EBM
Scientists Katalin Karikó and Drew Weissman, from Hungary and the United States respectively, have received the 2023 Nobel Prize in Physiology or Medicine for discoveries enabling the development of mRNA COVID-19 vaccines.
“The 2023 Nobel Prize in Physiology or Medicine has been awarded to Katalin Karikó and Drew Weissman for their discoveries concerning nucleoside base modifications that enabled the development of effective mRNA vaccines against COVID-19,” the body said. “The laureates contributed to the unprecedented rate of vaccine development during one of the greatest threats to human health in modern times.”
Dr Karikó was senior vice-president and head of RNA protein replacement at BioNTech until 2022, and has since acted as an adviser to the company. She is also a professor at the University of Szeged in Hungary, and adjunct professor at the University of Pennsylvania’s Perelman School of Medicine. Dr Weissman is professor in vaccine research at the Perelman School.
Dr Karikó invented a way to prevent the immune system from launching an inflammatory reaction against lab-made mRNA, previously seen as a major hurdle against any therapeutic use of mRNA. Together with Dr Weissman, she showed in 2005 that adjustments to nucleosides can keep the mRNA under the immune system’s radar.
The Journal ‘Nature’ reported the following:
This year’s Nobel Prize in Physiology or Medicine has been awarded to biochemist Katalin Karikó and immunologist Drew Weissman for discoveries that enabled the development of mRNA vaccines against COVID-19. The vaccines have been administered more than 13 billion times, saved millions of lives and prevented severe COVID-19 in millions of people, said the Nobel committee…
Karikó is the 13th female scientist to win a Nobel Prize in medicine or physiology. She was born in Hungary and later moved to the United States in the 1980s. “Hopefully, this prize will inspire women and immigrants and all of the young ones to persevere and be resilient. That’s what I hope,” she says.
The COVID-19 vaccines developed by Moderna and the Pfizer–BioNTech collaboration deliver mRNA that instructs cells to create SARS-CoV-2’s spike protein, which, in turn, stimulates the body to make antibodies.
For decades, mRNA vaccines were considered unfeasible because injecting mRNA triggered an immune reaction that immediately broke down the mRNA. Karikó and Weissman demonstrated in the mid-2000s that swapping one type of molecule in mRNA, called uridine, with a similar one called pseudouridine by-passes the cells’ innate defences.
“The ideas that she and Drew Weismann developed were critical for the success of RNA vaccines,” said John Tregoning, a vaccine immunologist at Imperial College London, in a press statement for the UK Science Media Centre. “They demonstrated that changing the type of the RNA nucleotides within the vaccine altered the way in which cells see it. This increased the amount of vaccine protein made following the injection of the RNA, effectively increasing the efficiency of the vaccination: more response for less RNA.”
“This discovery has opened a new chapter for medicine,” said Nobel committee member Qiang Pan-Hammarström, an immunologist at the Karolinska Institute in Stockholm, at a press conference following the prize announcement. “Investment in long-term basic research is very important.”
“It’s really like a revolution starting since the COVID pandemic,” says Rein Verbeke, an mRNA vaccine researcher at the University of Ghent in Belgium. He adds that Karikó and Weissman’s contributions were essential to the vaccines’ success during the pandemic, and beyond. “Their part was really crucial to the development of this platform.” …
The development of mRNA vaccines and therapeutics is in its infancy, says Robin Shattock, who studies vaccines, infections and immunity at Imperial College London. Scientists and biotechnology companies are busy coming up with new applications for mRNA technology, from cancer treatments to next-generation COVID-19 vaccines. Many teams are also working on improved ways of delivering mRNA. “What we see used today is not what it’s going to be used in the future,” says Shattock. “We’re at the beginning of an RNA revolution. The technology is really taking off.”
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On this blog, we had an abundance of discussions about mRNA vaccines. I wonder whether the anti-vaxx brigade will now consider their position. More likely, however, they will merely claim that the Nobel committe is just another element in the big conspiracy that is about to kill us all.
This sudy made me speachless. I best show the abstract in its full and unadulterated beauty:
Background
Studies have shown homoeopathy to effectively control blood sugar levels and improve quality of life (QOL), though a standard treatment protocol is required.
Objective
This study intended to assess the homoeopathic practice, prescription habits, experience, and perception of Indian Homeopathic Practitioners (HPs) in treating DM.
Methodology
A web-based cross-sectional with a snowball sampling method was conducted between 30th July 2021 and 18th August 2021. A questionnaire to record clinical attributes of Indian HPs in the management of DM was formed after the consensus of the subject experts and pilot testing for feasibility.
