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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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5 out of 4 Americans Do Not Understand Statistics

Ed: Doctors say he’s got a 50/50 chance at living.
Frank: Well there’s only a 10% chance of that
Naked Gun

There are several motivations for choosing a topic about which to write. One is to educate others about a topic about which I am expert. Another motivation is amusement; some posts I write solely for the glee I experience in deconstructing a particular piece of nonsense. Another motivation, and the one behind this entry, is to educate me.

I hope that the process of writing this entry will help me to better understand a topic with which I have always had difficulties: statistics. I took, and promptly dropped, statistics 4 times a college. Once they got past the bell shaped curve derived from flipping a coin I just could not wrap my head around the concepts presented. I think the odds are against me, but I am going to attempt, and likely fail, in discussing some aspects of statistics that I want to understand better. Or, as is more likely, learn for the umpteenth time, only to be forgotten or confused in the future. (more…)

Posted in: Basic Science, Science and Medicine

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Chemotherapy doesn’t work? Not so fast… (A lesson from history)

If there’s one medical treatment that proponents of “alternative medicine” love to hate, it’s chemotherapy. Rants against “poisoning” are a regular staple on “alternative health” websites, usually coupled with insinuations or outright accusations that the only reason oncologists administer chemotherapy is because of the “cancer industrial complex” in which big pharma profits massively from selling chemotherapeutic agents and oncologists and hospitals profit massively from administering them. Indeed, I’ve lost track of the number of such rants I’ve deconstructed over the years. Usually, they boil down to two claims: (1) that chemotherapy doesn’t work against cancer (or, as I’ve called it before, the “2% gambit“) and (2) that the only reason it’s given is because doctors are brainwashed in medical school or because of the profit motive or, of course, because of a combination of the two. Of course, the 2% gambit is based on a fallacious cherry picking of data and confusing primary versus adjuvant chemotherapy, and chemotherapy does actually work rather well for many malignancies, but none of this stops the flow of misinformation.

Misinformation and demonization aside, it is also important to realize that the term “chemotherapy,” which was originally coined by German chemist Paul Ehrlich, was originally intended to mean the use of chemicals to treat disease. By this definition, virtually any drug is “chemotherapy,” including antibiotics. Indeed, one could argue that by this expansive definition, even the herbal remedies that some alternative medicine practitioners like to use to treat cancer would be chemotherapy for the simple reason that they contain chemicals and are being used to treat disease. Granted, the expansive definition evolved over the years, and these days the term “chemotherapy” is rarely used to describe anything other than the cytotoxic chemotherapy of cancer that in the popular mind causes so many horrific side effects. But in reality virtually any drug used to treat cancer is chemotherapy, which is why I like to point out to fans of Stanislaw Burzynski that his antineoplastons, if they actually worked against cancer, would be rightly considered chemotherapy, every bit as much as cyclophosphamide, 5-fluorouracil, and other common chemotherapeutics.
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Posted in: Basic Science, Cancer, Clinical Trials, History

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A Different Perspective: Placebo, SCAM, and Advertising

Summertime, time, time

Child, the living’s easy.

Fish are jumping out

And the handicap, Lord

Handicaps high, Lord so high

~ Janis Joplin

It is summer. Time for the kids and the outside, not the computer. What follows is a summertime blog entry, for which I admit to feeling guilty for the comparatively little time I have spent on it, but as I have said before, no dying patient has ever told me “Doc, I wish I had spent more time at work.”

Mt. Hood has been a constant feature to the east my entire life. The mountain, on a clear day at least, is Portland’s most impressive geologic feature. If you are in the right part of the city, you may see Mt. St. Helens or the tips of Jefferson, Adams and even Rainier, but Mt. Hood dominates. It is solitary mass of rock, (diminishing) ice and snow only 50 miles from where I live. I have spent uncountable hours hiking in the Mt. Hood wilderness. When I think of Mt. Hood, in my mind’s eye it is from the perspective of west Portland looking east.

Last week was our yearly summer vacation in Sunriver, just south of Bend Oregon on the eastern side of the cascades in the Oregon High Desert. Driving north/south on highway 97 puts Mt. Hood in a different perspective. From the high desert you can see the huge swaths of the Cascades: calderas, mountains, lava fields and cinder cones. You see Mt. Hood differently. Not a single mountain to the east, but part of a chain of recent and distant historical volcanic activity along the Rim of Fire. Photographs do not do the view of the Cascades justice from this vantage point.

