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

The 30 most recent comments from all posts are listed below. Click on the post title to go to the comment on the post’s page.

  • Comment by Edzard on Spinal epidural hematoma caused by spinal manipulation Friday 22 October 2021: 12:10 everyone knows the limitations of PMS everyone knows the limitations of seatbelts BUT IT’S FAR WORSE DO CONTINUE WITHOUT THEM
  • Comment by DC on Spinal epidural hematoma caused by spinal manipulation Friday 22 October 2021: 12:10 Sigh. I was simply pointing out the limitations of such a system with regards to “true incidence “. Strange that ruffled feathers, well, not really. FAERS Limitations • Passive, voluntary surveillance • Underreporting occurs and is variable from drug to drug and over time – Some literature cites 1-10% – ActualisunknownsoFDAdoesnotassumeextent • Reporting bias exists • Quality of the reports is variable and often incomplete • Duplicate reporting of the same case occurs • Not population-based data source – Cannotreliablyestimateincidenceorprevalence – Numeratoruncertain,denominatorcanonlybeprojectedfromdrug utilization data https://www.fda.gov/files/about%20fda/published/Drug-Safety-Surveillance-and-the-FDA-Adverse-Event-Reporting-System-%28PDF—1.31MB%29.pdf
  • Comment by Dr Julian Money-Kyrle on Spermidine, the new ‘wonder supplement’? SADLY NOT! Friday 22 October 2021: 10:10 How is methylene blue a supplement? I am not aware of it being a nutrient of any kind. I know that it is being marketed for memory loss, but as far as I am aware there are no data from human trials showing that it is effective (nor of spermidine, for that matter). it is difficult to comment on potential interactions of drugs without knowing their mechanism of action (if any), how they are absorbed, how they are metabolised and what effect each one can have on the pathways involved in metabolising the other. Drugs can enhance each other, interfere with each other or cause toxicity together than they don’t have separately.
  • Comment by has on Spinal epidural hematoma caused by spinal manipulation Friday 22 October 2021: 09:10 @DC: “You know, be a team player instead of a heckler on the sidelines.” That is a very silly comment. I am not a chiropractor. I am not even medically trained (flunked 1st year premed and work in a totally different field now). It is not my job to play on your team. It is for you and your fellow chiropractors to get your act together and sort it out yourselves. It is laudable that you personally support the introduction of PMS and I do commend you for that attitude. But, talk is easy. You and your likeminded colleagues seriously need to light a fire under ALL of your fellow chiropractors as, a hundred years on, it is clear that far too many of them are happy to cruise along on “business as usual”, performing the procedures and taking the money, and not doing due dilligence in identifying adverse effects and correcting when they occur. It is well known that conventional medicine, thanks to various perverse incentives, all too often turns a blind eye to its own problems, at cost of patients’ trust, health, and even lives. But at least those failures eventually see light of day, because some are paying attention and refuse to let it slide forever. With AltMed, all too often the collective attitude is “as long as we never look for problems in our own house, then those problems don’t exist”, while simultaneously being first in line to screech and hoot loudly about conventional medicines screwups, real and imagined. The stench of that hypocrisy is both staggering and infuriating, given the double standard. But since few within AltMed wish to (or will dare) call out its own failings, that only leaves us outsiders to sit on the sidelines and, as you put it, remind y’all repeatedly that your first duty is to PATIENTS, not yourselves. No, we shouldn’t have to do that job either, but AltMed refuses to do it for themselves. And that is on all of you too. Heck, when your professional bodies won’t even censure lying incompetents like Arleen Scholten who kill vulnerable patients and still continue to practise, it clearly has a long way to go.
  • Comment by Edzard on Spinal epidural hematoma caused by spinal manipulation Friday 22 October 2021: 07:10 I don’t think anyone here cares a toss what you support. we want the chiropractic organizations to support PMS and get on with it.
  • Comment by DC on Spinal epidural hematoma caused by spinal manipulation Thursday 21 October 2021: 22:10 has: It is not our job to do your (chiropractors) job for you. I never said it was. I wrote “become part of the team” You know, be a team player instead of a heckler on the sidelines. But perhaps that is all some have to offer.
  • Comment by James on Spermidine, the new ‘wonder supplement’? SADLY NOT! Thursday 21 October 2021: 21:10 Is Spermidine considered a nootropic? If so would it be potentially problematic to take along with Methylene Blue supplements?
