science a Gogo reports that obesity is linked to stupidity, according to a new study based on brain scans. Apparently the reporter can’t read. That’s not at all what the study showed.

What the Study Really Said

The study was entitled “Brain structure and obesity.”It was published in Human Brain Mapping. There were 10 authors listed, with the two interviewed for the news report being the lead author (CA Raji) and the last listed author (PM Thompson). The study evaluated MRI scans of 94 elderly subjects who were cognitively normal and remained cognitively normal for at least 5 years after their scan. It found that obese people had 8 percent less brain tissue than people with normal weight, while overweight people had 4 percent less tissue. The deficits were in areas of the brain that have been associated with Alzheimer’s disease. The story reports that this put the subjects at high risk for Alzheimer’s disease. But the subjects remained cognitively normal for at least 5 years after the scan. They were not rendered stupid. They did not develop Alzheimer’s. They remained cognitively normal. You might also interpret the study as showing that obese patients with those findings on brain scan could be predicted not to develop Alzheimer’s or develop any other cognitive deficits for at least five years. (more…)

Posted in: Science and the Media

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AAFP Endorses CAM

I recently chastised the American Family Physician (the journal of the American Academy of Family Physicians) for assigning a high SORT (strength of evidence) rating to acupuncture treatments that did not merit that rating. While the AAFP claims to strongly support evidence-based medicine, I have observed a gradual infiltration of CAM into their journal, their website, and their CME offerings. They seem to be more concerned with the popularity of CAM and with not offending its believers than with maintaining scientific rigor. The problem is only getting worse.

Recently a “News Now” article was published on the AAFP website: “New Report Details Billions Americans Spend on Complementary, Alternative Medicine: Physicians Can Benefit from Adding CAM to Their Practices, Says FP” It is very disturbing. (more…)

Posted in: Science and Medicine

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Red Yeast Rice to Lower Cholesterol

The Medical Letter,  a highly respected source of reliable independent evaluations of drugs and therapeutics, has just published an evaluation of red yeast rice (Vol 51, Issue 1320, P 71-2, Sept 7, 2009). It has been widely promoted as a “natural” alternative to prescription medications for lowering blood LDL cholesterol levels. Studies have indeed shown that red yeast rice reduces LDL cholesterol levels and reduces the rate of major coronary events. The Medical Letter consultants concluded that it works, but they don’t recommend it. Why?

It’s Just Another Statin

When rice is fermented with the yeast Monascus purpureus, the resulting product contains numerous monacolins, which are naturally occurring HMG-CoA reductase inhibitors. One of these is identical to the prescription drug Mevacor (lovastatin). So it isn’t an alternative to prescription drugs, it’s just an alternative way of providing the same thing. (more…)

Posted in: Herbs & Supplements

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AFP Promotes Acupuncture

I subscribe to American Family Physician, the peer-reviewed journal of the American Academy of Family Physicians. It emphasizes evidence-based medicine and most articles include a table showing strength of evidence ratings for key recommendations for practice. Lately, its scientific rigor has been slipping. I have complained to the editor about several articles whose recommendations were not based on the best science, and I have been consistently ignored. 

Acupuncture for Chronic Low Back Pain 

A recent article on chronic low back pain recommended acupuncture and gave it an “A” rating corresponding to “consistent, good-quality patient-oriented evidence.” I wrote the following letter to the editor and to the author of the article:  (more…)

Posted in: Acupuncture

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Applying Rigorous Science to Messy Medicine

The PowerPoint presentation that I gave at the Skeptic’s Toolbox workshop at the University of Oregon on August 7, 2009 is up on their website with the complete text of what I said. The theme of the workshop was scientific method. The title of my talk is “Tooth Fairy Science and Other Pitfalls: Applying Rigorous Science to Messy Medicine.” Click here for the link. It covers a lot of things that are pertinent to the subjects we discuss on this blog, and I thought some of our readers might enjoy it. I put in a lot of information and some good cartoons. Note: this was a talk to the general public, not an academic presentation, and it does not include citations or references.

Posted in: Science and Medicine

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Swine Flu Vaccine Fearmongering

Fear is a curious thing. It often bears no relation to the actual risk of what we fear. When swine flu first broke out in Mexico, people were understandably afraid.  Travel was restricted, schools were closed, and so many people stayed home that the streets of Mexico City were empty. As the disease spread around the world, Egypt developed a paranoid fear of pigs and committed national pigicide. They ordered the slaughter of all 300,000 of their country’s innocent little porkers, ignoring the fact that the flu is spread person-to-person, not pig-to-person. Now that the disease has officially been labeled a pandemic, fears have switched from the real threat of the disease to an imagined danger from the vaccine. 

Some people just plain hate the idea of vaccines – to the point that they are willing to spread old falsehoods, make up new lies, distort the results of studies, misrepresent statistics, and endanger our public health. There are websites like “Operation Fax to Stop the Vax” and even anti-swine-flu-vaccine rap videos.   Press releases, e-mail campaigns, talk shows, and blogs are being used to stir up irrational fears. These people are irresponsible fearmongers. They are wrong, and they are dangerous.  
(more…)

Posted in: Vaccines

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“The Disappearing Male” – A Pinch of Science, a Pound of Speculation

A documentary film entitled “The Disappearing Male” was first shown on CBC in June, 2009. It can be viewed online here.

Some of its rhetoric is reminiscent of Chicken Little:

  • “Where have all the boys gone?”
  • “Millions of males are disappearing.”
  • “We’re on the Titanic and we see the iceberg but we just can’t turn the ship.”
  • “It may be a threat to the survival of the species.”

The claims behind the rhetoric are that male to female sex ratios at birth are decreasing, sperm quality and fertility are decreasing, and genitourinary birth defects like hypospadias are becoming more common. The film blames environmental chemicals, especially endocrine disruptors, and it claims they are causing “the most rapid period of evolution our species has ever seen” and that this may lead to our extinction. (more…)

Posted in: Science and the Media

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