Results
Participants were 513 HPs with mean age [Standard Deviation (SD)] of 40.44 years (11.16) and a mean duration of the homoeopathic medical practice of 14.67 years [95% Confidence Interval (CI) = 13.71–15.63]. The majority of HPs made classical homoeopathic prescription (201, 39.2%) though the success in the management of DM was better among HPs who prescribed more than one potentized medicine [vs classical prescription, Odds Ratio (OR) = 2.34, p = 0.032]. As perceived by the HPs, homoeopathic treatment resulted in a major improvement in QOL of the diabetic patients (418, 81.5%) with very few adverse effect (100, 19.5%). The blood sugar level was controlled better when homoeopathy was given alongside conventional medicine (348, 67.8%).
Conclusion
The clinical experience of HPs in this study has shown that homoeopathic treatment can benefit DM patients in preventing complications and improving QOL. It further reported that homoeopathy can be an important adjuvant to conventional treatment in managing DM.
Let’s be clear: there is no reliable evidence that DM – a life-threatening disease – can be effectively treated with homeopathy. And let’s be blunt: HPs who claim otherwise are in my view criminal.
I should mention that some of the patients had type 1 diabetes. Many HPs felt that “there was a lack of awareness about the effectiveness of homoeopathy in DM among the general population”. The data show that in 7% the HPs discontinued conventional ant-diabetic drugs completely, and in 73% they reduced them.
It seems that the general population is well advised to ignore homeopathy and its alleged effectiveness for DM. I would even go one step further and postulate that:
if patients rely on homeopathy to treat their diabetes, they risk their lives!
The COVID-19 pandemic has been notable for the widespread dissemination of misinformation regarding the virus and appropriate treatment. The objective of this study was to quantify the prevalence of non–evidence-based treatment for COVID-19 in the US and the association between such treatment and endorsement of misinformation as well as lack of trust in physicians and scientists.
This single-wave, population-based, nonprobability internet survey study was conducted between December 22, 2022, and January 16, 2023, in US residents 18 years or older who reported prior COVID-19 infection.
Self-reported use of ivermectin or hydroxychloroquine, endorsing false statements related to COVID-19 vaccination, self-reported trust in various institutions, conspiratorial thinking measured by the American Conspiracy Thinking Scale, and news sources.
A total of 13 438 individuals (mean [SD] age, 42.7 [16.1] years; 9150 [68.1%] female and 4288 [31.9%] male) who reported prior COVID-19 infection were included in this study. In this cohort, 799 (5.9%) reported prior use of hydroxychloroquine (527 [3.9%]) or ivermectin (440 [3.3%]). In regression models including sociodemographic features as well as political affiliation, those who endorsed at least 1 item of COVID-19 vaccine misinformation were more likely to receive non–evidence-based medication (adjusted odds ratio [OR], 2.86; 95% CI, 2.28-3.58). Those reporting trust in physicians and hospitals (adjusted OR, 0.74; 95% CI, 0.56-0.98) and in scientists (adjusted OR, 0.63; 95% CI, 0.51-0.79) were less likely to receive non–evidence-based medication. Respondents reporting trust in social media (adjusted OR, 2.39; 95% CI, 2.00-2.87) and in Donald Trump (adjusted OR, 2.97; 95% CI, 2.34-3.78) were more likely to have taken non–evidence-based medication. Individuals with greater scores on the American Conspiracy Thinking Scale were more likely to have received non–evidence-based medications (unadjusted OR, 1.09; 95% CI, 1.06-1.11; adjusted OR, 1.10; 95% CI, 1.07-1.13).
The authors concluded that, in this survey study of US adults, endorsement of misinformation about the COVID-19 pandemic, lack of trust in physicians or scientists, conspiracy-mindedness, and the nature of news sources were associated with receiving non–evidence-based treatment for COVID-19. These results suggest that the potential harms of misinformation may extend to the use of ineffective and potentially toxic treatments in addition to avoidance of health-promoting behaviors.
This study made me wonder to what extend a lack of trust in physicians or scientists, and conspiracy-mindedness are also linked to the use of so-called alternative medicine (SCAM) for treatning COVID infections. As I have often discussed, such associations have been reported regularly, e.g.:
- Homeopathy as an Adjuvant to Standard Care in Moderate and Severe Cases of COVID-19
- Arrests in Germany of healthcare professionals who issued fake COVID certificates
- Classical homeopathy worsens the prognosis of patients infected with COVID-19.
- “No jabby-jabby for me! Praise GOD!” But now this antivaxer has died of COVID-related pneumonia
- Homeopathy for COVID: opinions expressed on Twitter
- Efficacy of Persian barley water on clinical outcomes of hospitalized moderate-severity COVID-19 patients
- Effectiveness of Homeopathic Arsenicum album 30C in the Prevention of COVID-19
- Homoeopathy in the Prophylaxis and Symptomatic Management of COVID-19
- Is aromatherapy the answer to long-COVID? I fear not!
