Lyme Disease – Always Learning.

If you’ve ever been camping or hiking or hunting or had an outdoor pet or gone anywhere near a tree or have a TV or know anyone who fits any of these situations, you’ve probably heard of Lyme Disease. I live in Minnesota, land of forests and lakes, big-ass mosquitos and lots and lots of ticks. I think it’s only natural and healthy for me to have an interest in the subject.

Disclaimers: I am not a doctor, nor an infectious disease researcher, nor a specialist on Lyme Disease or post-treatment Lyme disease syndrome (PLDS). I do have experience with serological testing, immunoassays and laboratory science. This blog post was inspired by a press release about antibodies linked to long-term Lyme symptoms. I welcome and appreciate any comments, corrections or conversation that are expressed with respect, and in the case of claims, with references. Also, I hold up the Centers for Disease Control and Prevention (CDC) as the gold standard for dissemination of accurate and reliable public information on infectious disease. If you think that the CDC or “western medicine” is misguided or intentionally evil, or that all American physicians are controlled by the mob (hat tip to an earlier commenter), you should probably stop reading here.

Anecdotes

Ben Goldacre of Bad Science wrote an excellent piece yesterday about anecdotal evidence.  He wrote about the media coverage of the British National Health Service’s (NHS) decision to not cover a very expensive stomach cancer drug.  The media all told the story of one woman who lived FOUR YEARS longer than expected, most likely due to taking this drug.  Unfortunately, the large randomized trial (1401 patients) of the drug’s efficacy showed that the average patient on the drug only lived an average 6 months longer than those who received the placebo.  The drug costs £21,000 (approx. $32,592 USD), and the patient is likely to only live an average of six months longer.  The one woman in the story is an anomaly, but it makes good press.

I love the saying:

The plural of anecdote is anecdotes, not evidence.

(which may have come from Frank Kotsonis’ “The plural of anecdote is not data”)

Wikipedia has a nice couple of descriptions of anecdotal evidence:

1. Evidence in the form of an anecdote or hearsay is called anecdotal if there is doubt about its veracity; the evidence itself is considered untrustworthy.
2. Evidence, which may itself be true and verifiable, used to deduce a conclusion which does not follow from it, usually by generalizing from an insufficient amount of evidence.

We use anecdotal evidence in the form of personal experience all the time.  We bend rules when they don’t make sense to us or when we think they shouldn’t apply, we gamble in spite of the odds, we do dangerous things like ride motorcycles, go sky-diving and do back flips off of diving boards.  Some of us take herbal supplements because we swear we feel better or get over colds faster than if we don’t, even though all the evidence points to the contrary.

But if we want to make informed, evidence-based decisions, we have to stick to the…umm…evidence.  We have to ignore our gut feelings because homo sapiens is really bad at making good decisions based on instinct and emotion.

Brian Dunning recently did a Skeptoid episode about these fallacies, as well as a few others.  The link will take you to the podcast’s written transcript, but you can also download this episode on iTunes (episode #217).

Never have I ever had sex in…

Nerdiness and sex…

Would you ever volunteer to have sex for the betterment of science?  And no, it’s not just scientific research because you’re playing doctor; I’m talking about real sexual research conducted by real doctors.  My hat is off to the couple that managed to perform with this third partner in the room.  Or maybe third and fourth…where there’s an ultrasound there must be an ultrasound technician…

NCBI ROFL: And the most awkward sex of all time award goes to…

Coitus as Revealed by Ultrasound in One Volunteer Couple.

“The anatomy and function of the G-spot remain highly controversial. Ultrasound studies of the clitoral complex during intercourse have been conducted to gain insight into the role of the clitoris and its relation to vagina and urethra during arousal and penetration. Aim. Our task was to visualize the anterior vaginal wall and its relationship to the clitoris during intercourse. Methods. The ultrasound was performed during coitus of a volunteer couple with the Voluson(R) General Electric(R) Sonography system (Zipf, Austria) and a 12-MHz flat probe.”

