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Reverse Ageing Hype

There are a number of annoying clichés of science reporting, prime among them being the need to make a connection from any research to a specific application. It must be deeply embedded in the journalism culture, or written in a handbook somewhere.

In medicine this means that any study that involves viruses or the immune system’s ability to fight off infection might lead to a cure for the common cold. Any study that has anything to do with cell function might lead to a cure for cancer. Almost any study of the brain might one day cure Alzheimer’s disease.

Add to this – any study that alters a metabolic parameter that changes with age might, of course, reverse the ageing process.

Such were the headlines about a recent study in Cell looking at mitrochondrial function in mice. Here is the summary: (more…)

Posted in: Basic Science

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An Apple a Day

We (the authors and editors) at SBM get accused of many nefarious things. Because we deliberately engage with the public over controversial medical questions, we expect nothing less. It goes with the territory. In fact, if there were a lack of critical pushback we would worry that we were not doing our job.

Still, it is disconcerting to see the frequently-repeated ideological accusations in response to simply evaluating and reporting the evidence. That is what we do here – follow the science and evidence. When that trail leads to a conclusion that some people do not like (usually for ideological reasons) a common response is to accuse us of ideology, malfeasance, being part of a conspiracy, or having conflicts of interest or ulterior motives. That is easier, I suppose, than engaging with us on the science.

One common accusation is that we are shills for the pharmaceutical industry, and downplay or ignore the benefits of diet and “natural” treatments. A search through the SBM archives demonstrates that this accusation is false – we criticize bad science and poor-quality control, regardless of who is committing it. Sometimes pseudoscience is used to promote a drug, sometimes a nutritional supplement, and sometimes pure magic. (more…)

Posted in: Nutrition, Public Health

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Measles Spike in US

The Centers for Disease Control (CDC) announced in a recent press release the data for 2013 so far shows 175 confirmed cases of measles in the US. This is about three times the usual rate of 60 per year since endemic measles was eradicated in the US, and is the most in the last decade other than 2011, which saw 222 cases.

Measles is a highly contagious virus that primarily causes a respiratory infection. It is not benign. According to the CDC:

About one out of 10 children with measles also gets an ear infection, and up to one out of 20 gets pneumonia. About one out of 1,000 gets encephalitis, and one or two out of 1,000 die.

About 500 Americans died each year of measles prior to the introduction of the vaccine. Measles is still endemic in Europe and many other parts of the world, causing about 20 million infections and 164,000 deaths each year. (more…)

Posted in: Vaccines

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The Seralini GMO Study – Retraction and Response to Critics

Elsevier has announced that they are retracting the infamous Seralini study which claimed to show that GMO corn causes cancer in laboratory rats. The retraction comes one year after the paper was published, and seems to be a response to the avalanche of criticism the study has faced. This retraction is to the anti-GMO world what the retraction of the infamous Wakefield Lancet paper was to the anti-vaccine world.

The Seralini paper was published in November 2012 in Food and Chemical Toxicology. It was immediately embraced by anti-GMO activists, and continues to be often cited as evidence that GMO foods are unhealthy. It was also immediately skewered by skeptics and more objective scientists as a fatally flawed study.

The study looked at male and female rats of the Sprague-Dawley strain of rat – a strain with a known high baseline incidence of tumors. These rats were fed regular corn mixed with various percentages of GMO corn: zero (the control groups), 11, 22, and 33%. Another group was fed GMO corn plus glyphosate (Round-Up) in their water, and a third was given just glyphosate. The authors concluded: (more…)

Posted in: Genetically modified organisms (GMOs), Nutrition

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The FDA and Personalized Genetic Testing

The company 23andMe provides personal genetic testing from a convenient home saliva sample kit. Their home page indicates that their $99 genetic screening will provide reports on 240+ health conditions in addition to giving you information on your genetic lineage. The benefits, they claim, are that you will learn about your carrier status and therefore the risk of passing on genetic diseases to your children. The information will also inform you about health risks so that you can change your behavior to manage them. Finally the genetic information will tell you about how you might respond to different drugs so that you can “arm your doctor with information.”

The home page also contains a link to testimonials about how their DNA testing has changed people’s lives.

This all sounds great – the promise of genomics that we have been hearing about now for about two decades. Isn’t this exactly what we were led to expect once we mapped the human genome?

Why, then, has the FDA recently sent a warning letter to 23andMe instructing them to discontinue marketing their Personal Genome Service (PGS)?

The primary reason appears to be a lack of documentation for the validity and reliability of the tests, but I have concerns that go even deeper. (more…)

Posted in: Public Health

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The Nuances of Informed Consent

Modern medical ethics are built upon the concept of informed consent. This is not, however, as straightforward a concept as it may seem.

Physicians and health care providers have a duty to provide informed consent to their patients or their patients’ guardians, which means that they have to inform them appropriately about the risks and benefits of their recommendations and interventions. This includes informing them about the risks of not treating an illness.

This principle is, in turn, based largely upon the principle of autonomy – people have the right to control their own lives, and one cannot have control without information.

