Friday, December 27, 2013

Acupuncture as pseudoscience

Instapundit links:

SHOCKER: New Study Exposes Acupuncture As Pseudoscience. I think the reason the Chinese government pushed it so hard under Mao was that it was cheap, not that it was effective. . . .

I might add: I suspect it is related to placebo/hypnosis, which does work in a subpopulation.

Why? Well, when we took a course on hypnosis in medicine, the teacher observed that

ONE: those getting open heart surgery with acupuncture anesthesia were sitting there smiling. Ordinary folks, even if pain free, would be hyperventillating, especially when they sawed the chest open. That suggested a deep trance state rather than pain relief.

Two: one patient asked to be taught self hypnosis for chronic pain and it didn't work for him...and that patient mentioned that acupuncture didn't work either.

A lot of this could be sorted out by using the eye roll test, which correlates with hypnotizability.

And if you have a high score, you are also easily talked into doing things, and easily suggestible.

So I suspect accupuncture will work for these people, (along with placebo and faith healing)...

On the other hand: Acupuncture works on some there might be a "counter irritant" type blockage of the pain signal in acupuncture similar to the reason that moxification/old fashioned mustard plasters etc. work.

Thursday, December 26, 2013

Vaccine deaths in China?

BBC report on possible vaccine related deaths from Hepatitis B vaccine given to infants.

No previous problem with this vaccine: I wonder if it was made wrong...adulterated and counterfeit medicines are a major problem in China (and India) and here, where they can be sold as the real thing.

another question: Does this company make vaccines that are used in other countries?

NYTimes story here.

Investigators have not determined the cause of the deaths or linked them directly to the injections, but the cases come at a time of growing public concern in China about food and drug safety problems.
In recent years, China has been troubled by a series of scandals, including tainted rice and milk and the mysterious appearance of thousands of dead pigs floating in the Huangpu River in Shanghai. China has vowed repeatedly to crack down on food and drug safety violations and has moved to strengthen the powers of health officials.
In the vaccine cases, the government is focusing on the role of Shenzhen Kangtai, a privately run drug maker formed in 1992 with government support and the cooperation of the American pharmaceutical company Merck.

further down, it says the vaccine is to stop the two million cases of Hepatitis B that occur every is a wicked disease, and many doctors caught it in the past (especially surgeons) because of contact with blood...a friend of mine got it from his spouse who caught it from a patient, and ended up with a liver transplant...

Wednesday, December 25, 2013

The really important medical headline of the day

Don't want a hangover? Eat mashed potato before that first drink

Diabetic risk from Neanderthal genes?


this study is in Latin Americans and Mexicans: What is not answered is the ethnicity of those studies. Are they mainly upper class (with mainly Spanish blood) or lower class (metziso, mulatto, or Indian)?

Diabetes is very common in American Indian tribes: especially the Pima and the Objibwe (I worked with the latter).

And if so, how did this migrate to America? what is the percentage of Neanderthal genes in American Indians?

They discovered that the SLC16A11 sequence associated with risk of type 2 diabetes is found in a newly sequenced Neanderthal genome from Denisova Cave in Siberia.
Analyses indicate that the higher risk version of SLC16A11 was introduced into modern humans through interbreeding between early modern humans and Neanderthals.
It is not unusual to find Neanderthal genes. About 2% of the genomes of present-day non-Africans were inherited from this distinctive human group, which lived across Europe and western Asia from about 400,000-300,000 years ago until 30,000 years ago.

One thing about this "gene": it is a tendency to put on weight and develop metabolic syndrome if there is a lot of food...which means that during times of famine you are more likely to live.

bookmarked for later reading.

Wednesday, December 18, 2013

Abortion breast cancer link?

A meta analysis suggested the proposed link between breast cancer and abortion may actually be true: at least in chinese females.



We searched three English databases (PubMed, ScienceDirect, and Wiley) and three Chinese databases (CNKI, WanFang, and VIP) for studies up to December 2012, supplemented by manual searches. Two reviewers independently conducted the literature searching, study selection, and data extraction and quality assessment of included studies. Random effects models were used to estimate the summary odds ratios (ORs) and the 95 % confidence intervals (CIs).


