MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

case report

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If you google ‘chiropractic’ you might get the impression that an unusual number of US chiros are outright perverts. Here are four current cases that I found instantly without any in-depth seraching:

Case No 1

A “Christian chiropractor” is facing several criminal charges after at least eight former clients have accused him of rape and sexual assault. Roc Byrd, 61, of Danville, who worked as a chiropractor for Cornerstone Chiropractic in Avon, is facing one felony count of rape, five felony counts of sexual battery and four misdemeanor counts of battery. He is accused of raping a client, touching clients inappropriately over and under their clothes during appointments without consent and pressing his genitals up against multiple patients. Byrd identified himself as a practicing Christian and reportedly began each of his chiropractic appointments by praying with clients.

Case No 2

A Warren chiropractor faces significant legal problems and a criminal investigation into how he allegedly treated one of his patients. Officials say he sells himself as one of only a handful of Michigan “Chiropractic Neurologists,” but the former patient claims he is a sexual predator and offers video as apparent proof. The case involves Dr. John Pispidikis of the Spinal Recovery Center. The complaint was filed Friday (April 19) morning, which surprised the doctor. The patient involved remains unnamed in the civil court documents, but she claims the doctor groped her during a physical exam last February. But she had no proof, so she claims she went out and got some.

Case No 3

The Oklahoma Board of Chiropractic Examiners (OBCE) has ordered the Back Stop’s only chiropractor, Mark Kimble to surrender his license by next Monday after several sexual impropriety allegations against him have surfaced. Oklahoma Board of Chiropractic Examiners confirmed with KFOR that there are seven alleged victims of Kimble’s who have come forward.

Case No 4

The Los Angeles County Sheriff’s Department is looking for possible victims of a chiropractor accused of sexual assault. Richard Carnow, 65, was arrested by authorities on March 13 on four felony counts of sexual battery. Carnow is a chiropractor in San Dimas in the San Gabriel Valley, the Sheriff’s Department says. He’s accused of sexually assaulting multiple adult women between June 2023 and August 2023. Officials did not say if his alleged victims were current or former patients. Investigators say the nature of the alleged crimes have led them to believe there may be additional victims and they are asking for the public’s help to find them.

Yes, I know, these are (according to chiros’ assurances) regrettable, isolated cases – nothing to worry about!

But perhaps these assertions are wrong and there is a problem after all?

I am reminded of my post from 2021; let me refresh your memory:

Two chiropractors conducted a retrospective review of publicly available data from the California Board of Chiropractic Examiners. Their aim was to determine categories of offense, experience, and gender of disciplined doctors of chiropractic (DC) in California and compare them with disciplined medical physicians in California. The DC disciplinary categories, in descending order, were

  • fraud (44%),
  • sexual boundary issues (22%),
  • other offences (13%),
  • abuse of alcohol or drugs (10%),
  • negligence or incompetence (6%),
  • poor supervision (2%),
  • mental impairment (.3%).

The authors concluded that the professions differ in the major reasons for disciplinary actions. Two thirds (67%) of the doctors of chiropractic were disciplined for fraud and sexual boundary issues, compared with 59% for negligence and substance misuse for medical physicians. Additional study in each profession may reveal methods to identify causes and possible intervention for those who are at high risk.

The abstract of the paper does not provide comparisons to with the medical profession. Here they are; relative to doctors, chiropractors are:

  • 2 x more likely to be involved in malpractice,
  • 9 x more likely to commit  fraud,
  • 2 x more likely to transgress sexual boundaries.

________________________

Could it be, I askmyself, that there is something deeply wrong with the chiropractic profession? Could it perhaps be that chiro schools do not have a good hand when it comes to student recruitment? Could it be that chiro schools teach too little medical ethics, or none at all?

We have repeatedly discussed financial and other fraud by (mostly US chiropractors, e.g.:

Many of these cases are impressive in their illegality or even viciousness. Yet, this one takes the biscuit, I think:

It has been reported that a former chiropractor will be spending a long time behind bars following his conviction for running a colossal workers’ compensation fraud that bagged him $150 million over several years. Peyman Heidary has been sentenced to 54 years and 8 months in state prison on April 12, and will also have to shell out more than $23 million in fines, according to the Riverside County District Attorney’s Office.

