Health and Medicine – Page 17

How Alternative Medicine Fails Us

rhodiola-rosea I’m forever fending off the alternative medicine brigade who seem to clump around this website and email me all kinds of supposed miracle cures that will spell the end of all health ills. One herbal remedy I recently focused on is Rhodiola rosea, in which I critiqued a promotional email from a vested interest in the product. They made all kinds of claims for this material on the back of very limited clinical trials. Needless to say advocates of alternative medicine commented aplenty.

As a chemist, I take what I hope is a healthy and skeptical view of all the biochemical and physiological claims these people make for their products. I’m just worried that there are so many people who are perhaps desperate to fix their lives that they become easy prey for such marketing. Anyway, for those who feel a chemist has no place criticising their beloved remedy, I turned to a pharmaceutical expert in Sheryl Torr-Brown of the Future Trends in Health blog to provide some additional support for my argument. She has many years experience in pharmaceutical science and has no axe to grind and offers an honest appraisal of my original post and some of the comments left by Sciencebase readers.

A glance at the scientific literature covering this herb seems to be minimal and biased in the main, she told me, and as such she agrees with my argument.

“When dealing with alternative medicine,” she says, “it is not enough to be right if you want to avoid the attacks. You also have to be sensitive to the highly personal views of those who find benefit in the drug albeit most likely due to placebo effect.”

This is perhaps an important point. Yes, the placebo effect is valid, but these remedies are usually very expensive and people are often spending their hard-earned money on what amounts to sugar pills, something that should be avoided perhaps especially in the current economic climate when every penny counts.

“A major point that most of the non-scientific public do not understand is that there is no such thing as a safe drug, natural or not,” adds Torr-Brown, “The dose is the poison, as the father of modern toxicology, Paracelsus said in the fifteenth century. Anything and everything will be toxic if you have enough of it or it gets into the wrong place. Unfortunately, people are tired of Big Pharma advertising and the media frenzy around drug withdrawals.”

She points out that ‘natural’ is sounding better and better to many folks, despite the existence of natural belladonna, natural cobra venom, oh, and natural background radiation. In the age of the Internet, it is now very easy to get positive anecdotes about anything. “Basically, one can decide what one wants to believe and then go find the evidence to support it,” Torr-Brown adds, “For scientists, we look for controlled studies to prove a point, whereas the general public are happy with a personal story or two of success.”

Many people, including several of the original, negative commenters on my R rosea post, are grasping to find something that works for them. “You cannot discount [some of these views] from a human perspective, but it makes no sense scientifically, adds Torr-Brown, “I am shocked by the number of people I know who pay huge amounts of money for the latest panacea only to give it up after a couple of months, usually due to lack of interest.”

Innocent children and the most vulnerable can be hurt the most
Â£200m boom as demand for ‘natural’ cures soars
Rhodiola rosea
How not to do a study on the efficacy of “alternative” medicine
Rhodiola rosea

Sperm, Discharge, Heroin, and Alzheimers

alkaline-batteries Batteries are included (unfortunately) – A chemical cocktail of toxic gases is released when you burn alkaline batteries, according to the latest research from Spain. The investigating team highlights the issue with respect to municipal waste incineration, which is used as an alternative to landfill and suggests that recycling is perhaps the only environmentally viable alternative.

Today, UK government departments BERR and Defra, in conjunction with the Devolved Administrations,
today published a Consultation Document containing draft Regulations setting out proposed systems for the collection, treatment and recycling of waste portable, industrial and automotive batteries.

Cutting heroin analysis – Analysing samples of street heroin just got easier as researchers have developed a statistical method for removing uninformative signals from their near-infra-red spectra of seized samples.

Sperm and eggs – Scientists in Sweden have determined the precise molecular structure of a protein, ZP3, essential to the interaction of the mammalian egg coat and sperm. The work could eventually lead to improved contraceptives, has implications for fertility studies, and might, in some sense, explain how new species arise.

Untangling Alzheimer molecules – Magnetic resonance spectroscopy provides new clues about how a dipeptide molecule blocks the formation of the toxic amyloid beta-peptide aggregates in the mouse brain. The discovery could put paid to the theory that amyloid beta-peptide causes Alzheimer’s disease and suggest a therapeutic lead that focus on the real culprit at an earlier stage.

Alchemy Under the Spotlight

atlantic-bathymetry This week, The Alchemist is digging in the dirt to find out about the carbon cycle and climate change, taking his whisky (or is it whiskey) with or without water, and discovering how to juggle molecules, on the other hand. Also in biochemical news this week, the crystal structure of a plant hormone receptor is revealed while researchers in Israel focus on blocking the protein misfolding that occurs in Alzheimer’s disease.

And, under the December physical sciences Spotlight

It’s all in the marine mix – Mixing of surface waters in the Atlantic Ocean seems to have reverted in the winter of 2007/2008 to “normal” levels for the first time in almost a decade…

Well, wooden you know? – New materials that look and behave like plastics can be produced from a renewable raw material known as liquid wood. The bioplastics promise to displace petroleum as a feedstock for certain applications…

Running with knives – Stabbing is the most common form of murder in the UK and Ireland. However, while forensic scientists understand the basics of the process…

Rx Reviews Redux

A new(ish) website has launched that aims to provide unbiased patient-generated data on the benefits of 7000 prescription medications and their side-effects.

Rateadrug.com hopes to do for pharma products what dooyoo and ciao do for gadgets by bringing the crowd to the debate. Patients can anonymously rate and review any of the prescription drugs they take and view other people’s experiences for free.

