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

progress

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So-called alternative medicine (SCAM) is widely used in Saudi Arabia. One of the common practices is the use of camel urine alone or mixed with camel milk for the treatment of cancer, which is often supported by religious beliefs.

This study observed cancer patients who insisted on using camel urine, and to offer some clinically relevant recommendations. The authors observed 20 cancer patients (15 male, 5 female) from September 2020 to January 2022 who insisted on using camel urine for treatment. They documented the demographics of each patient, the method of administering the urine, reasons for refusing conventional treatment, period of follow-up, and the outcome and side effects.

All the patients had radiological investigations before and after their treatment with camel urine. All of them used a combination of camel urine and camel milk, and their treatment ranged from a few days to 6 months. They consumed an average of 60 ml urine/milk per day. No clinical benefit was observed after the treatment; 2 patients developed brucellosis. Eleven patients changed their mind and accepted conventional antineoplastic treatment and 7 were too weak to receive further treatment; they died from the disease.

The authors concluded that camel urine had no clinical benefits for any of the cancer patients, it may even have caused zoonotic infection. The promotion of camel urine as a traditional medicine should be stopped because there is no scientific evidence to support it.

If you suspected that this was a hoax, you were wrong!

Here is a recent paper on the ‘therapeutic potentials of camel urine’:

Camel urine has traditionally been used to treat multiple human diseases and possesses the most beneficial effects amongst the urine of other animals. However, scientific review evaluating the anticancer, antiplatelet, gastroprotective and hepatoprotective effects of camel urine is still scarce. Thus, this scoping review aimed to provide scientific evidence on the therapeutic potentials of camel urine. Three databases were searched to identify relevant articles (Web of Science, PubMed and Scopus) up to September 2020. Original articles published in English that investigated the effects of camel urine in various diseases were included. The literature search identified six potential articles that met all the inclusion criteria. Three articles showed that camel urine possesses cytotoxic activities against different types of cancer cells. Two studies revealed camel urine’s protective effects against liver toxicity and gastric ulcers, whilst another study showed the role of camel urine as an antiplatelet agent. All studies demonstrated significant positive effects with different effective dosages. Thus, camel urine shows promising therapeutic potential in treating human diseases, especially cancer. However, the standardised dosage and potential side effects should be determined before camel urine could be offered as an alternative treatment.

I have often asked myself the question whether some SCAMs are too absurd to merit scientific study. Over the years, I changed my mind on it; while initially I tended to answer it in the negative, I now think that YES: some ideas – even those that are ancient and, as Charles Windsor would argue, have thus stood the ‘test of time’ – are not worth the effort. Camel urine as a therapy might well be one of them.

Swedish researchers examined the relationship between cognitive ability and prompt COVID-19 vaccination using individual-level data on more than 700,000 individuals in Sweden.

The analyses were based on individual-level data from several administrative registers in Sweden. The study population consisted of all men and women who enlisted for military service in Sweden between 1979 and 1997. During this period, enlistment was mandatory for men the year they turned 18 or 19. Women could not enlist for military service before 1980 but were then allowed to do so on a voluntary basis.

The study population thus covered almost the entire population of Swedish men born between 1962 and 1979, in total 750,381, as well as the sample of women who enlisted during the period of 1980–1997, in total 2703. In addressing the role of confounders, the researchers analyzed the sub-sample of 6750 twin brothers (3375 twin-pairs) in the enlistment records (identified by shared biological mother and year and month of birth).

The results show a strong positive association between cognitive ability and swift vaccination, which remained even after controlling for confounding variables with a twin-design. Consistent with this, the researchers showed that simplifying the vaccination decision through pre-booked vaccination appointments alleviates almost all of the inequality in vaccination behavior.

The authors concluded that the complexity of the vaccination decision may make it difficult for individuals with lower cognitive abilities to understand the benefits of vaccination.