Convicted in January of 68 counts including insurance fraud, conspiracy, and money laundering, Heidary’s scheme involved the control of fake health clinics and law firms from 2009 to 2014. He manipulated the workers’ comp system to exploit legitimately injured people and run up unnecessary treatments to inflate insurance billings, according to a Riverside County jury.

District Attorney Mike Hestrin made clear the gravity of Heidary’s exploitation: “The California workers’ compensation system is designed to help injured workers get back on their feet without ruining them financially,” Hestrin stated, adding “Sophisticated criminals like Mr. Heidary don’t just steal money, they take advantage of innocent patients”.  The trial also heard from one such patient, Denise Rivera, a worker injured on the job who despite being promised care, was left untreated.

Originally pegged at $98 million, the fraud was ultimately revealed to have caused about $150 million in damages. Judge Charles Koosed, overseeing the sentencing, called out Heidary’s greed, exploiting his detailed knowledge of the workers’ compensation landscape, Judge Koosed noted, “’[Heidary] took advantage of that knowledge based on greed.”

Heidary used the sham law firm to recruit thousands of legitimately injured patients, referring them to his network of clinics to create unnecessary billing. One of the injured workers, Denise Rivera, slipped and fell while working as a certified nurse assistant for special needs children. Ms. Rivera testified that she was recruited into Heidary’s scheme, but never received any effective treatment. “[Heidary’s employees] released me,” Rivera told jurors. “They told me … basically I was okay. My knee was okay.” When asked during the trial if her knee actually was OK, she simply responded, “No.”

___________________________

It will probably not take long for some chiro to post a comment pointing out that dishonest chiropractors are extremely rare exceptions. Most are law-abiding and behave ethically, he/she will insist. It will then be useless, of course, to counter that, in fact, there is plenty of evidence that dishonesty is rife amongst chiropractors and more frequent than with other healthcare professionals. They will not accept that and would like me to withdraw the allegation.

Such arguments often remind me of the Labour politician, Dennis Skinner, who once stated in the UK Parliament: “Half the Tories opposite are crooks.” When the Speaker insisted he should retract this remark, he responded, “OK, half the Tories opposite aren’t crooks.

Prof Michael Frass is the undisputed star amongst researchers of homeopathy. Here are the awards and achievements that he mentions on his website:

  • 1994 until 2019Head, Special Outpatient Clinic “Homeopathy in Malignant Diseases”, Department of Internal Medicine I, General Hospital of the City of Vienna
  • 1992 until Feb. 2004Director, Intensivstation 13.i2, Klinik für Innere Medizin I
  • 1994 until 1998 Medical Director Maimonides Center
  • since May 1994Vice President of the “Medical Society for Classical Homeopathy” (ÄKH)
  • since Oct. 1995Head of the Working Group for Homeopathy of the ÄKH in Vienna
  • since Jan. 1998 Speaker of the ÄKH at training courses
  • 1999 – 2012Training Officer of the Austrian Society for Internal and General Intensive Care Medicine (ÖGIAIM)
  • 2001 until 2019 Coordinator of the lecture series “Selected chapters and scientific discussion of complementary medicine methods”, Med. Univ. Vienna, VO 560480
  • May 2002 – Dec. 2005Director of the Ludwig Boltzmann Institute for Homeopathy
  • since June 2003Member of the Scientific Advisory Board of the Vienna International Academy of Holistic Medicine
  • 2004 until 2019Expert in Airway Management and Homeopathy in Intensive Care Medicine at the Center of Excellence in Internal Critical Care Medicine (CEMIC).
  • 2005 until 2019Coordinator of the free elective “Homeopathy”, Med. Univ. Vienna, VO 562 923
  • since June 2005Director, Institute for Homeopathy Research
  • 2006 until 2019Member of the planning area + lecturer for the line element “Interdisciplinary Patient Management” (compulsory lecture for medical students)
  • since June 2006President of the Austrian Umbrella Association for Medical Holistic Medicine.
  • since Nov. 2010Chairman of the Scientific Society for Homeopathy (WissHom)