- Anthroposophical hospital defies COVID-19 regulations
- An Ayurvedic medication is effective for patients suffering from mild to moderate COVID-19 – true or false?
- Homeopathy for COVID-19: A randomized, double-blind, placebo-controlled trial shows that it does not work
- Micronutrient supplements for patients with COVID-19 infection
- A new trial of homeopathy for preventing COVID-19 infections
- Homeopathy and other SCAMs for long-COVID: WHERE IS THE EVIDENCE?
- Upper Bavaria is struggling with COVID-19, not least due to so-called alternative medicine
- And again: is vitamin C the solution for COVID-19 infections?
- Parents’ Willingness to Vaccinate with a COVID-19 Vaccine: strongly influenced by homeopathy
- A new study of homeopathy for the prevention of COVID-19 infections
- Homeopathic Treatment for COVID-19: a case of scientific misconduct and/or irresponsible behavior?
- The ‘AYUSH COVID-19 Helpline’: have they gone bonkers?
- Adjunctive homeopathic treatment of hospitalized COVID-19 patients. A case study of homeopathic delusion
- US Chiropractor in court for making false claims related to COVID-19
- Chinese Herbal Medicine for COVID-19? The evidence remains unconvincing
- Vitamin C and/or zinc for managing COVID patients?
- An RCT on the efficacy of ayurvedic treatment on asymptomatic COVID-19 patients
- Herbal solutions to the COVID-19 pandemic?
The authors point out that the endorsement of misinformation related to COVID-19 has been shown to decrease the intention to vaccinate against COVID-19, to decrease the belief that it is required for herd immunity, and to correlate with forgoing various COVID-19 prevention behaviors. Such false information is largely spread online and often originates as disinformation intentionally spread by political actors and media sources, as well as illicit actors who profit from touting supposed cures for COVID-19. A substantial minority of the public endorses false information related to COVID-19, although certain subgroups are more likely to do so, including those who are more religious, who distrust scientists, and who hold stronger political affiliations. Cultivating and maintaining trust is a crucial factor in encouraging the public to engage in prosocial health behaviors. The extent to which addressing conspiratorial thinking could represent a strategy to address obstacles to public health merits further investigation.
Blood electrification? If you had not heard about it, you are in good company. What is it? The Internet has many columns on it. Here is an article that I abbreviated a bit for the purpose of this blog:
Dr. Robert C. Beck is the inventor of blood electrification, which can be traced back to the work of Dr. Hulda Clark and Dr. Robert J. Thiel. The method is based on the assumption that parasites, bacteria, viruses and fungi are paralyzed by a low current pulse of 50 to 100 microamperes. As a result, the pathogens are no longer able to infect the body and the immune system can readily eliminate.
Dr. Beck found that the current flow, i.e., blood electrification, is more important than the frequency. Unlike previous ‘zappers’, the “Beck-Zapper” works only with a frequency of 3.920 Hz. Beck believes that the lower the frequency, the greater the current absorption, i.e. the more effective the therapy. Moreover, the Beck zapper is in harmony with the body’s own rhythm and is therefore not a stress trigger. Since the Beck zapper works with a higher voltage (27 volts) than the Clark zapper (9 volts), it is attached directly to the pulse vein and not held in the hands. Here’s how the Beckzapper works:
- The “enemy in the blood,” as Beck called parasites, viruses and bacteria, is fought with mild electricity between 50 and 100 microamperes at half the Schumann frequency of 3.92 Hz, he said.
- During blood electrification, colloidal silver is added to prevent secondary infection. Colloidal silver is extremely small silver particles dissolved in water, which are held in suspension by the water molecules. Although collodial silver enjoyed great importance in medicine hundreds of years ago, it fell into oblivion due to the introduction of antiobiotics and has only been gradually rediscovered in recent years.
- Powerful magnetic pulses are said to carry pathogens from the lymphatic system back into the bloodstream, where they can then be eliminated by the immune system.
Beck was able to prove that his patients became virus-free and symptom-free after the exact application of the blood electrification device. However, he also found that some of his patients became ill again with the same virus after a few months. After further study, he realized that the repeated infections were due to lingering viruses in the lymph fluid. Starting from the lymph fluid, the viruses returned to the bloodstream, where they re-infected cells and multiplied, causing the repeated symptoms of the disease. Beck then invented another device, the so-called magnetic pulser.
This generated an electrical flow by means of a magnetic pulse, which triggered contractions in the lymphatic channels. This forced movement of the lymph, causing the microbes to be forced back into the bloodstream where they could be electrified. Beck applied the Magnetpluser to some patients in combination with the blood electrifier and obtained surprisingly positive results.
