Mark Crislip aka sbmsdictator.  The 'nym is an attempt at ironic humor. Not everyone sees it as such.


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Not always so great

I like to refer to Portland (Oregon, not Maine) and its environs is the great Pacific NW. Seattle, of course, is excluded in that designation. Just need to be clear. Over the years Oregon has been a leader in environmental issues and great beer, two of the many reasons I like to live here.

Unfortunately, Oregon is also at the top of the list for unvaccinated Kindergartners. It is a sobering graphic with more than 6% of Oregonian exempt from vaccine for non-medical reasons. You can see what the rates are for your state and gloat accordingly.

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Trolls

This entry does not address an issue related to pseudo-medicine, but will likely inform future decisions related to the site and how it will be run.

Anyone who spends time on the web is aware that there are some, well, interesting people who excel at disrupting conversations. We call them trolls and one will probably descend on this site in the future.

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Points of Interest: 2/17/2014

It appears to be a worry that acupuncture is no better than placebo. Makes it hard to find an indication for acupuncture for the insurance companies. “The OAAOM continues to work with the OCOM research department on gathering evidence for presentations to insurance companies and evidence review boards. This is an evolving process which relies on the quantity and quality of the available evidence to support clinical practice in acupuncture. The lack of funding for this kind of research, and the problems of the placebo control for acupuncture — this is the bad news.” Special Feature HOMEOPATHY faith, fact or fiction? Fiction, of course. Personally, I prefer therapies that have efficacy, not “Perhaps one day, homeopathy will gain mass acceptance of scientists and laymen alike. Perhaps it’ll always remain an issue of debate. Between these two extremes will be people like you and me, who cherish homeopathy as an interesting art and a unique medical doctrine, having a beautiful magic of its own.” Row over ‘NHS lies’ as leaflet tells patients homeopathy ‘helps body heal itself’. “NHS Tayside has come under fire after telling patients the alternative remedies are ‘very safe’, ‘stimulate the body to heal itself’ and trigger improvements in the majority of cases.” But at least homeopathy is an interesting art, a unique medical doctrine with a beautiful magic all its own. Cover science responsibly and expose pseudoscience. “Matters of serious public policy hinge on science. It’s the lynchpin of medicine, agriculture, transportation, energy and other industries that drive the world economy. It deserves vigilant news coverage.” [“The National Institutes of Health has awarded $383,357](http://www.recordpub.com/news%20local/2014/02/17/neomed-researchers-receive–740–000-in-grants) to NEOMED in support of Tariq Haqqi, professor of anatomy and neurobiology in the College of Medicine, for his research on osteoarthritis….Haqqi is looking to Ayurveda and Unani systems of medicine, the two most widely practiced traditional systems in Indian medicine. In these ancient medical practices, the water extract of Butea monosperma flowers, appropriately named ”flame of the forest“ due to its bright orange-red color, is used to treat inflammatory conditions such as arthritis. Haqqi’s research aims to bring elements of this practice to conventional medicine, using BME to develop a safer and more cost-effective, therapeutic approach for the treatment and prevention of OA….Haqqi serves as principal investigator for his grant, which peaks at up to $2,276,298 at the end of the proposed five-year period. ” I searched ‘Butea monosperma arthritis’ on Pubmed. No hits. Not to say it couldn’t work but seems a thin gruel to spend over 2 million on.
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Points of Interest 2/16/2014

Left hand unaware of right hand department. How effective is the Homeopathy available from the NHS?. “There has been extensive investigation of the effectiveness of homeopathy. There is no good-quality evidence that homeopathy is effective as a treatment for any health condition.” But, if you are lucky enough to live in Tayside, science doesn’t apply to your bit of the NHS. You can go to the Royal Victoria Hospital Homeopathy Clinic in Dundee where their Homeopathy leaflet proudly announces: “Studies of the outcome of treatment in the Homeopathy clinic show that about 70% of patients experience at least some improvement in their symptoms. About 40% of patients have a moderate to good improvement” Something to watch: NHMRC to judge alternative meds. “National Health and Medical Research Council chief executive Warwick Anderson said panels of experts will review the global research on the efficacy of various alternative treatments. He said the aim is to release reports on individual treatments throughout the year in which the NHMRC will draw conclusions on how effective they are and whether they match claims made about them, including homoeopathy.” The start of something bad? Health officials warn California commuters, students of measles exposure. “A college student may have exposed thousands of San Francisco Bay Area commuters as well as other students at the University of California, Berkeley to the measles after he took public transportation and went to class while infected, public health officials warned.” A crowded Bart train and a disease with secondary attack rates are >90% in susceptible household and institutional contacts. Great.
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Points of Interest: 2/14/2014

