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<channel>
	<title>Using Me! &#187; Medicine</title>
	<atom:link href="http://blog.using.me.uk/category/science/medicine/feed/" rel="self" type="application/rss+xml" />
	<link>http://blog.using.me.uk</link>
	<description>Critical Thought, Science, Religion, Politics and more</description>
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		<title>Vaccination Immunity Duration</title>
		<link>http://blog.using.me.uk/2010/09/vaccination-immunity-duration/</link>
		<comments>http://blog.using.me.uk/2010/09/vaccination-immunity-duration/#comments</comments>
		<pubDate>Wed, 01 Sep 2010 10:02:01 +0000</pubDate>
		<dc:creator>PadainFain</dc:creator>
				<category><![CDATA[Critical Thinking]]></category>
		<category><![CDATA[Medicine]]></category>
		<category><![CDATA[Science]]></category>

		<guid isPermaLink="false">http://blog.using.me.uk/?p=382</guid>
		<description><![CDATA[You may have seen in the media that skepchick.org has a campaign to give people boosters to their Pertussis (Whooping Cough) vaccination immunity. At the recent DragonCon free injections were being given out.
Over the past year or two I&#8217;ve been doing a lot of research into vaccines and the anti-vax movement. One thing I did [...]]]></description>
			<content:encoded><![CDATA[<p>You may have seen in the media that <a href="http://skepchick.org/blog/free-vaccine-clinic-at-dragoncon/">skepchick.org has a campaign</a> to give people boosters to their Pertussis (Whooping Cough) vaccination immunity. At the recent DragonCon free injections were being given out.</p>
<p>Over the past year or two I&#8217;ve been doing a lot of research into vaccines and the anti-vax movement. One thing I did not know was how long the immunity you gain from vaccination can last. With a new baby in the family who is just approaching his first vaccinations and the recent re-emergence of Pertussis (particularly in California) I have become concerned whether my immunity is up to scratch and whether I or anyone else my son might come into contact with might even be a carrier of diseases that he could catch.</p>
<p>I had to visit my doctor yesterday so I asked him &#8220;Why we don&#8217;t have continual boosters throughout our life for Pertussis or Tetanus for example?&#8221;</p>
<p>He said that the perceived wisdom here in the UK is that after your childhood course of 5 vaccinations for each condition you are as good as protected for life. Now my doctor is pretty good and quite the skeptic himself. We recently had a good chat about Andrew Wakefield being struck off. So he didn&#8217;t state this as fact. He stated it as the NHS&#8217;s position.</p>
<p>Since then I&#8217;ve been looking for research articles on the duration of vaccination immunity and so far this is the kind of evidence that I&#8217;ve found:</p>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed/15876927">Pertussis vaccination immunity wanes in 4-12 years</a><br />
<a href="http://www.ncbi.nlm.nih.gov/pubmed/19876392">Natural immunity can last up to 30 years</a><br />
There are also articles which discuss <a href="http://ukpmc.ac.uk/abstract/MED/20192711">the need to re-vaccinate the elderly against diseases including Pertussis</a>.</p>
<p>So it seems on the surface at least that the NHS is wrong. If the last vaccination is given in the mid teens then by the age of 30, possibly even by the age of 20, people will have lost their immunity to at least some of the diseases they were vaccinated against. Those diseases may no longer pose a significant threat to their lives but they do still pose a risk to the lives of the young and old they come into contact with.</p>
<p>Now I am thoroughly confused about why we let this risk exist and I draw no firm conclusions at this point as to the level of the risk or the accuracy of the links above in relation to the specific NHS vaccination schedule. More research needs to be done but my opinion is clearly moving towards there being a real risk as a result of this vaccination policy. </p>
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		<title>The next bracelet phenomenom</title>
		<link>http://blog.using.me.uk/2010/08/the-next-bracelet-phenomenom/</link>
		<comments>http://blog.using.me.uk/2010/08/the-next-bracelet-phenomenom/#comments</comments>
		<pubDate>Wed, 18 Aug 2010 12:34:38 +0000</pubDate>
		<dc:creator>PadainFain</dc:creator>
				<category><![CDATA[Critical Thinking]]></category>
		<category><![CDATA[Medicine]]></category>
		<category><![CDATA[Science]]></category>
		<category><![CDATA[Woo and Bullshit]]></category>

		<guid isPermaLink="false">http://blog.using.me.uk/?p=377</guid>
		<description><![CDATA[Funny conversation at the golf course last night&#8230;

Man at front of queue gestures at bracelets on sale at the counter. The packaging says &#8220;Embedded Holographic Technology&#8221; and &#8220;May improve your strength and swing&#8221; etc.

