Archive for the 'Science and Medicine' Category

Sep 26 2016

Review Criticizes IgG Testing for Food Allergies

immunoglobulins-typesIf you have a child in school then you have probably already noticed how common perceived food allergies are. Every year we get a list of foods that are banned from the school because of reported allergies. Peanuts are the most common. This is a reasonable policy for the school as genuine food allergies can cause life-threatening anaphylactic reactions.

It has also been known for a long time that the number of people who perceive that they or their children have a food allergy (35%) is far greater than the number of people who have proven allergies (2-5%).

A recent review of the literature, published in the Canadian Medical Association Journal, takes aim at one factor contributing to this gap between public perception and medical reality – IgG antibody testing.  Continue Reading »

2 responses so far

Sep 22 2016

Is Mark Zuckerberg Going to Cure Disease?

zuckerberg-chanMark Zuckerberg, the founder of Facebook, and his wife, Priscilla Chan, recently announced their initiative to “cure, prevent or manage all diseases by the end of the century.”

That is a fairly ambitious goal, to say the least, but coming from someone with the resources of Zuckerberg it’s worth exploring what he actually intends to do. To start, he plans on investing $3 billion in medical research. That is a serious investment.

To put that in perspective, however, the NIH 2017 budget is $34.1 billion, an increase of $2 billion over 2016. That includes $1.39 billion for Alzheimer’s research alone. The NIH spent over $500 billion dollars since 2000.

So, while the Chan Zuckerberg Initiative is generous and is likely to have a positive impact, it is hard to imagine how $3 billion will accomplish what $500 billion has not. It’s not as if there aren’t thousands of medical researchers around the world already trying to prevent, cure, and manage disease.

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4 responses so far

Sep 13 2016

Organic Sugar Scam

gatorade-organicGatorade, which is basically sugar water with a little salt and potassium added, is extending their strategy of making sugar water sound healthful by marketing a prominently labeled “Organic” version of their product: G Organic.

What makes the product organic is that the sugar is sourced from organic sugar cane. This is an excellent example of how marketing creates then exploits a health halo around products even when it makes absolutely no sense.

Organic Sugar

The sugar industry, and producers of high sugar products, have been engaged in a campaign over decades to market sugary products to the public while somehow convincing them that the products are not bad for them, and in fact may be good for them.

The science is pretty clear. Having a diet high in refined sugar is a major health risk factor. It increases triglycerides, which increases risk of heart disease, it causes tooth decay and obesity, which leads to diabetes and other health issues.

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30 responses so far

Sep 09 2016

Anti-Vaccine Doctor, Bob Sears, Faces Disciplinary Action

bob-searsDr. Bob Sears is a Capistrano Beach pediatrician who is famous for opposing mandatory vaccinations and the current CDC vaccine schedule. He has promoted his alternate vaccine schedule, which spreads out the vaccines much greater than the standard schedule. This has made him a darling of the anti-vaccine movement, an expert who supports part of their narrative (specifically, “Too many too soon” and parental choice).

Recently the Medical Board of California filed a complaint against Sears for “gross negligence.” There are three counts, the first for recommending a 2 year old patient not receive any further vaccines because of apparent reactions to previous vaccines. The complaint alleges:

Respondent was grossly negligent and departed from the standard of care in that he did not obtain the basic information necessary for decision making prior to determining to exclude the possibility of future vaccines, leaving both patient J.G, the patient’s mother, and his future contacts at risk for preventable and communicable diseases.

The complaint also alleges that Sears failed to adequately assess the patient after a head injury with complaint of headache, and also that he failed to keep adequate records by not filing the letter excusing the patient from vaccines in the chart.

The Standard of Care Continue Reading »

16 responses so far

Sep 08 2016

The Future of Telemedicine

telemedicine_computerTelemedicine is essentially the practice of having a patient visit electronically rather than in person. I think as a practice this is underutilized for various reasons, but we are likely to see much more of it in the future.

Does it Work?

Before we talk about the barriers to the adoption of telemedicine practice, let’s address the key question – is it effective? Further, is it as effective as an in-office visit? The answer, as you might expect, is, it depends. In some situations, however, it can be just as effective.

A recent study, for example, compared telemedicine from an originating clinic to in-person care for patients with asthma and found no difference in outcome over six months. In this study telemedicine patients visited a local clinic staffed with a nurse or respiratory therapist.

Continue Reading »

8 responses so far

Sep 06 2016

Anatomy of the CAM Scam, NIH Edition

acupuncture2Here is the challenge: how do you take a treatment or set of treatments that clearly do not work, and in fact defy basic sciences like physiology and chemistry, and argue that they are worthwhile. The National Institutes of Health (NIH) was essentially given this challenge when the Office of Alternative Medicine was forced upon them in 1991. This office has since morphed into a center, with its current name, the National Center for Complementary and Integrative Health (NCCIH).