On this blog, we have repeatedly discussed similar or related findings, e.g.:

I know, it would be politically incorrect, unkind, unhelpful, etc. but is anyone not tempted to simplify the issue by assuming that people who are against (COVID) vaccinations are intellectually challenged?

King Charles III is an enthusiastic, albeit uncritical proponent of so-called alternative medicine (SCAM). Does that boost his popularity in the general population? Or does it have the opposite effect? I am not aware of reliable data on this issue, yet I suspect it is neither here nor there. So, his waning popularity is probably caused by other factors.

A survey of more than 2,000 adult Brits found that overall, 62% want to keep the monarchy and 59% of people thought Charles was “personally doing a good job”.. At first glance, this looks not too bad for Charles and William but a more detailed analysis is far less optimistic: among 18 to 24-year-olds, only 30% say the monarchy is “good for Britain”. This “remarkable difference between generations”, demonstrates that younger people are much less supportive on remaining a monarchy and more sceptical about the Royal Family representing good value for money.

A decade ago, the same YouGov tracking survey found 17% preferred an elected head of state, which in this latest survey has risen to 26%. On the question whether Britain should continue to be a monarchy or be replaced with an elected head of state, the poll found:

  • 62% wish no change,
  • 26% want an elected head of state,
  • 11% don’t know.

On the question whether the Royal Family is good value for money, 75% of the over-65s believe they are, but only 34% of 18 to 24-year-olds feel the same. And while 80% of the over-65s want Britain to stay as a monarchy, that figure falls to 37% for the 18 to 24-year-olds. There is also less support for the royals in Scotland or Wales than in England, where London has higher levels of people against the monarchy than elsewhere in the country.

Historian and royal commentator Ed Owens says the lack of support among the young should “certainly be of concern” to the Royal Family. But he says it will be difficult for the royals to turn this around, when many of the factors are outside their control. Dr Owens says opposition to the monarchy is part of a wider sense of “disenchantment” for younger generations about issues such as unaffordable housing, stagnant wages and student debt. “The system doesn’t seem to be working for them, so why should they celebrate an institution that seems to be at the heart of that system?” says Dr Owens.

Graham Smith, chief executive of the anti-monarchy campaign Republic, said the survey showed a “general trend of falling support, and that younger people will not be won back to the monarchist cause. Sooner rather than later we’ll see support for the monarchy fall below 50%.”

When the 1st edition of my book about about Charles’ (at the time, he was still ‘Prince of Wales’) love affair with SCAM came out, it was reviewd by the Daily Mail.  They courageously asked Charles’ press office for a comment on it. A Clarence House spokesperson then told the journalist: ‘The Prince of Wales believes in combining the best of evidence based, conventional medicine with an holistic approach to healthcare – treating the whole person rather than just the symptoms of disease and taking into account the effects on health of factors such as lifestyle, the environment and emotional well-being.’  I know this is not all that meaningful and just a (fairly daft and uninformed) formular for getting rid of a tedious request, yet – for what it’s worth – it does not indicate that, in the realm of SCAM, Charles is all that open to change. More recent activities of King Charles seem to support this impression.

With regards to his overall popularitiy in the UK, this might mean that Charles will continue to lose the support of skeptics, while gaining the one of SCAM enthusiasts.

And the net result of this?

I fear it will almost be negligible.

The KFF provides reliable, accurate, and non-partisan information to help inform health policy in the US. The KFF has just released its ‘Health Misinformation Tracking Poll Pilot‘ examining the public’s media use and trust in sources of health information and measuring the reach of specific false and inaccurate claims surrounding three health-related topics: COVID-19 and vaccines, reproductive health, and gun violence. It makes grimm reading indeed. Here are but a few excerpts pertaining to health/vaccination:

Health misinformation is widespread in the US with 96% of adults saying they have heard at least one of the ten items of health-related misinformation asked about in the survey. The most widespread misinformation items included in the survey were related to COVID-19 and vaccines, including that the COVID-19 vaccines have caused thousands of deaths in otherwise healthy people (65% say they have heard or read this) and that the MMR vaccines have been proven to cause autism in children (65%).