Man at front of queue: Do those really work then?
Boy behind counter: Yeah, I wear one all the time.
Me: Yeah, wearing a [...]]]></description>
			<content:encoded><![CDATA[<p>Funny conversation at the golf course last night&#8230;</p>
<blockquote><p>
<i>Man at front of queue gestures at bracelets on sale at the counter. The packaging says &#8220;Embedded Holographic Technology&#8221; and &#8220;May improve your strength and swing&#8221; etc.<br />
</i><br />
<b>Man at front of queue:</b> Do those really work then?</p>
<p><b>Boy behind counter:</b> Yeah, I wear one all the time.</p>
<p><b>Me:</b> Yeah, wearing a hologram on your wrist will really make you better at golf.</p>
<p><b>Boy behind counter:</b> Well I play off 4.</p>
<p><b>Man at front of queue:</b> <i>[With slight sarcasm]</i> There must be something in it then.</p>
<p><b>Me:</b> Yeah, Confirmation Bias.
</p></blockquote>
<p>Anyway I looked these things up and the company behind them is EFX. They have websites for many different countries. I stumbled across the <a href="http://www.efxusa.com">US</a>, <a href="http://www.efxsport.co.uk">UK</a> and <a href="http://www.efxhungary.com">Hungarian</a> sites in my top few google hits.</p>
<p>I decided to make a new Trading Standards complaint about it. And here&#8217;s my complaint sent to Consumer Direct:</p>
<blockquote><p>
Please would you forward this complaint to Kent Trading Standards, as the body responsible for applying the law in this company&#8217;s region.</p>
<p>The company detailed in this complaint is selling a range of products for which there exists no evidence to give backing to the claims they make for their &#8216;Embedded Holographic Technology&#8221;. The products are sold by many websites and shops around the country and are no more than snake-oil.</p>
<p>Allowing such blatant rubbish to be pedaled at the expense of those without a basic understanding of medicine and physics is shameful.</p>
<p>The claim on their website follows &#8211; ALL this from a mylar &#8216;holographic&#8217; device???</p>
<p>A side note &#8211; their main US website claims that Mylar is a &#8216;metallic substance&#8217; when in fact it is a polyester (plastic)&#8230; they can&#8217;t even get THAT right!</p>
<p>&#8212;</p>
<p>Q. What is the major benefit of EFX?</p>
<p>A. EFX helps restore natural in harmony to the body.</p>
<p>The effect is believed to stabilize and harmonize the body&#8217;s bioelectric current. When the body is in harmony, the muscles relax, cells un-clump, and blood circulation increases, allowing for greater stability, easier movement and pain relief.</p>
<p>EFX energetic power works instantly. The immediate effects experienced are; increase strength, balance, flexibility and range of motion. EFX products have also been reported to help relieve joint and muscle pain, improve blood circulation, reduce swelling, keep muscles conditioned and flexible, alleviate stress, boost endurance, and prevent motion sickness.
</p></blockquote>
<p>I am still waiting to hear back from the Trading Standards Office in Manchester about the &#8216;minus-ion&#8217; bracelets I complained about previously. They aren&#8217;t obliged to contact me unfortunately but the chap I spoke to there did say he would try and call me when he had something to report. </p>
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		<title>Magnetic Therapy, the Evidence</title>
		<link>http://blog.using.me.uk/2010/05/magnetic-therapy-the-evidence/</link>
		<comments>http://blog.using.me.uk/2010/05/magnetic-therapy-the-evidence/#comments</comments>
		<pubDate>Sat, 08 May 2010 22:19:51 +0000</pubDate>
		<dc:creator>PadainFain</dc:creator>
				<category><![CDATA[Medicine]]></category>
		<category><![CDATA[Science]]></category>
		<category><![CDATA[Woo and Bullshit]]></category>

		<guid isPermaLink="false">http://blog.using.me.uk/?p=322</guid>
		<description><![CDATA[In preparation for my pursuit of the claims made by the purveyors of magnetic bracelets I decided to Google &#8220;Clinical Trial Magnet Therapy&#8221; in an attempt to find some proper trials and evidence. Conversely if you Google &#8220;Magnetic Healing&#8221; you&#8217;ll find thousands of hits for sales of the devices, their claims and no evidence.
My top [...]]]></description>
			<content:encoded><![CDATA[<p>In preparation for my pursuit of the claims made by the purveyors of magnetic bracelets I decided to Google &#8220;Clinical Trial Magnet Therapy&#8221; in an attempt to find some proper trials and evidence. Conversely if you Google &#8220;Magnetic Healing&#8221; you&#8217;ll find thousands of hits for sales of the devices, their claims and no evidence.</p>
<p>My top 10 hits were:</p>
<p>1. <a href="http://www.bmj.com/cgi/content/extract/332/7532/4">BMJ Article on trials in 2006</a>.</p>
<p>I don&#8217;t have access to this full article but based on other articles that refer to it, the findings were negative and the trial was rigorous.</p>
<p>2. <a href="http://www.magnetictherapyinfo.com/">A website trying to sell books on Magnet Therapy</a></p>
<p>The front page refers to three trials that produced positive results but there are no references to any papers so I cannot check for double-blinding etc.</p>
<p>3. <a href="http://www.cancer.org/docroot/eto/content/eto_5_3x_magnetic_therapy.asp">The American Cancer Society</a></p>
<blockquote><p>Although there are anecdotal reports of healing with magnetic therapy, available scientific evidence does not support these claims. The U.S. Food and Drug Administration (FDA) considers magnets harmless and of no use for medical purposes. </p></blockquote>
<p>Enough said!</p>
<p>4. <a href="http://en.wikipedia.org/wiki/Magnet_therapy">A Wikipedia Article</a></p>
<blockquote><p>Magnet therapy is considered pseudoscientific  due to both physical and biological implausibility, as well as a lack of any established effect on health or healing.</p></blockquote>
<p>The above quote just from the introduction links to two books and one article alone.</p>
<p>5. <a href="http://www.anesthesia-analgesia.org/content/104/2/249.full">Anesthesia and Analgesia</a></p>
<p>A very good summary on how hard it is to disprove something that has so many claimed benefits. Fortunately trials have been run in some specific areas and if one claim is shown to be false it casts the others in a very poor light. Not only that but when it comes to advertising you have to be able to show evidence for your claims not a lack of evidence to the contrary.</p>
<p>6. Strangely is the same as hit number 5.</p>
<p>7. <a href="http://www.therionmagnetics.com/magnetic-therapy-articles.html">The &#8216;evidence&#8217; from a company selling Magnetic Therapy products</a></p>
<p>There is a vast amount of text on this site and I have read through a good chunk of it. By following a few links one can get some excerpts of research papers which have been published. Some of these excerpts show that the trials were improperly conducted. One on Asthma in children shows that there was no sham group to compare with for example. Another that stood out for me shows such extraordinary results that I wish I had a subscription to the Journal that published it to see if there were any follow-ups or rebuttals.</p>
<blockquote><p>RESULTS: Wounds in the magnet group healed in an average of 15.3 days, significantly faster than those in either the sham group (20.9 days, P = .006) or control group (20.3 days, P < .0001). There was no statistically significant difference between the sham and control groups (P = .45).</p>
<p>CONCLUSIONS: An externally applied, low-power, static magnetic field increases the rate of secondary healing. Review of the literature reveals conflicting evidence regarding the use of magnetic energy to aid the healing of bone, tendon, and skin. Level I studies are lacking and difficult to execute but are needed to define conclusively the role of magnets in clinical practice.</p>
<p>Eplasty: Journal of Burns and Wounds. 2008 July. 25;8:e40. PMID: 18725953</p></blockquote>
<p>The claim is that a magnet caused the rats&#8217; wounds to heal 25% quicker. That&#8217;s an astonishing claim and one that ought to be researched further if there has been no flaws found in the trial. But putting myself in the place of a researcher on the trial I can think of a dozen problems that might be found, e.g.</p>
<ul>
<li>I made the wounds on the control group a little deeper</li>
<li>I treated the control group a little more roughly when measuring their progress</li>
<li>I fed and watered the magnet group with more/better food</li>
</ul>
<p>etc. etc.</p>
<p>8. <a href="http://www.lifemagnets.org/magnetic-therapy---clinical-trials--research.html">A site with links to trials with positive outcomes</a></p>
<p>There are more than twenty trials listed here but not a single one of them is one of those that reported nothing more than a placebo effect. Since those studies exist and since nowhere on this site, as far as I can find, do they mention any doubts about the efficacy of the treatment, there is an obvious bias here. I didn&#8217;t take the time to read all of the studies but to take the first one mentioned:</p>
<blockquote><p>At 4 hours, VAS pain scores (+/- SE) on a 5-item scale (0-500, 500 worst) decreased 79 +/- 18 mm in the active group and 10 +/- 21 mm in the placebo group (P < 0.05). There were no significant differences in any primary or secondary measure of efficacy between the treatment groups at 6 weeks. Despite widespread testing for magnetic properties, at study end, 69% of the active group and 77% of the placebo group (P > 0.2) believed that they had been assigned to the active treatment group. CONCLUSION: Despite our small sample size, magnets showed statistically significant efficacy compared to placebo after 4 hours under rigorously controlled conditions. </p></blockquote>
<p>I don&#8217;t see how they can possibly have that conclusion! After a session the patients showed better pain reduction with magnets than with sham treatment. Fair enough but has there been any attempt to blind the medical staff giving the treatment from whether it is real or sham? Studies have shown that this is hugely important to the outcome. It is not mentioned.</p>
<p>The final outcome after six weeks of treatment shows no difference in efficacy. That alone shows that the treatment was no more than placebo. After the trial is over the subtleties of patient response to the professional will have decayed and the actual efficacy becomes more apparent to the patient.</p>
<p>Given that the above disagree with each other, I have to conclude that the response to a session must be down to some factor during the session, that possibly being the professional&#8217;s knowledge of which treatment is being administered.</p>
<p>9. <a href="http://altmedicine.about.com/od/magnetsmagnetictherapy/a/magnetic_therapy.htm">Alternative Medicine at About.com</a></p>
<p>Reference is made to 5 papers and the site must be given some credit for appearing balanced. However it does end up being rather confused because of it. It starts by saying there is little evidence but then states.</p>
<blockquote><p>
Even though claims that magnetic therapy can treat diseases like cancer and multiple sclerosis are unfounded, there is some evidence that it may help relieve pain related to these chronic conditions
</p></blockquote>
<p>It claims that Arthritic and Pelvic pain studies are positive. On the other hand it states that a fybromalgia study failed to account for the better quality of beds patients were resting in and that</p>
<blockquote><p>in studies on the use of magnetic therapy for relief of chronic low back pain and wrist pain related to carpal tunnel syndrome, researchers found magnets no more effective than placebo treatments</p></blockquote>
<p>Again, credit to them for at giving both positive and negative findings.</p>
<p>10. <a href-="http://nccam.nih.gov/health/magnet/magnetsforpain.htm">The National Centre for Complementary and Alternative Medicine</a></p>
<p>There is actually the best source of information in the top 10 links. It gives a good overview of what the treatment has been used for, historically and contemporarily, what magnets are, how they are used, what the speculation is over what they might do, and what the trials show.</p>
<blockquote><p>Preliminary scientific studies of magnets for pain have produced mixed results. Overall, there is no convincing scientific evidence to support claims that magnets can relieve pain of any type. Some studies, including a recent National Institutes of Health (NIH) clinical trial for back pain, suggest the possibility of a small benefit from using magnets for pain. However, the majority of rigorous studies have found no effect on pain.</p></blockquote>
<p>Notice they say preliminary and notice that they go on to say:</p>
<blockquote><p>
More research on magnets for pain is needed before reaching any firm conclusion.</p>
<p>More rigorous research is needed before reaching any firm conclusions about the effectiveness of magnets for pain.
</p></blockquote>
<p>They have been very professional in their approach to the topic but I do think those two statements indicate they really really want to believe it&#8217;ll work. I&#8217;d disagree and say that the best run studies have shown there is no benefit above placebo and that they constitute a large enough body of evidence to put the subject to rest. Either way it&#8217;s a good page on the subject.</p>
<p><u>Summary</u></p>
<p>So far I have not found any good quality trials with positive results. I haven&#8217;t even found any trials yet that cover most of the claims of the Trion:Z bracelets &#8211; reduced stress, better concentration, more powerful golf swings etc! The Cochrane Organization doesn&#8217;t have any meta-analyses on any Magnet-related subject.</p>
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		<title>About low Sodium Diets</title>
		<link>http://blog.using.me.uk/2009/11/about-low-sodium-diets/</link>
		<comments>http://blog.using.me.uk/2009/11/about-low-sodium-diets/#comments</comments>
		<pubDate>Thu, 05 Nov 2009 23:17:39 +0000</pubDate>
		<dc:creator>PadainFain</dc:creator>
				<category><![CDATA[Medicine]]></category>
		<category><![CDATA[Science]]></category>

		<guid isPermaLink="false">http://blog.using.me.uk/?p=162</guid>
		<description><![CDATA[I ought to note, briefly, that while the Cochrane Analysis that I mentioned two posts ago showed that a low sodium diet had little effect on blood pressure another Analysis by them does show that there is a significant benefit in reducing salt intake.
Specifically here for the long term effects.
Just goes to show how careful [...]]]></description>
			<content:encoded><![CDATA[<p>I ought to note, briefly, that while the Cochrane Analysis that I mentioned two posts ago showed that a low sodium diet had little effect on blood pressure another Analysis by them does show that there is a significant benefit in reducing salt intake.</p>
<p>Specifically <a href="http://www.cochrane.org/reviews/en/ab004937.html">here</a> for the long term effects.</p>
<p>Just goes to show how careful one needs to be even when someone has already done the research&#8230; reading that reduced Sodium wasn&#8217;t effective made me think that reduced Salt wasn&#8217;t effective until I had a really good look through their Hypertension group&#8217;s work.</p>
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		<title>Cochrane reviews of popular medical beliefs.</title>
		<link>http://blog.using.me.uk/2009/10/cochrane-reviews-of-popular-medical-beliefs/</link>
		<comments>http://blog.using.me.uk/2009/10/cochrane-reviews-of-popular-medical-beliefs/#comments</comments>
		<pubDate>Tue, 27 Oct 2009 10:16:45 +0000</pubDate>
		<dc:creator>PadainFain</dc:creator>
				<category><![CDATA[Critical Thinking]]></category>
		<category><![CDATA[Medicine]]></category>
		<category><![CDATA[Science]]></category>

		<guid isPermaLink="false">http://blog.using.me.uk/?p=150</guid>
		<description><![CDATA[I&#8217;ve been using the Cochrane Organisations systemic reviews to look into the evidence for a number of popular beliefs on the efficacy of treatments. Here are the results I have found so far.
Glucosamine for Osteoarthritis
I was expecting to find a negative result here but the review is not quite so clear cut. One brand, Rotta, [...]]]></description>
			<content:encoded><![CDATA[<p>I&#8217;ve been using the Cochrane Organisations systemic reviews to look into the evidence for a number of popular beliefs on the efficacy of treatments. Here are the results I have found so far.</p>
<li><a href="http://www.cochrane.org/reviews/en/ab002946.html">Glucosamine for Osteoarthritis</a></li>
<p>I was expecting to find a negative result here but the review is not quite so clear cut. One brand, Rotta, appears to have a statistically significant benefit over and above the placebo.</p>
<li><a href="http://www.cochrane.org/reviews/en/ab000980.html">Vitamin C and the Common Cold</a></li>
<p>Except in certain groups of people (e.g. marathon runners and sub-arctic soldiers!) Vitamin C does not provide any protection from catching a cold. It does help to reduce the length of the symptoms in children but only by 8%, which for the average cold would be half a day or so?</p>
<li><a href="http://www.cochrane.org/reviews/en/ab004022.html">Low Sodium Diet for Reducing Blood Pressure</a></li>
<p>I didn&#8217;t go looking for this one, it found me. Surprisingly, given how many doctors I know have recommended it, this diet change is of limited effectiveness and there is not enough evidence addressing any possible long term effects (positive or negative).</p>
<li><a href="http://www.cochrane.org/reviews/en/ab007176.html">Antioxidants for a longer life</a></li>
<p>This was the study I was most interested in finding as there is SO much in the media about super-foods and high-in-antioxidant foods. The study clearly shows no benefit. There is even evidence that some of the supplements, such as Vitamin A or beta-caroten, may DECREASE your life expectancy.</p>
<p>I need to find a link to this one particular study &#8211; and bear in mind it is only one study not a large analysis like the Cochrane one above &#8211; but there was a trial of beta-carotene in a group of patients at high risk of cancer. It had to be abandoned after a few years because the cancer rates in the group receving beta-carotene were 40% higher than those in the control group and mortality rates for all other non-cancer related causes were up 15%. Just one study as I said but I highly doubt anyone&#8217;s going to repeat it to see if it was a statistical anomaly!</p>
<p>Anyway, if you&#8217;re wondering if the health claims in the media are correct, or you have any concerns about medical treatments from your Doctor, head on over to <a href="http://www.cochrane.org/">cochrane.org/</a> and have a look around.</p>
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