QuackCast 28. Vitamin C, the common cold and the Peter Principle.

QuackCast 27. Update on Acupuncture and Chiropractic.

QuackCast 25. Fungi Shui.

QuackCast 24. Yeast Dis Connection.

QuackCast 23. Trust No One. But me
QuackCast 22. Boost your immune system And die
QuackCast 21. Acupuncture update
QuackCast 20. Influenza myths
QuackCast 19. Iridology
QuackCast 18. Update 2 Echinacea Meta Anal Ysis
QuackCast 17. Update 1 NUCCA and Hypertension
QuackCast 16. Probiotics
QuackCast 15. Magnet ‘Therapy’
QuackCast 14. Naturopathy Quacks of all trades, masters of none
QuackCast 13. Herbal "Remedies". Like "Fresh" Fish.
QuackCast 12. How to Identify Quackery and Homeopathic Horrors
QuackCast 11. Evidence to Support Efficacy and Complications of Chiropractic
QuackCast 10. History and Theory of Chiropractic
QuackCast 9. Lies, Damn Lies and the use of alt med
QuackCast 8. Acupuncture's Efficacy
QuackCast 7. Theory of Acupuncture
QuackCast 6. Prayer
QuackCast 5. Placebo Effect
QuackCast 4. Homeopathy Clinical Trials
QuackCast 3. Homeopathic Theory
QuackCast 2. Echinacea
QuackCast 1. Opening Salvo


QuackCast 28. Vitamin C, the common cold and the Peter Principle.


There are just a ton and a half of references for this podcasts.

Two central references will lead you to all the others.

Do vitamins C and E affect respiratory infections ?

Harri Hemilä

http://ethesis.helsinki.fi/julkaisut/laa/kansa/vk/hemila/

He seems help bent on proving that Vitamin C has a modest effect on the treatment of colds and other infections. Never have I seen so much efffoct to prove such a monor result. There is a nice summary of the hodgepodge of the animal studies in the appendix.

And

Vitamin C for preventing and treating the common cold

(Review)

Douglas RM, Hemilä H, Chalker E, Treacy B

The Cochrane Collaboration.

Adam and Eve, Vitamin C, and Pseudogenes Daniel Criswell,

http://www.icr.org/article/3271/


QuackCast 27. Update on Acupuncture and Chiropractic.


Sham device v inert pill: randomized controlled trial of two placebo treatments 2006;332;391-397;BMJ

Acupuncture for Treatment of Persistent Arm Pain Due to Repetitive Use A Randomized Controlled Clinical Trial
(Clin J Pain 2008;24:211–218)

Acupuncture induced necrotizing aortitis with infected pseudoaneurysm formation. Yonsei Med J. 2008 Apr;49(2):322-4.

Acupuncture-associated Listeria monocytogenes arthritis in a patient with rheumatoid arthritis. Joint Bone Spine. 2008 May 1.
Risk of Vertebrobasilar Stroke and Chiropractic Care Results of a Population-Based Case-Control and Case-Crossover Study SPINE Volume 33, Number 4S, pp S176 –S183


QuackCast 25. Fungi Shui.


A good jumping off place is a nice review from the 2003 Clin Microbiol Rev. 2003 January; 16(1): 144–172.
Indoor Mold, Toxigenic Fungi, and Stachybotrys chartarum: Infectious Disease Perspective.
I used this article to find all the important paper from before 2003; it has 465 references.

Allergy and "toxic mold syndrome".
Ann Allergy Asthma Immunol. 2005 Feb;94(2):234-9.
PMID: 15765738

Antibodies against molds and mycotoxins following exposure to toxigenic fungi in a water-damaged building.
Arch Environ Health. 2003 Jun;58(6):324-36.
PMID: 14992307

Baseline prevalence of symptoms related to indoor environment.
Scand J Public Health. 2006;34(4):387-96.
PMID: 16861189

Characterization of a population presenting with suspected mold-related health effects.
Ann Allergy Asthma Immunol. 2005 Jan;94(1):39-44.
PMID: 15702814

Culturability and toxicity of sick building syndrome-related fungi over time.
J Occup Environ Hyg. 2004 Aug;1(8):500-4.
PMID: 15238302

Double blind placebo controlled exposure to molds: exposure system and clinical results.
Indoor Air. 2005;15 Suppl 10:73-80.
PMID: 15926947

Effects of toxic exposure to molds and mycotoxins in building-related illnesses.
Arch Environ Health. 2003 Jul;58(7):399-405.
PMID: 15143852

Inhalational mold toxicity: fact or fiction? A clinical review of 50 cases.
Ann Allergy Asthma Immunol. 2005 Sep;95(3):239-46.
PMID: 16200814

Mixed mold mycotoxicosis: immunological changes in humans following exposure in water-damaged buildings.
Arch Environ Health. 2003 Jul;58(7):410-20.
PMID: 15143854

Mycotoxins, fungus and 'electrohypersensitivity'.
Med Hypotheses. 2000 Sep;55(3):208-14.
PMID: 10985910

Toxicological and neuropsychological findings in patients presenting to an environmental toxicology service.
J Toxicol Clin Toxicol. 1995;33(6):625-9.
PMID: 8523483

Fungus Shui - The Balance of Design, Construction and Maintenance http://www.aepronet.org/ge/es13.html


QuackCast 24. Yeast Dis Connection.

Dubious "Yeast Allergies" www.quackwatch.com

Effectiveness of nystatin in polysymptomatic patients. A randomized, double-blind trial with nystatin versus placebo in general practice.Fam Pract. 2001 Jun;18(3):258-65.

http://fampra.oxfordjournals.org/cgi/content/full/18/3/258#T3

Elevation of Candida IgG antibodies in patients with medically unexplained symptoms. J Altern Complement Med. 2007 Dec;13(10):1129-33.

NEJM Volume 323:1717-1723 December 20, 1990 Number 25 Next A randomized, double-blind trial of nystatin therapy for the candidiasis hypersensitivity syndrome.

Yeast connection among 100 patients with chronic fatigue. American Journal of Medicine 86:165-168, 1989.