Regardless of whether they have heard or read specific items of misinformation, the survey also asked people whether they think each claim is definitely true, probably true, probably false, or definitely false. For most of the misinformation items included in the survey, between one-fifth and one-third of the public say they are “definitely” or “probably true.” The most frequently heard claims are related to COVID-19 and vaccines.

Uncertainty is high when it comes to health misinformation. While fewer than one in five adults say each of the misinformation claims examined in the survey are “definitely true,” larger shares are open to believing them, saying they are “probably true.” Many lean towards the correct answer but also express uncertainty, saying each claim is “probably false.” Fewer tend to be certain that each claim is false, with the exception of the claim that more people have died from the COVID-19 vaccines than from the virus itself, which nearly half the public (47%) recognizes as definitely false.

Across the five COVID-19 and vaccine related misinformation items, adults without a college degree are more likely than college graduates to say these claims are definitely or probably true. Notably, Black adults are at least ten percentage points more likely than White adults to believe some items of vaccine misinformation, including that the COVID-19 vaccines have caused thousands of sudden deaths in otherwise healthy people, and that the MMR vaccines have been proven to cause autism in children. Black (29%) and Hispanic (24%) adults are both more likely than White adults (17%) to say that the false claim that “more people have died from the COVID-19 vaccine than have died from the COVID-19 virus” is definitely or probably true. Those who identify as Republicans or lean towards the Republican Party and pure independents stand out as being more likely than Democratic leaning adults to say each of these items is probably or definitely true. Across community types, rural residents are more likely than their urban and suburban counterparts to say that some false claims related to COVID vaccines are probably or definitely true, including that the vaccines have been proven to cause infertility and that more people have died from the vaccine than from the virus.

Educational attainment appears to play a particularly important role when it comes to susceptibility to COVID-19 and vaccine misinformation. Six in ten adults with college degrees say none of the five false COVID-19 and vaccine claims are probably or definitely true, compared to less than four in ten adults without a degree. Concerningly, about one in five rural residents (19%), adults with a high school education or less (18%), Black adults (18%), Republicans (20%), and independents (18%) say four or five of the false COVID-19 and vaccine misinformation items included in the survey are probably or definitely true.

________________________________

If you have followed some of the comments on this blog, you might find it hard to be surprised!

I do encourage you to read the full article.

For about 40 years, the RMIT University in Australia had a Bachelor of Health Science/Bachelor of Applied Science (Chiropractic), probably the first official course of its kind in Australia. “Get qualified with a chiropractic degree: a solid grounding in anatomy, physiology and pathology and practise at the RMIT Health Clinic” was how the RMIT advertised it. But now the website states this: “from 2023, this degree is no longer offered.”

The Australian Chiropractors Association (ACA) is appalled!!!

What is more, they claim that this decision was made without consultation with staff, students (Australian or international) or other relevant stakeholders such as the chiropractic professional bodies. A publicly funded university acting in this manner appears to fly in the face of the Albanese government’s positive philosophy around educational access, particularly for those in the regions.
What the ACA omits to mention is that the chiro-unit at the RMIT has a dismal research output and hardly ever tackled relevant research questions such as effectiveness and safety of spinal manipulations. The ACA have even posted a video and believe a public institution that selectively closes a program which serves the public health interest and is economically viable, requires scrutiny. Given the role chiropractors play in serving the ageing population, together with the fact that low back pain is the number one disability worldwide, this decision is contrary to future community needs and industry demands.
Really?
The role chiros play in terms of public health, serving the elderly, alleviating back pain, reducing disability is close to zero. The fact that it is not nothing at all is due to the fact that, arguably, it is a detrimental role. As we have discussed ad nauseam on this blog:
  • the main contribution of chiros to public health is that many of them advise AGAINST immunizations;
  • a significant contribution by chiropractors to the health of the elderly is that they have put many of them in wheelchairs.
The ACA state that they believe an institution funded by government must be accountable to its stakeholders both within and without.
Exactly!
I suspect and hope that this is precisely the reason why they closed the course.
Well dome RMIT!