A total of 36 articles (two cohort studies and 34 case–control studies) covering 14 provinces in China were included in this review. Compared to people without any history of IA, an increased risk of breast cancer was observed among females who had at least one IA (OR = 1.44, 95 % CI 1.29–1.59, I 2 = 82.6 %, p < 0.001, n = 34). No significant publication bias was found among the included studies (Egger test, p = 0.176). The risk increased to 1.76 (95 % CI 1.39–2.22) and 1.89 (95 % CI 1.40–2.55) for people who had at least two IAs and at least three IAs, respectively. Subgroup analyses showed similar results to the primary results. Meta-regression analysis of the included studies found that the association between IA and breast cancer risk attenuated with increasing percent of IA in the control group (β = −0.022, p < 0.001).


IA is significantly associated with an increased risk of breast cancer among Chinese females, and the risk of breast cancer increases as the number of IA increases. If IA were to be confirmed as a risk factor for breast cancer, high rates of IA in China may contribute to increasing breast cancer rates.

You can read the  whole thing for 36 dollars. (Sarcasm).

I remain sceptical (I am on record for being sceptical, because if the link was true, then we'd see very high numbers of cases of Breast cancer in past years in countries like Japan or Russia, where multiple abortions was a common way to control births).

Breast cancer is hormone related.

If you have 8 kids and breast feed them for one to two years, you rarely have a period...and your chance of breast cancer is low (as it was in Africa).

In the "good old days", we knew there was a much higher rate of breast cancer in some women: women who were "nulliparous" (no kids) or who had only one or two kids, or who had their first child later in life, or who didn't breast feed them.

welcome to the modern world, where women only have one or two kids, and rarely breastfeed for long (because they have a job outside the home, or are lazy, or it's not the custom anymore).

What else has changed? Uh, birth control pills/shots, anyone?

And what about all those phytoestrogens in the environment, from pesticides to plastics?

And then there is obesity: We used to call Rubenesque women "high estrogen profiles"... some obesity is associated with higher estrogen levels, (something about fat cells and hormones...sorry I'd have to look it up and the internet is unsable right now).

Then there is meat and soy, with associated hormone effects.

So is it the abortion, or is it the pollution/hormone contraception/lack of having kids?

Since women who contracept have more abortions, and women with few kids tend to be more affluent and fatter, one does wonder.

I think abortion is murder, and the denial that it affects the mom is a lie. "can a mother forget the child of her womb"? And regret/depression is not because of evil Christian fundamentalists either: Japan's temples have places where moms mourn abortion/stillbirths...and we once had a Russian immigrant hallucinating babies. Max, a good atheistic Russian psychiatrist who had recently immigrated, assured me that such "psychotic depressions" after abortion were common in his homeland...heh. Don't tell that to the PC who are trying to push it around the world (to limit population growth of the wrong races poor people).

So I don't think that a woman who is crass enough to use abortion for birth control will worry about this, and a woman in a trouble pregnancy who is surrounded by folks who all encourage/force her to get rid of it won't be persuaded either.

But it should influence the "do gooders" who are pushing it as public policy.

Sunday, December 15, 2013


just place for later thinking:

You have three choices: GM eggplant, eggplant full of pesticides, or eat the little buggers that infest them.

I should note that commonly the eggplants here are the slim "japanese" type, although we do have the round white ones too.

and the note about  GM soy allergies: uh, that was a common allergy thirty years ago...but didn't get the hysteria like we see the gluten intolerance problem, I suspect it is simply more cases being recognized or treated, since 30 years ago few anti histamines were used. The data doesn't support a huge rise in cases, and notes that many "food allergies" are merely intolerance to certain foods.

The real problems are exaggerated by bad science that gets picked up by the paranoid greens, who attribute every problem to either global warming or GM foods without good studies. So if allergies to peanuts are up, it must be because GM soy beans were introduced about then, never mind the other reasons that might be behind it.