QuackCast 23. Trust No One. But me

December 1 Lancet, Near-death experience in survivors of cardiac arrest: a prospective study in the Netherlands. It is on-line at http://www.thelancet.com/journals/lancet/article/PIIS0140673601071008/fulltext.

Skeptic

Electrocerebral accompaniments of syncope associated with malignant ventricular

arrhythmias.

Ann Intern Med. 1988 Jun;108(6):791-6.

Electroencephalographic changes during brief cardiac arrest in humans. Anesthesiology1990;73:821–25.


QuackCast 22. Boost your immune system And die

Int Arch Allergy Immunol. 2007;143(3):237-44. Epub 2007 Feb 9.

Probiotics have a different immunomodulatory potential in vitro versus ex vivo upon oral administration in children with food allergy.

Inflammation and Atherosclerosis (Circulation. 2002;105:1135-1143.)

Treatment of Periodontitis and Endothelial Function

NEJM 2007

Clinical Infectious Diseases 2007; 45:158–65

Lancet 2006;367:1075-1079.

Clayton TC, Thompson M, Meade TW. Recent respiratory infection and risk of cardiovascular

disease: case-control study through a general practice database. Eur Heart J.

2007:doi:10.1093/eurheartj/ehm516.


QuackCast 21. Acupuncture update


Stop Hypertension With the Acupuncture Research Program (SHARP): Results

of a Randomized, Controlled Clinical Trial

2006;48;838-845Hypertension

 

Randomized Trial of Acupuncture to Lower Blood Pressure

2007;115;3121-3129 Circulation Werner G. Daniel

Meta-analysis: Acupuncture for Osteoarthritis of the Knee

Ann Intern Med. 2007;146:868-877.

Acupuncture in the treatment of Rhematoid Arthritis a controlled pilot study.

BMC Complement Altern Med. 2007 Nov 3;7(1):35

 

ECCO-the European CanCer Conference

Acupuncture does not reduce radiotherapy-induced nausea, but patients believe it does

A pilot study of acupuncture as adjunctive treatment of rheumatoid arthritis.

Clin Rheumatol. 2007 Nov 8; [Epub ahead of print]

Abstract

German Acupuncture Trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups.

Arch Intern Med. 2007 Sep 24;167(17):1892-8. Erratum in: Arch Intern Med. 2007 Oct 22;167(19):2072.

PMID: 17893311

a german analysis:

http://aerzteblatt.de/v4/archiv/artikel.asp?id=54179


QuackCast 20. Influenza myths

This is a huge topic. Go to pubmed and search using influenza and vaccine you get almost 10,000 references, more than even I, with my superhuman abilities, can read.

A good summary is at http://www.cdc.gov/flu/ where the party line for the medical-industrial complex is avaiable.

If you want the vaccine liars at their best (worst) go to www.ratbags.com and search for influenza or vaccine. It is a website that should be in your bookmarks.

The list of them what should get the flu vaccine is:

* all persons, including school-aged children, who want to reduce the risk of becoming ill with influenza or of transmitting influenza to others

* all children aged 6–59 months (i.e., 6 months–4 years);

* all persons aged >50 years;

* children and adolescents (aged 6 months–18 years) receiving long-term aspirin therapy who therefore might be at risk for experiencing Reye syndrome after influenza virus infection;

* women who will be pregnant during the influenza season;

* adults and children who have chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological or metabolic disorders (including diabetes mellitus);

* adults and children who have immunosuppression (including immunosuppression caused by medications or by human immunodeficiency virus;

* adults and children who have any condition (e.g., cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders) that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration;

* residents of nursing homes and other chronic-care facilities;

* health-care personnel;

* healthy household contacts (including children) and caregivers of children aged <5 years and adults aged >50 years, with particular emphasis on vaccinating contacts of children aged <6 months; and

1.

*healthy household contacts (including children) and caregivers of persons with medical conditions that put them at higher risk for severe complications from influenza.

-from the CDC site.

Stay well.


QuackCast 19. Iridology

Thorsons Introductory Guide to Iridology by James and Sheelah Colton. This book is filled with incoherent concepts, but was worth the read just to see the Medical librarians face when I asked for a book on iridology.

An evaluation of iridology.

JAMA. 1979 Sep 28;242(13):1385-9.

Can iridology detect susceptibility to cancer? A prospective case-controlled study.

J Altern Complement Med. 2005 Jun;11(3):515-9.

Iridology Not Useful and Potentially Harmful

Arch Ophthalmol. 2000;118:120-121

Iridology Is Nonsense

Stephen Barrett, M.D.

www.quackwatch.com

Iridology: A systematic review.
Forsch Komplementarmed. 1999 Feb;6(1):7-9.

Looking for gall bladder disease in the patient's iris.

BMJ. 1988 Dec 17;297(6663):1578-81.

The American Journal of Chinese Medicine, Vol. 33, No. 3, 501–505

Novel Approach of Molecular Genetic Understanding of Iridology: Relationship Between Iris Constitution and Angiotensin Converting Enzyme Gene Polymorphism

Relationship between Iris Constitution Analysis and TNF-Alpha Gene Polymorphism

in Hypertensives The American Journal of Chinese Medicine, Vol. 35, No. 4, 621–629

Association between iris constitution and apolipoprotein e gene polymorphism in

hypertensives.

Altern Complement Med. 2004 Dec;10(6):1101-5.

http://www.wellpark.co.nz/crs_foundation_Naturopathy.asp


QuackCast 18. Update 2 Echinacea Meta Anal Ysis


Lancet Infect Dis. 2007 Jul;7(7):473-80.

Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis.

