Best of the blogs, November – on Science-Based Medicine, Jann Bellamy:
Wrote “FDA strengthens homeopathic drug enforcement (but falls short of actually enforcing the law).”
Posted “Ayurvedic practitioners push for licensing in Colorado.” “…we learn from the Application that Ayurvedic practitioners have taken a page from the chiropractic, naturopathic, and Traditional Chinese Medicine/acupuncture (TCM) playbook and set up a system of organizations that, on their face, mimic those of the medical profession, but are actually designed to incorporate and perpetuate their pseudoscientific belief systems and, via self-regulation, shield them from outside scrutiny.”
David Gorski:
Wrote “Shame on HBO! Bill Maher interviews Dr. Jay Gordon and the antivaccine misinformation flows.”
Published Part 5 of his series on Clinica 0-19, a cancer clinic in Mexico, analyzing new results from a clinical trial.
Harriet Hall:
Discussed the Tonaki Tinnitus Protocol, a mixture of ingredients claimed to stop tinnitus, but with no convincing evidence in support.
Wrote “Aging: Is it a preventable disease?” Work of David Sinclair was discussed. “I sincerely hope Sinclair will be proven right, that aging is a treatable and preventable disease, that the human lifespan has no limits, and that the elderly can be treated to maintain youthful standards of health and activity. But I’m not convinced by his arguments. I would have to see better evidence before I would embark on a regimen like Sinclair’s. Meanwhile, there are plenty of evidence-based actions we can all take to better our health, like exercising, eating a nutritious diet, avoiding tobacco, and controlling weight.”
Posted “SeroVital: Dubious anti-aging claims.” “SeroVital is marketed as an anti-aging remedy that works by raising human growth hormone (HGH) levels naturally with amino acids. The research consists of one preliminary study that measured HGH levels. There is no clinical evidence that it is effective for anything.”`
Sam Homola:
Posted “Upper Cervical Chiropractic: NUCCA - The Legacy of HIO.” “…I often receive letters from patients who have doubts about the validity of a treatment which requires that every patient have an atlas adjustment for whatever problem the patient might have, including low-back pain.”
Steven Novella:
Wrote “Zapping a cold with copper.” “My final assessment is that the copper zapper is another ‘snake oil’ type product with unsupported clinical claims. The basic science is real, however, and the idea is not entirely unreasonable, but we would need to do clinical trials to answer all the practical questions I listed above.”
Discussed unfavorable interactions between “Herbal products and cancer treatment.” “One thing to keep in mind is that when manipulating a complex dynamic homeostatic system, such as the body, in either a healthy or disease state, figuring out the net effects of any intervention is extremely difficult. It takes decades of research by experts thinking very carefully to calibrate the proper balance, and then individualizing that information to each specific patient. While doing this, it is generally not helpful for the patient to be interfering with the whole process by taking poorly regulated products often with unknown ingredients, of highly dubious quality control, and in doses that are essentially anyone’s guess.”
Posted “Scientific fraud in China.” “…we need to look at all research coming out of China with an especially careful eye. The system is broken, and cannot be given the benefit of the doubt.”
Grant Ritchey:
Wrote “Maternal fluoride and IQ – the scientific community pushes back.”
On Respectful Insolence, “Orac”:
Focused on antivaccination efforts. The Nov. 1 post, “Molecular mimicry: The new old antivaccine abuse of science,” related to claimed adverse effects of the HPV vaccine spread by Robert Kennedy Jr. The Nov. 7 post was “Tetyana Obukhanych swings at the measles immune amnesia studies—and whiffs!” “Using a combination of cherry picked science, red herrings, and a fairly decent Gish gallop, she weaves a pseudoscientific tale of misinformation that is likely to be very effective at keeping wavering antivaxers from entertaining too many doubts based on these new findings about the measles virus.” On Nov. 12 he wrote “Antivaxers are targeting minorities with their misinformation and conspiracy theories.” The Nov. 28 post concerned “Jami Hepworth (a.k.a. Skeptical Doctor’s Wife): The latest antivaccine activist on the block.” “She’s appealing to the false authority of being a doctor’s wife, and she’s even more ignorant of science than the average antivax activist.”
