Medical devices

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Medical science policy in the U.S. under Donald Trump

When Dr. Oz met Donald Trump: Somehow this photo just seemed appropriate for this post.

When Dr. Oz met Donald Trump: Somehow this photo just seemed appropriate for this post.

Last week, in an unexpected upset, Donald Trump won the Presidential election in the Electoral College while losing the popular vote and is now President-Elect. Regular readers of my not-so-super-secret other blog know my opinion of this; so I won’t belabor it too much here. If you’re curious, I have written about Donald Trump’s antivaccine views here before in the context of last year’s Republican debates, and, amusingly, I’ve even been at the receiving end of criticism from an “integrative medicine” activist in which my snark was compared to that of Donald Trump and my criticism labeled “Trumpism.” As you might imagine, I was not pleased.

Leaving all that aside and leaving aside how we’ve now had two Presidential elections out of the last five in which the candidate with fewer popular votes became President (no, I’m not a fan of the Electoral College), Donald Trump won fair and square and will be our next President. As an advocate of science-based medicine, naturally I wondered: What can we expect in terms of medical science under President Trump next year? Jann Bellamy already began the discussion on this blog by undertaking a fairly comprehensive overview of the disturbing anti-science positions Donald Trump and many now coming into his new administration espouse. I’m going to do a bit of the same, but I’m going to drill down and focus solely on medical science. While I agree that Trump’s position on human-caused climate change and his stated intent to pull out of important climate treaties and, in essence, cease any attempt to mitigate the effects of human activity on climate change is a looming disaster that our grandchildren and great-grandchildren and beyond will likely curse our generation for, this blog is Science-Based Medicine.
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Posted in: Basic Science, Clinical Trials, Medical devices, Pharmaceuticals, Politics and Regulation

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Blue Light. Special?

blaulicht
I do not sleep as well as I used to. Perhaps it is being tormented by guilt and worry combined with profound existential angst.

Or maybe it is my iPad. I gave up on most dead tree editions. I miss the smell and feel of books and magazines, but nothing is better than being able to increase the font size to 18. So I usually finish the day reading on the iPad.

I have noted programs that will remove the blue light from computer screen to aid in sleep. There is a night mode in iOS 9.3 and a program for the Mac I have on now that filter out the blue. Makes the screen oddly colored but it more restful on the eyes. I think. I am more in need of existential angst filter. (more…)

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

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Ultraviolet Blood Treatment Revisited

A man undergoing blood irradiation therapy.

A man undergoing blood irradiation therapy.

If there is one thing this election cycle has demonstrated it’s that, when ideology or emotions are involved, people can be entirely immune to facts. The narrative takes control, reinforced by motivated reasoning and confirmation bias.

Even worse, people tend to think they are actually informed, and are confident in their opinions, even when they are grossly misinformed. Regular contributors here frequently receive e-mails from people who truly believe they have it all figured out – modern medicine is a con and we are all shills, while alternative gurus speak the Truth. The confident reality distortion is amazing to behold.

A total lack of ethics and regulation

Let’s take one stunning example from the world of alternative medicine – ultraviolet blood treatment. Britt Hermes, who has contributed to SBM before, is an ex-naturopath who wrote recently about a medical device called the UVLrx. This is a device that is inserted into a vein like a catheter, and then emits UV light directly to the blood.

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Posted in: Health Fraud, Medical devices, Naturopathy

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Do pill organizers help or hurt?

"Blister packs" help people take their medication on the correct schedule.

“Blister packs” help people take their medication on the correct schedule.

In order for medication to work, getting a prescription filled isn’t enough. You have to actually take the medication. And that’s where you (the patient) come in. Estimates vary based on the population and the medication, but a reasonable assumption is that 50% of people given a prescription don’t take their medication as prescribed. In pharmacy terminology we usually call this medication compliance, but because that sounds a bit paternalistic, the term medication adherence is also used. People forget doses, deliberately skip doses, and sometimes even take more than directed. Often, the prescription isn’t finished completely. Perhaps not surprisingly, people are less likely to adhere to their prescribed medication schedule when the condition they are treating has no symptoms. All things being equal, you’re more likely to take your pain control medicine than your hypertensive medications: Pain medications have side effects, but should help you feel better right now. Hypertension medications can only make you feel worse. Statins (as a group of medications) are another good example. We treat high cholesterol to lower the risk of heart disease: heart attacks, strokes, and death. It has no obvious benefit now, nor will we ever be able to point to the benefit we received. We’re taking the medication to reduce the risk of something happening in the future. If the drug isn’t taken regularly (or at all) then you’re not going to get the expected benefits of statin therapy. The “value” that treatment delivers is reduced (or eliminated). And if you stop a medication periodically, then restart it, you might get more side effects than you would have if you just took it regularly. (more…)

Posted in: Medical devices, Pharmaceuticals, Quality Improvement, Science and Medicine

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Parabiosis – The Next Snakeoil

parabiosisThe pattern has repeated so many times that it is truly predictable. Scientists turn their eyes to one type of treatment that has theoretical potential. However, proper research from theory to proven treatment can take 10-20 years, if all goes well. Most such treatments will not work out – they will fail somewhere along the way from the petri dish to the clinic.