Dr. Beck assumed that parasites were responsible for the development of diseases. Beck also believed that parasites in the blood would limit human life expectancy to 70 to 80 years. Dr. Beck himself was convinced of the effectiveness of his zapper and lost 60 kg through it. He explained this weight loss by the fact that the parasites had previously consumed a large part of the nutrients, causing him to experience constant ravenous hunger. In addition, Beck’s blood pressure dropped significantly, as did his blood sugar. He also regained a full head of hair as an almost 70-year-old bald man. Beck attributed all these benefits to his zapper, which he was able to prove after a three-week treatment by means of a blood test using the dark field method: His blood count was perfect.
The blood zapper also helps with herpes diseases, AIDS, chicken pox, lung ulcers, leukemia and other types of cancer, as well as chronic fatigue syndrome, diabetes, flu-like infections, asthma and gastritis. In short, the blood zapper has been able to treat many diseases that are usually considered incurable.
Beck recommends performing blood electrification for two hours daily for 3 to 6 weeks, or longer if necessary.
- The Beckzapper can be carried in the breast pocket or on the belt.
- The cathode and anode are to be placed where on the one hand the blood flows and on the other hand the pulse beat can be felt.
- This can be, for example, on the wrist or feet.
- For the greatest possible freedom of movement during treatment, the “miniZAP” is recommended.
- This is a matchbox-sized zapper that can be worn comfortably on the wrist.
- The method of blood electrification can be performed by anyone. There are no known side effects when using the blood zapper.
Dr. Alfons Weber has presented research according to which most cancers are caused by excessive microbial infestation of blood cells. According to the findings of Prof. Pappa, this circumstance, in turn, can be attributed to a too low energy status. The use of electrotherapy can therefore achieve considerable success in the treatment of parasitic and energy-related cancers in particular.
- The use of the Beckzapper in cancer patients should be continuous
- According to Dr. Weber, the carcinoma protozoa are located in the blood cells and eat the hemoglobin here.
- The carcinoma protozoa located in the blood cells are first hardly affected by the increased current flow in the blood plasma.
- Only when the respective blood cell has been eaten empty do the carcinoma protozoa leave the blood cell in search of a new one.
- Once the carcinoma protozoa are outside the plasma, they can be eliminated by the continuous surge of the Beckzapper.
- In this way, new blood cells cannot be attacked in the first place.
The continuous application of the Beckzapper, possibly in combination with a magnetic pulse generator with collodial silver, can significantly reduce the number of protozoa.
Vis a vis so much nonsense, I am almost speechless. I did try to find any credible publications that might back up the multityde of claims made above. Neddless to say, I was not successful.
And what makes that anyone who promotes ‘blood electrification’ as a cure of anything?
The answer is easy:
A DANGEROUS CHARLATAN
The Skeptic reported that a cardiologist and one of the UK’s most influential critics of the COVID-19 vaccine, Dr Aseem Malhotra, has been named the 2023 recipient of the “Rusty Razor” award, the prize given by The Skeptic to the year’s worst promoters of pseudoscience.
Dr Malhotra has made a name for himself over the last decade as a cardiologist who advocates strongly against the broad use of statins. He has described the drugs as a multi-billion dollar “con” by the pharmaceutical industry, saying that his critics have “received millions in research funding from the pharmaceutical industry”. He has described the link between heart disease and saturated fat as a “myth”, drawing criticism from the British Heart Foundation.
In 2017, his book The Pioppi Diet put forward a diet that he claimed could prevent 20 million deaths per year from cardiovascular disease. The book was named by the British Dietetic Association as one of the celebrity diets to most avoid – with the BDA highlighting his apparently Mediterranean diet excluded pasta and bread, but included coconuts.
Throughout the COVID-19 pandemic, Dr Malhotra has been a prolific and powerful voice spreading narratives that run contrary to the best available evidence. In 2021, his book The 21-Day Immunity Plan included a diet claimed to improve the immune system and help fight off infections – claims that drew criticism from medical professionals.
In 2022, Dr Malhotra released a paper claiming that COVID-19 mRNA vaccines posed a serious risk to cardiovascular health and that the vaccines were “at best a reckless gamble”. The paper was published in the Journal of Insulin Resistance – where Dr Malhotra sits on the editorial board.
Dr Malhotra and his campaign against the COVID-19 vaccine was subsequently praised in Parliament by Andrew Bridgen MP as part of the reasoning behind his ongoing anti-vaccine crusade. In January of this year, Dr Malhotra used a BBC interview about statins to claim that deaths from coronary artery disease were actually complications from the vaccine, prompting a slew of complaints, and an apology from the broadcaster.
