By Brian Sutton, DC"Placebo Non-Effect"
For many years, doctors have been taught that a dummy medication can produce an improvement in up to one-third of the patients in a medical study, a phenomenon called the "placebo effect." However, research by Danish scientists is calling this long-held belief into question.The study, published in the New England Journal of Medicine,1 analyzed 114 studies from around the world that, in addition to keeping track of patients given placebos, also tracked patients given no treatment at all. In most of the studies that used objective means to evaluate patients, placebo patients fared no better than patients who received no perceived treatment.
The researchers speculate that flawed logic is to blame for the perception that placebos can help. In studies where patients report a subjective improvement, they may be giving the treatment the benefit of any doubt. Also, those involved in a study may be more careful about their health habits. The authors question the ethics of prescribing placebos (such as antibiotics for the common cold) in any setting other than a controlled medical experiment.
1. NEJM, May 24, 2001.
A report from researchers at the Children's Hospital of Philadelphia suggests that a doctor who checks a child's height may not be taking an accurate measurement. Pediatricians and family doctors erroneously measured two out of three patients (ranging from babies to teenagers) in this study of 660 children. Doctors were off by an average of 3/4 of an inch when a mistake was made, but some measurements were off by as much as 4-1/2 inches. Some of the reasons cited were floppy measuring arms on physician's scales, not requiring the youngsters to remove hats or shoes, high hairdos, or kids being squirmy.2
2. Associated Press, May 3, 2001.
Ecstatic Memory Problems
Research published in the Journal of Neuroscience3 suggests that the drug ecstasy, when used during pregnancy, can result in learning and memory problems. The drug, given to rats at the equivalent of a human's third trimester, produced problems with learning how to navigate mazes that lasted into adulthood.
3. Journal of Neuroscience, May 1, 2001.
Researchers from Brigham and Women's hospital in Boston say that right heart catheterization, a procedure used more than a million times each year, is not only useless, but may be killing people. Their data suggests a three-fold increase in the number of heart attacks and other cardiac problems when the procedure is used.4 Catheterization is used mainly as a monitoring tool for blood pressure, oxygenation, and a number of other statistics during non-cardiac surgeries (such as hip replacements, gall bladder operations, and other procedures), especially when the patient has a history of heart problems. The researchers are not sure if the increased death rate is from the procedure itself or from doctors overreacting to the data obtained.
4. Journal of the American Medical Association, July 18, 2001.
Pesticides and Infertility
A study published in Human Reproduction5 offers further data suggesting that pesticide compounds may be responsible for some of the declining sperm counts around the world. The research was focused on farmers in Argentina, where pesticide use is heavy.
The data shows a significant association between pesticide use and decreased fertility.
5. Human Reproduction, July 27, 2001.
Depression and Heart Failure
Researchers from the Emory University School of Medicine in Atlanta report that the development of congestive heart failure in elderly persons is more likely if the patient is depressed.6
In this study of more than 4,500 patients with high blood pressure, those judged to be depressed were diagnosed with heart failure twice as often. Some suggest that, in borderline cases, stresses created by depression increase the workload on the heart enough to manifest the problem.
6. Archives of Internal Medicine, July 23, 2001.
In June 2001, Connecticut became the first state in the United States to pass legislation aimed at combating the growing abuse of prescription drugs among children in school. The unanimously approved law prohibits teachers, counselors, and other school officials from recommending psychiatric drugs for any child. The school can still recommend that a student be evaluated by a doctor, but it is the doctor who must suggest the mode of treatment.
Many legislators are becoming alarmed at the number of children taking such drugs, which they see as an all-too-easy solution for parents, teachers or doctors who don't want to deal with individual situations. Some schools were even demanding that certain children be medicated before being allowed into the classroom. The federal Drug Enforcement Administration says that, in some elementary and middle schools, as many as six percent of all students are taking these drugs.7
7. Associated Press, July 17, 2001.
Butter Instead of Margarine
This may be old news for many of you, but a study from the Netherlands concludes that butter is better for you than margarine. The study focused on the ability of the volunteers' blood vessels to dilate. The researchers found that dilation was restricted by about 30 percent in the group that consumed trans fatty acids (such as found in margarine or other hydrogenated fats), compared to the butter group. In addition, levels of HDL (good cholesterol) were 20 percent lower.8
8. Atherosclerosis, Thrombosis and Vascular Biology, July 2001.
Bacteria Mixing and Matching
Federal researchers using new technology have verified that any of the 36 most troublesome strains of staphylococcus aureus, and probably most of the other 2,700-plus varieties, are able to swap genetic material from nearby bacteria to help survive in their environment. This includes gaining resistance to antibiotics. The researchers say their work shows that resistance to a given drug is most likely to begin simultaneously or repeatedly in many different geographical locations, not spreading out from a single mutation as previously believed.
These findings are reportedly sending a "wave of terror"9 through the nation's public health officials.10,11
9. Associated Press, quoting Dr. Abigail Salyers, a microbiological researcher at the University of Illinois, July 9, 2001.10. http://www.microbe.org/index.html.11. http://www.eurekalert.org.
Estrogen Drugs Stimulating Ovarian Cancer
Researchers from the University of Southern California report that one of their studies suggests that a drug commonly used in postmenopausal women to prevent osteoporosis may encourage growth of ovarian cancer. The drug, an estrogen supplement called raloxifene, does not appear to affect breast cancers or the uterine lining. However, in a laboratory setting, ovarian cancer cells showed increased growth when exposed to the drug.12
12. Reuters, July 3, 2001, reporting on the work of Dr. Richard Paulson, an OB/GYN professor.
Shark's Fin Soup Danger
A consumer group13 contends that sharks may be more dangerous dead than alive, at least if you use their fins to make soup. It reports that tests performed by the Thailand Institute of Scientific and Technological Research found mercury levels in sample fins up to 42 times the safe limit for human consumption.
Most of the contaminated samples came from Hong Kong, which distributes such products worldwide; however, contamination was also seen in fins from other areas.14
13. Wild Aid, a U.S.-based group.
Elderly Deaths from Medication
A new study of hospital patients in Norway suggests that many elderly people are dying not from disease, but from fatal-side effects of their medications. The project determined that 18 percent of the deaths among the elderly patients studied were due, either directly or indirectly, to the medications they were given. This rate is much higher, say the researchers, than that for the general population. They suggest that doctors take more care when prescribing drugs for older patients with complicated conditions. Most of the deaths resulted from drugs used to treat cardiovascular disease (including circulatory problems) or asthma.15
15. Archives of Internal Medicine, October 22, 2001.
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