  • Comment by has on MMS-salesman Andreas Kalcker has been arrested in Argentina Thursday 21 October 2021: 18:10 “Big Pharma are putting into the COVID vaccines and why so many people are dying of this lethal concoction” Frogs and snails and puppy-dog tails? Please. Read the damn ingredients list if you really want to know (5G anti-Trump nanobots not included). There are a handful of deaths which may be down to the vaccine, which sucks, but FIVE MILLION† deaths from the virus, which sucks a million times more. The serious side-effects of the vaccine are pretty much the same as the serious side-effects from the virus itself, only the virus is a lot more likely to cause them than the vaccine is. That’s the cold hard math that escapes you, and drinking industrial bleach won’t change that, although it will change you (starting with the dead intestinal lining you crap out). “Chlorine dioxide is a potent antiviral and antimicrobial with years of proof” Well, duh, it’s a bleach. Bleach indiscriminately kills pretty much anything and everything it comes into contact with; that’s what makes it a good household cleaning product and why it comes in childproof bottles plastered with large warning labels saying DO NOT DRINK THIS. And drinking the damn stuff from 100ml boutique bottles priced at $39.99 is incredibly stupid on two levels since not only 1. are you poisoning yourself, but 2. you are vastly, vastly overpaying to do it (you can buy it by the gallon for cleaning swimming pools for less than Jim Humble’s markup, mugs). — † Officially; the true figure is almost certainly much higher.
  • Comment by DC on Spinal epidural hematoma caused by spinal manipulation Thursday 21 October 2021: 18:10 EE exactly! and the information that is available is the tip of an iceberg. As is what is currently being reported elsewhere under a “mandatory” system. https://link.springer.com/article/10.2165%2F00002018-200629050-00003 I support PMS within chiropractic. As more information becomes available the risk can be recalculated. Geesh.
  • Comment by Richard Rasker on MMS-salesman Andreas Kalcker has been arrested in Argentina Thursday 21 October 2021: 15:10 @Andreas Andonevris [bleach] also kills MRSA and COVID. Strange. From what I see, it only kills brain cells.
  • Comment by Edzard on MMS-salesman Andreas Kalcker has been arrested in Argentina Thursday 21 October 2021: 14:10 thanks, that’s kind!
  • Comment by has on Spinal epidural hematoma caused by spinal manipulation Thursday 21 October 2021: 14:10 @DC: “If anyone here has a background in said projects and wants to become part of their team let me know.” It is not our job to do your (chiropractors) job for you. Perhaps if you’d had to set up your PMS before you set up your billing, you might have got it done by now. Says something about AltMed’s order of priorities: practice, profit, patient. @Prof Ernst: “the information that is available is the tip of an iceberg” Maybe, maybe not. Hence the need to reliable monitoring to capture the actual numbers instead of sampling and guesswork, and hoping it’s representative. That said, an upper limit might be reasonably estimated by counting the total number of characteristic injuries occuring annually in the population, as reported by A&Es and pathologists. (There might be some percentage that do not show up in the conventional medical system at all, but I’m guessing most folks who are stroking out or whatever get called an ambulance, whether they want it or not.)
  • Comment by Andreas Andonevris on MMS-salesman Andreas Kalcker has been arrested in Argentina Thursday 21 October 2021: 13:10 Why doesn’t the scum-bag Ernst investigate what Big Pharma are putting into the COVID vaccines and why so many people are dying of this lethal concoction. When the war criminal investigations are concluded, I am certain that Ernst will be amongst the crowd that get executed for going to war against the people for money from the drug companies. Chlorine dioxide is a potent antiviral and antimicrobial with years of proof – it also kills MRSA and COVID.
  • Comment by Edzard on Spinal epidural hematoma caused by spinal manipulation Thursday 21 October 2021: 13:10 ” they base the estimates on the information that is available” exactly! and the information that is available is the tip of an iceberg.
  • Comment by DC on Spinal epidural hematoma caused by spinal manipulation Thursday 21 October 2021: 13:10 Sigh. I have on several occasions stated in these blogs that a support a PMS. Until then they base the estimates on the information that is available. Currently this indicates that these serious AE are rare. I know some of the chiropractors who are involved in setting up such systems. If anyone here has a background in said projects and wants to become part of their team let me know. Otherwise you are just complaining for the sake of complaining. I’m moving on.
  • Comment by Edzard on Spinal epidural hematoma caused by spinal manipulation Thursday 21 October 2021: 13:10 do you have a point?
  • Comment by DC on Spinal epidural hematoma caused by spinal manipulation Thursday 21 October 2021: 12:10 Reference in Wikipedia page “ Drug registries do, however, have some limitations, including a potential for bias and confounding, long periods of follow-up and high cost.”
  • Comment by Edzard on Patients consulting chiropractors, homeopaths, or naturopaths are less likely to agree to the flu jab Thursday 21 October 2021: 11:10 yes, that breaks anyone’s irony meter.