Many of my readers will remember the case of the Prof. Frass et al study of homeopathy for cancer. On this blog, we have seen several articles about it:

The study and the suspicion of scientific misconduct it raised eventually resulted in an official complaint by the Viennese Medical School to the authority that deals with suspicions of publication fraud, the ‘Austrian Agency for Scientific Integrity’. It took a very long time, but recently they have published their final on-line summary of their assessment of the case; here is my translation:

Enquiry A 2021/10:
After an Austrian university was informed externally and by name of possible scientific misconduct in a study and the resulting publication, the institution concerned submitted the already publicised suspected case in the field of applied natural sciences to the OeAWI with a request for examination by the Commission.

After establishing sufficient suspicion of various violations of good scientific practice, the Commission declared itself responsible and initiated proceedings. In the course of this, the principal investigator was given the opportunity to submit a written statement and to provide the Commission for Research Integrity Annual Report 2022 material that would help to clarify the facts of the case, which the accused submitted in large quantities.

In a very complex, comprehensive investigation, which required, among other things, the on-site inspection of original documents, the Commission was able to substantiate the suspicion of data falsification, fabrication and manipulation. In a final statement, the study director, who no longer works for the university in question, and the numerous co-authors were informed in detail about the course and results of the commission’s investigation and informed of the recommendations to the university and journal.  The Commission recommended that the university concerned should consider investigating its own responsibilities and act accordingly, and that the publication should be withdrawn as a matter of urgency. The journal responsible for the publication was asked to withdraw the publication on the basis of the findings of the investigation.

Nobody who has studied the Frass paper in some detail can be surprised by the verdict. I do applaud the ‘Austrian Agency for Scientific Integrity’ for their work. Yet, I do also have some criticism: health fraud on the scale of Frass can easily costs lives. I find it therefore unacceptable that the verdict took so long to get published.

Even worse is, in my view, the fact that the journal, ‘Oncologist’, is still offering this paper today, albeit with this ‘expression of concern’:

This is an Expression of Concern regarding: Michael Frass, Peter Lechleitner, Christa Gründling, Claudia Pirker, Erwin Grasmuk-Siegl, Julian Domayer, Maximilian Hochmair, Katharina Gaertner, Cornelia Duscheck, Ilse Muchitsch, Christine Marosi, Michael Schumacher, Sabine Zöchbauer-Müller, Raj K. Manchanda, Andrea Schrott, Otto Burghuber, Homeopathic Treatment as an Add-On Therapy May Improve Quality of Life and Prolong Survival in Patients with Non-Small Cell Lung Cancer: A Prospective, Randomized, Placebo-Controlled, Double-Blind, Three-Arm, Multicenter Study, The Oncologist, Volume 25, Issue 12, December 2020, Pages e1930–e1955, https://doi.org/10.1002/onco.13548

In August 2022, the journal editors received credible information from the Austrian Agency for Research Integrity about potential data falsification and data manipulation in this article.*** While The Oncologist editorial team investigates and communicates with the corresponding author, the editors are publishing this Expression of Concern to alert readers that, pending the outcome and review of a full investigation, the research results presented may not be reliable.

Cancer patients will thus still read the dangerously misleading conclusions of the Frass fabrication: “Quality of life (QoL) improved significantly in the homeopathy group compared with placebo. In addition, survival was significantly longer in the homeopathy group versus placebo and control. A higher QoL might have contributed to the prolonged survival. The study suggests that homeopathy positively influences not only QoL but also survival. Further studies including other tumor entities are warranted.” And lives of cancer patients remain needlessly at risk. In my view, this is seriously unethical.

***As far as I know, they received credible information from others long before that!

Spinal manipulation is usually performed by a therapist (chiropractor, osteopath, physiotherpist, doctor, etc.). But many people do it themselves. Self-manipulation is by no means safer than the treatment by a therapist, it seems. We have previously seen cases where the results were dramatic:

Now, a further case has been reported. In this paper, American pathologists present a tragic case of fatal vertebral artery dissection that occurred as the result of self-manipulation of the cervical spine.