Edzard Ernst:
Dealt with chiropractic in six posts. Three (Nov. 12, Nov. 16, Nov. 19) dealt with the death of a patient following chiropractic neck manipulation. David Gorski also discussed the case on Science-Based Medicine. The Nov. 21 post was “Chiropractic spinal care for children is dangerous, unwarranted and must cease immediately.” On Nov. 22 he posted “Chiropractic spinal manipulation shows promise to alleviate symptoms of infant colic? Surely not!” The Nov. 30 post discussed a survey of Canadian chiropractic clinic websites showing that 33% “presented a theory of vertebral subluxations,” which was supposedly related to dozens of different conditions (Marcon et al. Arch Physiother. 2019 Nov 13;9:11 Paper).
Posted twice concerning homeopathy. On Nov. 5 he reported that “The FDA has sent more warning letters to homeopathic manufacturers.” On Nov. 20 he criticized a Bavarian government plan “for research to determine whether the over-use of antibiotics can be reduced by replacing them with homeopathic remedies.”
Discussed “A large-scale multisite effectiveness trial of Reiki.” “Without a control group, the study cannot even attempt to determine anything like the effectiveness of Reiki. What the results truly show is that consumers who consult (and pay) a Reiki master expect [it] to have a positive effect…”
Wrote about a study of effects of intercessory prayer on “psychological, spiritual and biological scores of breast cancer patients who are undergoing radiotherapy.” “The write-up of this study is very poor and most confusing…If I understand it correctly, the positive findings relate to changes within the experimental group. As RCTs are about compating one group to another, these changes are irrelevant. Therefore (and for several other methodological flaws as well), the conclusion that IP generates positive effects is not warranted by these new findings. Like all other forms of paranormal healing, IP is implausible and lacks support of clinical effectiveness.”
Posted “An ethicist, feminist view on so-called alternative medicine (SCAM).”
November – The European Academies Science Advisory Council and the Federation of European Academies of Medicine issued a Statement on traditional Chinese medicine (link to pdf file), in response to the World Health Organization proposing the inclusion of TCM in its International Classification of Diseases coding (ICD-11). Among the comments were: “Concepts of body and disease used in TCM have not been substantiated by conventional scientific investigation. This lack of a science base often makes TCM mechanisms and claims neither verifiable nor falsifiable by scientific experimentation. In Europe it is difficult to reconcile TCM with mainstream medicine and its frameworks for regulation. Moreover, TCM practitioners may disagree on what treatment would be appropriate for a particular patient and there is also often disagreement in making a diagnosis.” Edzard Ernst discussed the findings in his post entitled “European experts demand consistent proof of efficacy, safety and quality for TCM.”
November – Snyder and Cohen published “Medical Crowdfunding for unproven medical treatments: should GoFundMe become a gatekeeper?” (Hastings Cent Rep. 2019 Nov;49(6):32-38 Abstract). “The campaigns mislead donors, spread misinformation, and may even harm those receiving the money.” “Insofar as these campaigns are supporting the operations of businesses that engage in illegal activities, defrauding their customers, and potentially harming health, these campaigns lead to outcomes that justify prohibiting them.” On Science-Based Medicine, David Gorski commented in his post “How do we stop crowdfunding sites like GoFundMe from being used to fund quackery?”
November – Harriet Hall wrote “Whither Chiropractic” for Skeptical Inquirer (43(6):24-6 (2019)) (subscription required). She notes that chiropractors have set themselves as providers of many additional services. “It seems to me all this amounts to a tacit admission that they have realized chiropractic is inadequate.” She also notes an effort to reform chiropractic and “limit practice to short-term evidence-based treatments of selected musculoskeletal problems…The problem with reforming chiropractic is that it becomes indistinguishable from what physical therapists do…”
November – Agnihotri and Greenberger published “Unproved and controversial methods and theories in allergy/immunology” (Allergy Asthma Proc. 2019 Nov 1;40(6):490-3 Abstract). They wrote, “Unproved and controversial methods and theories do not have supporting data, validation, or sufficient scientific scrutiny, and they should not be used in the practice of allergy/immunology. Some examples of unproven theories about allergic/immunologic conditions include allergic toxemia, idiopathic environmental intolerance, and toxic disease from indoor molds. Unconventional diagnostic methods for allergic conditions include cytotoxic tests, provocation-neutralization, electrodermal diagnosis, applied kinesiology assessments, chemical analysis of body fluids, and serum immunoglobulin G (IgG) or IgG4 testing. Unproven treatments and intervention methods for allergic/immunologic conditions include acupuncture, homeopathy, halotherapy, and autogenous urine injections.