The influence of social norms on the dynamics of vaccinating behavior for paediatric infectious disease. “Social norms can strongly suppress vaccine uptake despite frequent outbreaks, as observed in some small communities. Significant portions of the parameter space also exhibit bistability, meaning long-term outcomes depend on the initial conditions. Depending on the context, social norms can either support or hinder immunization goals.” The acupuncturists won in Oregon, now they move on to Texas: Lawsuit claims getting acupuncture at a chiropractor is a public health threat. “Acupuncturists licensed by the Acupuncture Board must complete at least 1,800 instructional hours and complete at least two terms of a resident course from a reputable school to become licensed, according to the petition. They must study relevant subjects, including bacteriology, meridian and point locations, hygiene and public health.In contrast, the chiropractic board requires chiropractors to complete only 100 hours of acupuncture training to practice the procedure, the petition stated.” Are there health benefits to magnet therapy or is it all hype? Hype. How does magnet therapy work? It doesn’t. As you say “though there appears to be little benefit to magnet therapy ” Are there reasons to avoid magnet therapy? It’s worthless.
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Grounded

I have numerous alerts set up to see what is new each day in the world of complementary and alternative pseudo-medicines. There some patterns I think I see, but have not investigated in a rigorous manner, so could all be bias. Chiropractic practice building seems more common than Chiropractic research, at least considering what Google alerts serves up.

Lists are popular as well, although I tend to run across those on my Zite feed. As an example, 5 Unique Wellness Tips From Other Cultures. It was number 5 that peaked by curiosity: Earthing/Grounding.

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Points of Interest: 2/13/2014

Quality of acupuncture needles is less than perfect and must improve “surface irregularities and bent tips have not been completely eliminated, say the researchers…An estimated 1.4 billion acupuncture needles are used each year worldwide, with China, Japan, and Korea the main suppliers. China provides up to 90% of the world’s needles.” Thats a lot of needles. To bad it is impossible to improve the quality of acupuncture. New - Acupuncture Dragon & Tiger Relieves Menstrual Cramps & Pain. “The dragon and tiger fighting method involves alternately rotating the needle to the left nine times and rotating the acupuncture needle to the right six times. The dragon, Zi, is Yang and the tiger, Wu, is Yin. The dragon stands for the strengthening techniques of rotating to the left and the number 9, a Yang number. The tiger stands for the reducing method of rotating the needle to the right and the number 6, a Yin number. The motion of rotation is generated by rotating the needle by moving the thumb forward for the dragon technique and moving the thumb backwards for the tiger technique. Fighting stands for the alternation of rotating from one direction to the other.” Sounds like every Kung-Fu movie I ever saw, but I it is probably true, but nor the reasons they offer. See: Acupuncture applied as a sensory discrimination training tool decreases movement- in patients with chronic low back pain more than acupuncture alone: a randomised cross-over experiment. Acupuncturists win ‘dry needling’ case at Oregon appeals court. “The Oregon Court of Appeals ruled “dry needling” is acupuncture and not within the scope of practice of chiropractic medicine, the Oregon Association of Acupuncture and Oriental Medicine said in a news release.” Next I hope they decide that acupuncture and not within the scope of practice of acupuncture medicine and chiropractic and not within the scope of practice of chiropractic medicine.
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Points of Interest 2/12/2014

Leaving the Anti-Vaccine Movement. An interesting look into a person who left the dark side. Battle of the pseudo-medicines. Acupuncturists Needle Chiropractic Board in Court “Acupuncturists sued the Texas chiropractic board, claiming it creates a ”significant threat“ to public safety by allow chiropractors to do acupuncture.” I would suspect it is also a “significant threat” to public safety by allow chiropractors to do chiropractic and acupuncturists to do acupuncture. Here’s why we should research alternative therapies. Mostly an argument we should have a better understanding as to why people use pseudo-medicines. Juan Bi Tang. Qualifiers galore: “While Juan Bi Tang has a long history of use in traditional Chinese medicine, clinical trials testing this formula’s health effects are currently lacking. Still, a number of scientific studies indicate that certain herbs found in Juan Bi Tang may be beneficial in relieving pain and improving the health of joints and muscles….It should also be noted that, due to dietary supplements being largely unregulated, the content of some herbal products may differ from what is specified on the product label. While consumers face such risk with any dietary supplement, they may be greater when purchasing Juan Bi Tang and other products with a variety of herbs in varying doses.” And that is from a proponent. I think I would pass. What Does Being Healthy Really Mean? 5 Difference Between Chinese and Western Medicine: “Ancient Chinese physicians went one better. Like the comic book Superman, a number of the famous ones had supernormal X-ray vision. and ”Western medicine considers microbes most important. Finding microbes, isolating microbes, and preventing their spread is key in winning the fight against illnesses." I am skeptical of the former and embrace the latter. There is a War on Integrative Medicine.. It is odd as I see the progressive use of worthless pseudo-medicines. Ah, different perspectives.
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Double Standard