The Skeptic Editor Michael Marshall said: “In our opinion, Dr Malhotra has been an incredibly prolific promoter of pseudoscience throughout the pandemic, including spreading the false notion that vaccines are responsible for thousands of excess deaths.
“Dr Malhotra’s media career has given him a very large platform, from which he spreads misinformation that undermines confidence in a health intervention that has saved the lives of countless people across the world. In doing so, he stokes the flames of conspiracy, paranoia and mistrust of medical consensus.
“For anyone with so large a platform to do this would be concerning enough, but Dr Malhotra shares these pseudoscientific messages as a registered medical professional whose opinions have influenced at least one current member of parliament.
“All of this, we feel, makes Dr Aseem Malhotra a highly deserving winner of the 2023 Rusty Razor award”
The ‘Rusty Razor’ award was announced as part of The Skeptic’s annual Ockham Awards at a ceremony that took place during Saturday’s QED conference on science and skepticism, in Manchester. Also recognised during the event was the Knowledge Fight podcast, who won the 2023 award for Skeptical Activism.
I agree, Malhortra is a deserverd winner. The prize raises, in my view, an important question:
WHAT ON EARTH IS THE GENERAL MEDICIN COUNCIL (GMC) DOING ABOUT THIS GUY?
Malhotra’s activities have been compared to the case of Andrew Wakefield who falsely claimed that the MMR vaccine was linked to autism. While Wakefield was ultimately struck off by the GMC in 2010, the regulator has so far rebuffed repeated pleas to investigate Dr Malhotra.
The BMJ recently reported that Dr. Matt Kneale, who had previously complained to the GMC about the conduct of Aseem Malhotra, was told that the GMC would not be investigating Malhotra because his statements were not sufficiently “egregious” to merit action and he had a right to “freedom of speech.” Kneale’s appeal against this decision in 2023 was also turned down.
Kneale has now filed a claim with the High Court, arguing that the GMC should consider not only whether a doctor’s behaviour could harm individual patients but also whether their actions undermined public trust in medicine. He said that this was particularly important when examining statements relating to vaccines, where doctors with a high profile on social media could potentially cause great harm.
The US ‘Public Citizen‘ is an American non-profit, progressive consumer rights advocacy group, and think tank based in Washington, D.C. They recently published an article entitled “FDA Guidance on Homeopathic Drugs: An Ongoing Public Health Failure“. Here are a few excerpts:
In December 2022, the U.S. Food and Drug Administration (FDA) issued new guidance on homeopathic drug products. The guidance states that the agency now “intends to apply a risk-based enforcement approach to the manufacturing, distribution and marketing of homeopathic drug products.”
Under this new risk-based approach, the agency plans to target its enforcement actions against homeopathic drug products marketed without FDA approval that fall within the following limited categories:
- products with reports of injury that, after evaluation, raise potential safety concerns
- products containing or purportedly containing ingredients associated with potentially significant safety concerns (for example, infectious agents or controlled substances)
- products that are not administered orally or topically (for example, injectable drug products and ophthalmic drug products)
- products intended to be used to prevent or treat serious or life-threatening diseases
- products for vulnerable populations, such as immunocompromised individuals, infants and the elderly
- products with significant quality issues (for example, products that are contaminated with foreign materials or objectionable microorganisms)
But this new FDA guidance fails to adequately address the public health threat posed by the agency’s decades-long permissive approach to these illegal drug products.
Under FDA regulations, prescription and over-the-counter (OTC) homeopathic products are considered drugs and are supposed to be subject to the same review and approval requirements as all other prescription and OTC medications. However, under a flawed enforcement policy issued in 1988, the FDA has allowed these drug products to be marketed in the U.S. without agency review or approval. Thus, all products labeled as homeopathic are being marketed without the FDA having evaluated their safety, effectiveness or quality…
… there is no plausible physiologic or medical basis to support the theory underlying homeopathy, nor is there evidence from well-designed, rigorous clinical trials showing that homeopathic drugs are safe and effective.
The FDA should declare unequivocally that all unapproved homeopathic drug products are illegal and direct all manufacturers to immediately remove such products from the market. In the meantime, as we have recommended for many years, consumers should not use homeopathic products. At best, the products are a waste of money, given the lack of any evidence that they are effective. At worst, they could cause serious harm because of the lack of FDA oversight to ensure safety.
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I fully agree with these sentiments. The harm caused by homeopathy is considerable and multi-facetted. Many previous posts have discudded these problems, e.g.:
- Nine cases of severe homeopathy-induced liver injuries
- Another death by homeopathy
- HOMEOPATHY – “It is not just irresponsible, it’s downright dangerous.”
