Medicine

OSHA took the long road to adopt a standard to address respirable crystalline silica. Although the final rule was issued in March 2016, it is being challenged by both industry and labor groups. The first says OSHA went too far, the other says OSHA didn’t go far enough. The long road, however may be coming close to end. The U.S. Court of Appeals for the District of Columbia Circuit heard oral arguments last week from parties that are challenging the rule. Judges Merrick Garland, David Tatel and Karen LeCraft Henderson spent more than two hours listening to arguments from the National Stone,…
Guns are the third leading cause of injury-related death in the country. Every year, nearly 12,000 gun homicides happen in the U.S., and for every person killed, two more are injured. Whether Congress will do anything about this violence is a whole other (depressing) article. But there is evidence that change is possible. Last year, a study published in Epidemiologic Reviews “systematically” reviewed studies examining the links between gun laws and gun-related homicides, suicides and unintentional injuries and deaths. Researchers eventually gathered evidence from 130 studies in 10 countries,…
Last week, I wrote about Rigvir, a highly dubious cancer therapy developed in Latvia. Rigvir is an oncolytic virus, and its proponents claim that it targets only cancer cells for destruction, leaving normal tissue alone. Its history and how it came to be approved in Latvia in 2004 and added to the Latvian Health Ministry's list of reimbursable medications in 2011 remain rather mysterious, but how it is being marketed does not. For example, Rigvir has become a new favorite treatment at a number of quack clinics, such as the Hope4Cancer Institute in Mexico, where Rigvir is offered along with…
Back in the day I used to do a weekly feature every Friday that I used to call Your Friday Dose of Woo. For purposes of the bit, woo consisted of particularly ridiculous or silly bits of pseudoscience, quackery, or mysticism, such as the Quantum Xrroid Consciousness Interface. Amazingly, I managed to keep that up for a couple of years, but over time I started sensing that I was getting a bit too repetitive. The same bits of pseudoscience kept recurring. Over time I had to dig more and more to find suitable bits of woo that amused me enough to inspire me to ever more over-the-top heights of…
The reason there wasn't a post yesterday is simple. The night before, I was feeling a bit under the weather. As a result, I went to bed early, neglecting my blogly responsibilities. As I result, I missed the release of a whopper of a study that normally would have been all over like...well...choose your metaphor. On the other hand, the one day delay isn't necessarily all bad because it lets me see the reaction of cranks to this study, the better to apply some not-so-Respectful Insolence to it. The crankiest of these cranks, of course, is Mike Adams, a grifter deep in the thrall of any form of…
A week ago, I wrote about a naturopath in Utah named Harry Adelson, who was advertising his use stem cells to treat lumbar and cervical disk problems, including degenerated and dehydrated disks. That alone was bad enough, but what elevated "Not-a-Dr." (my preferred translation of the "ND" that naturopaths like to use after their names to confuse patients because it's so close to "MD") Adelson above and beyond the usual naturopathic quackery is his cosplay of an interventional radiologist, in which he purchased a C-arm to use fluoroscopy to inject his "stem cells" right into the intervertebral…
As a medical blogger with a skeptical bent and a rather aggressive proclivity towards defending science-based medicine, I generally like STAT News. Sure, it's occasionally screwed up royally (e.g., its credulous false balance reporting on a patient of cancer quack Stanislaw Burzynski named Neil Fachon), but in general it's usually a good source of medical news and analysis. No publication is perfect, of course, but STATNews is generally better than average, and I appreciate that. That's why I was disappointed to see how thoroughly a pharma-backed astroturf group whose mission is to loosen…
I write frequently about naturopathy here because, of all the dubious pseudoscientific medical "disciplines" out there, naturopathy (along with chiropractic) has achieved the most "respectability." Indeed, as I like to point out in my own specialty (breast cancer), the Society for Integrative Oncology (SIO) even admits naturopaths as members. Indeed, the immediate past president of SIO is a naturopath (and, depressingly, faculty at my medical alma mater, the University of Michigan), as was the SIO president in 2014. So entrenched are naturopaths in SIO that they have been prominent co-authors…
Across the country, federally qualified health centers provide a critical safety net, delivering needed medical care regardless of a person’s ability to pay. And so it’s worrisome when researchers document a sharp increase in dissatisfaction among the clinicians and staff who make those centers run. “We’re not sure why we saw things getting worse in the centers,” said Mark Friedberg, a senior natural scientist at Rand Corporation and director of their Boston office. “The best takeaway from this study is we need to track this. We need to get to the bottom of it because it is alarming.”…
I've frequently written about bogus stem cell clinics that use hard sell techniques to sell unproven and expensive "stem cell treatments" to desperate patients. For instance, I deconstructed the story claiming that hockey great Gordie Howe improved so markedly after a severe stroke, thanks to stem cells offered to him for free (because of his celebrity) by a dubious stem cell company (Stemedica) through its Mexican partner (Clínica Santa Clarita). The whole incident basically opened my eyes to just how unethical the for-profit stem cell clinic industry is, as clinics use hard sell techniques…