I was asked by NATURE to provide a comment on the WHO Traditional Medicine Global Summit: Towards health and well-being for all which is about to take place in India:

The First WHO Traditional Medicine Global Summit will take place on 17 and 18 August 2023 in Gandhinagar, Gujarat, India. It will be held alongside the G20 health ministerial meeting, to mobilize political commitment and evidence-based action on traditional medicine, which is a first port of call for millions of people worldwide to address their health and well-being needs.

The Global Summit will be co-hosted by WHO and the Government of India, which holds the presidency of the G20 in 2023. It will be a platform for all stakeholders, including traditional medicine workers, users and communities, national policymakers, international organizations, academics, private sector and civil society organizations, to share best practices and game-changing evidence, data and innovation on the contribution of traditional medicine to health and sustainable development.

For centuries, traditional and complementary medicine has been an integral resource for health in households and communities. It has been at the frontiers of medicine and science laying the foundation for conventional medical texts. Around 40% of pharmaceutical products today have a natural product basis, and landmark drugs derive from traditional medicine, including aspirin, artemisinin, and childhood cancer treatments. New research, including on genomics and artificial intelligence are entering the field, and there are growing industries for herbal medicines, natural products, health, wellness and related travel. Currently, 170 Member States reported to WHO on the use of traditional medicine and have requested evidence and data to inform policies, standards and regulation for its safe, cost-effective and equitable use.

In response to this increased global interest and demand, WHO, with the support of the Government of India, established in March 2022 the WHO Global Centre for Traditional Medicine as a knowledge hub with a mission to catalyse ancient wisdom and modern science for the health and well-being of people and the planet. The WHO Traditional Medicine Centre scales up WHO’s existing capacity in traditional medicine and supplements the core WHO functions of governance, norms and country support carried out across the six regional Offices and Headquarters.

The Centre focuses on partnership, evidence, data, biodiversity and innovation to optimize the contribution of traditional medicine to global health, universal health coverage, and sustainable development, and is also guided by respect for local heritages, resources and rights.

cross-regional expert panel will advise on the Summit’s theme, format, topics and issues to address. All updates will be posted here and on the forthcoming webpages for the First WHO Traditional Medicine Global Summit.

In case you are interested, the programme can be seen here.

And my comment? I am afraid, it was not very encouraging. I doubt that Nature will publish it in full. So, allow me to show you my unabridged comment:

The WHO has a long history of uncritically promoting alternative therapies. The Indian government has recently advocated irresponsibly dangerous nonsense, such as the use of homeopathy for the prevention and treatment of covid infections. The two together make an ominous initiative when it comes to alternative medicine.
Of course, there is nothing wrong in hosting a constructive dialogue about this subject. What seem ill-conceived, however, is the fact that the conference exclusively includes speakers who are staunch proponents of alternative medicine, a subject that, after all, remains highly controversial. Progress is not created by voicing one-sided, biased opinions. I fear that this meeting will result in the often before voiced platitudes and wishful thinking which no true scientist is then able to take seriously.

We discussed the 2015 Australian NHMRC report on homeopathy many times before, e.g.:

In a nutshell, the report was an hugely influential analysis of the effectiveness of homeopathy which came to squarely negative conclusions. Thus it was celebrated as a thorough and conclusive piece evidence demonstrating the madness of homeopathy. Unsurprisingly, homeopaths did not like it at all and produced various criticisms claiming that it was neither thorough nor conclusive.