Read on for the rest of the summary by the NCBI ROFL Discover Blog and the link to the actual paper published in the Journal of Sexual Medicine.

Pet Acupunture – Grrrrr! Ruff!

Last Saturday’s Stribe (Star Tribune) included an article called “On Paws and Needles“, which described the growing practice of pet acupuncture in the Twin Cities.  I have very little faith in acupuncture for humans and about the same amount of faith in anecdotal evidence, but that’s what author Kristin Tillotson asks us to accept when she writes

“Whether or not you’re ready to embrace the concept of chi flowing through your body, it’s tough to argue with pet owners who have seen their beloveds go from listless and limping to perky and playful.”

Tillotson does let us know that there is some controversy surrounding pet acupuncture with her section entitled “Not enough proof?” (here, I fixed it for you: “Not enough proof?.), but the quote from Dr. Craig Smith is brief, and I get the impression that the author included it so she could argue that she has presented a fair and balanced look at the issue.  She quotes Dr. Smith:

Most studies that have shown benefits have been for muscular-skeletal pain.  But for seizures and asthma, we do not have the evidence at this time that it’s as beneficial as drugs can be.

However, she follows this logical assertion with a description of  ONE CASE that begs to differ.  And she also lists an extensive group of local veterinary practices where one can find pet acupuncture.

Dr. Smith reasons that there probably isn’t a push by Big (Vet?) Pharma to incorporate acupuncture sessions into mainstream veterinary practice, as needles are inexpensive.  However, at $75 a session and an ability to prescribe as many sessions as an owner will let you get away with, I can see where there might be other financial incentives that could help select for an increase in the occurence of pet acupuncture. 

One statement in the article that interests me is a quote by Dr. Keum Hwa Choi, a practitioner of veterinary CAM (complementary and alternative medicine) who started a Vet CAM service at the University of Minnesota eight years ago:

“Dogs don’t experience any placebo effect like humans can.  Their brains don’t tell them, ‘Gee, I got these needles stuck in me so I must be better.’  They either feel better or they don’t.”

Hmmm…placebo effects in animals…???  Interesting thought exercise.  Although, if not placebo effect, perhaps another variable?  I imagine that an acupuncture session is fairly relaxing for the pet – the article indicates that the animal is the center of attention during these exercises – they are petted, nuzzled, spoken to in calming adult-cooing baby language, placed on warm blankets with candle light and soft music, perhaps?  One woman reported that her cat’s bp dropped from 220 to 169 by the end of a 10-minute HEAT LASER treatment (apparently, cranky 17 year-old Annie isn’t having any of that sharp sh*t poked in her head, so the vet uses heat lasers rather than “dry needles” to complete the treatment.  But don’t worry, I have a very strong suspicion that the two treatments do exactly the same thing…that is…nothing).  Apparently, giving your pet attention – petting it, being nice to it, keeping it warm – encourages a calm and happy demeanor.  Do needles or frickin’ lasers really add anything to that experience? 

And just for fun, here’s a picture of a puppy with pins in his head.  Poor little PinHead.source: http://www.habitatboise.com/custom_content/5558_acupuncture.html

They’re bringing “Quack” back

Hahaha – look out, all you medical skeptics: A group in Oregon is taking back “Quack”! 

At the American Quack Association (AQA), Quack stands for QUAlity Care with Kindness.  I sh*t you not.  It appears that all of us of the close-minded perpetually ignorant persuasion are going to have to come up with new ways to torment these serious practitioners of alternative medicine.

As the South Coast QUACK Center website proclaims:

A Quack may be a Doctor, either of medicine, dentistry, osteopathy, chiropractic, naturopathy, or naprapathy, or a nutritionist, massage therapist, light worker, or of some other persuasion.

Ummm…No argument here.  I do have to give them this: I’ve never seen such refreshing honesty in advertising in alternative medicine.

