Monthly Archives: February 2021
Tuina is a massage therapy that originates from Traditional Chinese Medicine. Many of the techniques used in tuina resemble those of a western massage like gliding, kneading, vibration, tapping, friction, pulling, rolling, pressing, and shaking. Tuina involves a range of manipulations usually performed by the therapist’s finger, hand, elbow, knee, or foot. They are applied to muscle or soft tissue at specific locations of the body.
The aim of Tuina is to enhance the flow of the ‘vital energy’ or ‘chi’, that is alleged to control our health. Proponents of the therapy recommend Tuina for a range of conditions, including paediatric ones. Paediatric Tuina has been widely used in children with acute diarrhea in China. However, due to a lack of high-quality clinical evidence, the benefit of Tuina is not clear.
This study aimed to assess the effect of paediatric Tuina compared with sham Tuina as add-on therapy in addition to usual care for 0-6-year-old children with acute diarrhea.
Eighty-six participants aged 0-6 years with acute diarrhea were randomized to receive Tuina plus usual care (n = 43) or sham Tuina plus usual care (n = 43). The primary outcomes were days of diarrhea from baseline and times of diarrhea on day 3. Secondary outcomes included a global change rating (GCR) and the number of days when the stool characteristics returned to normal. Adverse events were assessed.
Tuina treatment in the intervention group was performed on the surface of the children’s body using moderate pressure (Fig. 1a). Tuina treatment in the control group was different: the therapist used one hand to hold the child’s hand or put one hand on the child’s body, while the other hand performed manipulations on the therapist’s own hand instead of the child’s hand or body (Fig. (Fig.11b).
Tuina was associated with a reduction in times of diarrhea on day 3 compared with sham Tuina in both ITT and per-protocol analyses. However, the results were not significant when adjusted for social-demographic and clinical characteristics. No significant difference was found between groups in days of diarrhea, global change rating, or number of days when the stool characteristics returned to normal.
The authors concluded that in children aged 0-6 years with acute diarrhea, pediatric Tuina showed significant effects in terms of reducing times of diarrhea compared with sham Tuina. Studies with larger sample sizes and adjusted trial designs are warranted to further evaluate the effect of pediatric Tuina therapy.
This study was well-reported and has interesting features, such as the attempt to use a placebo control and blinding (whether blinding was successful is a different matter and was not tested in the trial). It is, therefore, all the more surprising that the essentially negative result is turned into a positive one. After adjustment, the differences disappear (a fact which the authors hardly mention in the paper), which means they are not due to the treatment but to group differences and confounding. This, in turn, means that the study shows not the effectiveness but the ineffectiveness of Tuina.
Researchers of so-called alternative medicine (SCAM) don’t come more impressive than Wayne Jonas. Here is what he has to say about himself:
- Integrative Health Expert, Family Physician, Researcher, and Author
- Former Director NIH Office of Alternative Medicine
- Former Director World Health Organization Center for Traditional Medicine
- Former Director of Medical Research Fellowship at Walter Reed Army Institute of Research
- Retired Lt. Colonel United States Army Medical Corps
- Practicing Family Physician at Fort Belvoir Community Hospital Pain Clinic
- Clinical Professor of Family Medicine, Georgetown University
- Executive Director of Samueli Integrative Health Programs
Wayne Jonas, MD, is a board-certified, practicing family physician, an expert in integrative health and health care delivery, and a widely published scientific investigator. Additionally, Dr. Jonas is a retired Lieutenant Colonel in the Medical Corps of the United States Army. From 2001-2016, he was President and Chief Executive Officer of Samueli Institute, a non-profit medical research organization supporting the scientific investigation of healing processes in the areas of stress, pain and resilience.
Dr. Jonas was the Director of the Office of Alternative Medicine at the National Institutes of Health from 1995-1999, and prior to that served as the Director of the Medical Research Fellowship at the Walter Reed Army Institute of Research. He is a Fellow of the American Academy of Family Physicians.
His research has appeared in peer-reviewed journals such as the Journal of the American Medical Association, Nature Medicine, the Journal of Family Practice, the Annals of Internal Medicine, and The Lancet. Dr. Jonas received the 2015 Pioneer Award from the Integrative Healthcare Symposium, the 2007 America’s Top Family Doctors Award, the 2003 Pioneer Award from the American Holistic Medical Association, the 2002 Physician Recognition Award of the American Medical Association, and the 2002 Meritorious Activity Prize from the International Society of Life Information Science in Chiba, Japan.