November – Fraguas and others reviewed “Dietary interventions for autism spectrum disorder” (Pediatrics. 2019 Nov;144(5). pii: e20183218 Paper). The authors concluded, “This meta-analysis does not support nonspecific dietary interventions as treatment of ASD but suggests a potential role for some specific dietary interventions in the management of some symptoms, functions, and clinical domains in patients with ASD.” Commentary by Weitlauf et al. (Pediatrics. 2019 Nov;144(5). pii: e20191680 Preview) was somewhat more skeptical of the specific interventions noted. “Ultimately, Fraguas et al best support the assertion that there is little evidence to support the use of nutritional supplements or dietary therapies for children with ASD, which has been the conclusion of other reviews and analyses.”
November 7 – Tran wrote “Firehosing: the systemic strategy that anti-vaxxers are using to spread misinformation.” “Anti-vaxxers keep telling the same obvious lies without shame, despite being debunked and factchecked.”
November 11 – Perry and others published “An overview of systematic reviews of complementary and alternative therapies for infantile colic.” (Syst Rev. 2019 Nov 11;8(1):271 Paper). “Probiotics, fennel extract and spinal manipulation show promise to alleviate symptoms of colic, although some concerns remain. Acupuncture and soy are currently not recommended. The majority of the reviews were assessed as having high or unclear risk of bias and low confidence in the findings.” [However, with respect to spinal manipulation, note the Nov. 21 Edzard Ernst item above, which states that chiropractic manipulation for colic “is a dangerous practice in itself and it potentially impedes the proper assessment and management of an infant.”]
November 12 – Goldenberg and others published a Cochrane review of “Biofeedback for treatment of irritable bowel syndrome” (Cochrane Database Syst Rev. 2019 Nov 12;2019(11).CD012530.pub2 Abstract). They wrote “We conclude that the existing data on biofeedback for IBS are limited and leave us uncertain about its value in IBS symptom management. The studies currently available all have design limitations that make the results difficult to apply to clinical settings. We do, however, recommend further study in this area, as biofeedback could represent a unique approach for a difficult to manage condition.”
November 18 – An article on turmeric supplements appeared in The Medical Letter (61(1585):185). The conclusion was: “Large randomized controlled trials supporting the efficacy of turmeric are lacking for any indication. Turmeric may interact with drugs taken concomitantly and may cause bleeding and iron deficiency anemia.”
November 27 – Wolfe wrote “New study says some marketers of brain boosting supplements are flouting an FDA ban.” Companies are selling supplements containing piracetam despite risks of adverse effects and little evidence of effectiveness.
Best of the blogs, December – on Science-Based Medicine, David Gorski:
Wrote “Would you pay $1 million to enroll in a phase 1 clinical trial of an 'anti-aging' gene therapy?” “The bottom line is that I view Libella’s clinical trial to be profoundly unethical…Libella’s marketing of its pay-to-pay [sic; should be “play”] antiaging clinical trial is so egregiously overblown that even enthusiastic advocates of ‘life extension’ and ‘radical antiaging’ treatments have problems with Libella’s marketing of it…”
Posted “Spinning a negative acupuncture study: Same as it ever was.” The study involved radiation-induced xerostomia (Garci et al. JAMA Netw Open. 2019 Dec 2;2(12):e1916910 Paper. See also Comment from Karst and Li. JAMA Netw Open. 2019;2(12):e1916929). True acupuncture gave better results than sham at a Chinese center but not at an American center. Gorski feels that the most likely explanation relates to the fact that “more than 98% of all acupuncture clinical trials from China are positive.” Edzard Ernst also commented on the study. “In essence, trial therefore confirms that acupuncture is little more than a theatrical placebo, particularly if we consider the US data which, in my opinion, are more trustworthy.”
Published “NCCIH surveys physicians on their recommendation of ‘complementary health approaches,’ with depressing results.” “Over 50% of physicians have recommended a CHA in the last year. Of course, these numbers are inflated, as they are with all such surveys, by the inclusion of a modality like massage…Massage, when properly done, feels good, and that should be enough for its use. There’s also nothing ‘complementary” or “integrative’ about it. If massage can be used to relieve pain or loosen joints, it’s part of medicine…” Concerning the report, he wrote: “Expect it to be used to argue how popular CAM is, how many doctors accept it, and thus to argue to policymakers and insurance companies that CAM should be reimbursable by government and private health insurance plans.” Edzard Ernst also discussed the survey. “Who cares what type of SCAMs [so-called alternative medicines] US physicians recommended to their patients 7 years ago? And who knows what the true figures would have looked like, if the ~40% who did not respond would have been included? Such surveys usually tell us little of relevance. What is worse, they are misused for exploiting the ‘appeal to authority’ fallacy which hold that, if physicians recommend SCAMs, they must be fine.”