Now the final evaluation of what has been going on was finally published (ISSUED BY THE COMMONWEALTH OMBUDSMAN, IAIN ANDERSON, ON 4 AUGUST 2023):

The Office of the Commonwealth Ombudsman (the Office) has finalised an investigation relating to the National Health and Medical Research Council’s (NHMRC) review of the evidence for the effectiveness of homeopathy, conducted between 2010 and 2015. We commenced this investigation in September 2017 in response to concerns raised with us about how the NHMRC review had proceeded.
The Office conducts its investigations in private, and the Ombudsman generally does not make a public statement in the absence of a formal report. In the circumstances of this matter, including that the then-Ombudsman released a public statement on 4 June 2021 which acknowledged the Office was investigating, we believe it is important to share publicly the information we can, now that the investigation is complete.
Our investigation was finalised in July 2023. We acknowledge the length of time the investigation has taken. This is in part due to the extensive efforts the Office made to source independent scientific expertise to advise us on some detailed and specific questions of scientific methodology that were raised with our Office, including some that were only brought to our attention as our investigation progressed. Despite our best efforts, it was not possible to engage an expert (or experts) to provide independent advice to our Office on this subject. In the absence of independent, expert scientific expertise we have not been able to conclusively determine those matters of scientific methodology. This did not prevent our Office from forming a view on other aspects of the matter.
Our investigation did not result in any adverse findings about the review or the NHMRC. When finalising investigations, we may offer comments and suggestions to an agency about areas for future improvement. In this instance, we offered comments and suggestions to the NHMRC about how it records and publicly explains decisions about its activities. The NHMRC also independently made several improvements to its processes during the course of our investigation.

________________

In essence, this means that the conclusions of the report stand:

Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness. People who are considering whether to use homeopathy should first get advice from a registered health practitioner. Those who use homeopathy should tell their health practitioner and should keep taking any prescribed treatments.

Thus the matter is closed – that is closed for rational thinkers. For irrationalists, the matter will no doubt continue to be a stone of contention. No, homeopath will be able to accept these conclusions simply because a member of a cult ceases to be a cultist once he/she accepts the criticism agaist the cult.

We have discussed dental amalgam and its risks to human health before. Finally, there is new legislation in sight. The European Commission has revised the EU Mercury Regulation to protect EU citizens and the environment from toxic mercury. Among other things, this will completely ban the use of dental amalgam, for which 40 tons of mercury are currently consumed annually in the EU. The revised mercury ordinance provides for the following:
– No more use of dental amalgam from January 1, 2025; viable mercury-free alternatives are available.

– Ban on the manufacture and export of dental amalgam from the EU from January 1, 2025;

– Ban on the manufacture and export of six mercury-containing lamps from January 1, 2026 and January 1, 2028 (depending on lamp type).

The delegated act adopted under the Mercury Regulation transposes into EU law the decisions taken at the fourth Conference of the Parties (2022) to the Minamata Convention by introducing a ban on the production, import, and export of eight additional mercury-containing products, including mercury-containing lamps and non-electrical equipment.

The Minamata Convention is the main international legal framework for the protection of human health and the environment from anthropogenic emissions and releases of mercury to air, water, and soil. Like the Mercury Regulation, it addresses the entire life cycle of mercury, from primary mercury mining to mercury waste management.

The revised Mercury Regulation must now be approved by the European Parliament and the Council under the ordinary legislative procedure. The delegated act will be sent to the European Parliament and the Council for consideration.

Mercury is a highly toxic chemical that poses a threat to both human health and the environment. When released into the environment, it enters the food chain where it accumulates (mainly in fish). High mercury exposure can damage the brain, lungs, kidneys, and immune system.

Historically, mercury has been used in a wide range of applications, including gold mining, batteries, fluorescent tubes, thermometers, and barometers. Over the last twenty years, the EU has developed a comprehensive body of legislation, in particular the Mercury Regulation, which protects human health and the environment from anthropogenic emissions and releases of mercury, taking into account the entire life cycle of mercury from primary mercury mining to final disposal of mercury waste. It also includes measures on trade in mercury-containing products and mercury pollution.