Dr. Jonas is currently the Executive Director of Samueli Integrative Health Programs, an effort supported by Henry and Susan Samueli to empower patients and doctors by providing solutions that enhance health, prevent disease, and relieve chronic pain.
Could such a high-flyer be a candidate for membership in THE ALTERNATIVE MEDICINE HALL OF FAME? In other words, is he as adept in avoiding the publication of negative conclusions as all these geniuses who are already members?
- Harald Walach (various SCAMs, Germany)
- Andreas Michalsen ( various SCAMs, Germany)
- Jennifer Jacobs (homeopath, US)
- Jenise Pellow (homeopath, South Africa)
- Adrian White (acupuncturist, UK)
- Michael Frass (homeopath, Austria)
- Jens Behnke (research officer, Germany)
- John Weeks (editor of JCAM, US)
- Deepak Chopra (entrepreneur, US)
- Cheryl Hawk (US chiropractor)
- David Peters (osteopathy, homeopathy, UK)
- Nicola Robinson (TCM, UK)
- Peter Fisher (homeopathy, UK)
- Simon Mills (herbal medicine, UK)
- Gustav Dobos (various SCAMs, Germany)
- Claudia Witt (homeopathy, Germany/Switzerland)
- George Lewith (acupuncture, UK)
- John Licciardone (osteopathy, US)
Let’s see. My Medline search for ‘Jonas WR, clinical trial‘ generated 74 hits, of which 11 papers referred to clinical trials or systematic reviews of SCAMs. Here are their conclusions or key passages from the abstracts:
- It is possible that individualised homeopathy entails specific psychotherapeutic processes in addition to possible therapeutic action of the homeopathic remedy, but the relative contributions of each remain to be determined.
- This study indicates that niacinamide may have a role in the treatment of osteoarthritis. Niacinamide improved the global impact of osteoarthritis, improved joint flexibility, reduced inflammation, and allowed for reduction in standard anti-inflammatory medications when compared to placebo.
- Based on the results of our review, acupuncture appears to be effective for treating headaches and, although more research is needed, seems to be a promising treatment option for anxiety, sleep disturbances, depression and chronic pain.
- The database on studies of homeopathy and placebo in psychiatry is very limited, but results do not preclude the possibility of some benefit.
- These results are consistent with the finding from the previous study that individualized homeopathic treatment decreases the duration of diarrhea and number of stools in children with acute childhood diarrhea.
- Observational research into uncontrolled homeopathic practice documents consistently strong therapeutic effects and sustained satisfaction in patients.
- When laboratory studies were compared to clinical studies in the areas of hands-on healing and distance healing across the quality criteria for internal validity, distance healing studies scored better than hands-on healing studies, and laboratory studies fared better than clinical studies.
- Three independent systematic reviews of placebo-controlled trials on homeopathy reported that its effects seem to be more than placebo, and one review found its effects consistent with placebo. There is also evidence from randomized, controlled trials that homeopathy may be effective for the treatment of influenza, allergies, postoperative ileus, and childhood diarrhea.
- Participants in the acupuncture group experienced a 23% reduction in pain before leaving the ER, while average pain levels in participants in the standard medical care group remained basically unchanged. (p < 0.0005). However, both groups experienced a similar reduction in pain 24 hours following treatment in the ER.
- There was a trend towards less narcotic usage in the Traumeel patients. No statistically beneficial effect from Traumeel was demonstrated for mucositis. We could not confirm that Traumeel is an effective treatment for mucositis in children undergoing HSCT.
- Acupuncture was effective for reducing PTSD symptoms.
Considering the above CV of Wayne Jonas, the quantity of this collective output seems a bit underwhelming. But can Wayne join THE ALTERNATIVE MEDICINE HALL OF FAME nevertheless? Who could refuse such an influential author of exclusively positive conclusions?
WELCOME WAYNE JONAS!
The purpose of this survey (the authors call it a ‘study’) was to evaluate the patient-perceived benefit of yoga for symptoms commonly experienced by breast cancer survivors.
A total of 1,049 breast cancer survivors who had self-reported use of yoga on a follow-up survey, in an ongoing prospective Mayo Clinic Breast Disease Registry (MCBDR), received an additional mailed yoga-focused survey asking about the impact of yoga on a variety of symptoms. Differences between pre-and post- scores were assessed using Wilcoxon Signed Rank Test.