Wrote “’Natural health’ and the antivaccine movement: The case of Dr. Joseph Mercola.”
Harriet Hall:
Wrote “Alternative medicine: Placebos for pets.” “A skeptical veterinarian reviews the evidence for alternative medicine for pets, and concludes it’s mostly placebos.”
Discussed “Supplements with multiple ingredients, many with no apparent rationale.”
Reviewed the book A Grain of Salt: The Science and Pseudoscience of What We Eat, by Joe Schwarcz.
Posted “Ellura: A supplement backed by evidence.” “Ellura is a dietary supplement marketed to treat recurrent urinary tract infections. There is promising evidence and a credible mechanism of action, and using it instead of antibiotic prophylaxis could reduce antibiotic resistance.”
Wrote “Elderberry elixir for the common cold.” “The research on elderberry for colds and flu is promising, but better evidence is needed... While standardized elderberry extracts are generally recognized as safe (GRAS) by the FDA, homemade preparations may be poisonous. The commercial preparations have not been tested in long-term studies or in pregnancy, and precautions are advised. Prolonged use (more than 12 weeks) or use during pregnancy and breastfeeding are not advised; and patients with autoimmune diseases are advised to avoid elderberry because stimulating the immune system might be expected to make symptoms worse.”
Steven Novella:
Wrote “Decision Against Spelling to Communicate – A Small Victory for Science.” The pseudoscientific method “is essentially a form of facilitated communication (FC).”
On Respectful Insolence, “Orac”:
Had three posts on antivaccination efforts. The Dec. 10 post was entitled “Sherri Tenpenny and James Grundig: Desperately denying that measles kills.” On Dec. 17 it was “Gayle DeLong responds to the retraction of her dumpster fire of a study on HPV vaccination and fertility.” The Dec. 19 post was “What causes ALL [acute lymphoblastic leukemia]? An antivaxxer says—surprise!—it’s vaccines.”
Wrote “The Lung Institute and the stem cell hard sell.” “Every single for-profit stem cell clinic is a quack clinic scamming patients…If there is an exception to this rule of thumb, I have yet to find it, and I’ve been looking for a decade now. For-profit stem cell clinics charge large amounts of money for unproven and potentially risky treatments…”
Edzard Ernst:
Posted four times on chiropractic. The Dec. 3 post was “Chiropractic spinal manipulation of children: an independent review.” “Based on this review of effectiveness, spinal manipulation of children cannot be recommended for: headache, asthma, otitis media, cerebral palsy, hyperactivity disorders, torticollis. The possible, but unlikely, benefits of spinal manipulation in the management of colic or enuresis should be balanced by the possibility, albeit rare, of minor harm.” The Dec. 4 post dealt with chiropractic maintenance care, which he feels “is not supported by sound evidence for effectiveness; as chiropractic manipulations are costly and not risk-free, its risk/benefit balance fails to be positive. Therefore, this approach cannot be recommended.” On Dec. 6 he discussed two reviews dealing with back pain, one showing the benefits of exercise, the other showing that there was no conclusive evidence favoring spinal manipulation compared to exercise. Ernst concluded “Exercise is preferable to chiropractic and other manipulating SCAMs [so-called alternative medicines] because: It is cheaper; It is safer; It is readily available to anyone; And you don’t have to listen to the bizarre and often dangerous advice many chiros offer their clients.” The Dec. 26 post was “Surprise, surprise! Chiropractors recommend chiropractic management of neck pain.”
Had three posts dealing with traditional Chinese medicine. The Dec. 2 post was “Tiger balm: not free of adverse effects and not supported by convincing evidence.” The Dec. 11 post, “Death by Traditional Chinese medicine (TCM),” dealt with a fatality from a remedy containing realgar, an arsenic mineral. On Dec. 13 he wrote “The 1st Chinese herbal medicine with a UK license,” concerning Sigesbeckia. He could find no clinical trials in support. “I would nevertheless have thought that, 4 years after obtaining a license, the manufacturer could have conducted a study to test whether the product works. In my view this should be a moral and ethical, if not legal obligation.”
