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A thousand points of pseudo-science.

Selections from the Society for Science-Based Medicines Points of Interest, a daily compendium of links of interest with comments.

There is not enough time to write a complete blog post on the thousand points of pseudo-medicine that show up in my feeds. But some stars need to be noticed and commented upon. Duty Calls.

NECSS will be June 29-July 2, 2017 in New York City with an entire day, June 28, devoted to science-based medicine. More details to follow but registration is open.

What’s the harm?

Does this sound like a good idea to you? Go to a stem cell clinic, pay $5,000 to have the stem cells from your abdomen isolated, then inject those stem cells simultaneously into both eyes to treat macular degeneration. It is not a good idea as “Doctors Say Unproven Stem Cell Treatment Blinded 3 Women” demonstrates:

This report joins a small but growing medical literature highlighting the risks of such wanton misapplication of cellular therapy,” he wrote. Providing such treatments for profit outside a proper research setting “is a gross violation of professional and possibly legal standards…

I had a patient whose naturopath was injecting abdominal stem cells into the knee to treat osteoarthritis and into the gums to treat a receding gum line. She ended up with a knee infection caused by a mouth bacteria. I never could ascertain exactly how the infection occurred, but a suspicious combination of events.

Stem cells are the new antineoplastons, only much more popular.

Vaccination

The adverse effects of the anti-vaccine movement are growing. There has been a threefold rise in measles cases as Italy’s anti-vaccine movement grows with over 700 cases this year, but no deaths. So far.

Other countries are not so fortunate: “Romania Urges Vaccinations to Stop Measles Outbreak.” With a country that has a less than 80% vaccination rate for measles, they are well below levels needed for herd immunity. So they have had over 3,400 cases of measles and 17 children have died, all unvaccinated. I wonder if Dr. Wakefield feels any remorse or guilt?

30% of Croatian Parents Reluctant to Vaccinate Their Children” and as a result measles has returned to Croatia.

Australia, always competitive, is looking to take the lead in outbreaks of vaccine preventable illnesses: “Vaccinations: Northern Beaches mum wants to open ‘vaccine-free daycare’ to avoid No Jab No Play laws.” What better way to start an epidemic than to cluster all the susceptible children in one place? They should name it the Epicenter Daycare.

Acupuncture

From the Department of Guaranteed False Positives.

Clinical trials that compare an intervention to standard care are often useless.

As Dr. Ernst points out, it is

A trial design that generates only ”positive” results.

We conclude that the ‘A + B versus B’ design is prone to false positive results

Where A is an intervention (acupuncture, chiropractic, reiki, homeopathy) and B is standard care.

Yet that is the methodology beloved by traditional Chinese pseudo-medicine and other pseudo-medical researchers. Probably because it tells them what they want to hear. Here are this week’s likely false positives:
Acupuncture in Patients with Allergic Asthma: A Randomized Pragmatic Trial.” Pragmatic is Latin for no valid control. Pragmatic in the title guarantees the trial was a waste of time and money and no conclusions can be drawn:

Patients with allergic asthma were included in a randomized controlled trial and randomized to receive up to 15 acupuncture sessions over 3 months or to a control group receiving routine care alone.

And the acupuncture group had subjective benefits, as would be predicted from a classic placebo effect. Researchers in TCPM don’t read the literature, don’t understand the literature, or ignore the literature. I can think of no other reasons they keep churning out these methodologically-suspect studies.

And now there is a meta-analysis on false positive studies: “The Efficacy of Acupuncture for Treating Depression-Related Insomnia Compared with a Control Group: A Systematic Review and Meta-Analysis.”

Of course they show benefit from acupuncture but it is classic GIGO. When you collect all the small cow pies into one large pile the result is not spun gold, just a large pile of cow pie.

There is also the standard conclusion for most pseudo-medical meta-analysis. Some variation of ‘may be of small benefit but only poor quality studies were located (see above) so more and better studies are required.’ You can almost predict the conclusion when you see Meta-Analysis in the title. As an example, “Clinical Evidence of Chinese Massage Therapy (Tui Na) for Cervical Radiculopathy: A Systematic Review and Meta-Analysis“, which concluded:

Tui Na alone or Tui Na plus cervical traction may be helpful to cervical radiculopathy patients, but supportive evidence seems generally weak. Future clinical studies with low risk of bias and adequate follow-up design are recommended.

Same as it ever was.

Chiropractic

The British Chiropractic Association brings goofy to a new high. First it was text neck. (bunk!) Now “British Chiropractic Association issues health warning over skinny jeans and other wardrobe items“:

WEARING skinny jeans and large fluffy hoods can be bad for your back, experts have warned.

Experts?!? Chiropractors are experts only at instilling fear to generate customers for their worthless interventions.

They refer to a ‘study‘ that was not a study but a consumer survey, the actual results of which I can’t find. We have to take the BCA’s word for it. But evidently 73% of British women had back pain and the BCA blames their wardrobe.

Those skinny jeans are evil:

Tim Hutchful, a chiropractor with the BCA, has said that “they restrict free movement in areas such as the hips and knees, affecting the way we hold our bodies.” Tim went on to berate restrictive clothing in general, saying it “can lead to a loss of ‘bounce’ in your stride, and the natural shock-absorbing qualities in your walk, causing pressure in your joints.” Who knew?

Who knew? No one. It is why it is called chiropractic manipulation. The advice of a chiropractor is worthless.