- Adverse effects of homeopathy and aggravations at NAFKAM
- Homeopathy: it’s time to stop the double standards
- Homeopathy can cause serious harm – and finally, the NHS England has realised it
- Vidatox, homeopathy’s answer to cancer or outright fraud?
- Another child has died because of homeopathy
- Doctor homeopaths violate fundamental rules of ethics when practising homeopathy
- ‘Best homeopathy doctor in Delhi’ offers treatment for HIV/AIDS
- DIY-Homeopathy: how to kill your entire family
- The risks of homeopathy?
- The FDA has warned 4 manufacturers of unapproved injectable homeopathic drugs
- Is this the crown of the Corona-idiocy? Nosodes In Prevention And Management Of COVID -19
- The FDA has sent more warning letters to homeopathic manufacturers
- Walmart is being sued for selling homeopathic products
- Homoeopathic remedies may be safe, but do all homeopaths merit this attribute?
- Recommending homeoprophylaxis is unethical, irresponsible and possibly even criminal
- FDA: homeopathic teething remedies were toxic
- “Homeoprophylaxis, the homeopathic vaccine alternative, prevents disease through nosodes.”
- A truly dangerous homeopath
- The scandalous attitude of some homeopaths and their supporters towards immunisations
- Oh yes, let’s have homeopaths as primary care practitioners! But only in a parallel universe,please.
Having warned about the dangers of homeopathy for decades, I feel it is high time for regulators across the world to take appropriate action.
Charles III is about to pay his first visit to France, his second visit to any state. Earlier this year, he has already visited Germany. Originally, France had been first on his list but the event was cancelled in view of the violent protests that rocked the country at the time. Now he is definitely expected and the French are exited. I am currently in France and have been asked to give several interviews on the king’s love affair with so-called alternative medicine (SCAM).
The French have long been fascinated by our royal family which seems a bit odd considering what they did to their own. Now that Charles and Camilla are about to appear with an entourage of about 50 servants between them, the press is full with slightly bemused reports and comments:
Since childhood, Charles has been accustomed to a luxurious, gilded life, which is reproduced on every trip outside the royal palaces, to ensure maximum service, comfort and security… The new king always travels with his private secretary, Sir Clive Alderton, his press advisor, his steward, his doctor, his personal valets, his security guards, and his private chauffeur, Tim Williams… And, of course, his regular osteopath to relieve his lower back. Since he’s had a lot of falls playing polo, Charles regularly suffers from back pain…”.
Really, just an osteopath?
What about all the other SCAM-practitioners whose businesses Charles so regularly supported in the past:
- · Acupuncture
- · Aromatherapy
- · Ayurveda
- · Chiropractic
- · Detox
- · Gerson therapy
- · Herbal medicine
- · Homeopathy
- · Iridology
- · Marma massage
- · Massage therapy
- · Pulse diagnosis
- · Reflexology
- · Tongue diagnosis
- · Traditional Chinese Medicine
- · Yoga
Will they not be disappointed?
I do wonder who Charles’ osteopath and doctor are. Are they competent? I am sure they both must be well-informed and evidence-based experts. If that is the case, they will have, of course, told Charles that osteopathy is hardly an optimal solution for an injured back.
In any case, now I am concerned about the royal back and therefore urgently recommend that HIS MAJESTY reads some of my previous posts on the subject, e.g.:
- Manual therapy (mainly chiropractic and osteopathy) does not have clinically relevant effects on back pain compared with sham treatment
- Spinal manipulative therapy for older adults with chronic low back pain fails to generate convincing results
- NICE no longer recommends acupuncture, chiropractic or osteopathy for low back pain
- The Effects of Yoga, Naturopathy, and Conventional Medical Treatment in Managing Low Back Pain
- Chronic non-specific low back pain: comparing cognitive functional therapy and movement system impairment (MSI)-based treatment
- Cognitive functional therapy for chronic low back pain
- Meditation for Chronic Low Back Pain Management?
Let’s hope all goes well here in France, and please let’s not be so akward as to ask about the environmental aspects – we all know how worried Charles truly is about not just his health but also the health of the planet – of moving such an entourage for a two-day visit.
PS
Charles flew in a private jet from London to Paris and took his Bentley with him.
Exercise is often cited as a major factor contributing to improved cognitive functioning. As a result, the relationship between exercise and cognition has received much attention in scholarly literature. Systematic reviews and meta-analyses present varying and sometimes conflicting results about the extent to which exercise can influence cognition. The aim of this umbrella review was to summarize the effects of physical exercise on cognitive functions (global cognition, executive function, memory, attention, or processing speed) in healthy adults ≥ 55 years of age.