Treatment of the Common Cold with Echinacea: A Structured Review

Clinical Infectious Diseases 2005; 40:807–10

Treatment of the Common Cold with Unrefined Echinacea

A Randomized, Double-Blind, Placebo-Controlled Trial

Ann Intern Med. 2002;137:939-946. www.annals.org

NEJM

Volume 337:536-542 August 21, 1997 Number 8

Discrepancies between Meta-Analyses and Subsequent Large Randomized, Controlled Trials=

Epidemiology and Reporting Characteristics of Systematic Reviews

PLoS Medicine | www.plosmedicine.org March 2007 | Volume 4 | Issue 3 | e780447

How Quickly Do Systematic Reviews Go Out of Date? A Survival Analysis

Ann Intern Med. 2007;147:224-233. www.annals.org

Outcome reporting bias in randomized trials funded by the Canadian Institutes of Health Research

CMAJ • SEPT. 28, 2004; 171 (7) 735

JAMA Vol. 291 No. 20, May 26, 2004

Empirical Evidence for Selective Reporting of Outcomes in Randomized Trials Comparison of Protocols to Published Article

review meta-asupported meta-analyses and other Cochrane reviews compared with industry

2006;333;782-; originally published online 6 Oct 2006; BMJ

Bräunig B, Knick E. Therapeutische Erfahrungen mit Echinaceae pallidae bei

grippalen Infekten. Ergebnisse einer plazebokontrollierten Doppelblindstudie.

Naturheilpraxis, 1993, 46:72–75.

That I cant find and I can’t read german anyway.

The WHO document. I prefer Tommy.

www.whqlibdoc.who.int/publications/1999/9241545178.pdf


QuackCast 17. Update 1 NUCCA and Hypertension

J Hum Hypertens. 2007 May;21(5):347-52. Epub 2007 Mar 2. Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study.

Bakris G, Dickholtz M, Meyer PM, Kravitz G, Avery E, Miller M, Brown J, Woodfield C, Bell B.

Department of Preventive Medicine, Rush University Hypertension Center, Chicago, IL, USA.

Anatomical abnormalities of the cervical spine at the level of the Atlas vertebra are associated with relative ischaemia of the brainstem circulation and increased blood pressure (BP). Manual correction of this mal-alignment has been associated with reduced arterial pressure. This pilot study tests the hypothesis that correcting mal-alignment of the Atlas vertebra reduces and maintains a lower BP. Using a double blind, placebo-controlled design at a single center, 50 drug naïve (n=26) or washed out (n=24) patients with Stage 1 hypertension were randomized to receive a National Upper Cervical Chiropractic (NUCCA) procedure or a sham procedure. Patients received no antihypertensive meds during the 8-week study duration. The primary end point was changed in systolic and diastolic BP comparing baseline and week 8, with a 90% power to detect an 8/5 mm Hg difference at week 8 over the placebo group. The study cohort had a mean age 52.7+/-9.6 years, consisted of 70% males. At week 8, there were differences in systolic BP (-17+/-9 mm Hg, NUCCA versus -3+/-11 mm Hg, placebo; P<0.0001) and diastolic BP (-10+/-11 mm Hg, NUCCA versus -2+/-7 mm Hg; P=0.002). Lateral displacement of Atlas vertebra (1.0, baseline versus 0.04 degrees week 8, NUCCA versus 0.6, baseline versus 0.5 degrees , placebo; P=0.002). Heart rate was not reduced in the NUCCA group (-0.3 beats per minute, NUCCA, versus 0.5 beats per minute, placebo). No adverse effects were recorded. We conclude that restoration of Atlas alignment is associated with marked and sustained reductions in BP similar to the use of two-drug combination therapy.

 

National Upper Cervical Chiropractic (NUCCA) www.nucca.org

and

nucca.com

A video of NUCCA in action (or inaction, they don’t appear to do much)

http://www.nucca.com/video/nucca/NUCCA_S.wmv

Stroke. 2001 Dec 1;32(12):2950-5.

Long-term results after microvascular decompression in essential hypertension.

Frank H, Schobel HP, Heusser K, Geiger H, Fahlbusch R, Naraghi R.

Medical Department IV/Nephrology, Clinic of Neurosurgery, University Erlangen, and Medical Department IV/Nephrology, University Frankfurt/Main, Germany.

BACKGROUND AND PURPOSE: In 1998, 8 patients with severe, intractable arterial hypertension and MR tomography-demonstrated neurovascular contact of a looping artery at the root entry zone of cranial nerves IX and X, causing neurovascular compression, underwent neurosurgical decompression. The short-term results showed a normalization of blood pressure with a markedly reduced antihypertensive drug regimen in 7 patients. To determine the longer-term outcome concerning blood pressure and secondary organ damage after neurovascular decompression, we studied these 8 operated patients prospectively for a mean follow-up of 3.5 years after surgical intervention. METHODS: Eight hypertensive patients who had undergone microsurgical decompression were monitored every 6 months after surgery to assess blood pressure (by 24-hour ambulatory pressure readings) and the need for antihypertensive medication. To evaluate secondary organ damage, echocardiographic assessment of left ventricular hypertrophy, fundoscopic assessment of hypertensive lesions, and analysis of renal function and proteinuria were done. RESULTS: Three of the 8 operated patients remained normotensive in the long-term period with decreased antihypertensive medication. Two patients required gradual increases of antihypertensive medication after the first postoperative year, after which arterial blood pressure levels were 10% to 15% lower than preoperative levels. Three patients suffered serious cardiovascular and renal complications, with the incidence of lethal intracerebral hemorrhage in 1 patient and end-stage renal disease in 2 patients, of whom 1 experienced sudden cardiac death. CONCLUSIONS: The long-term results verify that microsurgical decompression is a successful alternative therapy in a certain subgroup of patients with arterial hypertension due to neurovascular compression. However, the relevance of the looping artery in the other cases, who did not improve, is not clear. Prospective studies to elucidate the pathophysiological role of neurovascular abnormalities and arterial hypertension are needed.

Surg Neurol. 2001 Jan;55(1):2-10;

Microvascular decompression in the treatment of hypertension: review and update.

Levy EI, Scarrow AM, Jannetta PJ.

Department of Neurosurgery, University of Pittsburgh School of Medicine, UPMC Presbyterian Hospital, 200 Lothrop Street, Suite B-400, Pittsburgh, PA 15213-2582, USA.

BACKGROUND: Neurogenic hypertension in association with vascular compression of the left rostral ventrolateral medulla has been documented. A recent group of these clinical reports has raised great interest in decompression of this area of the brainstem as a definitive therapy for essential hypertension. METHODS: To further clarify the mechanism by which decompression of the left rostral ventrolateral medulla relieves neurogenic hypertension, we describe in detail the basic science, animal models, human studies, and most recent clinical trials regarding surgical decompression of this area. CONCLUSION: Multi-disciplinary evidence supports the hypothesis that a sub-population of hypertensive patients achieve significant relief of their hypertension after microvascular decompression. A multi-institutional, prospective, randomized study is necessary to determine the efficacy of microvascular decompression for neurogenic hypertension.