  • Comment by Richard Rasker on Patients consulting chiropractors, homeopaths, or naturopaths are less likely to agree to the flu jab Thursday 21 October 2021: 10:10 An interesting thing to note in this regard is that lots of homeopaths ‘explain’ how homeopathy works by comparing it to vaccination: ‘A tiny bit of what causes disease helps against the disease’. Which of course only shows that homeopaths are ignorant even about homeopathy itself (and about vaccination of course): – Vaccines contain very real amounts of active (immunogenic) ingredients, usually 50 micrograms per pathogen species in a 0.5 ml vaccine dose. In homeopathic terms, this would equal a mere 2C dilution (1:10,000). Homeopathic preparations as a rule contain no active substance whatsoever – even though the label hilariously designates the utterly absent substance as ‘active ingredient’. – Homeopathic preparations are administered exclusively based on disease symptoms, and treatment is stopped once these symptoms have disappeared. Which means that they are only to be used when someone already has contracted a disease and exhibits symptoms. Vaccines OTOH prevent disease, something that homeopathy by definition can’t do, as there are of course no symptoms to base any ‘treatment’ on. Which nevertheless hasn’t stopped many homeopaths from defrauding the general public with their ‘homeoprophylaxis’, often for very serious diseases such as polio.
  • Comment by has on Spinal epidural hematoma caused by spinal manipulation Thursday 21 October 2021: 09:10 Here’s the actual paper, since @DC neglected to link it. I’ve only quickly skimmed it, but it’s worth noting that it is not limited to chiro but covers osteopathy and other procedures as well, and looks to extrapolate its risk numbers from trial data, not collect them directly from post-treatment surveillance. That’s pretty weak sauce: without full monitoring, how do we know which procedures are the riskiest, and how do we know if the rate of serious AEs is going up or down? And without knowing these things, how can we hope to correct for them? Or is @DC fine with N patients being injured and killed each year, and nothing being done about it? Also worth noting as a takeaway (and stop us if you’ve heard this one before): Given the limited proven benefits of manipulative therapies and small risk of serious adverse events, additional high-quality, adequately powered studies are needed before definitive recommendations can be made for treating many conditions. Business as usual, in other words. (Not only do we not know how dangerous it is, we don’t even know if that danger is worth it!) So, @DC, do patients not deserve to have these questions accurately answered? Or is it all about you?
  • Comment by has on David Daniel Palmer: the life of a genius or the career of a charlatan? Thursday 21 October 2021: 09:10 Patients can and do die of medical error. Alties are fond of quoting a certain notorious calculated study that claimed 100K/year, which is probably 10x what it actually is. I think drug ODs also tend to get conflated, so things like opiates bought illegally without prescription to feed an addiction get thrown in with opiates prescribed by a doctor for severe pain control. (And yes, overprescription of opiates is a problem, but that’s its own discussion.) Unfortunately, a lot of countries treat medical errors as something to be argued for and against by lawyers, creating perverse incentives for the medical profession not to admit its mistakes, which both denies patients fast compensation and prevents those mistakes being analysed and, where human error, processes revised so they can’t happen again (up to and including recognizing incompetent physicians and permanently banning them from practice, and passing their details to the law to deal with as appropriate). The adversarial response also associates bad medical outcomes with medical incompetence in the public’s mind, which is both wrong and counterproductive. So much of medicine is about gauging and balancing risks: the risks of doing too much or not enough, the risks of adverse effects versus therapeutic effects. Should the brain surgeon excising a tumor remove less tissue or more? Less risks leaving cancer cells behind. More increases the damage to the patient’s faculties. Even if the procedure is 100% successful, the patient is left damaged to some degree (which Alties will happily screech about); yet if the procedure is not done then the patient will almost certainly suffer poor QoL followed by death (which Alties conveniently ignore). And then there is the risk that the patient ruptures a blood vessel a few days later; everyone did everything right, but the tissue, fragile from the damage done by both cancer and knife, finally gave way under pressure. The patient dies, or is left vegetative. Is that a medical error? The patient and her doctors gambled on winning her a chance at life, knowing the alternative was certain death if they do nothing at all. But while some will win, it’s a cold hard fact of simple probabilities that some will roll snake-eyes. The callousness of Alties who recruit such personal tragedies into their own quasi-religious lynch mob disgusts me beyond words. But then, if they were capable of subtlety or doubt, they wouldn’t remain such ideological zombies for long. I think countries like Sweden have the right idea: no-fault compensation paid out of insurance; reserving civil suits and criminal proceedings for egregious malpractice and coverups. Oddly, Alties never seem to suggest this as a solution; almost as if they aren’t interested in actually solving the problem at hand. I can’t imagine why…
  • Comment by Edzard on Spinal epidural hematoma caused by spinal manipulation Thursday 21 October 2021: 06:10 “…but these are rare” HOW DO THEY KNOW? there is no PMS and thus nobody knows!