The decedent was a 40-year-old man with no significant past medical history. He was observed to “crack his neck” while at work. Soon after, he began experiencing neck pain, then developed stroke-like symptoms and became unresponsive. He was transported to a local medical center, where imaging showed bilateral vertebral artery dissection. His neurological status continued to decline, and brain death was pronounced several days later.

An autopsy examination showed evidence of cerebellar and brainstem infarcts, herniation, and diffuse hypoxic-ischemic injury. A posterior neck dissection was performed to expose the vertebral arteries, which showed grossly visible hemorrhage and dilation. There was no evidence of traumatic injury to the bone or soft tissue of the head or neck. Bilateral dissection tracts were readily appreciated on microscopic examination. Death was attributed to self-manipulation of the neck, which in turn led to bilateral vertebral artery dissection, cerebellar and brainstem infarcts, herniation, hypoxic-ischemic injury, and ultimately brain death.

It seems clear to me that only few and spectacular cases of this nature are being published. In other words, the under-reporting of adverse effects of self-manipulation must be close to 100%. It follows that the risk of sel-manipulation is impossible to quantify. I suspect it is substancial. In any case, the precautionary principle compells me to re-issue my warning:

do not allow anybody to manipulate your neck, not even yourself!

It has been reported that 5 people who took a Japanese health supplement have died and more than 100 have been hospitalized as of Friday, a week after a pharmaceutical company issued a recall of the products, officials said. Osaka-based Kobayashi Pharmaceutical Co. came under fire for not going public quickly with problems known internally as early as January. Yet the first public announcement came only on 22 March. Company officials said 114 people were being treated in hospitals after taking products — including Benikoji Choleste Help meant to lower cholesterol — that contain an ingredient called benikoji, a red species of mold. Some people developed kidney problems after taking the supplements, but the exact cause was still under investigation in cooperation with government laboratories, according to the manufacturer.

“We apologize deeply,” President Akihiro Kobayashi told reporters last Friday, bowing for a long time to emphasize the apology alongside three other top company officials. He expressed remorse to those who have died and have been taken ill and to their families. He also apologized for the troubles caused to the entire health food industry and the medical profession, adding that the company was working to prevent further damage and improve crisis management.

The company’s products have been recalled — as have dozens of other products that contain benikoji, including miso paste, crackers, and a vinegar dressing. Japan’s health ministry put up a list on its official site of all the recalled products, including some that use benikoji for food coloring. The ministry warned the deaths could keep growing. The supplements could be bought at drug stores without a prescription from a doctor, and some may have been purchased or exported before the recall, including by tourists who may not be aware of the health risks.

Kobayashi Pharmaceutical had been selling benikoji products for years, with a million packages sold over the past 3 fiscal years, but a problem crept up with the supplements produced in 2023. Kobayashi Pharmaceutical said it produced 18.5 tons of benikoji last year. Some analysts blame the recent deregulation initiatives, which simplified and sped up approval for health products to spur economic growth.

________________________

Anouther source reported that Japanese authorities on Saturday raided a drug factory after a pharmaceutical company reported at least five deaths and 114 hospitalizations possibly linked to a health supplement. About a dozen Japanese health officials walked into the Osaka plant of the Kobayashi Pharmaceutical Co., as seen in footage of the raid widely telecasted on Japanese news. The health supplement in question is a pink pill called Benikoji Choleste Help. It is said to help lower cholesterol levels. A key ingredient is benikoji, a type of red mold. The company has said it knows little about the cause of the sickness, which can include kidney failure. It is currently investigating the effects in cooperation with Japan’s government.

___________________________

More recent reports update the figure of affected individuals: Japanese dietary supplements at the center of an expanding health scare have now been linked to at least 157 hospitalizations, a health ministry official said Tuesday.The figure reflects an increase from the 114 hospitalization cases that Kobayashi Pharmaceutical said on Friday were linked to its products containing red yeast rice, or beni kōji.

____________________________

A Kobayashi Pharmaceutical spokeswoman confirmed the latest hospitalization cases without elaborating further.

