MARCH-APRIL 2013 NEWS

March - an issue of Psychiatr. Clin. North Am. discussed omega-3 fatty acids, St. John’s wort, Ginkgo biloba, tai chi, and qigong. Mischoulon and Freeman (36, 15-23 (2013) Abstract) reported encouraging results for the use of omega-3 fatty acids, especially eicosapentaenoic acid (EPA), for depression. Sarris (36, 65-72 (2013) Abstract) concluded that “Evidence supports the use of St. John’s wort (SJW) for the treatment of mild-to-moderate depression and somatization disorder, with tentative support in seasonal affective disorder (SAD). Evidence does not support the use of SJW for anxiety disorders, attention-deficit hyperactivity disorder (ADHD), or other psychiatric illnesses.” Diamond and Bailey (36, 73-83 (2013) Abstract) concluded that “ginkgo has the potential to provide a safe alternative and complementary tool in treating a variety of symptoms and disorders,” especially as related to dementia. There is, however, an increased risk of bleeding associated with its use. Abbott and Laveretsky (36, 109-119 (2013) Abstract) found that there was some evidence that tai chi and qigong are useful for treating mental disorders, including depression, stress, anxiety, and mood disorders. However, the evidence is not strong.

March - the Institute for Science in Medicine has related a White Paper by J. Mercer entitled “Attachment Therapies and Associated Parenting Techniques” (pdf file available at: http://www.scienceinmedicine.org/policy/papers/). Attachment Therapies attempt to treat childhood mental disturbances by “re-enactment of typical episodes of early infancy.” They are lacking in evidence of effectiveness and are potentially harmful.

March - a study found that osteopathic manual therapy provided short-term reduction in chronic low back pain (Licciardone et al., Ann. Fam. Med. 11, 122-129 (2013) Paper).

March - some alternative practitioners use 2,3-dimercaptopropane-1-sulfonate (DMPS), as a topical preparation (transdermal) intended to treat autism by chelation of mercury. Cohen and others demonstrated that transdermal DMPS is not absorbed and does not increase mercury excretion (J. Med. Toxicol.9, 9-15 (2013) Abstract). Thus, the treatment is unlikely to be effective in chelation. (Moreover, autism is not caused by mercury poisoning, so the premise of the method is unfounded.) McKay provides a Commentary (pp. 1-3).

March 4 - Park and others reviewed the use of acupuncture for ankle sprains (BMC Complement. Altern. Med. 13, 55 (2013) Paper). They found that the quality of studies performed to date was poor, such that “the evidence is insufficient to recommend acupuncture as an evidence-based treatment option.”

March 7 – A Report by Begley and Respaut questioned the survival data of Cancer Treatment Centers of America. CTCA promotes the idea of “integrative cancer care,” combining conventional and unconventional methods. According to the report, the survival data published by CTCA are misleading because they select patients who are more likely to survive longer (for example, with fewer elderly or underinsured patients). “Orac” provides additional commentary on the Respectful Insolence blog.

March 23 – A meta-analysis of studies involving nearly 50,000 subjects, followed for five years, found that folic acid supplementation did not affect the incidence of cancer (Vollset et al., Lancet 381, 1029-1036 (2013) Paper). Miller and Ulrich provide a Comment on the paper (pp. 974-975).

March 26 – Results from a 2011 conference on glucosamine and joint health were published (Henrotin et al., BMC Res. Notes 6, 115 (2013) Paper). Rather than deal with the issue of effects of glucosamine on existing arthritis, the focus was on prevention of cartilage ageing and joint health. At present there is not convincing evidence of an effect in healthy subjects. Moreover, plasma levels of glucosamine obtained after large oral doses are far lower than used in laboratory studies of cells and tissues.

March 27 – Lamas and others reported results of a large controlled trial (the TACT trial) of chelation therapy for heart disease (JAMA 309, 1241-1250 (2013) Paper) News story. Subjects had previously had a myocardial infarction, and were treated with chelation or placebo. Using a composite endpoint representing adverse cardiovascular events, there appeared to be a small benefit of chelation, “but not sufficient to support the routine use of chelation therapy.” In an accompanying Editorial, Bauchner and others (pp. 1291-1292) reiterated that the results were insufficient to recommend chelation, and noted “Whether chelation therapy may have any role in the prevention and treatment of cardiovascular disease remains to be determined.” Another Editorial, by Nissen (pp. 1293-1294), was more critical, noting several limitations of the study: inclusion of investigators and sites using unscientific methods; differences in withdrawals between groups, suggesting unmasking of treatment assignments; and the use of a composite endpoint heavily influenced by the less reliable components. Nissen concluded that “the results cannot be accepted as reliable and do not demonstrate a benefit of chelation therapy.” Results from the study were announced at a meeting in November, 2012; our November 4 item from November-December 2012 News provides further discussion.

April – The compound resveratrol, found in red wine, has been suggested to have a variety of beneficial effects, based on studies in animals. Poulsen and others tested the effects of resveratrol supplements on aspects of metabolism related to diabetes in obese men (Diabetes 62, 1186-1195 (2013) Paper). No effects were observed. The authors conclude that the result “raises doubt about the justification of resveratrol as a human nutritional supplement in metabolic disorders.” Crandall and Barzilai provide a Commentary (pp. 1022-1023).

April – Reflexology is an unscientific healthcare method that proposes that stimulation of specific areas of the foot brings about effects on specific organs in the body. Jones and others reviewed studies on whether reflexology has specific hemodynamic (blood flow) effects (J. Complement. Altern. Med. 19, 319-328 (2013) Abstract). Although hemodynamic effects of reflexology were shown, they were nonspecific and not shown to be different from general effects of massage.

April – A review concluded that mud pack therapy was useful for treatment of knee osteoarthritis (Espejo-Antúnez et al., Rheumatology 52, 659-668 (2013) Paper).

April 2 – A trial of the use of acupuncture for treatment of Bell’s palsy found that the stronger the sensation of de qi, the greater the therapeutic effect (Xu et al., CMAJ 185, 473-478 (2013) Paper). However, since no sham acupuncture was used, placebo effects cannot be ruled out.

April 8 and 9 – According to Consumer Health Digest, “On March 28, the Dr. Oz Show featured a demonstration purporting to show that brushing the teeth that contain amalgam fillings releases toxic levels of mercury vapor within the mouth. Two articles that explain why this demonstration was misleading have been published.” These are: Baratz and Barrett on Dental Watch and Barrett on Quackwatch.

April 22 – A study of nearly 400,000 subjects concluded that “high intake of supplemental calcium is associated with an excess risk of CVD [cardiovascular disease] death in men but not in women” (Xiao et al., JAMA Intern. Med. 173, 639-646 (2013) Paper). A Commentary by Larsson (pp. 647-648) discusses the findings First page.