Lancet. 1998 Aug 8;352(9126):446-9.

Decrease of blood pressure by ventrolateral medullary decompression in essential hypertension.

Geiger H, Naraghi R, Schobel HP, Frank H, Sterzel RB, Fahlbusch R.

Department of Internal Medicine IV, Johann Wolfgang Goethe University Frankfurt, Germany.

BACKGROUND: About 20% of adults worldwide will develop hypertension. Studies and clinical observations suggest an association between hypertension and pulsatile compression of the ventrolateral medulla oblongata by a looping artery. We investigated whether neurosurgical microvascular decompression substantially decreases blood pressure long-term in patients with severe essential hypertension. METHODS: We included eight patients who had received three or more antihypertensive drugs without adequate control of blood pressure, intolerable side-effects, or both. All patients underwent microvascular decompression at the root-entry zone of cranial nerves IX and X after neurovascular compression of the ventrolateral medulla oblongata was seen on magnetic-resonance angiography. FINDINGS: 3 months after surgery, blood pressure and antihypertensive regimens had decreased substantially in three patients. Four patients who were followed up for more than 1 year became normotensive, but their antihypertensive regimens remained the same as those at 3 months. One patient did not improve. No complications associated with decompression occurred. One patient experienced a transient vocal-cord paresis after the laryngeal part of the vagus nerve was manoeuvered during surgery. INTERPRETATION: We showed a direct causal relation between raised blood pressure and irritation of cranial nerves IX and X. A subgroup of patients with essential hypertension may exist who have secondary forms of hypertension related to neurovascular compression at the ventrolateral medulla and who may be successfully treated with decompression.

Ann Surg. 1985 Mar;201(3):391-8. Neurogenic hypertension: etiology and surgical treatment. I. Observations in 53 patients.

Jannetta PJ, Segal R, Wolfson SK.

Although an extensive literature exists concerning essential arterial hypertension, the primary etiology has been unclear. Arterial compression of the left lateral medulla oblongata by looping arteries of the base of the brain was seen incidently in 51 of 53 hypertensive patients who underwent left retromastoid craniectomy and microvascular decompression for unrelated cranial nerve dysfunctions. Such compression was not noted in normotensive patients. Treatment by vascular decompression of the medulla was performed in 42 of the 53 patients. Relief in the hypertension was seen in 32 of the patients and improvement in four. Arteriosclerosis and arterial ectasia contribute to arterial elongation and looping. If pulsatile compression of the left lateral medulla occurs, hypertension may develop as a consequence of an imbalance in the neural control systems that normally regulate blood pressure. The hypertension may further contribute to arterial elongation, providing a vicious circle of pathophysiologic changes.

Neuroradiology. 2000 Feb;42(2):99-103.

The role of MRI in screening for neurogenic hypertension.

Johnson D, Coley SC, Brown J, Moseley IF.

Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK. declanl@skynow.net

Neurovascular compression (NVC) of the left ventrolateral medulla (VLM) has been implicated as a cause of essential hypertension. We investigated whether high-resolution MRI of the posterior cranial fossa could identify patients with essential hypertension who may benefit from surgery. A retrospective analysis of imaging and clinical records from 162 patients was performed. There were 38 patients with essential hypertension and 124 who were normotensive. Contact or compression of the VLM was present in 42.1 % (16/38) of the hypertensive group on the left and 47.3 % (18/38) on the right. In the normotensive group it was seen in 32.2 % (40/124) on the left and 26.6 % (33/124) on the right. There was no significant difference between the hypertensive and control groups with regard to contact or compression of the left VLM. The results support the contention that neurovascular compression (NVC) of the left or right VLM is a common finding on MRI in normotensive individuals. We therefore believe that high-resolution MRI cannot be used as a screening tool to identify patients who may benefit from surgery.


QuackCast 16. Probiotics


If you put the title into pubmed or google you can often get the complete reference.

There are over 3000 probiotic references on promed.

To be honest, I am just too damn lazy today to do the cutting and pasting for the references.

I will do it during some Scrubs marathon on a rainy day here in Portland, but the sun is shining and the golf course is calling me and my sons.

If you want a specific reference, email me at knowitall@quackcast.com


QuackCast 15. Magnet ‘Therapy’

For more of Dr. Duarf Ekaf, listen to the Tank, the podcast of the Austrialian Skeptics at http://www.skeptics.com.au/tank/tank.htm. I think they are laugh out loud funny.

N Rays: the importance of unconscious bias in good scientists. http://skepdic.com/blondlot.html

http://www.peloop.com/ Everything you want to know about magnets and none of it is true.

Magnetic and Electromagnetic Therapy. David Ramey. The Scientific Review of Alternative Medicine. Vol 2, No1. Page 13. 1998.

Franz bread the good bread, flavor beyond compare. Welcome to PDX. http://www.usbakery.com/

Propositions Concerning Animal Magnetism http://web.archive.org/web/20040710162753/http://www.unbf.ca/psychology/likely/readings/mesmer.htm

The more things change, the more they stay the same.

ANTON MESMER AND SAMUEL HAHNEMANN http://www.acampbell.ukfsn.org/essays/altmed/mesmer.html

Magnet Therapy A Billion-dollar Boondoggle http://www.csicop.org/si/2006-04/magnet-therapy.html

See how rapidly magnetic fields drop off with distance http://www.magnetapplications.com/UK/faq.htm

The effectiveness of magnet therapy for treatment of wrist pain attributed to carpal tunnel syndrome. : J Fam Pract. 2002 Jan;51(1):38-40. Didn’t work.

Static magnetic field therapy for symptomatic diabetic neuropathy: a randomized, double-blind, placebo-controlled trial.

Arch Phys Med Rehabil. 2003 May;84(5):736-46.

 

Effect of magnetic vs sham-magnetic insoles on nonspecific foot pain in the workplace: a

randomized, double-blind, placebo-controlled trial. Mayo Clin Proc. 2005 Sep;80(9):1138-45.