Herbs and supplements

Hymenaea are a species of South American tree whose sap is used in a product called jatoba as a restorative. The common name of the tree is Stinkingtoe, which does not inspire confidence, and jatoba can be purchased on Amazon as:

an energizing and toning bark. It is also useful as an antibacterial, antifungal, anti-inflammatory, expectorant, anti-yeast and hepatoprotector (liver tonic). It is loaded with nearly 40 phytochemicals, making it useful for many more conditions, as well as a general tonic…

40 phytochemicals! I am impressed, especially since it is an antifungal AND anti-yeast. More is better. As is so often the case when similar products are analyzed, what is on the label is not what is in the product. In “Adulteration and Contamination of Commercial Sap of Hymenaea Species” they analyzed commercial products and found:

…the metabolites composition and multivariate analysis revealed that none of the commercial samples were authentic. In the microbiological contamination analysis, five of the six commercial samples showed positive cultures within the range of 1,700-100,000 CFU/mL

Maybe it should be sold as a probiotic. And they concluded with:

…the commercial samples were deemed inappropriate for consumption and represent a danger to the population.

Quackademia

This London University Keeps Hosting Pseudoscientific Events.” Regent’s University London has hosted a series of events and lectures which promote pseudoscientific treatments such as homeopathy and screenings of Vaxxed`:

A member of the House of Commons science and technology committee told BuzzFeed News that any universities “lending their good name” to such events risked giving credibility to “unproven quack cures”.

LOL. This from same country with homeopathic hospitals. When you consider all the pseudo-medicine infiltrating US medical institutions under Integrative Medicine, I think we need to redo Casablanca

University: I’m shocked, shocked to find that quackery is going on in here!

[an Integrative Clinic hands University a pile of money]

Clinic: Your earnings, sir.

University: [sotto voce] Oh, thank you very much.

Legal and legislative

Drinkable sunscreen would seem to be ridiculous. Because it is. And others agree: “Iowa attorney general: Drinkable sunscreen ‘flat-out dangerous to consumers’.” The makers feel picked upon by the AG who:

…claims to represent Iowans and yet we have only sold roughly 35 bottles of UV Neutralizer into Iowa in the 5 years it has been for sale. He has no complaints or reports of individuals being burned so we still don’t understand why he thought this was an important spend of taxpayers money.

Of course they were burned, you just need to apply definition 31. That’s why the AG is involved.

Complaint puts New Age healers on Minnesota regulators’ radar.” The healer in question is Mas Sajady, who offers:

…a powerful meditation and healing tool to help support and accelerate total abundance in all areas of your life; health, wealth, relationships and spirituality.

The Health Department is trying to determine if Mas Sajady is practicing medicine and if so:

…decide whether the provider is following state rules, such as providing a Client Bill of Rights and factual advertising.

They are not in the business of determining:

…whether a treatment is effective or fraudulent.

Which is a good thing for University of Minnesota, which is enthusiastic over holistic practices such as:

Acupuncture and Traditional Chinese Medicine
Aromatherapy
Ayurvedic Medicines
Botanical Medicine
Clinical Hypnosis
Craniosacral Therapy
Creative Therapies
Food as Medicine
Healing Environments
Healing Touch
Holistic Pregnancy and Childbirth
Intuition in Healthcare
Massage Therapy
Mind-Body Therapies
Mindfulness
Naturopathy
Osteopathic Medicine
Prayer
Qigong
Reflexology
Reiki
Shamanism
Shiatsu
Social Support
Therapeutic Touch
Tibetan Medicine
Yoga

And has their own Center for Spirituality & Healing. If you want to offer fraudulent and ineffective therapies, do so in a Integrative Medical Clinic at a University following the rules. You can even get tenure.

Remember to go to Summary Pending Legislation 2017 to keep abreast of the pseudo-scientific legislative shenanigans in your state.

Weirdness

Effects of Intravenous Pharmacopuncture with Harmonizing and Releasing Formulas on Hepatic Recovery after Partial Hepatectomy in Rats.”

Intravenous pharmacopuncture: From the day after the partial hepatectomy, herbal extract (10 mg/kg) was given intravenously.

Intravenous injections are now pharmacopuncture. LOL. I order my antibiotics as pharmacopuncture. Anything and everything can be some form of puncture, just like every political scandal eventually has ‘gate’ appended to it. I still want to do a study of blood draws, with half the patients being told their blood is being drawn through an acupuncture point to decrease discomfort and increase energy. I bet I would show less pain in the phlebopuncture group. And those who draw blood can be called phlebopuncturists. Since neither word shows up on a google search with that spelling, I hereby trademark and copyright the terms. Pay me if you want to use them.

And people do the weirdest stuff, some of it being published. There is placentopuncture: “Therapeutic effect of acupuncture point injection with placental extract in knee osteoarthritis.” This is the usual useless study: no placebo control. Unfortunately, all the links to the full text are dead ends, so I can’t see whose placenta was being extracted and how, although all the articles I could find on placentopuncture are out of Korea for pain. Usually placenta is touted for postpartum depression, so I wonder how it would work on knee pain.

And we finish with: “Shockingly, Fetus Water Will Not Cure Your Lesbianism .” The homeopathic preparation Dr.Reckeweg R20 Glandular drops for Women apparently:

Treats the failure of a female to respond to sexual stimulus (frigidity), lesbian tendencies, congestion and faulty circulation

Yep. All those issues belong together. Does it work? Nope. A funny tongue in cheek N of 1 trial resulted in:

Outcome at day five: totally gay. At the end of the week, I’m just as filled with lesbian tendencies as I was when I started. The only thing that’s significantly different about me are my hands—which are much softer thanks to the moisturizer that came free with the R20.

And that’s it. See you next week.

Posted by Mark Crislip

Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, since 1990. He is a founder and  the President of the Society for Science-Based Medicine where he blogs under the name sbmsdictator. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His growing multi-media empire can be found at edgydoc.com.