This review of systematic reviews with meta-analyses invested the effect of exercise on cognition. Databases (CINAHL, Cochrane Library, MEDLINE, PsycInfo, Scopus, and Web of Science) were searched from inception until June 2023 for reviews of randomized or non-randomised controlled trials. Full-text articles meeting the inclusion criteria were reviewed and methodological quality assessed. Overlap within included reviews was assessed using the corrected covered area method (CCA). A random effects model was used to calculate overall pooled effect size with sub-analyses for specific cognitive domains, exercise type and timing of exercise.
A total of 20 met the inclusion criteria. They were based on 332 original primary studies. Overall quality of the reviews was considered moderate with most meeting 8 or more of the 16 AMSTAR 2 categories. Overall pooled effects indicated that exercise in general has a small positive effect on cognition (d = 0.22; SE = 0.04; p < 0.01). Mind–body exercise had the greatest effect with a pooled effect size of (d = 0.48; SE = 0.06; p < 0.001). Exercise had a moderate positive effect on global cognition (d = 0.43; SE = 0,11; p < 0,001) and a small positive effect on executive function, memory, attention, and processing speed. Chronic exercise was more effective than acute exercise. Variation across studies due to heterogeneity was considered very high.
The authors concluded that mind–body exercise has moderate positive effects on the cognitive function of people aged 55 or older. To promote healthy aging, mind–body exercise should be used over a prolonged period to complement other types of exercise. Results of this review should be used to inform the development of guidelines to promote healthy aging.
It seems to me that the umbrella review hides the crucial fact that many of the primary studies had major flaws, e.g. in terms of:
- lack of randomisation,
- lack of blinding.
Eleven studies investigated the effects of aerobic exercise on cognition. Only three studies investigated the effects of mind body exercise on cognition, two analysed the effects of resistance exercise, and five investigated the effects of mixed exercise interventions. I am therefore mystified how the authors managed to arrive at such a hyped conclusion in favour of the effectiveness of mind body exercises. Even an optimistic interpretation of the data would allow merely a weak indication that a positive effect might exist. To state that mind body exercises should be promoted for ‘healthy aging’ borders on the irresponsible, in my view. Surely even the most naive researcher must see that, for such a far-reaching recommendation, we would need much more solid evidence.
I strongly suspect that a proper review of the primary studies of mind body exercise with a critical evaluation of the quality of the primary studies would lead to dramatically different conclusion.
It has been reported that two London councils have written to parents to warn that children who are not vaccinated against measles may need to self-isolate for 21 days if a classmate is infected with the disease. It comes after modelling by the UK Health Security Agency (UKHSA) warned that up to 160,000 cases could occur in the capital alone as a result of low vaccination rates. Just three-quarters of London children have received the two required doses of the MMR jab, which protects against measles. This is 10 per cent lower than the national average.
Barnet Council wrote to parents on July 20 warning that any unvaccinated child identified as a close contact of a measles case could be asked to self-isolate for up to 21 days. “Measles is of serious concern in London due to low childhood vaccination rates. Currently we are seeing an increase in measles cases circulating in neighbouring London boroughs, so now is a good time to check that your child’s MMR vaccination – which not only protects your child against measles but also mumps and rubella – is up to date,” the letter reads. “Children who are vaccinated do not need to be excluded from school or childcare,” the letter added.
Neighbouring Haringey Council also warned that children without both MMR doses may be asked to quarantine for 21 days. Just over two-thirds (67.9 per cent) of children in the area had received both doses by the age of five. The councils stated that they had sent the letters based on guidance by the UKHSA, but the agency said that headteachers should consider “excluding” unvaccinated pupils who become infected with measles rather than instructing them to self-isolate.
Data published by the UKHSA showed that 128 cases of measles were recorded between January 1 and June 30 this year, compared to 54 cases in the whole of 2022. Two-thirds of the cases were detected in London. The agency have said that there is a high risk of cases linked to overseas travel leading to outbreaks in specific population groups such as young people and under-vaccinated communities.
Dr Vanessa Saliba, a consultant epidemiologist at UKHSA, said: “When there are measles cases or outbreaks in nurseries or schools, the UKHSA health protection team will assess the situation, together with the school and other local partners, and provide advice for staff and pupils. “Those who are not up to date with their MMR vaccinations will be asked to catch up urgently to help stop the outbreak and minimise disruption in schools.”
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Measles is a significant concern with approximately 10 million people infected annually causing over 100,000 deaths worldwide. In the US before use of the measles vaccine, there were estimated to be 3 to 4 million people infected with measles annually, causing 400 to 500 deaths. Complications of measles include otitis media, diarrhea, pneumonia, and acute encephalitis. Measles is a leading cause of blindness in the developing world, especially in those who are vitamin A deficient. Malnourished children with measles are also at higher risk of developing noma (or cancrum oris), a rapidly progressive gangrenous infection of the mouth and face. Most deaths due to measles are caused by pneumonia, diarrhea, or neurological complications in young children, severely malnourished or immunocompromised individuals, and pregnant women. A rare sequela of measles is subacute sclerosing panencephalitis.