Effect of magnetic vs sham-magnetic insoles on plantar heel pain: a randomized controlled trial.

JAMA. 2003 Sep 17;290(11):1474-8.

A randomized, double-blinded, placebo-controlled pilot study to investigate the effectiveness of a static magnet to relieve dysmenorrhea. J Altern Complement Med. 2005 Aug;11(4):681-7.

Static magnetic fields neither prevent nor diminish symptoms and signs of delayed onset muscle soreness. Arch Phys Med Rehabil. 2005 Mar;86(3):565-70.

A critical review of randomized controlled trials of static magnets for pain relief.

J Altern Complement Med. 2005 Jun;11(3):495-509.

Randomised controlled trial of magnetic bracelets for relieving pain in osteoarthritis of the hip and knee. BMJ. 2004 Dec 18;329(7480):1450-4.

Altern Ther Health Med. 2004 Mar-Apr;10(2):36-43.

Double-blind placebo-controlled trial of static magnets for the treatment of osteoarthritis of the knee: results of a pilot study.

The effect of flexible magnets on hand muscle strength: a randomized, double-blind study.

J Strength Cond Res. 2002 Feb;16(1):33-7.

Treatment of myofascial shoulder pain in the spinal cord injured population using static magnetic fields: a case series. J Spinal Cord Med. 2004;27(2):138-42.

The influence of permanent magnetic field therapy on wound healing in suction lipectomy patients: a double-blind study. Plast Reconstr Surg. 1999 Dec;104(7):2261-6;

 

Questions and Answers About Using Magnets To Treat Pain http://nccam.nih.gov/health/magnet/magnet.htm


QuackCast 14. Naturopathy Quacks of all trades, masters of none

If you put the title into pubmed or google you can often get the complete reference.

Home page the American Association of Naturopathic Physicians.

http://www.naturopathic.org/

The ANMA, or the other guys

http://www.anma.com/

Deaths Associated with Hypocalcemia from Chelation Therapy --- Texas, Pennsylvania, and Oregon, 2003--2005

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5508a3.htm

J Clin Microbiol. 2003 Aug;41(8):3986-8.

Severe Serratia liquefaciens sepsis following vitamin C infusion treatment by a naturopathic practitioner.

Characteristics of pediatric and adolescent patients attending a naturopathic college clinic in Canada.

Pediatrics. 2005 Mar;115(3):e338-43.

Characteristics of pediatric and adolescent patients attending a naturopathic college clinic in Canada.

Pediatrics. 2005 Mar;115(3):e338-43.

Rogue Scientist Has Own Scientific Method

http://www.theonion.com/content/node/49180

Bastyr University

http://www.bastyr.edu/

 

The Flexner Report and the Standardization of American Medical Education

http://jama.ama-assn.org/cgi/content/full/291/17/2139

Quackwatch.com

Naturowatch.org

http://www.naturalhealth.org/tradnaturo/

And I thought surgeons bickered.

APPLIED EVIDENCE

Naturopathic medicine: What can patients expect?

VOL 54, NO 12 / DECEMBER 2005

www.jfponline.com


QuackCast 13. Herbal "Remedies". Like "Fresh" Fish.

If you put the title into pubmed or google you can often get the complete reference.

HERBAL REMEDIES

N Engl J Med, Vol. 347, No. 25 December 19, 2002

A good overview of the whole topic.

A randomized, double-blind, placebo-controlled trial of two doses of Ginkgo biloba extract in dementia of the Alzheimer's type.

Curr Alzheimer Res. 2005 Dec;2(5):541-51.

Eur J Neurol. 2006 Sep;13(9):981-5.

Ginkgo biloba and donepezil: a comparison in the treatment of Alzheimer's Pharmacological studies supporting the therapeutic use of Ginkgo biloba extract forAlzheimer's disease.

Pharmacopsychiatry. 2003 Jun;36 Suppl 1:S8-14.


Ginkgo for memory enhancement: a randomized controlled trial.

JAMA. 2002 Aug 21;288(7):835-40.

 

The New England Journal of Medicine

February 23, 2006 vol. 354 no. 8

Glucosamine, Chondroitin Sulfate, and the Two in Combination for Painful Knee Osteoarthritis

 

NEJM -- Echinacea angustifolia in Rhinovirus Infections http://content.nejm.org/cgi/content/full/353/18/1971

Volume 353:1971-1972 November 3, 2005 Number 18

Echinacea angustifolia in Rhinovirus Infections

NEJM February 9, 2006 vol. 354 no. 6

Saw Palmetto for Benign Prostatic Hyperplasia

 

St John's Wort for depression

Cochrane Database of Systematic Reviews 2006 Issue 4

 

JAMA. 2002 Apr 10;287(14):1807-14. Related Articles, Links

Effect of Hypericum perforatum (St John's wort) in major depressive disorder: a randomized controlled trial.

Treatment of Vasomotor Symptoms of Menopause with Black Cohosh, Multibotanicals, Soy, Hormone Therapy, or Placebo

Ann Intern Med. 2006;145:869-879.

Mechanism Of Black Cohosh Versus Hot Flashes Revealed

http://www.eurekalert.org/pub_releases/2006-12/uoia-mob122106.php

Genetic Polymorphism of the Binding Domain of Surfactant Protein–A2 Increases Susceptibility to Meningococcal Disease

CID 1 December 2006Volume 43 Number 11

http://www.journals.uchicago.edu/CID/journal/contents/v43n11.html

QuackCast 12. How to Identify Quackery and Homeopathic Horrors

The Seven Warning Signs of Bogus Science

By ROBERT L. PARK

The National Aeronautics and Space Administration is investing close to a million dollars in an obscure Russian scientist's antigravity machine, although it has failed every test and would violate the most fundamental laws of nature. The Patent and Trademark Office recently issued Patent 6,362,718 for a physically impossible motionless electromagnetic generator, which is supposed to snatch free energy from a vacuum. And major power companies have sunk tens of millions of dollars into a scheme to produce energy by putting hydrogen atoms into a state below their ground state, a feat equivalent to mounting an expedition to explore the region south of the South Pole.