Benikoji is widely sold and used; not just in Japan. It comes under a range of different names:

  • red yeast rice,
  • red fermented rice,
  • red kojic rice,
  • red koji rice,
  • anka,
  • angkak,
  • Ben Cao Gang Mu.

It is a bright reddish purple fermented rice which acquires its color from being cultivated with the mold Monascus purpureus. Red yeast rice is used as food and as a medicine in Asian cultures, such as Kampo and TCM.

It contains lovastatin which, of course, became patented  and is marketed as the prescription drug, Mevacor. Red yeast rice went on to become a non-prescription dietary supplement in the United States and other countries. In 1998, the U.S. FDA banned a dietary supplement containing red yeast rice extract, stating that red yeast rice products containing monacolin K are identical to a prescription drug, and thus subject to regulation as a drug.

Some abstracts of medical papers are so bizarre that they must not be tempered with, I find. This is one of them:

Rationale:

This case report aims to provide clinical evidence on the effectiveness of integrating chiropractic and moxibustion techniques for treating pseudomyopia accompanied by elevated intraocular pressure resulting from cervical spine issues because the application of complementary medicine modalities for managing such vision disorders currently lacks adequate investigations.

Patient concerns:

A 6-year-old patient presented with blurred vision, intermittent ocular discomfort, and upper cervical discomfort.

Diagnoses:

Spine-related increased intraocular pressure and pseudomyopia.

Interventions:

The patient received integrative treatment of chiropractic and walnut-shell moxibustion 3 times a week for a total of 10 treatment sessions.

Outcomes:

The patient exhibited progressive improvements in visual acuity and reductions in intraocular pressure over the treatment period, with unaided vision exceeding 2 lines of improvement in visual acuity charts and normalized intraocular pressure after 10 treatment sessions. These therapeutic effects were sustained at 3-month follow-up.

Lessons:

The integrative use of chiropractic and walnut-shell moxibustion demonstrates considerable potential in alleviating symptoms of pseudomyopia, reducing intraocular pressure, and restoring visual function in spine-related pseudomyopia cases.

Pseudomyopia is a spasm of the ciliary muscle that prevents the eye from focusing in the distance. It differs from myopia which is caused by the eye’s shape or other basic anatomy. Pseudomyopia may be either organic, through stimulation of the parasympathetic nervous system, or functional in origin, through eye strain or fatigue of ocular systems. It is common in young adults after a change in visual requirements, such as students preparing for an exam, or a change in occupation. The condition is often transitory and it is necessary to request psychiatric consultation in each case of pseudomyopia. Comorbidity of anxiety and depressive disorders is more common in pseudomyopia cases. In addition, as the severity of psychiatric symptoms increases, the amount of accommodation also appears to increase.

A few question, if I may:

  • Walnut-shell moxibustion? Yes, it exists! Moxibustion with walnut shell spectacles is a characteristic therapy of Guang’anmen Hospital, developed on the basis of walnut shell moxibustion, and mainly composed of an eye moxibustion frame, a walnut shell soaked with wolfberry and chrysanthemum liquid, and moxibustion strips. Moxibustion with a walnut shell was first recorded by Shicheng Gu for treating surgical ulcers in the Qing dynasty. Then, moxibustion with walnut shell spectacles was reformed by us, combining Shicheng Gu’s experience with our clinical practice, and is mainly used for the treatment of optic nerve atrophy and myopia.
  • The authors state that, “based on traditional Chinese medicine principles, moxibustion is known to warm meridians, dredge collaterals, relax tendons, and enhance blood circulation”. Is this true? Well, based on TCM, anything goes, but it does not make it true.
  • How can we know whether chiropractic or walnut-shell moxibustion or both caused the outcome? We can’t!
  • Can we be sure what caused the child’s problem? No!
  • Do we know whether the outcome was not a spontaneous recovery? No!
  • The authors claim that “cervical spine imbalance leads to visual impairment”. Is that correct? Not as far as I know.
  • The authors state that “the patient in this case, presenting with pseudomyopia, elevated intraocular pressure, and neck pain, likely had a cervical spine-derived condition. Currently, such spine-derived vision disorders lack sufficient clinical recognition.” Is this true? No, I’d say such spine-derived vision disorders might not even exist.
  • Why would anyone publish a paper about the case? Search me!

