Some people think circumcision is mutilation; others want one even if they don’t know what it is. When I was working in an Air Force hospital emergency room one night, a young airman came in requesting a circumcision. I asked him why he wanted one. He said a couple of his friends had had it done, and he’d heard it was a good idea, and he was going to be getting out of the Air Force pretty soon and wanted to have it done while Uncle Sam would still foot the bill. I examined him: he had a neatly circumcised penis without so much as a hint of any foreskin remnant. I’ve always wondered what he thought we were going to cut off.
The subject of circumcision evokes strong emotions. Some people think of neonatal circumcision as a religious duty or a valuable preventive health measure; others think it is the epitome of child abuse. I have no strong feelings either way. I’m not sure what I would have decided if I’d had sons; fortunately my children were both daughters so I didn’t have to decide. I’m going to try to stand back and look at the scientific evidence objectively. What are the medical benefits and risks of circumcision? (more…)
Sometimes I read an article in a medical journal that makes me say, “Well, duh! I could have told you that without a study.” Sometimes I read collected data that make me ask, “So what?” Sometimes I read an article that makes me wonder what kind of pogo stick they used to jump from their data to their conclusions. Sometimes I read a study that is so poorly conceived that you couldn’t hope to get any useful information from it. Sometimes I read a study that reminds me of class projects or term papers where you just thought of something easy to do to fill the squares to get credit. Sometimes I read a study funded by the NCCAM that makes me very angry that they wasted my tax dollars. Sometimes all these things coincide in one article.
“Ophthalmology Patients’ Religious and Spiritual Beliefs: An Opportunity to Build Trust in the Patient-Physician Relationship” is such an article. A questionnaire was anonymously filled out by 124 consecutive return patients in one ophthalmologist’s practice. It asked about their religious and spiritual beliefs and their understanding and level of concern about their eye condition. (more…)
Note: This is slightly revised from an article I originally wrote as a “SkepDoc” column for Skeptic magazine. It was pre-released online in eSkeptic and it has already generated a lot of comments, including “a truly amazing piece of peurile pseudo-intellectualism,” “an ad hominem attack on one form of alternative medicine so beset by poor thinking that one must come to the conclusion this woman might just be paid to write such propaganda,” and “twaddle wrapped in swaddling rhetoric.” (I treasure comments like those as evidence that my critics are so bankrupt of real arguments that they have to dip into the insult pouch for ammunition.) I thought it would be interesting to post it here on the blog and see how much controversy it would stir up among my co-bloggers and readers. Please keep in mind that it was written for a popular audience and excuse the lack of scholarly citations. You may recognize some of the studies I refer to from previous blog entries.
“Alternative” medicine is by definition medicine that has not been scientifically proven and has not been accepted into mainstream scientific medicine. The question I keep hearing is, “But what about acupuncture? It’s been proven to work, it’s supported by lots of good research, more and more doctors are using it, and insurance companies even pay for it.”
It’s time the acupuncture myth was punctured – preferably with an acupuncture needle. Almost everything you’ve heard about acupuncture is wrong. (more…)
I recently learned of a study entitled “Dominican Children with HIV not Receiving Antiretrovirals: Massage Therapy Influences their Behavior and Development.” It disturbed me, and I couldn’t get it out of my head. They’re massaging these kids but letting them die of AIDS? I went back and read the complete article, and it left me even more disturbed.
They studied 48 Dominican children ages 2-8 with untreated HIV/AIDS, randomizing them to receive twice weekly sessions of either massage or play therapy for 12 weeks. The abstract said that those in the massage group improved in self-help abilities and communication, and that children over the age of 6 showed a decrease in depressive/anxious behaviors and negative thoughts. That’s what the abstract said. The text revealed a more complex story. (more…)
I’m really tired of arguing about cholesterol, but I feel obliged to stand up once more to defend science-based medicine from unfair calumny.
Lewis Jones’s article “Cholesterol-shmesterol” in Skeptical Briefs (December 2007) included errors and misconceptions about cholesterol. It was a re-hash of the same kind of misinformation that is being spread by The International Network of Cholesterol Skeptics (THINCS) and that I addressed in an earlier post. THINCS would like us to believe that cholesterol has nothing to do with heart disease; that low cholesterol is harmful and high cholesterol is beneficial; and they demonize statins, even falsely claiming that they cause cancer.
I answered Jones with my own article “Cholesterol Clarifications” in the June 2008 issue of Skeptical Briefs. I said I agreed that cholesterol does not “cause” heart disease, that low-fat and low-cholesterol diets have been promoted way beyond the evidence and that statins are being over-prescribed. The public has a lot of misconceptions, but thoughtful science-based doctors agree that the evidence shows: (more…)
Diet advice changes so fast it’s almost a full-time job to keep up with it. Avoid cholesterol; no, avoid saturated fats; no, avoid trans-fats. Avocados are bad; no, avocados are good. Wheat germ is passé; now omega 3s are de rigueur. The supermarket overwhelms us with an embarras de richesses, a confusing superabundance of choices from “organic” to low-sodium. How can we decide what to have for dinner?