Discussed etiopathy. “Founded in 1963 by the French Christian Trédaniel, etiopathy is a method of reasoning to determine the causes of a health problem and remove them acting on them. Etiopathy seems particularly popular in France, but is now slowly making inroads also elsewhere…etiopathy is a SCAM like many others – plenty of hot air, fantasy and hype combined with an absence of science, evidence and data.”
Discussed a review suggesting that integrative medicine can reduce opioid use for chronic pain. Ernst found flaws in the review, and concluded that the way to reduce opioid use is to prescribe less opioids, not rely on so-called alternative medicine.
Wrote “Shark cartilage: trust supplements at your peril.” The products are not good for cancer or any other condition. A study of products sold in the US found that “48% of the samples had at least one instance of non-compliance with labeling regulations.” “In summary, it seems that shark cartilage supplements are bad for all concerned: Patients who rely on them might hasten their death; Sharks are becoming an endangered species; Consumers are being mislead and misinformed. There is just one party smiling: the supplement manufacturers who make a healthy profit destroying the health of gullible consumers and patients.”
Posted “Carbon 60: the new ‘cure all’? Although it is marketed as a dietary supplement with numerous supposed benefits, Ernst found only two clinical trials, both involving application to the skin.
In response to those who think he has only negative remarks about alternative medicine, supported the idea that “Autogenic training is an effective therapy for managing stress.”
Wrote “The anti-vaccination movement is financed by the dietary supplement industry.”
Reprinted an article from 20 years ago, “So-called alternative medicine (SCAM): if it sounds too good to be true, it probably is,” and noted that little has changed since then.
December – Fasinu and Rapp published “Herbal Interaction With Chemotherapeutic Drugs - A Focus on Clinically Significant Findings” (Front Oncol. 2019 Dec 3;9:1356 Paper). They concluded that “It is therefore prudent and advisable to avoid the concomitant use of anti-cancer drugs and herbal products, especially echinacea, garlic, ginseng, grapefruit juice, milk thistle, and St John's wort.”
December – A review by Doll and others (Neuropediatrics. 2019 Dec;50(6):346-352 Abstract) concluded that “Acupuncture appears to be safe and effective for the treatment of migraine in children.”
December – Lohani and others reviewed “Immunomodulatory actions of a Polynesian herb Noni (Morinda citrifolia) and its clinical applications” (Complement Ther Med. 2019 Dec;47:102206 Abstract). They wrote: “Our results indicate that Noni is beneficial for various diseases with its crude extracts showing therapeutic benefit for a wide range of pathological diseases. We believe that further pharmacological and toxicological studies in addition to well-designed controlled clinical trials can validate Noni to be an effective and novel natural product for prophylactic and therapeutic use of several diseases.”
December – A review by Moradi et al. (Complement Ther Med. 2019 Dec;47:102211 Abstract) concluded that “Spirulina supplementation significantly reduces body weight, especially in obese individuals.”
December 5 – The Federal Trade Commission reached a settlement preventing misleading claims for Synovia, a dietary supplement alleged to provide relief from arthritis Press release. According to the FTC, the company “lied to consumers about the product’s results and also used fake testimonials and fake doctor endorsements.”
December 6 – Exosomes are small vesicles released from cells. Currently some clinics are using these as a basis for delivering supposedly beneficial materials in the treatment of disease. The Food and Drug Administration issued a Public safety notification on exosome products. “There are currently no FDA-approved exosome products. Certain clinics across the country, including some that manufacture or market violative ‘stem cell’ products, are now also offering exosome products to patients. They deceive patients with unsubstantiated claims about the potential for these products to prevent, treat or cure various diseases or conditions. They may claim that they these products do not fall under the regulatory provisions for drugs and biological products – that is simply untrue.” Jann Bellamy discussed the topic on Science-Based Medicine. Referring to stem cell biologist Sean Morrison, she notes, “According to Dr. Morrison, the disagreement over whether exosomes have a physiologic function or if they are simply ‘just some cellular waste product’ continues. He added that even the methods for purifying exosomes grown from culture are controversial among scientists ‘raising questions about what’s in the vials being used in treatment.’ ‘What these snake oil salesmen do is they pick a word out of the scientific literature that gets people excited, and they start to sell it,’ Morrison told MedPage Today.”
December 6 – Another FDA warning dealt with umbilical cord blood products Press release. Products from Liveyon were unapproved and had “significant deviations from current good tissue practice (CGTP) and current good manufacturing practice (CGMP) requirements,” putting patients at risk.