 

I had never heard of him – but after getting insulted by ‘Dr. Nick Campos’ I became interested and looked him up. What I found was interesting. Here is how he describes himself.

Dr. Nick Campos is a teacher of universal principles and truths as they pertain to the health, wellness and evolution of body, mind and spirit, particularly as they relate to human growth and potential.

As a healer trained in the art of chiropractic, and as a prominent chiropractic sports physician, he has helped thousands of people overcome physical injury and trauma, allowing them to regain their functional lives.

Dr. Campos believes that wellness encompasses more than just the physical body, so a balanced mental and spiritual life is also necessary for full expression of being. Therefore, Dr. Campos assists people with mental and spiritual challenges and misperceptions, while teaching them tools to empower themselves in all areas of life.

Dr. Campos teaches universal principles of health, wellness, growth and evolution as they pertain to body, mind and spirit. His work is carried out through several media including books, articles and a widely-read, syndicated blog (Optimal Health). His book The Six Keys to Optimal Health is the quintessential guide to achieving and maintaining optimal wellness in the twenty-first century. Dr. Campos’ mission is to inspire people to adopt a new way of thinking and living.

In 2010 Dr. Campos launched his evolutionary personal growth and development consulting business dedicated to helping people tune-into and manifest their most inspired dreams. As the Dream Designer™, Dr. Campos shows people how to uncover their life’s purpose, and how to implement powerful strategies designed to create the life of their dreams.

Dr. Nick Campos has a planetary vision of impacting billions of people for years to come. His inspired mission is to help people tap into their incredible self-healing, self-regulating powers. With certainty and gratitude, he aims to teach the world the power inherent in the human mind, and prepare humankind for the next phase of planetary evolution. As the world changes rapidly, those that adapt steadily and most-balanced will have the greatest advantage to navigating new horizons.

Dr. Campos is committed to discovering, understanding and sharing the tools that human beings will invariably need to be successful in a changing world—health, wellness, financial security, effective communication and interpersonal relations, leadership, business purpose and development, parenting, and education to name a few. Through research, collaborative exchange of information, and mass educational accessibility, Dr. Campos strives to empower human beings to be successful pioneers into a vast technological, informational and explorational age.
After this platitude-overload, I asked myself: what does Dr Campos actually do for a living?
The answer is simple: He is ‘Dream Designer’!
What?
Yes, did you not know? A dream designer helps people define and design their dream lives:

Many people limp through their lives following other people’s standards, and striving for achievement in areas not really inspiring to them. As a result, they end up suffering from frustration, lack of fulfillment and potentially depression. Does this sound like you?

By not following your innermost drives, or by repressing your true heart’s desires, you run the greatest risk of succumbing to physical and mental pressures, strain and ultimately illness. Life can be stressful enough without the added anxiety of not knowing who you are or where you are going.

Chronic fatigue syndrome and fibromyalgia are modern manifestations of this lack of purpose,  but that doesn’t have to be your destiny.

Dream Design consulting services starts by helping you tune-in to your most authentic self—who you are, what you value, and how your body and mind work to direct you down your most inspired path. You will uncover the fears, resentments and infatuations that have been acting as barriers to your personal growth, and learn effective ways to overcome them.

And Dr Campos gives courses. On his website, we currently find Upcoming dates:

January 14, 2023                                                         Burbank, CA

January 26, 2023                                                          Palm Desert, CA

February 11, 2023                                                         Thousand Oaks, CA

February 23, 2023                                                         Palm Desert, CA

March 11, 2023                                                               Burbank, CA

March 25, 2023                                                              Palm Desert, CA

______________________________

Either this line of his business is not doing all that well or he offers time travel as part of the package.

On X 9formally Twitter), ,Dr’ Campos called me a LOSER – perhaps I should return the compliment?

 

 

Dry needling is a therapy that is akin to acupuncture and trigger point therapy. It is claimed to be safe – but is this true?