  • Comment by Björn Geir on Spinal epidural hematoma caused by spinal manipulation Wednesday 20 October 2021: 21:10 Seems like you do not understand the issue. No surprise. https://en.wikipedia.org/wiki/Postmarketing_surveillance?wprov=sfti1
  • Comment by has on David Daniel Palmer: the life of a genius or the career of a charlatan? Wednesday 20 October 2021: 20:10 Nope. The AMA lost an antitrust case. The court said the AMA couldn’t obstruct free enterprise, not that chiro was medically valid: The plaintiffs clearly want more from the court. They want a judicial pronouncement that chiropractic is a valid, efficacious, even scientific health care service. I believe that the answer to that question can only be provided by a well designed, controlled, scientific study… No such study has ever been done. In the absence of such a study, the court is left to decide the issue on the basis of largely anecdotal evidence. I decline to pronounce chiropractic valid or invalid on anecdotal evidence. I’m sure @DC, who is a stickler for accuracy, will be happy to confirm here that I am correct and you are wrong. (A court of law is, in any case, not qualified to determine what is and isn’t medicine so, even if the court had said “Chiro is too real medicine”, such an opinion would be worth very little and a serious overstep of the court’s responsibilities and competence.)
  • Comment by has on David Daniel Palmer: the life of a genius or the career of a charlatan? Wednesday 20 October 2021: 19:10 Articles of faith, mindlessly repeated. Much yawn. So bored. Oddly, Alties never progress from “real medicine has problems” (well done, Einstein) to “we should fix those problems and redesign processes so they can’t occur again”, but instead to “let’s burn it to the ground and replace with homeochiroreikitherapy instead”. So, absolutely no hint of duplicitous self-serving agenda there, then. Two-faced twits.
  • Comment by Richard Rasker on David Daniel Palmer: the life of a genius or the career of a charlatan? Wednesday 20 October 2021: 18:10 @Jbzimm All medical doctors do is prescribe pills to cover up symptoms. Um, no. They first listen to patients, diagnose them and try to figure out what is wrong with them. Then they try to correct the problem (e.g. by advising lifestyle changes), or refer the patient to a specialist for further diagnosis and perhaps treatment. Yes, they MAY prescribe pills to mitigate symptoms – but there is nothing wrong with that. If someone is in pain, then doctors can help by prescribing painkillers – but only if the cause of the pain is known. If a patient complains about chest pain, a doctor will NOT just prescribe painkillers to ‘cover up the symptoms’ and send the patient home. And lots of pills actually cure ailments – antibiotics to treat infections are an example. Why can’t medical doctors actually fix the problem. Um, because medicine is VERY HARD? Even after 10 years of hard study and practice, doctors can’t always ‘fix the problem’, simply because there are lots of problems that can’t be fixed (yet). And still they can fix lots of problems – more than ever before in history, in fact. Please also note that it is quacks and charlatans such as Palmer and his ilk who claim that they can fix all problems, easy and without painful treatments. They are all lying. In fact, doctor induced death is a leading cause of death in America This is a myth. Yes, up until about 150 years ago, doctors often did more harm than good. But things have changed dramatically since then, as reflected by a huge decrease in child mortality and an increase in life expectancy, as well as ever more ailments being treatable. Yes, lots of people die when they are in the care of a doctor. This, however, is not because the doctor is the cause of their death, but because these people usually have very serious conditions for which they consult a doctor. And these doctors can’t always help them, let alone prevent death in all cases. No, not all doctors are saints, and some doctors are indeed lazy pill pushers or make serious mistakes – and they should be held accountable and punished for that. But most doctors really try to help their patients the best they can.
  • Comment by DC on Spinal epidural hematoma caused by spinal manipulation Wednesday 20 October 2021: 18:10 current view: “Serious adverse events associated with manipulative therapies are typically defined as conditions that lead to hospital admission or death, but these are rare.” Am Fam Physician. 2019 Feb 15;99(4):248-252.
  • Comment by Edzard on David Daniel Palmer: the life of a genius or the career of a charlatan? Wednesday 20 October 2021: 18:10 “All medical doctors do is prescribe pills to cover up symptoms.” Yes, that’s what many quacks say – but it does not make it right.
  • Comment by Edzard on David Daniel Palmer: the life of a genius or the career of a charlatan? Wednesday 20 October 2021: 18:10 you forgot to mention how long ago this was; since then medicine has moved on, but chiro hasn’t
  • Comment by Jbzimm on David Daniel Palmer: the life of a genius or the career of a charlatan? Wednesday 20 October 2021: 17:10 The American medical board had to sit down and admit they were wrong about chiropractic, after the AMA was sued for misleading the public against chiropractic. The medical doctors lost and were proven to be wrong in their assertions against chiropractic.
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