My take: The problem is a small number that may or may not be more common than 30 years agp, and there are many hysterical reactions to mild cases.

and what if there are other causes? For example, all those "low cholesterol" ways of preparing peanuts. From the article above:
Instead, changes in food manufacturing might be to blame. Dry-roasting peanuts, common in the USA, UK and Australia, increases allergenicity compared with boiling or frying peanuts, as is common in China

and true allergies, such as peanut allergies, might indeed be higher, but the problem is that we don't have GM peanuts...and indeed, GM peanuts have been proposed to stop the allergy problem by removing the protein behind the reaction (ditto for soy beans).


Friday, December 13, 2013

You mean laughter is not the best medicine?

From the UKTelegraph:

Health warning: laughter could leave you in stitches

A review of the benefits of laughter in patients by Oxford University has found that far from being the best medicine, it can lead to heart ruptures, asthma attacks and incontinence

Wednesday, December 11, 2013

FYI (you probably don't want to know)

A Brief history of toilet paper from the ancient standard site.

Actually, in Africa, they used leaves (in our rural area the term o use a restroom was "go to the forest")

In the Philippines, most homes still have a nice bowl with a handle to use to ewash, and then you dry using a "butt towel"...
the more sophisticated way is to use a sprayer (similar to the sprayer for washing dishes in many US homes).

water filters

Water purification

I wrote about problems with water in emergencies over on BNN...

linking to how to make an emergency flower pot purifier, similar to the ceramic one we used for years.

But StrategyPage has an article about more sophisticated devices here.

Sunday, December 8, 2013

The Daily mail to the rescue

much of the medical news reported on the NYTimes newfeed is excellent, with nuances and expert opinions.

But for ordinary folks, I used to refer my patients to the national enquirer...the British equivalent of this is the UKMail.

So today's headlines:

Eating Brussel spouts helps fertility

if it's the folic acid content, then maybe a pill would work just as well.

Viagra suppositories might stop menstral cramps.

you know that "bloating" feeling? Well, a good orgasm will make it go away... and viagra, by increasing the blood supply, will help remove the congestion...ditto for men suffering from a similar syndrome.

 Can watching the eye movement when you look at a picture help diagnose your disease?

when we hypnotized people, we check the "eye roll" to see if their neurophysiological ability to be hypnotized. (look up, and slowly close your eyes looking up. If you see a lot of white eye, they are easily hypnotized, easily persuadable, more creative, and more prone to conversion reactions. No white eye, and you have a scientific type who can't be hypnotized).

But in both cases, medicine, fatigue, and nervousness could mess up the results.

finally the good news: Deaths from common cancers are down, due to earlier diagnoses and better treatment.

the cancer picture has changed since I started medical school.

Bowel cancer used to be mainly in the rectal area, and now is rarely there, and more common upstream...lung cancer used to be a men's disease, but now is common in women...breast cancer is found much earlier and usually is cureable when found (ditto for prostate cancer)...and now we rarely see cancer of the stomach, and when we find it, it is usually a lymphoma...

Wednesday, December 4, 2013

Dialysis in older people

NYTimes discusses.

yes, often they have many other diseases that kill them (usually heart disease or stroke or poor circulation to their legs).

But when I read an article that says "Hard Choices", my bullshit antenna goes up, because it means they will be explaining why we should not treat these people.

The object is to let people die to save money

But in general, the evidence supporting a survival advantage in very old patients on dialysis is weak, according to Dr. Thorsteindottir. And there’s growing concern among experts that too many elderly patients with severe kidney disease may be starting dialysis without the potential for significant benefit.
“Concerns about overtreatment are focused on older adults, especially those who are frail or have other severe or life-limiting conditions,” according to the authors of an editorial in The Journal of the American Medical Association last year.

of course, the dirty little secrets it that my patients on "supportive treatment" have a lousy quality of life: So you have to balance the numerous incidents of shortness of breath and cramps and weakness with the inconvenience of dialyzing three times a week for 8 hours.

And yes, I've had people stop dialysis when their bodies simply were deteriorating: There is a point when you are prolonging dying, not prolonging life. But with the government in charge of health care, I suspect that we'll have more articles full of similar propaganda saying don't dialyze grandmom...

epa report on radioactivity in cigarettes


How does radioactive material get into a cigarette?