Researchers from Ghent presented a series of 4 women aged 28 to 35 who were seen at the emergency department (ED) with post-dry needling pneumothorax between September 2022 and December 2023. None of the patients had any relevant medical history. All had been treated for a painful left shoulder, trapezius muscle or neck region in outpatient physiotherapist practices. At least three different physiotherapists were involved.

One patient presented to the ER on the same day as the dry needling procedure, the others presented the day after. All mentioned thoracic pain and dyspnoea. Clinical examination in all of these patients was unremarkable, as were their vital signs. Diagnosis was confirmed with ultrasound (US) and chest X-ray (CXR) in all patients. The latter exam showed left-sided apical pleural detachment with a median of 3.65 cm in expiration.

Two patients were managed conservatively. One patient (initial pneumothorax 2.5 cm) was discharged. The US two days later displayed a normally expanded lung. One patient with an initial apical size of 2.8 cm was admitted with 2 litres of oxygen through a nasal canula and discharged from the hospital the next day after US had shown no increase in size. Her control CXR 4 days later showed only minimal pleural detachment measuring 6 mm. The two other patients were treated with US guided needle aspiration. One patient with detachment initially being 4.5 cm showed decreased size of the pneumothorax immediately after aspiration. She was admitted to the respiratory medicine ward and discharged the next day. Control US and CXR after 1 week showed no more signs of pneumothorax. In the other patient, with detachment initially being 5.5 cm, needle aspiration resulted in complete deployment on US immediately after the procedure, but control CXR showed a totally collapsed lung 3 hours later. A small bore chest drain was placed but persistent air leakage was seen. Several trials of clamping the drain resulted in recurrent collapsing of the lung. After CT-scan had shown no structural deformities of the lung, suction was gradually reduced and the drain was successfully removed on the sixth day after placement. The patient was then discharged home. Control CXR 3 weeks later was normal.

The authors concluded that post-dry needling pneumothorax is, contrary to numbers cited in literature, not extremely rare. With rising popularity of the technique we expect complications to occur more often. Patients and referring doctors should be aware of this. In their informed consent practitioners should mention pneumothorax as a considerable risk of dry needling procedures in the neck, shoulder or chest region. 

The crucial question, in my view, is this: do the risks of dry-needling out weigh the risks of this form of therapy? Let’s have a look at some of the recent evidence that we discussed on this blog:

The evidence is clearly mixed and unconvincing. I am not sure whether it is strong enough to afford a positive risk/benefit balance. In other words: dry needling is a therapy that might best be avoided.

I have been called just about everything during my professional life (not to mention the private one). Yesterday, a new addition arrived: a German psychologist who chose to misunderstand a re-Tweet (or is that re-X these days?), Sebastian Bartoschek, implied I am an anti-Semite.

My re-Tweet quoted without any comment by me a Holocaust survivor stating “The Nazis made me afraid to be a Jew, and the Israelis made me ashamed to be a Jew”.

My re-Tweet was meant to make people reflect critical about the horrendous atrocities that is currently happening in Gaza. However, Bartoschek decided it was anti-semitism and demanded I explain myself. As I had previously had an unpleasantly unproductive encounter over an entirely different matter with him, I did not quite see why I should comply to the wishes of this guy. What followed was a rather ridiculous triade by Bartoschek. It included him alerting DIE WELT that someone who sometimes writes for the paper propagates anti-semitism.

A third party (I don’t know who) must have suggested that this amounts to denunciation. Bartoschek replied: “If asking someone why they share anti-Semitic content is denunciation for you, then so be it.” Eventually he sent me this Tweet:

To EdzardErnst – I’ll wait until 11 a.m. tomorrow, Sunday, for a statement. After that, I’ll write about it without it.

This is why I feel that I am blackmailed. Either I explain what I feel is too obvious to explain, or he will write about the matter in what can be expected to be a defaming way.

Well, I prefer to write about it myself by stating categorically that I am definitely not an anti-semite. What is more, I can prove it. I have since many years published numerous articles (around 30, I guess) that make my position entirely clear; to mention just three:

So, now it will be great fun to see whether Bartoschek has lost his marbles and what version of the truth he will tell in his own write-up of the story.

