January 26th, 2011 by Mark Crislip, M.D. in Opinion, Research
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It always somewhat surprises me how some interventions never seem to die. One therapy that refuses to be put to rest, or even to be clarified, is the use of cranberry juice for urinary tract infections (UTIs). PubMed references go back to 1962, and there are over 100 references. Firm conclusions are still lacking.
There is a reasonable, but incomplete, basic science behind the use of the cranberry juice for UTIs. E. coli , the most common cause of UTIs, causes infection in the bladder by binding to the uroepithelial cells. To do this, they make fimbriae, proteinaceous fibers on the bacterial cell wall. Fimbriae are adhesins that attach to specific sugar based receptors on uroepithelial cells. Think Velcro. Being able to stick to cells is an important virulence factor for bacteria, but not a critical one — it is not the sine qua non of bladder infections.
Are all E. coli causing UTIs fimbriated? No. It is the minority of E. coli that cause UTI that have fimbria, and the presence of fimbriae may be more important for the development of pyelonephritis (kidney infection) than cystitis (bladder infection). Read more »
*This blog post was originally published at Science-Based Medicine*
January 9th, 2011 by admin in Better Health Network, Health Tips
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By Scott Gavura, BScPhm, MBA, RPh for Science-Based Medicine
My stimulant of choice is coffee. I started drinking it in first-year university, and never looked back. A tiny four-cup coffee maker became my reliable companion right through graduate school.
But since I stopped needing to drink a pot at a time, an entirely new category of products has appeared — the energy drink. Targeting students, athletes, and others seeking a mental or physical boost, energy drinks are now an enormous industry: From the first U.S. product sale in 1997, the market size was $4.8 billion by 2008, and continues to grow. (1)
My precious coffee effectively has a single therapeutic ingredient, caffeine. Its pharmacology is well documented, and the physiologic effects are understood. The safety data isn’t too shabby either: it’s probably not harmful and possibly is even beneficial. (I’m talking about oral consumption — no coffee enemas. Please.) In comparison, energy drinks are a bewildering category of products with an array of ingredients including caffeine, amino acids, vitamins, and other “natural” substances and assorted “nutraceuticals,” usually in a sugar-laden vehicle (though sugar-free versions exist). Given many products contain chemicals with pharmacologic effects, understanding the risks, signs of adverse events, and potential implications on drug therapy, are important.
So are energy drinks just candied caffeine delivery systems? Or are these syrupy supplements skirting drug regulations?
The Message
The ads are seductive. Who doesn’t want more energy? Who doesn’t want their mind and body “vitalized?” And don’t we have time-starved lifestyles? Initially envisioned for athletes, energy drinks are now marketed mainly towards teens and young adults, where uptake has been dramatic. Cross-promotion with extreme sporting events, and creating names like “Full Throttle,” “Rockstar,” and even “Cocaine” burnish the “extreme” image. The market is now segmented further with products targeted at women, vegetarians, diabetics, celiacs, and more. However you identify yourself, there’s probably an energy drink developed with you in mind. Read more »
*This blog post was originally published at Science-Based Medicine*
January 6th, 2011 by Steve Novella, M.D. in Better Health Network, Opinion
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It seems that for every established science there is an ideological group who is motivated to deny it. Denialism is a thriving pseudoscience and affects any issue with the slightest political or social implications. Sometimes, even easily verifiable facts can be denied, as people seem willing to make up their own facts as needed.
Denialists have an easy job — to spread doubt and confusion. It is far easier to muddy the waters with subtle distortions and logical fallacies than it is to set the record straight. Even when every bit of misinformation is countered, the general public is often left with the sense that the topic is controversial or uncertain. If denial is in line with a group’s ideology, then even the suggestion of doubt may be enough to reject solid science.
We see this when it comes to the effectiveness of vaccines, the evolution of life on earth, and anthropogenic global warming. A recent Pew poll shows that the campaign of global warming denial has been fairly successful — while the science becomes more solid around the consensus that the earth is warming and humans are contributing to this, the public is becoming less convinced.
I often encounter denial even when it comes to simple things, like body weight. You would think that the question of how many Americans are overweight or obese would be fairly straightforward, but no data is so straightforward that it cannot be distorted by dedicated ideologues. Read more »
*This blog post was originally published at Science-Based Medicine*
December 16th, 2010 by Harriet Hall, M.D. in Better Health Network, Humor, Medical Art, Opinion, Research
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In 1996, Alan Sokal got a bogus paper published in the journal Social Text. It was a parody full of meaningless statements in the jargon of postmodern philosophy and cultural studies. The editors couldn’t tell the difference between Sokal’s nonsense and the usual articles they publish.
Now a British professor of medical education, Dr. John McLachlan, has perpetrated a similar hoax on supporters of so-called “integrative” medicine. He reports his prank in an article in the British Medical Journal (BMJ).
After receiving an invitation to submit papers to an International Conference on Integrative Medicine, he invented a ridiculous story about a new form of reflexology and acupuncture with points represented by a homunculus map on the buttocks. He claimed to have done studies showing that
responses are stronger and of more therapeutic value than those of auricular or conventional reflexology. In some cases, the map can be used for diagnostic purposes.
The organizers asked him to submit an abstract. He did. In the abstract he said he would present only case histories, testimonies, and positive outcomes, since his methods did not lend themselves to randomized controlled trials; and he suggested that his “novel paradigm” might lead to automatic rejection by closed minds. Read more »
*This blog post was originally published at Science-Based Medicine*
December 2nd, 2010 by Steve Novella, M.D. in Better Health Network, Health Policy, News, Opinion, Research
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The controversy over the human consumption of meat and dairy products from cloned cows continues. The UK Advisory Committee on Novel Foods and Processes, after reviewing the evidence, concluded that there was no substantial difference between meat and dairy from cloned cows compared to conventional cows. However, food products from cloned animals and their offspring remain banned in Europe.
Use of offspring of cloned cows, sheep and pigs are legal in the U.S., South America, and Asia. Australia is likely to follow suit in a year or two. The European Union (EU) has an effective ban at the moment, but the policy is under review. The UK is also negotiating with the EU regarding the use of clones.
There is not much of a theoretical reason to suspect that cloned animals would present a health risk. The primary concern is that something unanticipated might have occurred during the cloning process, causing the animal to be genetically or developmentally abnormal. However, if the cloning process works properly this should not happen. Further, if mutations do occur but the animal lives, it is likely that any changes do not represent a risk to humans who consume the meat or dairy from such clones. Read more »
*This blog post was originally published at Science-Based Medicine*
