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Archive for Science and Medicine

Hi Ho Silver

I was making rounds at the hospital and, for some strange reason, I was being asked about influenza. No, this is not going to be an entry on influenza. But I was asked if there was anything besides the vaccines that can prevent influenza.  Masks and good hand washing will help, I said.

Anything else?

A nurse suggested colloidal silver.
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The New Plague

I’m taking this opportunity to introduce a new blog to the SBM audience, and to draw yet more attention to the growing and dangerous trend of parental vaccine refusal. So, please take a momentary break from your perusal of this most esteemed font of knowledge, and point your browser to Gotham Skeptic.

Posted in: Public Health, Science and Medicine, Vaccines

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Copper and Magnetic Bracelets for Arthritis

A recent study published in the journal Complementary Therapies in Medicine shows no benefit from copper or magnetic bracelets for symptomatic treatment of arthritis. While this is a relatively small study, it highlights the lack of evidence to support this billion dollar plus industry.

The study is a double-blind, controlled crossover study involving 45 subjects with osteroarthritis. Each subject wore one of four bracelets – copper, two types of magnetic bracelet, and one demagnetized, in random order each for 16 weeks. It showed no difference among the four groups.

This is only the second published controlled trial looking at copper bracelets for arthritis. The first is from 1976 and showed some benefit. Then there are no published studies (just reviews and comments) for the next 33 years, until this current study.

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Mixed Messages on Campus

The past two months have been my first time working in the hospital, as a third-year medical student in my Internal Medicine clerkship. It’s been exciting not only to see how medicine works but to be a part of the action! It really is striking to see the dramatic increases in proficiency and confidence with each stage of the training. From junior student to acting intern to intern to resident to chief resident and eventually to attending, each year brings both more responsibility and more competence. Importantly, physicians-in-training also get very efficient in seeking out and communicating information. Just like SBM editors read widely and blog prolifically whereas I struggle to put together one post a month, experienced clinicians have responsibility for dozens of patients at a time whereas I feebly tag along with one or two each day. Watching my elders on the medical team, I feel excited about how much smarter and more effective I will become as I progress through my training.

Anyway, I want to share an interesting sight in my hospital last month. There were three 3-foot posters on tripods prominently displayed in the hospital lobby, in the cafeteria, and in other public places. The first one read: (more…)

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The wild Weil world of woo

Dr. Weil is often seen as the smiling “mainstream” of alternative medicine. He’s a real doctor (unlike, say, Gary Null), and much of what he advocates is standard and uncontroversial nutritional advice. But Weil illustrates the two biggest problems with so-called alternative medicne: once you’ve decided science is dispensible, the door is open to anything, no matter how insane; and no matter how altruistic you may start, sooner or later you start selling snake oil. Most doctors out there are working hard to help their patients prevent and overcome disease use the available evidence.  Others decide that science is too constraining and start practicing at the periphery of knowledge, throwing plausibility and ethics to the wind.

The fact that Weil claims to donate to charity all of his ill-gotten gains does not mitigate the harm he causes.

The flu pandemic has been challenging to all of us who practice medicine.  We try to keep up day to day with the latest numbers, evidence, and best practices, while trying not to worry about getting ill.  And since the vaccine isn’t widely available yet, we also worry about our family’s health.  So we go about our work every day, wearing masks when appropriate and washing hands frequently.  If the numbers reach a certain threshold, we will implement sophisticated pandemic plans.

All of that is rather hard, though, so perhaps we should just throw caution to the wind and start selling flu snake oil just like the smiling Dr. Weil.

The FDA and FTC have let Weil know in very clear terms that his fake flu remedies are being marketed illegally.  Weil has taken the site down, but here’s a relevant screen shot.
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Oh Canada.

Oh Canada. Look over here. Not there. Not at the press release. Look here. A real study. Published. With methodologies you can evaluate. Something you can sink your teeth into to help guide policy decisions.  You know, published epidemiology.  Science.

Its called  “Partial protection of seasonal trivalent inactivated vaccine against novel pandemic influenza A/H1N1 2009: case-control study in Mexico City.” and published on line in the BMJ on October 6th.

Are you aware of….Oh, Canada, pay attention, your eyes are wandering.
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9 Reasons to Completely Ignore Joseph Mercola

Some of our more astute readers may have noticed that we are paying influenza slightly more attention than other topics of late.  That’s because this situation is new, rapidly changing, and covers more areas of science and medicine than one can easily count.  It’s also a subject about which the general public and media are keenly interested.  This is an outstanding learning and teaching opportunity for us as a professional community.  Unfortunately, it is also fertile ground for confusion, fear, and misinformation, and a playground for those who would exploit such things.