Yesterday I discussed a highly unethical clinical trial of a new herpes vaccine, based on what appears to be questionable science but backed by über-Libertarian Peter Thiel. The reason the trial is so unethical is because Rational Vaccines, the company that developed the herpes vaccine and is conducting the clinical trial, not only arranged to carry it out offshore but, unlike all American companies carrying out clinical trials offshore for purposes of gathering data to support an application for FDA approval, Rational Vaccines apparently carried the trial out without any oversight by an…
In the early 1980s in the wake of reports, publicized by a news report and later a book by Harris Coulter and Barbara Loe Fisher (DPT: A Shot in the Dark), that the whole cell DPT vaccine was linked to encephalitis and brain damage, a flood of product liability lawsuits was on the verge of bringing the US vaccine program to its knees. Later studies exonerated the DPT, especially a large case-control study, but those studies did not come until the 1990s. Even though existing evidence at the time did not clearly support a link, it did not clearly rule one out. As a result vaccine manufacturers…
Poor Robert F. Kennedy, Jr. He went from admired environmental activist to reviled antivaccine campaigner so quickly. It began when he outed himself in 2005 with his infamous conspiracy mongering screed about thimerosal in Salon.com and Rolling Stone. Basically, RFK Jr. is a member of what we used to call the mercury militia, a branch of the antivaccine movement that believes, more than anything else, that it is the mercury-containing preservative thimerosal that used to be in several childhood vaccines until 2002 drove an "epidemic" of autism. He's still a member, too, having recently…
Alternative medicine, by definition, consists of medicine that either has not been shown to work or has been shown not to work. To paraphrase an old adage yet again, medicine that has been shown to work with an acceptable risk-benefit ceases to be "alternative" and becomes simply "medicine." Unlike the case for many conditions commonly treated with alternative medicine, whether or not a treatment works against cancer is determined by its impact on the hardest of "hard" endpoints: Survival. A patient either survives his cancer or he does not. Even the "softer" endpoints used to assess the…
Here we go again. Antivaxers don't like vaccines. This, we know. They blame them for everything from autism to autoimmune diseases to diabetes to sudden infant death syndrome. They even sometimes claim that shaken baby syndrome is a "misdiagnosis" for vaccine injury. However, there are two vaccines that stand out above all as the objects of antivaccine scorn. the first, of course, is the MMR vaccine. That's on Andrew Wakefield., of course, who almost singlehandedly popularized the fear that the MMR vaccine causes autism. The second most hated vaccine (by antivaxers) is Gardasil or Cervarix,…
A few of the recent pieces I recommend reading: Larissa MacFarquhar in the New Yorker: When Should a Child Be Taken from His Parents? Brian Rinker at STAT: 32 churches and no methadone clinic: struggling with addiction in an opioid ‘treatment desert’ Renee Bracey Sherman in the New York Times: The Right to (Black) Life Brianna Ehley at Politico: ‘I just started flowing. It was the only thing that helped.’In tough neighborhoods, can high-school mental health counselors cut the school-to-prison pipeline? Yamiche Alcindor in the New York Times: In Sweltering South, Climate Change Is Now a…
Someone yesterday was not very happy with my attitude towards naturopaths, as evidenced in my post yesterday about the death of a young woman named Jade Erick due to intravenous infusion of curcumin by—you guessed it—a naturopath. Amusingly, that someone going by the 'nym of JR said that he or she didn't "like the tone of this article and it’s complete disregard for naturopaths." Well, JR, you're right. I do have a complete disregard for naturopaths because they are quacks who mix a small amount of good advice about diet and exercise with a whole lot of pure quackery (like homeopathy) and…
Kim Kelly, ND (Not A Doctor). He prescribed the dose of intravenous turmeric that killed Jade Erick. Finally, a mystery has been solved. Nearly five months ago, a 30 year old woman named Jade Erick suffered a cardiac arrest, most likely due to anaphylactic shock, during the infusion of intravenous curcumin ordered by a California naturopath named Kim Kelly, ND (for Not-a-Doctor). Because Erick's death was so sudden and dramatic, the story briefly made national news. I viewed the tragic incident as yet another example of why "licensed" naturopaths, such as those in California or other…
"In the future, maybe quantum mechanics will teach us something equally chilling about exactly how we exist from moment to moment of what we like to think of as time." -Richard K. Morgan It’s absolutely true that, in quantum mechanics, there are certain pairs of properties that we simply can’t measure simultaneously. Measure the position of an object really well, and its momentum becomes more uncertain. Measure its energy, and its time becomes more uncertain. And measure its voltage, and the free charge becomes more uncertain. Although this is disconcerting to some, it’s a fundamental part of…
Umair Shah’s story isn’t an uncommon one in public health. Starting out in medicine, with a career as an emergency department doctor, he said it quickly became clear that most of what impacts our health happens outside the hospital and in the community. Today, that philosophy drives his work as executive director of Harris County Public Health (HCPH) in Houston, Texas — an agency that serves the third-largest county in the nation, home to about 4.5 million residents. In fact, Shah, who first joined the agency in 2004 and become director in 2013, said the agency’s mantra is this: “Health…