The eastern view puts Mt. Hood in a broader geologic and time perspective. It is still the same Mt. Hood, but in a different context. Like running into a nurse outside of the hospital, you have to recalibrate the context in which you understand and know the person.

I have written on placebo, the placebo effect, and its relationship to SCAM. To my understanding the preponderance of literature indicates there is no placebo effect upon any objective medical problem, only a change in the patients perspective of the problem. (more…)

Posted in: Basic Science, Clinical Trials, Science and Medicine

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Human Sex Determination: Psychic Sperm and the Gambler’s Fallacy…..

Carl Sagan supposedly once said that randomness is clumpy. Those three words have become one of my favorite go-to quotes, particularly when teaching residents and medical students who are often overly impressed with improbable runs of similar diagnoses or exam findings. I love this quote because it is so simple and yet reveals so much about our experience with observing the natural world. Sagan’s ability to offer up insightful nuggets of rational thought, even if he didn’t actually produce this gem, was unmatched and his efforts to bring science and reason to the public have been sorely missed. If you haven’t read any of Sagan’s works, I highly recommend The Demon-Haunted World: Science as a Candle in the Dark.

If you have a coin, and a few hours to kill, record the results of a long run of flips and you’ll see what Sagan meant about the nature of randomness. You will inevitably observe clusters of heads or tails that might seem improbable, but eventually the outcomes will average out to about half of the flips being heads and half resulting in tails. The more trials that you perform, the closer the outcomes will approach 50% for each possible result, assuming you aren’t gaming the system by using a trick coin.

I don’t think that very many people would argue with the fact that on average a coin flip is random chance, although there are still people out there who think that the Earth is flat and that Justin Bieber is a reptilian humanoid. But because of a deeply rooted cognitive bias, the gambler’s fallacy, we frequently fail at recognizing that randomness is clumpy. We accept the established overall odds, but our acceptance wavers in the face of short runs that go against our expectations. This error in logic can lead to the belief, for instance, that after five heads in a row there is a higher than 50% chance that the next flip with land on tails as if to magically even things out.

In my line of work as a pediatric hospitalist, I frequently experience other healthcare professionals making this mistake in a variety of circumstances. There is a known likelihood of bacteremia when an infant less than 28 days of life is evaluated for fever, for example. Despite this, it is common for physicians and nurses to lament, upon seeing fever as the triage chief complaint, that they are due for this life threatening infection after a number of recent febrile neonates have had negative blood cultures. (more…)

Posted in: Basic Science, Critical Thinking, Obstetrics & gynecology

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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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Meet Your Microbes: uBiome Offers New Service

We are not alone. Walt Whitman didn’t know how right he was when he said, “I contain multitudes.” The microbes on and in our bodies outnumber our own cells 10:1.  Perhaps that creeps you out. Perhaps that makes you curious to know just who all these billions of creatures are that are using your body for a home and a transportation device.

For just $89 you can learn what’s in your gut, nose, mouth, skin, genitals…or sample anything!

The offer comes from uBiome, a “citizen science startup” that has scientific goals somewhere down the line, but for the moment is happy to just provide a personal service, to sequence your microbiome and tell you how you compare to others. The current utility of this offering is questionable. It’s just not ready for prime time. (more…)

Posted in: Basic Science, Medical Ethics, Science and Medicine

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More bad science in the service of anti-GMO activism

More bad science in the service of anti-GMO activism

I never used to write much about genetically modified organisms (GMOs) before. I still don’t do it that often. For whatever reason, it just hasn’t been on my radar very much. That seems to be changing, however. It’s not because I went seeking this issue out (although I must admit that I first became interested in genetic engineering when I was in junior high and read a TIME Magazine cover article about it back in the 1970s), but rather because in my reading I keep seeing it more and more in the context of anti-GMO activists using bad science and bad reasoning to justify a campaign to demonize GMOs. Now, I don’t have a dog in this hunt, (Forgive me, I have no idea why I like that expression, given that I don’t hunt.) I really don’t. I was, not too long ago, fairly agnostic on the issue of GMOs and their safety, although, truth be told, because I have PhD in a biomedical science and because my lab work has involved molecular biology and genetics since I was a graduate student in the early 1990s, I found the claims of horrific harm attributable to GMOs not particularly convincing, but hadn’t bothered to take that deep a look into them. It was not unlike my attitude towards the the claims that cell phones cause cancer a few years ago, before I looked into them and noted the utter lack of a remotely-plausible mechanism and uniformly negative studies except for a group in Sweden with a definite ax to grind on the issue. Back then, I realized that there wasn’t really a plausible mechanism by which radio waves from cell phones could cause cancer in that the classic mechanisms by which ionizing radiation can break DNA molecular bonds and cause mutations don’t apply, but I didn’t rule out a tiny possibility that there might be an as-yet unappreciated mechanism by which long term exposure to radio waves might contribute to cancer. I still don’t, by the way, which has gotten me into the odd kerfuffle with some skeptics and one physicist, but I still view the likelihood that cell phone radiation can cause cancer as being just a bit more plausible than homeopathy.