Winkler Whistleblower Injustice

I first read about this story at sciencebasedmedicine.org from Dr. David Gorski.  Apparently a dinkus doctor at the Winkler County Memorial Hospital in Kermit, TX was performing questionable medical procedures and hawking herbal treatments – from his personal side business – in the emergency rooms to his patients.  A couple of nurses, Anne Mitchell and Vickilyn Gall,  anonymously reported him to the Texas Medical Board.  Yeah!  Go, ladies!

When Dr. Dinkus, excuse me – Dr. Rolando Arafiles – found out that a complaint had been filed against him, he went to extraordinary measures to discover who had placed the complaint, which makes a laughingstock of the idea that one should be able to anonymously report injustices, abuses, and quality violations without fear of retaliation.  After being identified as the complainants, Nurse Mitchell and Nurse Gall were dismissed from their positions.  Gee, I wonder why they filed an anonymous report? 

To add to the outrage: Aside from being unjustly fired, the nurses were threatened with a jail sentence of  up to TEN YEARS and a fine of $10,000!  Charges were dropped for one of the women, Nurse Galle, but Nurse Mitchell’s trial for “misuse of official information,” a third-degree felony in Texas, started yesterday. 

In his defense, Dr. Dinkus – darn it, did it again – Dr. Arafiles says that he is the victim here.  He claims that Nurse Mitchell has a history of making inflammatory statements about him, and that she was trying to damage his career when she filed the complaint.  If this *is* a case of unfair harrassment against Dr. Din…Arafiles, I’m interested in legal route he’s chosen.  There is no way he looks like a sympathetic character here…why isn’t he highlighting previous instances of harrassment, slander, etc? Surely he’s filed complaints against the nurses in the past, and of course the hospital administration can provide adequate reasoning for firing the nurses that have nothing to do with retaliation for reporting a doctor for unsafe medical practices, right?  Riiiight.  Somehow, I think not.

There are ALWAYS good places and causes to which we can send our hard-earned money, but this case has irked me enough to open my wallet.  If you’d like to help support Nurses Mitchell and Galle, the Texas Nurses Association is accepting donations, and matching every dollar donated up to $5000.  Consider giving, and if not with money, then consider spreading the news of this story.  These women’s long careers at Winkler County Memorial Hospital are over, and Nurse Mitchell is being threatened with imprisonment for reporting unsafe medical practices, which is a legal obligation – not harassment. 

Other sources:
Texas Nurses Association
ABCnews.go.com – 2/9/2010
NYTimes.com – 2/6/2010
Advance for Nurses – 2/8/2010

Props to the St. Paul Pioneer Press

I’ve finally gotten around to reading the weekend papers (well, Saturday’s papers – I’ll catch the Sunday Mpls Tribune later today).  I’m usually a Stribe (that’s Star Tribune, for you non-locals) gal, but I had to pick up a copy of this Saturday’s St. Paul Pioneer Press because it had a front page article that caught my eye:

Vaccine surveys alarming officials

I’m a supporter of childhood vaccination, and a budding anti-anti-vaxer, so this article looked very promising.  Jeremy Olson authored this piece, and he walked a nice line between presenting easily-understood, useful science and presenting a human interest piece.  

He also mentioned Every Child By Two, the pro-vaccination advocacy organization run by Rosalynn Carter and Betty Bumpers, who were instrumental in the development of mandated school-age vaccinations.  Rock on!

A lot of the online comments are rather supportive of the pro-vaccination mindset, and the anti-vax questions are – for the most part – being answered calmly and rationally, which is nice to see. 

All in all, nice article.  Bravo to Jeremy Olson, and to the Pioneer Press for printing the story on the front-page – even above the fold!).

Fight “Big Floss”!

Check out Dr. Amy Tuteur’s satirical article on sciencebasedmedicine.org   Warning – very freaking funny, and as one commenter pointed out, you may not want to be drinking milk during reading.