802/1,049 (76%) of women who were approached to participate, consented and returned the survey. 507/802 (63%) reported use of yoga during and/or after their cancer diagnosis. The vast majority of respondents (89.4%) reported some symptomatic benefit from yoga. The most common symptoms that prompted the use of yoga were breast/chest wall pain, lymphedema, and anxiety. Only 9% of patients reported that they had been referred to yoga by a medical professional. While the greatest symptom improvement was reported with breast/chest wall pain and anxiety, significant improvement was also perceived in joint pain, muscle pain, fatigue, headache, quality of life, hot flashes, nausea/vomiting, depression, insomnia, lymphedema, and peripheral neuropathy, (all p-values <0.004).
The authors concluded that data supporting the use of yoga for symptom management after cancer are limited and typically focus on mental health. In this study, users of yoga often reported physical benefits as well as mental health benefits. Further prospective studies investigating the efficacy of yoga in survivorship are warranted.
I have little doubt that yoga is helpful during palliative and supportive cancer care (but all the more doubts that this new paper will further the reputation of research in this area). In fact, contrary to what the conclusions state, there is quite good evidence for this assumption:
- A 2009 systematic review included 10 clinical trials. Its authors concluded that although some positive results were noted, variability across studies and methodological drawbacks limit the extent to which yoga can be deemed effective for managing cancer-related symptoms.
- A 2017 systematic review with 25 clinical trials concluded that among adults undergoing cancer treatment, evidence supports recommending yoga for improving psychological outcomes, with potential for also improving physical symptoms. Evidence is insufficient to evaluate the efficacy of yoga in pediatric oncology.
- A 2017 Cochrane review included 24 studies and found that moderate-quality evidence supports the recommendation of yoga as a supportive intervention for improving health-related quality of life and reducing fatigue and sleep disturbances when compared with no therapy, as well as for reducing depression, anxiety and fatigue, when compared with psychosocial/educational interventions. Very low-quality evidence suggests that yoga might be as effective as other exercise interventions and might be used as an alternative to other exercise programmes.[3]
So, why publish a paper like the one above?
Search me!
To be able to add one more publication to the authors’ lists?
And why would the journal editor go along with this nonsense?
Search me again!
No, hold on: Global Advances in Health and Medicine, the journal that carried the survey, is published in association with Academic Consortium for Integrative Medicine & Health.
Yes, that explains a lot.
As I have pointed out several times before, surveys of this nature are like going into a Mac Donald’s and asking the customers whether they like Hamburgers. You might then also find that “the vast majority of respondents (89.4%) reported”… blah, blah, blah.
The title of the paper is ‘Real-World Experiences With Yoga on Cancer-Related Symptoms in Women With Breast Cancer‘.
PS
NOTE TO MYSELF: never touch a paper with ‘real-world experience’ in the title.
People who have followed this blog for any length of time will have encountered it:
THE DULLMAN SYNDROME
The DULLMAN SYNDROME (DS) is characterized by the compulsion to publish a comment that has certain features:
- It flies in the face of rationality and contradicts the known facts.
- It is made triumphantly and without the slightest hesitation, doubt or self-criticism.
- It contradicts a statement that someone (usually I) has just published.
- It is aimed at making the opponent (usually me) look uninformed, naive, or stupid.
- It discloses the author’s lack of understanding of the subject at hand.
- It is formulated aggressively and does not invite discussion.
- It usually is something that the author has stated (many times) before.
What happens next in the course of the DS is important:
NOTHING!
After making his point, the DS-afflicted commentator falls silent as though he is proud of his wisdom, satisfied to have made his mark, and sure that he has convinced the rest of the world with his (non-) argument. Meanwhile, other commentators are active posting comment after comment correcting the DS-victim and trying to make him realize his error. Yet, the DS-victim remains silent; he feels that he has done what needed doing. He has made his point and there is no use entering into a discussion about it. That would only dilute his (non-) argument and might even reveal that he cannot defend it.
And that’s the end of it?
No, not exactly.
A few weeks later, our DS-victim is back.
To do what?
To do it all over again: make his nonsensical point, get corrected, and again remain silent.
This cycle repeats itself ad infinitum. There might be slight variations but the essence of the syndrome does not change.
Experts think that the DS might be a form of obsessive-compulsive behaviour. It displays a way of repeating a point that seems to be very precious to the DS-victim, but which he does not dare to debate, presumably because deep down he feels that it is indefensible.