There is, alas, no scientific claim so preposterous that a scientist cannot be found to vouch for it. And many such claims end up in a court of law after they have cost some gullible person or corporation a lot of money. How are juries to evaluate them?

Before 1993, court cases that hinged on the validity of scientific claims were usually decided simply by which expert witness the jury found more credible. Expert testimony often consisted of tortured theoretical speculation with little or no supporting evidence. Jurors were bamboozled by technical gibberish they could not hope to follow, delivered by experts whose credentials they could not evaluate.

In 1993, however, with the Supreme Court's landmark decision in Daubert v. Merrell Dow Pharmaceuticals, Inc. the situation began to change. The case involved Bendectin, the only morning-sickness medication ever approved by the Food and Drug Administration. It had been used by millions of women, and more than 30 published studies had found no evidence that it caused birth defects. Yet eight so-called experts were willing to testify, in exchange for a fee from the Daubert family, that Bendectin might indeed cause birth defects.

In ruling that such testimony was not credible because of lack of supporting evidence, the court instructed federal judges to serve as "gatekeepers," screening juries from testimony based on scientific nonsense. Recognizing that judges are not scientists, the court invited judges to experiment with ways to fulfill their gatekeeper responsibility.

Justice Stephen G. Breyer encouraged trial judges to appoint independent experts to help them. He noted that courts can turn to scientific organizations, like the National Academy of Sciences and the American Association for the Advancement of Science, to identify neutral experts who could preview questionable scientific testimony and advise a judge on whether a jury should be exposed to it. Judges are still concerned about meeting their responsibilities under the Daubert decision, and a group of them asked me how to recognize questionable scientific claims. What are the warning signs?

I have identified seven indicators that a scientific claim lies well outside the bounds of rational scientific discourse. Of course, they are only warning signs -- even a claim with several of the signs could be legitimate.

1. The discoverer pitches the claim directly to the media. The integrity of science rests on the willingness of scientists to expose new ideas and findings to the scrutiny of other scientists. Thus, scientists expect their colleagues to reveal new findings to them initially. An attempt to bypass peer review by taking a new result directly to the media, and thence to the public, suggests that the work is unlikely to stand up to close examination by other scientists.

One notorious example is the claim made in 1989 by two chemists from the University of Utah, B. Stanley Pons and Martin Fleischmann, that they had discovered cold fusion -- a way to produce nuclear fusion without expensive equipment. Scientists did not learn of the claim until they read reports of a news conference. Moreover, the announcement dealt largely with the economic potential of the discovery and was devoid of the sort of details that might have enabled other scientists to judge the strength of the claim or to repeat the experiment. (Ian Wilmut's announcement that he had successfully cloned a sheep was just as public as Pons and Fleischmann's claim, but in the case of cloning, abundant scientific details allowed scientists to judge the work's validity.)

Some scientific claims avoid even the scrutiny of reporters by appearing in paid commercial advertisements. A health-food company marketed a dietary supplement called Vitamin O in full-page newspaper ads. Vitamin O turned out to be ordinary saltwater.

2. The discoverer says that a powerful establishment is trying to suppress his or her work. The idea is that the establishment will presumably stop at nothing to suppress discoveries that might shift the balance of wealth and power in society. Often, the discoverer describes mainstream science as part of a larger conspiracy that includes industry and government. Claims that the oil companies are frustrating the invention of an automobile that runs on water, for instance, are a sure sign that the idea of such a car is baloney. In the case of cold fusion, Pons and Fleischmann blamed their cold reception on physicists who were protecting their own research in hot fusion.

3. The scientific effect involved is always at the very limit of detection. Alas, there is never a clear photograph of a flying saucer, or the Loch Ness monster. All scientific measurements must contend with some level of background noise or statistical fluctuation. But if the signal-to-noise ratio cannot be improved, even in principle, the effect is probably not real and the work is not science.

Thousands of published papers in para-psychology, for example, claim to report verified instances of telepathy, psychokinesis, or precognition. But those effects show up only in tortured analyses of statistics. The researchers can find no way to boost the signal, which suggests that it isn't really there.

4. Evidence for a discovery is anecdotal. If modern science has learned anything in the past century, it is to distrust anecdotal evidence. Because anecdotes have a very strong emotional impact, they serve to keep superstitious beliefs alive in an age of science. The most important discovery of modern medicine is not vaccines or antibiotics, it is the randomized double-blind test, by means of which we know what works and what doesn't. Contrary to the saying, "data" is not the plural of "anecdote."

5. The discoverer says a belief is credible because it has endured for centuries. There is a persistent myth that hundreds or even thousands of years ago, long before anyone knew that blood circulates throughout the body, or that germs cause disease, our ancestors possessed miraculous remedies that modern science cannot understand. Much of what is termed "alternative medicine" is part of that myth.

Ancient folk wisdom, rediscovered or repackaged, is unlikely to match the output of modern scientific laboratories.

6. The discoverer has worked in isolation. The image of a lone genius who struggles in secrecy in an attic laboratory and ends up making a revolutionary breakthrough is a staple of Hollywood's science-fiction films, but it is hard to find examples in real life. Scientific breakthroughs nowadays are almost always syntheses of the work of many scientists.

7. The discoverer must propose new laws of nature to explain an observation. A new law of nature, invoked to explain some extraordinary result, must not conflict with what is already known. If we must change existing laws of nature or propose new laws to account for an observation, it is almost certainly wrong.

I began this list of warning signs to help federal judges detect scientific nonsense. But as I finished the list, I realized that in our increasingly technological society, spotting voodoo science is a skill that every citizen should develop.

Robert L. Park is a professor of physics at the University of Maryland at College Park and the director of public information for the American Physical Society. He is the author of Voodoo Science: The Road From Foolishness to Fraud (Oxford University Press, 2002).

http://chronicle.com

Section: The Chronicle Review

Volume 49, Issue 21, Page B20

Journal of Alternative and Complementary Medicine

Homeopathic Combination Remedy in the Treatment of Acute Childhood Diarrhea in Honduras

Oct 2006, Vol. 12, No. 8 : 723 -732

 

Don't rely on homeopathy to beat malaria, doctors warn

by FIONA MACRAE, Daily Mail Last updated at 09:22am on 14th July 2006

http://www.dailymail.co.uk/pages/live/articles/news/news.html?in_article_id=395568&in_page_id=1770


QuackCast 11. Evidence to Support Efficacy and Complications of Chiropractic

There are a lot of good web sites about chiropractic:

Chiropractic: Flagship of the Alternative Medicine Fleet by Steven Novella, MD

Dr. Novella is part of the Skeptics Guide to the Universe, and excellent podcast available on iTunes.