December 7 – Weill reported that “Alan Keyes Is Helping Sell a Toxic Bleach ‘Cure’ to the Vulnerable and Desperate.” The supposed remedy, containing chlorine dioxide, is known as Miracle Mineral Solution.
December 10 – Stone wrote “Whole Foods is selling dangerous anti-vaccine propaganda in its checkout aisles.” Orac also discussed the story on Respectful Insolence. “In the end, Whole Foods’ letting the distributors of a couple of free magazines that promote “natural” quackery is just part of the package that is Whole Foods’ promotion of nonsense. Of course Whole Foods stocks these sorts of free rags! It sells homeopathy, supplements, ‘detox’ cleanses, gluten-free everything, whether it ever had gluten in it or not or whether it’s even meant to be consumed. Antivaccine pseudoscience is part and parcel of the whole package...”
December 18 – A column on Skeptical Raptor was entitled “Ex-scientist James Lyons-Weiler publishes junk science about vaccines.” The column dealt with the allegation that vaccines contain toxic levels of aluminum. Orac also discussed the issue on Respectful Insolence.
December 19 – Cohen and Bass wrote “Injecting Safety into Supplements - Modernizing the Dietary Supplement Law” (N Engl J Med. 2019 Dec 19;381(25):2387-9 Preview). They called on manufacturers to submit all product labels to FDA, and be required to “submit basic safety data for all new ingredients.”
December 24 – Paley and Johnson published “Acupuncture for the Relief of Chronic Pain: A Synthesis of Systematic Reviews” (Medicina (Kaunas). 2019 Dec 24;56(1). pii: E6 Paper). The authors reviewed 177 previous systematic reviews. “The large quantity of RCTs [randomized controlled trials] on acupuncture for chronic pain contained within systematic reviews provide evidence that is conflicting and inconclusive, due in part to recurring methodological shortcomings of RCTs.” David Gorski discussed the review on Science-Based Medicine, in a post entitled “More evidence that acupuncture doesn’t work for chronic pain.” Edzard Ernst also commented: “This is a most valuable addition to the literature about acupuncture. It can serve as a reference for all who are interested in an honest account of the (lack of) value of acupuncture in the management of chronic pain. If a therapy has been tested in hundreds of (sadly often flawed) trials and the conclusions fail to come out clearly in favour of it, it is most likely not a very effective treatment. Until we have data to the contrary, acupuncture should not be considered to be an effective therapy for chronic pain management.”
Additions to earlier pages
September, 2019 – The National Lipid Association Nutrition and Lifestyle Task Force published “Review of current evidence and clinical recommendations on the effects of low-carbohydrate and very-low-carbohydrate (including ketogenic) diets for the management of body weight and other cardiometabolic risk factors” (J Clin Lipidol. 2019 Sep - Oct;13(5):689-711 Paper). “Based on the evidence reviewed, low-CHO and very-low-CHO diets are not superior to other dietary approaches for weight loss. These diets may have advantages related to appetite control, triglyceride reduction, and reduction in the use of medication in T2D management. The evidence reviewed showed mixed effects on low-density lipoprotein cholesterol levels with some studies showing an increase. There was no clear evidence for advantages regarding effects on other cardiometabolic risk markers.”
October, 2019 – A review of green-coffee extract for obesity was published by Gorji et al. (Phytomedicine. 2019 Oct;63:153018 Abstract). “The results of current meta-analysis study support the use of GCE supplementation for the improvement of obesity indices, with sub-group analysis highlighting greater improvements in individuals with a starting BMI ≥25 kg/m2.”
October 2, 2019 – Meyer and others wrote “Unravelling functional neurology: does spinal manipulation have an effect on the brain? - a systematic literature review” (Chiropr Man Therap. 2019 Oct 2;27:60 Paper). “The available evidence suggests that changes occur in ‘brain function’ in response to spinal manipulation but are inconsistent across and - sometimes - within studies. The clinical relevance of these changes is unknown. It is therefore premature to promote the use of spinal manipulation as a treatment to improve ‘brain function’.”
October 4, 2019 – Abu and others published “Religious practices and long-term survival after hospital discharge for an acute coronary syndrome” (PLoS One. 2019 Oct 4;14(10):e0223442 Paper). They found that the practices were not associated with post-discharge survival. Edzard Ernst commented on the review. “Personally, I don’t consider prayer as a therapy. Those who do, might now have to concede that yet another SCAM [so-called alternative medicine] has been shown to have no positive effects on post-operative survival.”