However, the media likes a good story, and one of their favorite narratives is the “new miracle cure.” They will often take preliminary basic science research and present it with headlines promising a cure for some horrible disease (sometimes they will add a question mark).

When we see these headlines, we know what will happen next – hucksters will ride the hype with a wave of snake oil products promising the same cure, and claiming to be based in science. Dr. Oz will probably promote it on his show, and Mike Adams will rant about the government conspiracy to keep this cure from the public (but he will sell it to you).

We have seen this pattern with antioxidants, stem cells, resveratrol, and countless others. Sometimes the hucksters manufacture their own hype, as with green coffee beans. They don’t wait for actual scientists, they corner the market on some worthless bean or berry, then invent health claims for it and try to hype demand through the usual channels. This sadly works. (more…)

Posted in: Medical devices, Medical Ethics

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The Gene: An Intimate History

A superb writer, Siddhartha Mukherjee's books are easier to read than his name is to spell

A superb writer, Siddhartha Mukherjee’s books are easier to read than his name is to spell

Six years ago I reviewed Siddhartha Mukherjee’s book The Emperor of All Maladies: A Biography of Cancer. It was hands-down one of the best books I have ever read on a medical topic. Now he’s done it again. His new book is titled The Gene: An Intimate History.

Mukherjee is a superb writer. Much of what I said about his first book applies equally to his second, so I will quote myself:

It is a unique combination of insightful history, cutting edge science reporting, and vivid stories about the individuals involved: the scientists, the activists, the doctors, and the patients. It is also the story of science itself: how the scientific method works…

Beautifully written and informative

Reads like a detective story with an exciting plot.

He links this second book to his first by pointing out that cancer is an ultimate perversion of genetics, and that studying cancer means also studying its obverse: normalcy. He gives the subject a human face by interspersing anecdotes from his own family’s struggles with mental illness and its connection to inherited genes. He sets out to tell the story of the birth, growth, and future of one of the most powerful and dangerous ideas in the history of science: the gene. He says it is one of three destabilizing ideas that have transformed science: the concept that irreducible units underlie matter (the atom), digitized information (the byte or bit), and biological information (the gene). He explains how the consequences of these ideas have transformed our thinking, our language, our culture, politics, and society. (more…)

Posted in: Basic Science, Book & movie reviews, History, Medical devices

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Use of Dental Appliances in the Management of Tourette Syndrome

Editor’s note: This Science Based Medicine blog post is another collaborative effort between Grant Ritchey and Clay Jones. Not only have they previously co-authored an SBM post on fluoride, their partnership has recently expanded into other areas of science journalism. Since the departure of Dr. Jason Luchtefeld as co-host of The Prism Podcast, Clay has joined Grant as the new co-host. To this end, Clay and Grant have added a Science Based Medicine segment to each podcast episode, in which recent SBM blog posts are reviewed and discussed with the authors themselves. Check them out on iTunes or your favorite podcatcher.

"We'll remove that headgear when your tics improve."

“We’ll remove that headgear when your tics improve.”

One of our primary goals is to promote the concept of scientific skepticism and the importance of prior plausibility when interpreting new research. On the pages of this website, and in extracurricular activities like our various podcasts and personal blogs, we often call upon these two load-bearing pillars of science-based medicine when investigating implausible and unproven claims championed by well-meaning true believers and outright charlatans. What our collective experience has revealed time and time again is that both will often hope that a gullible public will put their trust in a warped version of science, while relying on emotional responses to anecdotes and testimonials.

In our post today, we will walk readers through our investigation of thus far unproven claims involving the treatment of a complex neurological disorder, Tourette syndrome (TS), with a fitted dental appliance aimed at improving the alignment of a patient’s jaw. From the perspective of a dentist (Grant) and a pediatrician (Clay), there aren’t any obvious connections between the jaw and this childhood-onset neuropsychiatric disorder, but proponents believe that there is one and that these appliances can significantly reduce the severity of symptoms. Although impossible to enter into an investigation such as this completely free of emotion or bias, we truly attempted to keep an open mind throughout the process.

First up, a disclaimer:

Clay was diagnosed with Tourette syndrome when he was 7 years old. As both a pediatrician who has now cared for a number of patients with TS and someone who has personally experienced many of the negative physical and social sequelae associated with the condition, this is a topic that Clay takes rather personally. Although his symptoms are now on the milder end of the severity spectrum, and are far from debilitating, they do often serve as a source of frustration in his day-to-day life. The thought of children with Tourette syndrome being taken advantage makes him angrier than that time somebody switched out his regular coffee for Colombian decaffeinated crystals.