The NCCIH recently put out a document that is, in my opinion, the pinnacle of their strategy for promoting worthless treatments (whether they think that is what they are doing or not). It reads like a blueprint for how to spin a political narrative out of negative medical studies.

Focus of Subjective Symptoms

The paper is, “Evidence-Based Evaluation of Complementary Health Approaches for Pain Management in the United States.” Pain is a favorite target for CAM because it is a subjective symptom and there are known neurological mechanisms by which the perception of pain can be easily manipulated.

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7 responses so far

Aug 23 2016

Deaths in Alternative Cancer Clinic Investigated

3-BRImagine you or a loved-one has cancer. You have a choice between two treatment options. You can be treated by a physician who is a cancer specialist using therapies that have been extensively researched, where we know the risks vs benefit, we know how to dose the treatments, and how to monitor for and manage potential side effect.

On the other hand you can be treated by someone who is not a physician (let alone a cancer specialist), who will also use powerful chemotherapeutic agents, but ones that have not been adequately studied, reviewed, or approved. We don’t know how to safely dose them, what all the possible risks are, or even if the agents work for your type of cancer (or at all, for that matter).

Which would you chose? It is hard for me to imagine why someone would choose the latter. Yet, if you slap the word “alternative” in front of the name of the latter clinic some people will think that it magically makes it the better choice. Also, some people have been so confused by conspiracy narratives they think that the con artist who isn’t a doctor is more trustworthy than the person who has dedicated their life to treating cancer.

Amazingly, they will argue that they don’t trust the doctors because there is too much money in cancer treatment, and then go to a clinic that will charge them $11,000 for unproven therapy. Continue Reading »

23 responses so far

Aug 22 2016

What Is Precision Medicine?

precision_medicineI feel that a lot of what I do here is separate marketing or ideological hype from reality. It’s a never-ending task, I think because humans have a tendency to view the world through narratives. We build a story about how we think the world works, and then that story drives our perception of the evidence (rather than the other way around).

Not only do we create our own narratives, but we communicate with each other through narratives, especially when we are trying to be persuasive. Marketing is an excellent example, because it has evolved over decades, trying multiple strategies, and preferring those strategies which work best. You may have noticed that many commercials and ads do not try to persuade you with fact, but rather try to convey a feeling, an image – a narrative. The same is also true of politics.

So deep is this tendency to view the world thematically rather than empirically, that even in science-based and highly technical areas like medicine we can encounter it. In the last few years I have been encountering the terms “personalized medicine” and “precision medicine” more often. Frequently this is in the context of blatant pseudoscience, but these terms are used even within respectable science-based medicine.

What do these terms actually mean and how is this different than what we are already doing?

Continue Reading »

6 responses so far

Aug 16 2016

Delivering Chemotherapy with Nanocarriers

nanocarriersOne of the great promises of nanotechnology is that we will be able to send swarms of these microscopic robots into your body to do all sorts of helpful things, like clean plaque from your arteries, repair cell damage, and kill cancer cells. Theoretically, these are all great ideas. There are, however, non-trivial technological hurdles to realizing the potential of this technology.

Another related great idea is the concept of delivering chemotherapy directly to cancer cells with some sort of targeted nanocarrier. Chemotherapy for cancer primarily refers to toxic drugs that kill cells. Specific drugs are given in specific doses so that they primarily kill rapidly dividing cells, which include cancer cells, but have less of a toxic effect on cells with a more typical rate of division. Still, chemotherapy makes people very sick and we are generally pushing this toxicity to its limits in order to maximize the effect against cancer cells.

What if, however, we could deliver the chemotherapy directly to cancer cells? In fact, anything we can do to increase the concentration of chemotherapy in the cancer and reduce the concentration outside of the cancer will enhance efficacy and reduce side effects.

Continue Reading »

15 responses so far

Aug 02 2016

Supplements and Contract Research

snake-oilI dislike double standards. They are inherently intellectually dishonest. Sometimes double standards are the result of a deliberate campaign to confuse the public or regulators in order to create special privileges.

Alternative medicine is a great example of a double standard. Proponents want their own special standard for research, for evidence, and for practice. They, in fact, have succeeded in passing laws in many states which explicitly create a double standard for practices arbitrarily deemed “alternative”.

Organic farmers can use toxic pesticides while criticizing their competitors for using less toxic pesticides. They also eschew GMO cultivars, while using those resulting from mutation farming or forced hybridization.

One clear double standard is the marketing of supplements – the industry has successfully created a double standard for their products. They criticize the pharmaceutical industry while being guilty of far worse practices.  Continue Reading »

8 responses so far

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