This is all simple enough, but where it becomes tricky is in deciding how much information to give patients, and how to present it. (more…)

Posted in: Critical Thinking, Medical Ethics, Science and Medicine

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Detecting Consciousness in the Vegetative

People in a vegetative state, usually as a result of brain trauma or anoxia (lack of oxygen) by definition have no signs of conscious awareness or activity. The definition, therefore, is based largely on the absence of evidence for consciousness.

Of course, arguments based upon the absence of evidence are only as compelling as the degree to which evidence has been properly searched for. In recent years technology has advanced to the point that our ability to detect the possible subtle signs of consciousness in those presumed to be vegetative has increased – mainly through functional MRI scans (fMRI) and electroencephalograms (EEGs).

There has been a steady stream of studies demonstrating that a small minority of patients thought to be vegetative actually display some signs of minimal consciousness. The latest such study was recently published in Neuroimage: Clinical by a research team from the University of Cambridge.

But let’s back up a bit first. Even prior to evaluating vegetative patients with fMRI and advanced EEG techniques, several studies showed that a detailed neurological exam specifically designed to detect the most subtle clinical signs of consciousness could find such signs in some patients who were diagnosed as being vegetative by more standard neurological exam. According to one study as many as 41% of patients diagnosed as vegetative were really minimally conscious, meaning they had subtle signs of consciousness, but still cannot wake up, converse, or act purposefully. (more…)

Posted in: Neuroscience/Mental Health

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Lorenzo’s Oil

Augusto Odone is an Italian economist best known for his son, Lorenzo, after which Odone named the oil that he helped develop to treat his son’s neurological disease. Lorenzo’s oil was the subject of a 1992 movie starring Nick Nolte and Susan Sarandon, and of course what most people think they know about the story they learned from the Hollywood version.

This past week Augusto Odone died at the age of 80, prompting another round of media reporting about Lorenzo’s oil.

Probably because of the Hollywood movie, this story more than any other is an iconic example of the disconnect between the simple narratives the media love to tell (and we love to tell ourselves) and the more complex reality.

The basic facts of the story are not in dispute. Lorenzo Odone, son of Augusto and his wife, had a neurological disease known as X-linked adrenoleukodystrophy (X-ALD). This is a devastating genetic disease in males, with two basic forms. Childhood onset tends to progress rapidly and typically death occurs by age 10, although lifespan can be increased if an early bone marrow transplant is given. In adult onset, symptoms may not appear until adulthood, and then tends to progress more slowly, over decades. Some boys with the X-ALD gene do not develop clinical findings. Women are carriers, with partial protection from their second X chromosome. About half of female carriers become symptomatic, with the slower adult form of the disease.

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Posted in: Neuroscience/Mental Health, Science and Medicine

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The CAM Worldview

Harriet has written some excellent recent posts about how to talk to CAM (complementary and alternative medicine) proponents, and answers to common CAM fallacies. I have written about this myself numerous times – we deal with the same logically-challenged claims so often that it’s useful to publish standard responses.

In fact, I often wonder about the seeming uniformity of poor arguments put forward by advocates of CAM and critics of SBM. Do their arguments represent common problems of thought, pathways of mental least resistance, or are we seeing the repetition of arguments resonating in the echochamber of a subculture? I suspect it’s all of those things, which all feed into a particular world-view.

Actually CAM proponents seem to fall into one of several common world views, or flavors, as I like to call them, ranging across the spectrum from pseudoscience to anti-science. There is substantial overlap, however, with common anti-scientific themes.

I recently had an exchange with an SBM reader who was demanding that a particular post be taken down, because “every single fact in the article is wrong.” I responded as I always do – please point out the factual errors, with proper references, and I will make sure that all appropriate corrections are made. This did not satisfy the e-mailer who insisted that the article was 100% false and libelous.

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Posted in: Science and Medicine

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Monochloramines in Tap Water

I recently had a clogged drain requiring the services of a plumber. While discussing the details of the job, he took out brochures and a “fact sheet” prepared by his company explaining that my city tap water was going to kill me. Fortunately, they could provide a solution – a home-wide water filtration system.

The plumber seemed naively sincere, and genuinely fearful of the cancer-causing contaminants found in drinking water. He invited me to read through the material he provided while he unclogged by drain. I did better than that. I took the time to do a quick search for some more objective information on the topic.

Monochloramines

The focus of this particular scaremongering is the additive monochloramine, which is added to city water. According to the Environmental Protection Agency (EPA):

Chloramines are disinfectants used to treat drinking water. Chloramines are most commonly formed when ammonia is added to chlorine to treat drinking water. The typical purpose of chloramines is to provide longer-lasting water treatment as the water moves through pipes to consumers. This type of disinfection is known as secondary disinfection. Chloramines have been used by water utilities for almost 90 years, and their use is closely regulated. More than one in five Americans uses drinking water treated with chloramines. Water that contains chloramines and meets EPA regulatory standards is safe to use for drinking, cooking, bathing and other household uses.

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Posted in: Public Health, Science and Medicine

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