Without hesitation, we would love for there to be another effective treatment option for Tourette syndrome in our armamentarium, especially one that would be essentially risk free and relatively inexpensive. Again, as scientific skeptics we are open to new evidence as it emerges. But before we get to the claim and the research being used to back it up, we will give a primer on the scientific consensus on TS so that readers can better assess for themselves the prior plausibility of this proposed treatment.
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Posted in: Critical Thinking, Dentistry, Medical devices

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The Blood Cleaner: Invented by Ray Jardine

Imaginary germs awaiting imaginary electrocution by Ray Jardine's Blood Cleaner device.

Imaginary germs awaiting imaginary electrocution by Ray Jardine’s Blood Cleaner device.

I recently heard about a man who was planning a hike in a tick-infested area and thought he could avoid Lyme disease by using Ray Jardine’s Blood Cleaner. Ray Jardine is a well-known mountaineer, rock climber, long-distance hiker, and outdoor adventurer. A lightweight hiking enthusiast, he has branched out into selling lightweight equipment like backpack kits, tarps, and insulated hats. Most of his products are reasonable, but one is not: the Blood Cleaner. It is a micro electronic device that allegedly kills or disables pathogens in a person’s bloodstream. It is worn on the wrist in a pocket on a wristband that has another pocket holding a 9-volt battery. He and his wife make the devices themselves at home and sell them for $78.95. It could not possibly work as claimed. It is as useless as Hulda Clark’s infamous zappers.

How Ray’s Blood Cleaner supposedly works

It sends pulsed micro-currents through the skin and into the blood vessels. The micro-currents are claimed to electrocute the germs in the bloodstream, killing bacteria, protozoa, and fungi, and disabling viruses, without harming the white blood cells. It is supposed to clean germs out of the blood just as taking a shower cleans germs off of the skin. It comes with two probes, one for cleaning the bloodstream and another for making nano-silver in a glass of water to kill pathogens in the upper GI tract. Nano-silver (a form of colloidal silver) may kill germs in vitro, but it is useless and potentially harmful when ingested by humans. Colloidal silver has been known to turn people as blue as a Smurf. (more…)

Posted in: Lyme, Medical devices

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Pulsed Electromagnetic Field Snake Oil

noel edmonds
Noel Edmonds is a game show host, famous for Britain’s version of Deal or No Deal. As far as I can tell, he has no medical or scientific qualifications at all. This unfortunately has not stopped him from using his celebrity status to offer dubious medical advice via his Twitter feed. Such is the world in which we live.

Edmonds tweeted, referring to the EMP Pad:

A simple box that slows ageing, reduces pain, lifts depression and stress and tackles cancer. Yep tackles cancer!

This Twitter-brief statement packs in many red flags for quackery and snake oil: such as a simple device that can tack a wide range of medical conditions that do not appear to share a common cause or mechanism. The word “tackle” is vague, but implies either a cure or at least a significant treatment. Anyone claiming to treat or cure cancer deserves close scrutiny.

In response, cancer patient Vaun Earl tweeted:

I think Noel Edmonds should stick to what he’s good at. Presenting quiz shows and beard trimming, rather than curing cancer.

To which Edmonds responded:

Scientific fact-disease is caused by negative energy. Is it possible your ill health is caused by your negative attitude? #explore.

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Posted in: Cancer, Medical devices, Science and Medicine

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April Fool Cannot Surpass SCAM

Stick some coffee up the tailpipe and you've got yourself some complementary and alternative auto care!

Stick some coffee up the tailpipe and you’ve got yourself some complementary and alternative auto care!

It’s April Fools’ day in the US of A. One of the internet traditions is to come up with a story that is weird or unlikely, but not so weird or unlikely that it is not believable, in order to fool people that the story is real.

I gave it the old SBM try, I really did, but I couldn’t do it. I wanted to come up with a SCAM therapy so weird, so unlikely, that I could not find an example of it actually being practiced.

It can’t be done. Like a Trump utterance*, you can’t invent a SCAM (Supplements, Complementary and Alternative Medicine) that someone, somewhere, has already pulled out of, er, well, thin air and are using it on patients.

Of course, what would you expect given that many SCAMs were in fact, pulled out of, er, well thin air. Think chiropractic and DD Palmer, iridology by August von Peczely, and reiki by Mikao Usui. Making up fantastical stuff is what they do.

But even within the spectrum of pseudo-medicine there are those are practices and papers that are so bizarro they should be an April Fools’ joke. But are not. It may be a matter of taste, what one person considers wack-a-loon another would find imminently reasonable. There are certainly assigned delegates that prove that assertion. But even within the wack-a-loon world of SCAM, there are those practices and papers that are more wack-a-loon than others and should be April Fools’ jokes. Maybe it is like more unique. Unique is one of a kind, so something can’t be more one of a kind. More wack-a-loon? Such is the world of SCAM. (more…)

Posted in: Acupuncture, Energy Medicine, Homeopathy, Medical devices, Naturopathy, Politics and Regulation, Science and Medicine

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