As was the case for the nonexistent cell phone-cancer link, there has now been a steady drip-drip-drip of bad studies touted by anti-GMO activists as “evidence” that GMOs are the work of Satan that will corrupt or kill us all (and make us fat, to boot). Not too long ago, I came across one such study, a truly execrable excuse for science by Gilles-Eric Séralini at the University of Caen purporting to demonstrate that Roundup-resistant genetically modified maize can cause horrific tumors in rats. I looked at the methods and conclusions and what I found was some of the worst science I had ever seen, every bit as bad as the quack “science” used by the antivaccine movement. It wasn’t for nothing that I made the comparison, because the anti-GMO movement is very much like the antivaccine movement and the cranks who claim that cell phone radiation causes cancer. As if to demonstrate that very point, last week I came across an article by the all-purpose crank to rule all cranks, Mike Adams, at NaturalNews.com entitled GMO feed turns pig stomachs to mush! Shocking photos reveal severe damage caused by GM soy and corn:
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Posted in: Basic Science, Genetically modified organisms (GMOs), Nutrition, Science and the Media

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People Encouraging Turtle Agony*

Lest anyone think I am a heartless bastard, I would like it to be known that I do not like to see any creature suffer or die. I am the kind of person who, when finding a spider in the house, is likely to catch it and toss it outside. I always think, “I can’t squish the end result of 6 billion years of evolution”. Except mosquitoes. Those I squish with glee. Infection vectors can die die die die.

I like animals and hate to see them suffer unnecessarily. Like sticking them with needles. Frontal lobes are nice to have. They can let you know that pain is coming and provide preparation and compensation. Once I had a steel bar smack me on the head, opening up a six-inch cut to the bone. No, my brain was not affected, thank you very much. Everything predates the head trauma. When the ER doc numbed the scalp for sutures, he missed the last half-inch and I felt the needle. Knowing what was going on I steeled myself and let him do the last two sutures with no lidocaine, since the needle hurt only a little worse than the lidocaine injection. I have had many other unpleasant medical procedures in my 56 years but knowing what was coming and understanding why makes it easier to tolerate a needle popping into the knee joint or an abdominal drain being pulled.

Animals, and young humans, lack the ability to comprehend the what and why of pain inflicted as part of medicine. Adults can make a conscious decision to be endure pain and fool themselves into thinking it is of benefit. No pain, no gain. Animals can make no such choice.

For example consider sea turtles, who, apparently, are subjected to all sorts of nonsense at the New England Aquarium including acupuncture and laser therapy. As is obvious, I am no veterinarian, the only animal of which I have any understanding of anatomy and physiology is a human, but even with that background it is remarkable what is reported from New England. I used to say the ‘B’ students went into journalism; given the credulous reporting perhaps the standards have been lowered. They certainly have for marine biologists and veterinarians, who are evidently shortchanged in their education. (more…)

Posted in: Acupuncture, Basic Science, Energy Medicine, Science and Medicine, Traditional Chinese Medicine

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A brief note on killing cancer cells in a dish

I am taking the Memorial Day holiday off. I will return next week (or even earlier if something comes up that I can’t resist blogging about). In the meantime, here’s a general principle that needs to be remembered in cancer research:

I would also add to that list: So does bleach. So does acid. So does alkali. So does pouring the media out of the dish and letting the cells dry out. So do a variety of lethal poisons. So does heat. So does cold. The list goes on.

The point, of course, is that it’s very easy to kill cells in a cancer dish. What is difficult is selectively killing cancer cells in the human body while not harming normal cells.

See you all next week!

Posted in: Basic Science, Cancer

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