The tobacco leaves used in making cigarettes contain radioactive material, particularly lead-210 and polonium-210. The radionuclide content of tobacco leaves depends heavily on soil conditions and fertilizer use.
Soils that contain elevated radium lead to high radon gas emanations rising into the growing tobacco crop. Radon rapidly decays into a series of solid, highly radioactive metals (radon decay products). These metals cling to dust particles which in turn are collected by the sticky tobacco leaves. The sticky compound that seeps from the trichomes is not water soluble, so the particles do not wash off in the rain. There they stay, through curing process, cutting, and manufacture into cigarettes.Lead-210 and Polonium-210 can be absorbed into tobacco leaves directly from the soil. But more importantly, fine, sticky hairs (called trichomes) on both sides of tobacco leaves grab airborne radioactive particles.
For example, phosphate fertilizers, favored by the tobacco industry, contain radium and its decay products (including lead-210 and polonium-210). When phosphate fertilizer is spread on tobacco fields year after year, the concentration of lead-210 and polonium-210 in the soil rises.

Polonium, cigarettes and conspiracy theories

DeborahBlum at Wired writes about poisons in her column, and has this one about Yasser Arafat and polonium in cigarettes.
She explains about Polonium's short half life and chemical/radiological characteristics and adds:

All of this — the low level of natural occurrence, the very targeted efficiency of the poison — tell you that it’s highly unlikely for anyone to accidentally receive a lethal dose of polonium-210.
But it is possible to give yourself a nasty little dose — and that’s by becoming a heavy smoker of cigarettes. There’s a detailed description of some of these risks at the website of Lenntech, a company that makes air and water filters. It cites among other things, data from the CDC that “Americans are exposed to more radiation from tobacco smoke than any other source.” It also notes that polonium-210 has been isolated from both the blood and urine of heavy smokers.

another article mentions other toxins in cigarettes.

And when I read the FDA list of hazardous compounds in cigarette smoke and found not only polonium-210 (the radioactive element suspected in Arafat’s death) but two well-known isotopes of uranium  best associated with nuclear reactors (uranium-235 and uranium-238), I thought – wow, how did I miss that?

As it turns out, there’s a real case to be made that I – and really all of us – missed this because the tobacco companies hid the information, that cigarette makers flagged the problem internally by 1960s and studied it in secret. The best evidence for that comes from the companies’  confidential documents, which were released in the 1998 Tobacco Master Settlement Agreement between four major companies – Philip Morris, R.J. Reynolds, Brown & Williamson and Lorillard – and attorney generals from 46 states.
An analysis of those documents by public health researchers at the University of California-Los Angeles was published last year in the journal, Nicotine and Tobacco Research.  As that study (paywall) notes:
The documents show that the industry was well aware of the presence of a radioactive substance in tobacco as early as 1959. Furthermore, the industry was not only cognizant of the potential “cancerous growth” in the lungs of regular smokers but also did quantitative radiobiological calculations to estimate the long-term (25 years) lung radiation absorption dose (rad) of ionizing alpha particles emitted from the cigarette smoke.

1962 L&M advertisement using a “family theme” Photo: The Stanford School Of Medicine
This wasn’t the first study to note the corporate coverup; an earlier report in American Journal of Public Health reached the same conclusion.  Still, let’s call the information an imperfectly kept secret (as so many are). In 1964, for instance, we find scientists from the Harvard School of Public Health reporting that they had discovered hot spots, fizzing with polonium-210, in the lungs of regular smokers.  They published that finding in the highly visible New England Journal of Medicine in 1965, warning that “we believe 210Po may be an important factor in the initiation of bronchial carcinoma in humans”.  It wasn’t, actually, that tobacco companies were entirely successful at hiding the radioactive nature of cigarettes; it was that the rest of us weren’t entirely successful at paying attention.
 but it gets worse, she says:

But, as the UCLA analysis points out, internal documents revealed something else. Not only did cigarette makers know about polonium-210 contamination of their product for decades – they knew how to fix it and chose not to. And to understand that, you need to know why tobacco plants become such little radiation factories.

and here is an article in Scientific American: