June 21st, 2007 by Dr. Val Jones in News, Opinion
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An interesting meta-analysis was recently published in the Annals of Internal Medicine. It showed that acupuncture for knee arthritis can reduce pain, but its effects are likely due to the placebo effect. The placebo effect is nicely described in Wikipedia:
A so-called placebo effect occurs when a patient’s symptoms are altered
in some way (i.e., alleviated or exacerbated) by an otherwise inert
treatment, due to the individual expecting or believing
that it will work. Some people consider this to be a remarkable aspect
of human physiology; others consider it to be an illusion arising from
the way medical experiments are conducted.
Because of the mind-body connection, we humans can actually alter our experience of pain if we will ourselves to do so. We experience more intense pain when we’re depressed or particularly fixated upon it (via boredom for example). And we experience less pain when we’re happy (take women immediately after giving birth – they barely even notice the Ob as she sews up their tears).
When it comes to pain management, there are many non-medical techniques that can improve the experience of pain, even if it doesn’t affect the physiology of it. And so if we can find ways to put ourselves in a frame of mind that minimizes the pain sensations, that can be really valuable.
But as far as the physiology of acupuncture is concerned, we have not yet been able to explain exactly how it works. I’ve often wondered if it may be due to the fact that the sharp pain fibers (stimulated by acupuncture needles in different locations) travel along slightly different nerve pathways than the fibers from the actual painful area for which one is getting the acupuncture. The pain input might subconsciously distract the mind from the duller (or more chronic) pain input from the arthritic joint (or other pain generator). This might explain why sham acupuncture works (meaning, putting the needles anywhere, rather than in certain specified meridians).
I’m sure some of you will disagree with this – and it’s only a theory. But it does seem that inserting tiny sharp needles into the skin improves pain sensations in knee arthritis – no matter where the needles are put. How do we explain this placebo effect? I’m not sure – but if the treatment is quite harmless, and seems to decrease pain, how important is it to have an explanation?
And by the way, I was just about to post this when I found another interesting article about acupuncture in the journal Circulation. In this study, they found that acupuncture (when performed 3-5 times a week for 30 minutes each time) was able to reduce blood pressure by about the same amount as a low dose ACE inhibitor pill. Interestingly, though, in this case the needles placed according to Traditional Chinese Medicine (in certain meridians) rather than sham acupuncture (random placement) decreased blood pressure significantly more. I wonder if the TCM placements are activating the autonomic nervous pathways in this case?
At this point the jury’s still out on how all this works. But acupuncture does have measurable effects – even if they’re due to the placebo effect and/or stimulation of the autonomic nervous system. The real question is: would you rather pop a pill each day or travel to and from an acupuncturist’s office 3-5 times a week for 30 minute treatment sessions?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 20th, 2007 by Dr. Val Jones in Opinion
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Little did I know that there is a raging debate about whether or not it’s a good idea to circumcise male babies. I was reading #1 Dinosaur’s blog and almost fell off my chair at the passionate series of comments. Apparently, 90% of American males were circumcised in the 1960s, but that rate has dropped to about 57% today.
Pro Circumcision: circumcision decreases the rate of transmission of HIV and HPV and is hygienically desirable. It does not appear to adversely affect sexual function, is a fairly minor and non-traumatic procedure, and is a reasonable health intervention.
Against Circumcision: condoms are more effective at reducing HIV and HPV transmission than circumcision. It is ethically wrong to circumcise an infant because he cannot give his consent and the procedure is painful. Some people believe that there is an important sensory nerve in the frenulum that is often severed during circumcision.
The American Academy of Pediatrics takes the position that: Existing scientific evidence demonstrates potential medical benefits of
newborn male circumcision; however, these data are not sufficient to
recommend routine neonatal circumcision.
The American College of Obstetricians & Gynecologists takes no position: Newborn circumcision is an elective procedure to be performed at the
request of the parents on baby boys who are physiologically and
clinical stable.
I had always assumed that circumcision was a personal choice that people didn’t feel that strongly about one way or the other. I guess I was wrong!
Why do you think this topic is so passionately debated?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 20th, 2007 by Dr. Val Jones in Expert Interviews
2 Comments »
There has been a lot of buzz about the new diet pill,
Alli (Orlistat). Gastro Girl and Dr. Val
decided to interview the incoming president of the American College
of Gastroenterology, Dr. Brian Fennerty, about the weight loss drug. He had lots of interesting things to say –
check out these 6 podcast links:
1. Who is a good candidate for Alli?
Answer
2. What should patients know about Alli?
Answer
3. What about oily stool?
Is that a worrisome side effect?
Answer
4. What about people with IBS?
Can they take Alli?
Answer
5. Is there a link between Alli and colon cancer?
Answer
6. What’s the bottom line about Alli?
Answer
Would you like to see more podcasts with experts on this blog? Let me know!
P.S. Want to see what another expert is saying about Alli? Check out James O. Hill, PhD’s blog post.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 20th, 2007 by Dr. Val Jones in Medblogger Shout Outs, News
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I was perusing Dr. Hsien Hsein Lei’s blog and noticed a link to a pretty interesting tool. Dr. Lei describes it as a “low tech paternity test” and it’s a probability calculator that relies on 3 traits: blood type, eye color, and ear lobe type. Yep, it’s sometimes possible to exclude certain father candidates based on these traits.
Apparently attached earlobes (that don’t hang) are a recessive trait, so if a child has unattached earlobes, both parents can’t have attached earlobes. And as far as eye color is concerned, two blue eyed parents can’t have a brown eyed child – so there’s some opportunity for exclusion there (I was interested to see that two dark brown eyed parents can have a blue eyed child, though it’s rather unlikely).
Did you know about the genetics of ear lobes? I learn something new every day.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 19th, 2007 by Dr. Val Jones in News
2 Comments »
This was one of the strangest news items in my inbox this week. Apparently, British cattle are catching tuberculosis from the local badger population. Now, the only thing that I thought the two animals had in common was their coloring… but I guess they must hang out together with sufficient frequency to pass on TB infections.
In fact, one BBC News report suggests that farms with larger hedges had lower rates of cattle TB infections… presumably because the hedges kept the badgers from fraternizing as much with the cows. This finding provides a nice alternative to badger culling, a practice that the animal rights folks do not endorse.
But what does this mean for humans? Well, according to the CDC, cattle TB (caused by a special strain of mycobacterium – M. bovis) has been virtually eradicated in the US due to herd culling and milk pasteurization methods. Cattle TB doesn’t tend to infect the lungs, so it’s less transmissible via droplets and such. So even if you’re in England and Bessy the cow sneezes on you, you probably won’t catch TB. But if you drink Bessy’s unpasteurized milk or cheese products, you’ve got yourself a risky situation. As for badgers – they’re not very affectionate anyway, so I wouldn’t try to befriend them.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