Medical trials are complicated. There is not only the treatment being evaluated, but there is the complex, dare I say it, biopsychosocial components of the interaction that can make efficacy difficult to determine. Interactions between the patient and the medical-industrial complex can all sorts of benefits and detriments even when there is no change in the underlying physiology.

People will usually perceive themselves as improved after a positive intervention with a provider. At its core it is probably no different than when a parent kisses an injury to make it better.

It is in part why we do placebo controlled clinical trials. They are not treatment vrs placebo/sham treatment. They are the entirety of the medical experience plus treatment vrs the entirety of the medical experience plus placebo/sham.

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Points of Interest: 2/07/2014

If a therapy is equal to placebo then usually the therapy is considered to be ineffective. It is why we no longer do mammary artery ligation for angina. Unless it is an acupuncture study. Then being equal to placebo demonstrates efficacy. Real, sham acupuncture improved patient-reported outcomes in breast cancer After an announcement for career in investigative law enforcement, they follow with a class in fraud: Homeopathy class promotes self-healing. I have mentioned continual recombination of pseudo-medicines to come up with new therapies. It continues: Cannabis and Yoga as Complementary Medicines. “Called Ganja Yoga, 420 Remedy Yoga, or Cannabis-enhanced, a growing number of yoga instructors are more than accepting of medical marijuana patients; they are encouraging their students to partake in cannabis before and sometimes during class.”
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Points of Interest: 2/6/2014

I can't tell if tongue in cheek: Bay activist: I made it rain with earth acupuncture. I hope so. Seems like the Canadians (and Austrailans) have more spine: Traditional Chinese medicine is still a divisive issue in B.C. Ask the Doc: Can upper cervical chiropractic help traumatic brain injury?   Well, no. Not even with advanced physics. Now DC's are doing upright MRI's to document, well, "subtle misalignment of the head and neck junction (that) is associated with loss of overall healing potential...The notable fact about the upper cervical procedure we practice for people with trauma is that the adjustment is not felt (NUCCA). The advanced physics render it very soft-touch."  
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Good News of a Sort

CVS, the second biggest pharmacy chain in the US, is no longer selling tobacco products as of October 1. They will lose 2 billion a year in sales as a result.

That’s a good thing for an industry that is ostensibly in health care.

“As the delivery of healthcare evolves with an emphasis on better health outcomes, reducing chronic disease and controlling costs, CVS Caremark is playing an expanded role in providing care,” Larry J. Merlo, the president and chief executive officer, said in a statement. “Put simply, the sale of tobacco products is inconsistent with our purpose.”

and

“Making cigarettes available in pharmacies in essence ‘renormalizes’ the product by sending the subtle message that it cannot be all that unhealthy if it is available for purchase where medicines are sold,” the company’s chief medical officer, Dr. Troyen Brennan, wrote in a new article in the Journal of the American Medical Assn.

And yet.

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Birchin'

“There is really no such thing as alternative medicine, just medicine that works and medicine that doesn’t.”

So much of the alternative medicine world can be almost be dismissed out of hand on the basis of prior plausibility. Rieki, Homeopathy, Reflexology, Chromatotherapy are not based on reality and should not have any effect once bias is removed. Other interventions are simply forms of exercise that are called alternative medicine, like tai-chi.

There is one intervention that is neither intrinsically ludicrous nor a rebranding of a standard practices:  botanicals. While the provenance as to why a given botanical is recommended for a given problem can be sketchy, plants often have valuable and effective chemicals to fight many diseases and improve life. Like coffee and caffeine.