The Minamata Convention entered into force on August 16, 2017, and has so far been ratified by the European Union and 143 countries, including all EU Member States. The fifth session of the Conference of the Parties to the Minamata Convention on Mercury (COP-5) will be held in Geneva, Switzerland, from October 30 to November 3, 2023.

_____________________________

In the UK – this post is mainly for UK readers – journalists and opinion leaders are currently falling over themselves reporting about a major breakthrough: an Alzheimer’s drug has been shown to slow the disease by around 36%. “After 20 years with no new Alzheimer’s disease drugs in the UK, we now have two potential new drugs in 12 just months,” wrote Dr Richard Oakley, associate director at the Alzheimer’s Society. And the Daily Mail headlined: “New drug which claims to slow mental decline caused by Alzheimer’s by 36% could spell ‘the beginning of the end’ for the degenerative brain disease”.

That’s excellent news!

Many people will have made a sigh of relief!

So, why does it make me angry?

Once we listen to the news more closely we learn that:

  • the drug only works for patients who are diagnosed early;
  • for an early diagnosis, we need a PET scan;
  • the UK hardly has any PET scanners, in fact, we have the lowest number among developed countries;
  • these scanners are very expensive;
  • the costs for the new drug are as yet unknown but will also be high.

Collectively these facts mean that we have a major advance in healthcare that could help many patients. At the same time, we all know that this is mere theory and that the practice will be very different.

Why?

  • Because the NHS has been run down and is on its knees.
  • Because our government will again say that they have invested xy millions into this area.
  • The statement might be true or not, but in any case, the funds will be far too little.
  • The UK has become a country where some patients suffering from severe toothache currently resort to pulling out their own teeth at home with pairs of pliers.
  • In the foreseeable future, the NHS will not be allocated the money to invest in sufficient numbers of PET scans (not to mention the funds to buy the new and expensive drug).

In other words, the UK celebrates yet another medical advance raising many people’s expectations, while everyone in the know is well aware of the fact that the UK public will not benefit from it.

Does that not make you angry too?

It been reported that the German HEILPRAKTIKER, Holger G. has been sentenced to serve a total of 4 years and three months behind bars. He made himself a pair of glasses out of aluminum foil and appeared at the start of his trial wearing a Corona protective mask. The accusations against him were fierce: He was accused of having issued false Corona vaccination certificates en masse in Munich and of having given medication to patients. A woman, who had contracted Corona and had been treated by Holger G. with vitamin solutions, had died last year.

According to the verdict, Holger G. had violated the German Medicines Act. The court announced he was also convicted of 96 counts of dangerous bodily harm and 102 counts of unauthorized trading in prescription drugs. In addition, the court ordered the HEILPRAKTIKER to be placed in a rehab facility.

The 71-year-old MAN had issued Corona vaccination cards since April 2021, without actually vaccinating the people concerned. For the forged vaccination cards, he charged several tens of thousands of Euros. In addition, the former HEILPRAKTIKER illegally sold prescription drugs. The judgment is so severe because Holger G. has form. He also ordered to bear the costs of the proceedings.

___________________________

I have long criticized the German HEILPRAKTIKER. In my recent book on the subject, I make the following points:

– Today, no one can provide reliable data on the number of HEILPRAKTIKER in Germany.
– The training of HEILPRAKTIKER is woefully inadequate.
– The far-reaching rights of the HEILPRAKTIKER are out of proportion to their overt lack of competence.
– This disproportion poses a serious danger to patients.
– This danger is further increased by the fact that there is no effective control of the activity of the HEILPRAKTIKER does not take place.
– Existing laws are almost never applied to the HEILPRAKTIKER.
– Most HEILPRAKTIKER mislead the public unhindered with untenable therapeutic claims.
– The federal government seems to put off over and over again any serious discussion of the HEILPRAKTIKER.

Cases like the one above show that it is high time for reform – or, should that prove impossible, the discontinuation of this utterly obsolete and highly dangerous profession.

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