Back in 2003, we investigated what advice UK homeopaths, chiropractors and general practitioners give on measles, mumps and rubella vaccination programme (MMR) vaccination via the Internet. Online referral directories listing e-mail addresses of UK homeopaths, chiropractors and general practitioners and private websites were visited. All addresses thus located received a letter of a (fictitious) patient asking for advice about the MMR vaccination. After sending a follow-up letter explaining the nature and aim of this project and offering the option of withdrawal, 26% of all respondents withdrew their answers. Homeopaths yielded a final response rate (53%, n = 77) compared to chiropractors (32%, n = 16). GPs unanimously refused to give advice over the Internet. No homeopath and only one chiropractor advised in favour of the MMR vaccination. Two homeopaths and three chiropractors indirectly advised in favour of MMR. More chiropractors than homeopaths displayed a positive attitude towards the MMR vaccination. We concluded that some complementary and alternative medicine providers have a negative attitude towards immunisation and means of changing this should be considered.
The problem is by no means confined to the UK. German researchers, for instance, showed that belief in homeopathy and other parental attitudes indicating lack of knowledge about the importance of vaccinations significantly influenced an early immunisation. Moreover, being a German homeopath has been independently associated with lower own vaccination behavior. Data from France paint a similar picture.
Some homeopaths, of course, claim that ‘homeopathic vaccinations’ are effective and preferable. My advice is: DON’T BELIEVE THESE CHARLATANS! A recent study demonstrated that homeopathic vaccines do not evoke antibody responses and produce a response that is similar to placebo. In contrast, conventional vaccines provide a robust antibody response in the majority of those vaccinated.
Many community pharmacies in Switzerland provide so-called alternative medicine (SCAM) approaches in addition to providing biomedical services, and a few pharmacies specialise in SCAM. A common perception is that SCAM providers are sceptical towards, or opposed to, vaccination.
The key objectives of this study were to examine the potential roles of biomedically oriented and SCAM-specialised pharmacists regarding vaccine counselling and to better understand the association between vaccine hesitancy and SCAM. The researchers thus conducted semistructured, qualitative interviews. Transcripts were coded and analysed using thematic analysis. Interview questions were related to:
- type of pharmaceutical care practised,
- views on SCAM and biomedicine,
- perspectives on vaccination,
- descriptions of vaccination consultations in community pharmacies,
- and views on vaccination rates.
Qualitative interviews in three language regions of Switzerland (German, French and Italian). A total of 18 pharmacists (N=11 biomedically oriented, N=7 SCAM specialised) were invited.
Pharmacist participants expressed generally positive attitudes towards vaccination. Biomedically oriented pharmacists mainly advised customers to follow official vaccination recommendations but rarely counselled vaccine-hesitant customers. SCAM-specialised pharmacists were not as enthusiastic advocates of the Swiss vaccination recommendations as the biomedically oriented pharmacists. Rather, they considered that each customer should receive individualised, nuanced vaccination advice so that customers can reach their own decisions. SCAM-specialised pharmacists described how mothers in particular preferred getting a second opinion when they felt insufficiently advised by biomedically oriented paediatricians.
The authors concluded that vaccination counselling in community pharmacies represents an additional option to customers who have unmet vaccination consultation needs and who seek reassurance from healthcare professionals (HCPs) other than physicians. By providing individualised vaccination counselling to vaccine-hesitant customers, SCAM-specialised pharmacists are likely meeting specific needs of vaccine-hesitant customers. As such, research and implementation efforts should more systematically involve pharmacists as important actors in vaccination provision. SCAM-specialised pharmacists particularly should not be neglected as they are important HCPs who counsel vaccine-hesitant customers.
I must say that I find these conclusions odd, perhaps even wrong. Here are my reasons:
- Pharmacists are well-trained healthcare professionals.
- As such, they have ethical obligations towards their customers.
- These obligations include behaving in a way that is optimal for the health of their customers and follows the rules of evidence-based practice.
- This includes explaining to vaccine-hesitant customers why the recommended vaccinations make sense and advising them to follow the official vaccination guidelines.
- SCAM-specialised pharmacist should ask themselves whether offering SCAM is in line with their ethical obligation to provide optimal care and advice to their customers.
I fear that this paper suggests that SCAM-specialised pharmacists might be a danger to the health of their customers. If that is confirmed, they should consider re-training, in my view.