Quackwatch The best source for information on alt.med.

Chirobase An off shoot of Quackwatch with an emphasis on chiropractic. Their mission statement says

“Chirobase is a joint project of Quackwatch, the National Council Against Health Fraud, and Victims of Chiropractic. Its aims are:

•To provide comprehensive information about chiropractic history, theories, and current practices.

•To encourage and support the use of science-based practices by chiropractors.

•To identify and oppose the use of unscientific practices by chiropractors.

•To warn the public about inappropriate chiropractic care.

•To help people seeking appropriate chiropractic care to locate it.

•To pinpoint the risks involved in pursuing a chiropractic career.”

For some reason, the AMA isn’t involved.

A COMPARISON OF OSTEOPATHIC SPINAL MANIPULATION WITH STANDARD

CARE FOR PATIENTS WITH LOW BACK PAIN

N Engl J Med 1999;341:1426-31.

Spinal Manipulative Therapy for Low Back Pain

A Meta-Analysis of Effectiveness Relative to Other Therapies

Ann Intern Med. 2003;138:871-881. www.annals.org

A COMPARISON OF ACTIVE AND SIMULATED CHIROPRACTIC MANIPULATION

AS ADJUNCTIVE TREATMENT FOR CHILDHOOD ASTHMA

N Engl J Med 1998;339:1013-20.

Spinal manipulation in the treatment of episodic tension-type headache: a

randomized controlled trial.

JAMA. 1998 Nov 11;280(18):1576-9.

Chiropractic: A Profession at the Crossroads of Mainstream and

Alternative Medicine

Ann Intern Med. 2002;136:216-227. www.annals.org

Chiropractic Admission Standands Lowest among Health Professionals

http://www.chirobase.org/03Edu/adm.html

Attitudes on immunization: a survey of American chiropractors.

J Manipulative Physiol Ther. 1994 Nov-Dec;17(9):584-90.

Complications following vertebral manipulation-a survey of a French region physicians

Ann Readapt Med Phys. 2003 Feb;46(1):33-40.

Clinical perceptions of the risk of vertebral artery dissection after cervical manipulation: a survey of California neurologists.

Neurology. 1995 Jun;45(6):1213-5.

The role of chiropractic adjusting tables as reservoirs for microbial diseases.

Am J Infect Control. 2006 Apr;34(3):155-7.

An outbreak of amebiasis spread by colonic irrigation at a chiropractic clinic.

Volume 307:339-342 August 5, 1982 Number 6


QuackCast 10. History and Theory of Chiropractic

There are a lot of good web sites about chiropractic:

Chiropractic: Flagship of the Alternative Medicine Fleet by Steven Novella, MD

Dr. Novella is part of the Skeptics Guide to the Universe, and excellent podcast available on iTunes.

Quackwatch The best source for information on alt.med.

Chirobase An off shoot of Quackwatch with an emphasis on chiropractic. Their mission statement says

“Chirobase is a joint project of Quackwatch, the National Council Against Health Fraud, and Victims of Chiropractic. Its aims are:

•To provide comprehensive information about chiropractic history, theories, and current practices.

•To encourage and support the use of science-based practices by chiropractors.

•To identify and oppose the use of unscientific practices by chiropractors.

•To warn the public about inappropriate chiropractic care.

•To help people seeking appropriate chiropractic care to locate it.

•To pinpoint the risks involved in pursuing a chiropractic career.”

For some reason, the AMA isn’t involved.

Wikipedia entry on chiropractic.

AMA vrs Chiropracters. AMA loses.

National Council Against Health Care Fraud position paper


QuackCast 9. Lies, Damn Lies and the use of alt med

It was Lincoln who said: “You may fool all the people some of the time; you can even fool some of the people all the time; but you can’t fool all of the people all the time” see http://www.bartleby.com/73/609.html.

He obviously did not live in a time of good advertising.

I said it wast was PT Barnum who said: No one ever went broke underestimating the gullibility of the American people. It was HL Menken who said “No one ever went broke underestimating the intelligence of the American people.” http://www.bartleby.com/59/3/nooneeverwen.html.

Benjamin Disraeli. Quoted by Mark Twain in his Autobiography. “There are three kinds of lies: lies, damned lies and statistics.” http://www.bartleby.com/66/99/16799.html

People use 10% of the their brains. see http://www.theness.com/articles.asp?id=12.

Eskimos have 38 words for snow. see http://en.wikipedia.org/wiki/Eskimo_words_for_snow.

Unconventional Medicine in the United States -- Prevalence, Costs, and Patterns of Use

NEJM 328:246-252 January 28, 1993 Number 4

David M. Eisenberg, Ronald C. Kessler, Cindy Foster, Frances E. NorlCalkins, and Thomas L. Delbanco

Full text available on line at www.nejm.org.

Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA. 1998;280:1569-75.

Eisenberg DM, Davis RB, Ettner SL, et al.

The Eisenberg Data: Flawed and Deceptive

Timothy N. Gorski, MD, FACOG

www.quackwatch.org/11Ind/eisenberg.html.


QuackCast 8. Acupuncture's Efficacy

http://www.cochrane.org. Enter the search word ‘acupuncture’

http://www.acuwatch.org/general/nihcritique.shtml. A review of the NIH position paper on accupuncture.

www.pubmed.com. Enter the search words acupuncture and either complications or infection to see what harm can be done with quackery.

Acupuncture and Knee Osteoarthritis A Three-Armed Randomized Trial

Hanns-Peter Scharf, MD; Ulrich Mansmann, PhD; Konrad Streitberger, MD; Steffen Witte, PhD; Ju ̈ rgen Kra ̈ mer, MD; Christoph Maier, MD;

Hans-Joachim Trampisch, PhD; and Norbert Victor, PhD

Ann Intern Med. 2006;145:12-20. www.annals.org. Never letting data get in the way of conclusions.