And the cure?
Unfortunately, the prognosis is not good. Experts say the DS is still a therapeutic enigma. Research has as yet not provided any definitive answers. One hypothesis is based on the observation that the victims are often homeopaths. Thus some scientists have looked up what homeopathy has to offer. Here are the options:
Homeopathic Medicines For Obsessive Compulsive Disorder
Arsenic Album And Calcarea Carb – Best Homeopathic Medicines For Obsessive Compulsive Disorder When Mind Is Obsessed With Thoughts Of Germs
The most common presentation of OCD is constant thoughts of germs and fear of contamination or contracting a contagious disease. In such cases, the most amazing recoveries have been seen with the use of Homeopathic medicines Arsenic Album and Calcarea Carb. The two are rated among the best Homeopathic medicines for obsessive compulsive disorder where the person is obsessed with the idea of every object they touch being contaminated. They believe that they might contract an infection, germs or even a contagious disease from these objects. These thoughts are constant, uncontrollable and get fixated in the mind. Their presence leads to anxiety and restlessness. Arsenic Album and Calcarea Carb are the most effective prescriptions among Homeopathic medicines for obsessive compulsive disorder with the above symptoms.
Medorrhinum And Syphilinum – Top Rated Homeopathic Medicines For Obsessive Compulsive Disorder With Constant Compulsion To Wash Hands
Medorrhinum and Syphilinum are top of the line Homeopathic medicines for obsessive compulsive disorder. They have proved extremely beneficial in OCD cases where compulsive repetitive washing of hands is the main symptom presentation. Persons who wash their hands several times a day for fear every object is carrying germs will benefit greatly from Homeopathic medicines Medorrhinum and Syphilinum. In such cases, the frequency of washing hands is so high that the person starts to neglect his responsibilities towards family and work. Medorrhinum and Syphilinum work wonderfully well in such situations and break the habit. They will prove to be the best choice of Homeopathic medicines for obsessive compulsive disorder of this type.
Iodum And Natrum Mur – Effective Homeopathic Medicines For Obsessive Compulsive Disorder With Compulsion To Check Everything Twice Or More
The most effective Homeopathic medicines for obsessive compulsive disorder where a person feels a compulsion to check everything twice or more are Iodum and Natrum Mur. The guiding symptom is the constant thought that the person is forgetting something. Anxiety, hurriedness, irritability and cross behavior are some accompanying symptoms. Natrum Mur is highly useful in cases where a person checks doors several times for fear of robbers breaking into the house.
Arsenic Album And Carcinosin – Top Grade Homeopathic Medicines For Obsessive Compulsive Disorder With Need For Order
Arsenic Album and Carcinosin are well indicated Homeopathic medicines for obsessive compulsive disorder with the compulsiveness to maintain order. OCD with the compulsive need to maintain order or symmetry in everything can be most effectively dealt with the prescription of Homeopathic medicines Arsenic Album and Carcinosin. A person with these symptoms gets restless if things are not in their proper place and will be constantly seen arranging things in a particular way. Such persons also demand that every place be neat and tidy. They have a kind of cleanliness fetish. They spend much of their useful time in arranging things their way. Family and work suffer.
Psorinum – Best Among Homeopathic Medicines For Obsessive Compulsive Disorder Where The Mind Is Obsessed With Thoughts Of Ill-Health Or Death
Psorinum is one of the best Homeopathic medicines for obsessive compulsive disorder where thoughts of being ill and death consume the mind. Here a person constantly feels that he is in ill health and feels that there is no hope for recovery. Thoughts of death also preoccupy the mind. Such persons make their life as well as the lives of those around them intensely miserable. They are full of fears and anxieties. Homeopathic medicine Psorinum offers great help in treating such cases.
It is too early to tell whether any of these remedies are effective. The studies were slow to start and are still not concluded. Personally, I am skeptical about a homeopathic cure of the DS and have suggested several other SCAMs. From what I hear, they might try slapping therapy next.
PS
Oh, I almost forgot to explain where the term ‘DULLMAN SYNDROME’ comes from. Some suspect that it is called after a famous US homeopath and DS-victim. This hypothesis is, however, erroneous. The name comes from the fact that most skeptics, when reading the DS-victim’s repetitive posts, exclaim: ‘Oh dear, this is so dull, man!’