Mercola.com is a horrible chimera of tabloid journalism, late-night infomercials, and amateur pre-scientific medicine, and is the primary web presence of Joseph Mercola.  Unfortunately, it is also one of the more popular alternative medicine sites on the web and as such is uncommonly efficient at spreading misinformation.  I am not a fan, and have addressed his dross in the past.

Joseph Mercola has recently posted an excerpt from an individual he evidently holds in high regard, Bill Sardi.  Bill published “18 reasons why you should not vaccinate your children against the flu this season.”  Mercola chose his nine favorites (one would assume the nine best reasons), and re-posted it on Mercola.com.  There are so many mistakes, so much misinformation in so little space, it’s almost a work of art.  You know, like that crappy art that you might expect to find on the wall at an hourly motel.  Without further delay, let’s examine Mercola and Sardi’s nine best reasons for you not to vaccinate your children against influenza this season: (more…)

Posted in: Public Health, Science and Medicine, Vaccines

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CFS: Viral vs somatization

On 10/08/09, the NIH and Science through press releases announced the following remarkable information:  Consortium of Researchers Discover Retroviral Link to Chronic Fatigue Syndrome (CFS.) From Science on line:

Scientists have discovered a potential retroviral link to chronic fatigue syndrome, known as CFS, a debilitating disease that affects millions of people in the United States. Researchers from the Whittemore Peterson Institute (WPI), located at the University of Nevada, Reno, the National Cancer Institute (NCI), part of the National Institutes of Health, and the Cleveland Clinic, report this finding online Oct. 8, 2009, issue of Science.

“We now have evidence that a retrovirus named XMRV is frequently present in the blood of patients with CFS. This discovery could be a major step in the discovery of vital treatment options for millions of patients,” said Judy Mikovits, Ph.D., director of research for WPI and leader of the team that discovered this association. Researchers cautioned however, that this finding shows there is an association between XMRV and CFS but does not prove that XMRV causes CFS.

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Posted in: History, Medical Academia, Neuroscience/Mental Health, Science and Medicine

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Science-based medicine and Eurocentrism

A reader sent me an interesting post from her own blog. It’s well-written, compelling, and betrays an exceptional intelligence. It’s also completely wrong.

The piece is called, “Bias, Racism, and Alternative Medicine”, an intriguing title. The first part tries to establish that “Western medicine” in one of many ways of understanding health and disease. She starts with some personal anecdotes—always interesting, rarely generalizable:

While receiving Western biomedical treatment for ADD, the side effects of my therapy convinced me that western medication alone would not provide a solution to my problems.

One of the author’s fundamental misunderstandings is that the failure of a particular treatment to make her feel better does not invalidate all of medical science, and more important, it does not validate “other ways of thinking”. Still, I can understand how this happens. Personal experience is powerful; unfortunately, it is also misleading. I like this writer. She seems very kind. She goes on to describe her enlightenment further, but this is where a pleasant anecdote goes terribly wrong: (more…)

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Medicine is hard and should be practiced with caution

It’s tempting to think that the practice of medicine should be simple and intuitive.  Unlike other sciences, we all have access to the basic materials—ourselves.  We feel that because we are intimately familiar with our bodies, we know a lot about how they work.  Unfortunately, it’s a little more complicated than that.  The biochemical processes walking around in this sack of meat are pretty complicated.  Learning these processes is important, but in medicine, it’s not enough.  If we have a hypothesis that some change in biochemistry will affect some disease, we must test this in groups of real people in well-designed clinical trials.  Or, we can use the Huffington Post method and  just make it all up.

The latest abomination is an article on diabetes, by Kathy Freston.  Bad information on diabetes is particularly dangerous.  The longer diabetes goes untreated, the higher the likelihood of complications.  When reading medical writing it’s important to evaluate the source.  The author of this article wrote a book called, The Quantum Wellness Cleanse which pretty much says it all. But is it really fair to judge someone on a crappy book title?

Well, yes, but more important is the crappy interview she conducts with Dr. Neal Barnard.  I have no way of knowing with absolute certainty whether Barnard is as dangerous a fool as he sounds, but I suspect so.  He and Freston promulgate a dangerously over-simplified view of diabetes.   (more…)

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