WATCH THIS SPACE.

 

Guest post by Ken McLeod

This week a Coroner’s Inquest into the death of Jarrad Antonovich resumes [1] in Byron Bay, New South Wales, Australia. Meanwhile, pending the outcome of Inquests and other investigations, the NSW Health Care Complaints Commission has imposed interim prohibition order on Mr Soulore Solaris, ‘….a Counsellor who facilitates Ayahuasca ceremonies.’

Under section 41AA of the Health Care Complaints Act 1993 (Act), Mr Solaris: “….must not under any circumstances provide, or cause to be provided, any health services, either in paid employment or voluntary, to any member of the public.” [2] This applies until 11 March 2024, when the matter will be reconsidered.

So what is all this about? To go back a while, Mr Antonovich died from a perforated oesophagus after consuming ayahuasca and kambo frog toxin in October 2021, at the age of 46, while attending the ‘Dreaming Arts festival’, a six-day retreat at Arcoora near Kyogle in northern New South Wales. At the festival he had consumed ayahuasca and participated in a “Kambo” ceremony, involving secretions harvested from an Amazonian tree frog.

Ayahuasca is a psychedelic substance made from boiling plants that is used in ritualistic ceremonies in the Amazon basin. [3] Ayahuasca contains chemicals of concern, such as N,N-Dimethyltryptamine (DMT), a highly psychedelic substance and a Schedule I drug under the Convention on Psychotropic Substances. Ayahuasca is illegal in many countries, and it is illegal to sell, import, produce and possess it in Australia. [4]

Kambo is made from secretions harvested from an Amazonian tree frog. Kambo is usually used in a group setting, called a Kambo circle or Kambo ceremony. Wikipedia lists a whole smorgasbord of dangerous consequences, including tachycardia, nausea, vomiting, diarrhea, psychosis, SIADH, kidney damage (including acute renal failure), pancreas damage, liver damage including toxic hepatitis, dermatomyositis, esophageal rupture, seizures, and death. [5]

The Australian Therapeutic Goods Administration has listed it as a schedule 10 poison, in the category for “substances of such danger to health as to warrant prohibition of sale, supply and use”. [6]

Earlier in the Inquest we heard that:

  • – While Jarrad Antonovich‘s condition worsened there was resistance to calling for an ambulance. An ambulance was finally called at 11.30pm and took an hour to arrive because of the remote location.
  • -One ambulance officer reported that a female told them to “move away from Jarrad because it was affecting his aura” and no one told them he had consumed Kambo. [7]
  • -The event organiser Soulore “Lore” Solaris described Jarrad Antonovich’s death as ‘beautiful.’ [8]
  • -Fred Woller, the site manager at Arcoora, was unaware those running the event did not have any medical training. [9]
  • -Soulore “Lore” Solaris said Mr Antonovich ”…. had good support, a couple of kinesiologists with him and they couldn’t find anything wrong,” [10]
  • -Mr Antonovich “was surrounded by people who loved him and an Aboriginal elder called Uncle Andrew who was chanting sacred songs and calling the spirit out of his body” and “the koalas were making a special sound that is known to the elders when the land accepts a spirit”.
  • -“Mr Solaris has stated that he has plans to leave Australia for Brazil to visit his teachers.” [11]

We will keep you informed.

REFERENCES

  • 1 Court Lists http://tinyurl.com/3fzjd6uy
  • 2 Health Care Complaints Commission http://tinyurl.com/yh76rzc6
  • 3 The Guardian http://tinyurl.com/328manjt
  • 4 Wikipedia https://en.wikipedia.org/wiki/Legal_status_of_ayahuasca_by_country
  • 5 Wikipedia https://en.wikipedia.org/wiki/Kambo_(drug)
  • 6 The Guardian http://tinyurl.com/2s398psy
  • 7 The Guardian http://tinyurl.com/328manjt
  • 8 ABC http://tinyurl.com/5n7ejydy
  • 9 The Guardian http://tinyurl.com/59wa3rmn
  • 10 ABC http://tinyurl.com/5n7ejydy
  • 11 Byron Bay Echo http://tinyurl.com/44n78s2w
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