Michael Pollan, the author of The Omnivore’s Dilemma, has written a new book: In Defense of Food: An Eater’s Manifesto. He argues for a simplification of diet advice. He hones it down to seven words: Eat food. Not too much. Mostly plants. (more…)
I’m frequently asked, “Is what that ad says really true?” Three recent inquiries have been about products advertised in Scientific American. An ad may acquire a certain cachet by appearing in a prestigious science magazine, but that doesn’t mean much. Scientific American’s editorial standards apparently don’t extend to its advertising department. I remain skeptical about the claims for all three of these: Juvenon, the StressEraser, and the ROM exercise machine. I discussed the ROM machine last week.
This product is advertised as “The Supplement That Can Slow Down the Clock on Aging Cells.” Andrew Weil also sells this on his website. It supposedly helps keep your mitochondria from decaying, promotes brain cell function, sustains energy levels, and is a powerful antioxidant.
The first time I noticed an ad for Juvenon in Scientific American I wrote the following letter to the editor: (more…)
I know I should exercise regularly, but I’m congenitally lazy and am ingenious at coming up with excuses. There’s an exercise machine that sounds like the end of all excuses, a dream come true. You’ve probably seen the ads in various magazines. The ROM Machine: “Exercise in Exactly 4 Minutes per Day.” It claims that you can get the same benefit, at home, from 4 minutes a day on the ROM as you can from 20 to 45 minutes aerobic exercise plus 45 minutes weight training plus 20 minutes stretching at the gym. It allegedly balances blood sugar and repairs bad backs. It is for everyone from age 10 to over 100.
Does this sound too good to be true? That’s usually a clue that it is too good to be true. I was skeptical and I sent in for the company’s free DVD. There were more clues in the DVD. They had testimonials from 2 chiropractors, several trainers, and lots of satisfied users, but they didn’t have recommendations from a single medical doctor or scientist. In fact, they mentioned a couple of doctors who disputed their claims, including one cardiologist who told his patient that kind of strenuous exercise could kill him. To prove you could get a good workout from the machine, they put people on it, got them to huff and puff and sweat a lot, and then got them to say, “That was a real workout!” (more…)
Kava is a plant that grows in the western Pacific. It was traditionally prepared as a drink and used for its psychoactive properties, including sedation, relaxation, and relief of anxiety. It is intoxicating but not addictive.
It has become a popular supplement in the US, used to treat anxiety, depression, insomnia, stress, and menopausal symptoms. It has also been suspected of killing quite a few people.
The AAFP Recommends Kava
In August 2007 American Family Physician, the journal of the American Academy of Family Physicians, published an article on “Herbal and Dietary Supplements for Treatment of Anxiety Disorders.”
They concluded that
St. John’s wort, valerian, and omega-3 fatty acids have little therapeutic value for anxiety disorders, and their use should be discouraged.
But they recommended kava. Not only that, they gave it the highest quality-of-evidence rating: A. They said,
Short-term use of kava is recommended for patients with mild to moderate anxiety disorders who are not using alcohol or taking other medicines metabolized by the liver, but who wish to use “natural” remedies.
There was a full-page ad in my local paper today for Back in Action Spine and Health Centers, targeted at sufferers from almost any kind of chronic back pain. It started with “Are You Ready to Throw in the Towel and Just Live with Hurting So Bad?” It went on to make a number of claims:
- Doctors can fix the problem.
- Breakthrough medical technologies.
- Treatments are FDA cleared.
- Treatments are scientifically proven.
- No side effects.
- Best kept secrets for healing “bad backs.”
- Corrects scoliosis.
- Corrects compressed discs.
- Several university studies at Johns Hopkins, Stanford and Duke have confirmed that these treatments work.
- Medical researchers have reported these methods up to 89% effective.
- Treatments work for back and neck pain, sciatica/numbness, herniated and/or bulging discs, degenerative disc disease (arthritis), spinal stenosis, facet syndromes, spondylolisthesis.
- Their questionnaire can determine who will benefit – if you fit even one criterion like “does your back feel out of alignment?” or “do you have arthritis?” you should call right away.
The ad offers a “Free Qualifying Exam” but you “Must Not Wait” because appointments are limited and they can only honor this free offer for 3 weeks. To encourage you to call, they sweeten the pot with a FREE $49 gift bag.
Are you suspicious yet? You should be. (more…)