Meta-Analysis: Acupuncture for Low Back Pain Eric Manheimer, MS; Adrian White, MD, BM, BCh; Brian Berman, MD; Kelly Forys, MA; and Edzard Ernst, MD, PhD Intern Med. 2005;142:651-663. www.annals.org. More intellectual dishonesty from what was once a trusted source of medical information.


QuackCast 7. Theory of Acupuncture

www.skepdic.com. The Skeptics Dictionary: good definitions and links on acupuncture, chi, vitalism etc.

Acupuncture, Magic, and Make-Believe (Skeptical Inquirer March 2003) http://www.csicop.org/si/2003-03/acupuncture.html.

Acupuncture: Theory, Efficacy, and Practice

Ted J. Kaptchuk, OMD

Ann Intern Med. 2002;136:374-383. www.annals.org.

The most dishonest, apologist review of quackery in a ‘reputable’ medical journal ever written. It was with this article I lost all respect for the intellectual integrity of the Annals. Just sayin’.

Be Wary of Acupuncture, Qigong, and "Chinese Medicine"http://www.quackwatch.org/01QuackeryRelatedTopics/acu.html.

You cant beat the Quackwatch.

NCAHF Position Paper on Acupuncture http://www.ncahf.org/pp/acu.html.


QuackCast 6. Prayer

A Skeptic Looks at Christian Science http://www.skepticreport.com/health/christianscience.htm

Comparative Mortality of Two College Groups, 1945 - 1983 http://www.cdc.gov/mmwr/preview/mmwrhtml/00015022.htm

Child Fatalities From Religion-motivated Medical Neglect

http://pediatrics.aappublications.org/cgi/content/full/101/4/625

Pediatrics 1998;101:625– 629;

Journal of Reproductive Medicine Volume 46, Number 9 September 2001

Does Prayer Influence the Success of in Vitro Fertilization–Embryo Transfer? Report of a Masked, Randomized Trial. The original with skeptical commentary. http://www.uic.edu/classes/psych/Health/Readings/Prayer%20-%20in-vitro%20fertilization,%20JrRepMed-Skeptical%20Inquirer.doc.

Am Heart J. 2006 Apr;151(4):934-42. Study of the Therapeutic Effects of Intercessory Prayer (STEP) in cardiac bypass patients: a multicenter randomized trial of uncertainty and certainty of receiving intercessory prayer.

More Questions on Healing Prayer A medical journal responds to its critics http://www.time.com/time/columnist/jaroff/article/0,9565,982245,00.html

Prayer & Healing The Verdict is in and the Results are Null

by Michael Shermer http://www.skeptic.com/eskeptic/06-04-05.html

The Deity in the Data What the latest prayer study tells us about God. Searching in the Darkness: About Prayer and Medical Cures

By William Saletan

http://www.slate.com/id/2139373/

The Cochrane Database of Systematic Reviews 2006 Issue 2

Intercessory prayer for the alleviation of ill health

http://www.cochrane.org/reviews/en/ab000368.html

Searching in the Darkness: About Prayer and Medical Cures

http://www.medscape.com/viewarticle/498576


Episode 5: Placebo IS THE PLACEBO POWERLESS? An randomized of Clinical Trials Comparing Placebo with No Treatment N Engl J Med, Vol. 344, No. 21 · May 24, 2001 Deconstructing the Placebo Effect and Finding the Meaning Response. Ann Intern Med. 2002;136:471-476. A review of regression to the mean: http://www-users.york.ac.uk/~mb55/talks/regmean.htm Medical Examples of regression to the mead: http://bmj.bmjjournals.com/cgi/content/full/309/6957/780shapeimage_1_link_0shapeimage_1_link_1


QuackCast 5. Placebo Effect

IS THE PLACEBO POWERLESS? An randomized of Clinical Trials Comparing Placebo with No Treatment N Engl J Med, Vol. 344, No. 21 · May 24, 2001

Deconstructing the Placebo Effect and Finding the Meaning Response. Ann Intern Med. 2002;136:471-476.

A review of regression to the mean: http://www-users.york.ac.uk/~mb55/talks/regmean.htm

Medical Examples of regression to the mead: http://bmj.bmjjournals.com/cgi/content/full/309/6957/780


QuackCast 4. Homeopathy Clinical Trials

I know: meta analysis, schemta analysis.  Lancet Lancet 2005; 366: 726–32 \

Are the clinical effects of Comparative study of placebo-controlled trials of homoeopathy and allopathy.

http://www.bag.admin.ch/kv/forschung/d/2005/shang_huwiler.pdf


QuackCast 3. Homeopathic Theory

The ever helpful www.quackwatch.org

The best essay on the topic was in the 1840’s by http://www.quackwatch.org/01QuackeryRelatedTopics/holmes.html

Phone it in: http://www.digibio.com/cgi-bin/node.pl?lg=us&nd=n4_3 homeopathy over the phone lines.


QuackCast 2. Echinacea

Treatment of the Common Cold with Unrefined Echinacea A Randomized, Double-Blind, Placebo-Controlled Trial Ann Intern Med. 2002;137:939-946.

Treatment of the Common Cold with Echinacea: A Structured Review Clinical Infectious Diseases 2005; 40:807–10.

An Evaluation of Echinacea angustifolia in Experimental Rhinovirus Infections NEJM July 28 , 2005 vol.353 no 4.

Studying Herbal Remedies Wallace Sampson, M.D. NEJM Volume 353:337-339 July 28, 2005.

Echinacea Treatment for the Common Cold Clinical Infectious Diseases 2005; 40:811–2

Echinacea purpurea for Prevention of Experimental Rhinovirus Colds. Clinical Infectious Diseases 2004; 38:1367–71.

Echinacea for the Common Cold: Can Alternative Medicine Be Evidence-Based Medicine? 17 December 2002 Annals of Internal Medicine Volume 137 Number 12.


QuackCast 1. Opening Salvo

What happens when you review Alternative Medicine without benefit of critical thinking? See any of the Annals of Internal Medicine articles on the topic. Weep to see what happens when a good journal goes bad. http://www.annals.org.