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Points of Interest: 2/5/2014

Why it’s good to be wary of homeopathic remedies for asthma.  Yes.  Avoid useless medications for potentially fatal problems. “Medical research in clown shoes” Quackademic medicine down under. Homeopathic ophthalmology and chromatotherapy? Keep my eyes away! "Dr. Agrapart and his fellow chromatotherapists seem to conclude, shining colored light into the eyes can improve health and cure all manner of diseases up to and including cancer."
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Points of Interest: 2/4/2014

Chiropractic ranks second on ‘Forbes’ magazine list. "In yet another indication that the profession is poised for continued success, chiropractic offices were recently second on a Forbes magazine list of the “20 most-profitable industries and their pretax margins.”"  Although chiropractors have highest student loan default rate of any first profession health care field, the actual rate is quite small, at about 1.1%.

Public editor: Homeopath’s advice needs to be balanced.  I might suggest that given homeopathy is not reality based, there is no need for balance, any more than you need astrologers in an astronomy report or alchemists in a story on chemistry.

Homeopath develops treatment based on personality.  Given what is in homeopathy, it is only used on people with no personality?

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Bring Out Your Science

Peasant Woman: Well, how’d you become a doctor, then? King Arthur: The Homeopathic Lady of the Lake, her arm clad in the purest shimmering samite, held aloft Excalibur from the bosom of the water, signifying by divine providence that I, Arthur, was to carry Excalibur. That is why I am your doctor. Dennis the Peasant: Listen. Strange women lying in ponds distributing swords is no basis for a system of medicine. Supreme medical power derives from scientific inquiry, not from some farcical aquatic ceremony. Arthur: Be quiet! Dennis the Peasant: You can’t expect to wield medical power just ’cause some watery tart threw a sword at you!

Monty Python and the Holy Grail. Sort of.

Good satire can be indistinguishable from reality. The Onion does it all the time and sometimes their articles show up in my feed and I think they are legitimate.

When I saw the headline “Prince Charles tells skeptics “Be more scientific except homeopathy” at first I thought it was legit. It wasn’t. But it close enough to reality that it could have been.

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Recent Comments
Alan
Once you resort to name calling, you have already lost the argument. What happened to the scientific approach? Prove it wrong if y... Read More
Monday, 10 November 2014 17:28
Alan
Once you resort to name calling, you have already lost the argument. What happened to the scientific approach? Prove it wrong if y... Read More
Monday, 10 November 2014 17:28
Guest — Alan
Actually, it is incumbant upon the CAM community to prove that CAM works. Not the other way around. That is the scientific appro... Read More
Friday, 12 December 2014 18:27
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Acupuncture as Gamma-hydroxybutyrate

Interesting headline: 80-Year-Old Man Paralyzes Women with Acupuncture, Molests Them. It continues:

Seo is also accused of taking off A’s panties and molesting her after paralyzing her with acupuncture needles in the foot, he got access to A after promising to treat her uterus. Another victim, a 22-year-old employee, was also molested after receiving paralyzing acupuncture from Seo.

As one commentator said

I thought paralysis acupuncture was only possible in movies.

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Placebo Nocebo

One of the interesting aspects of medicine is how interactions with patients, even if nothing is done, can have both good and bad effects. It is one of the characteristics of human behavior that makes it very difficult to know if an intervention works. I usually consider the patient-HCW interaction to be mostly positive and it is not unlike the salubrious effects that occur when one monkey grooms another. However, as a physician

in deference to a million years of evolution, I will not attempt to pick fleas off the patient.

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Points of Interest: 2/1/2014

At least it is not battle field acupuncture, but I feel for the vets none-the-less.  Acupuncturists to offer free clinic for veterans. Chiropractic care comes with mild adverse events. And no efficacy. "The researchers discovered that 33% of the sham group and 42% of the usual group reported at least one adverse event. Events that were commonly reported include headache, muscle stiffness and increased pain."
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Points of Interest: 1/31/2014

Homeopathy healing 80 % leprosy patients, claims Ayush.  "multi-drug allopathic treatment cures leprosy, it often fails to cure the lack of sensation and disability in the affected body parts. "After the year-long homeopathy course, it was found that more than 80% of the patients had recovered the senses in their affected body parts and their wounds had healed."  I would be a wee bit skeptical. And I never thought of antibiotics as a "multi-drug allopathic treatment." American Chiropractic Association to honor Sen. Tom Harkin during NCLC. "a longtime champion of chiropractic who is known on Capitol Hill for his penchant for green ties." and a total lack of understanding of medicine.  And the picture doesn't even have a green tie. I Visited a Chickasaw Healer. See how many cognitive errors you can find in one article.  I think I have my next SBM post. $49.5 plus postage and handling New York Doctor Thrilled Original Copper Heeler Insole Expands US Presence.   I thought the Onion already offered this.
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