“All information on this site is unique, community data that is not biased by pharmaceutical or corporate objectives,” says spokesman Jack Dowd. He adds that, “The site provides patients with truly independent survey results about the risks and benefits of their medications. The more people that start using the site to rate their prescription medications (a quick 5-minute survey), the greater this resource will become.”

Using a prescription drug appropriate to your condition and your genetics can have significant, and often life-saving benefits, but with physicians particularly in the UK and a few other places emphasising how patients should help manage their own illness it is important to know what problems may arise or whether asking for a different prescription might actually be better for them.

Not all medications hit everyone in the same way, because of various factors including your SNPs (single nucleotide polymorphisms), that affect your body’s enzyme and receptor activity. “What’s effective and side-effect free for one person might not be the best drug for someone else, yet most harried doctors prescribe the same drug for 90% of their patients with similar conditions – regardless of individual sensitivities,” the site’s developers say. They hope that Rateadrug will prevent the next Vioxx from happening.

A side project of Rateadrug is involving pre-med students through the PreMed Prescription Rating and Experience Program (PREPP) where the students help senior citizens become more proactive with their drug intake by reporting their experiences through Rateadrug.com.

The site blurb suggests you use the reviews together with your doctor’s advice and FDA disclosures to achieve the best possible outcome for your (or your loved ones) medical condition. Of course, spammers and corporate shills will be readying themselves to distort the results in their favour, unless preventative measures are put in place. “To prevent spam and ensure a real person is taking each survey we require email verification where the user has to click on a link that we email to them,” Dowd told Sciencebase, “We also flag accounts that submit more than one rating for a specific drug. We’re committed to providing quality, real-user data and will continue to ensure that our results are not skewed by spam or anyone trying to influence the results of a specific drug.”

The site also drops a cookie on to your machine so that it knows how many people log in from a specific computer or IP address. If it looks like there are a lot of ratings for the same drug from the same IP address, they will flag those ratings for manual checking.

I asked Dowd to expand on how they are addressing security and validity issues. “At the moment we receive 20 or fewer ratings per day, and carefully review each one,” adds Dowd, “As the volume increases significantly it will become more difficult to impact and distort results – real ratings should outweigh any attempts to skew ratings. But, we will do our best to prevent this type of tampering.”

“Right now, we have a database of over 7000 drugs, but only about 300 have been rated and reviewed by users/patients,” he adds. Dowd and his colleagues hope that as more people find out about this site, the numbers will grow. “Our intention is to provide real ratings by real people and will do everything we can to assure this as we progress,” he told me.

According to CEO Mark Deuitch, RateADrug is currently hoping to get large numbers of patients to review the cholesterol-lowering statin drugs Lipitor, Lescol, Mevacor, Pravachol, and Zocar, anti-depressants such as Lexapro, Prozac, Effexor, Paxil, Zoloft, and Pristiq, and drugs used to treat insomnia including Ambien, Lunesta, Sonata, Rozerem, and Benzodiazepines.

In related news from the UK’s National Health Service: Drug reference information in the British National Formulary will become a key element of the new NHS Evidence portal due to be launched in April 2009. As a result, responsibility for provision of this information for the NHS will transfer from the Department of Health to the National Institute for Health and Clinical Excellence (NICE), as part of the development of NHS Evidence.

Top Ten Mutants

dna-test If you ever thought genetics was only about disease, then check out the popular SNPs list on SNPedia. A SNP (pronounced “snip”) is a single nucleotide polymorphism, which in BradSpeak(TM) is basically a difference in a bit of your DNA that makes you different from the rest.

Anyway, here’s the Top Five SNPs that might be described as having no obvious direct medical importance.

rs1815739 sprinters vs endurance athletes (I reckon I lack both)
rs7495174 green eye color and rs12913832 for blue eye color
rs6152 can prevent baldness (this was discovered far too late for me)
rs1805009 determines red hair (some “comedians” might suggest this be swapped to the second list below)
rs17822931 determines earwax (and presumably how well your ears stay clear of insect infestation)

And, here’s the more sober list of SNPs that could have serious medical implications should you happen to discover you have one of these when you have your genome read by the likes of 23andMe.

rs9939609 triggers obesity (not a genetic excuse for eating too much)
rs662799 prevents weight gain from high fat diets (ditto)
rs4420638 and rs429358 can raise the risk of Alzheimer’s disease by tenfold or more
rs7903146 and rs12255372 linked to type-2 diabetes, the latter also to breast cancer
rs324650 influences alcohol dependence, rs1799971 makes alcohol cravings stronger (it would not be funny to say, “Mine’s a pint, with a whisky chaser”, right now)

It was a twitter discussion between SNP experts mza and attilacsordas that led me to the SNP list.

Shedding Light on Neon Signs

As regular readers know, I like to keep a fairly close eye on what Sciencebase visitors are searching for so that I can put together new posts that provide answers to the questions readers want answering. Recently, there has been a spate of search queries related to neon signs. Perhaps not the most exciting of subjects, but there is some nice chemistry to be learned from all the different colours available, so I thought I’d shed some light on the subject of noble gas illumination.

Incidentally, for those unaware of the history of noble gases, they were at one time known as inert gases because chemists thought their full outer shell of electrons made them unreactive. As more and more reactions for these so-called inert gases were discovered, it became necessary to abandon the “inert” label and focus on their nobility.

A neon light is not really much more than a fluorescent tube (actually, it’s less as it needs no phosphor coating on the inside), neon tubes contain the noble gas neon, surprise, surprise. Pass an electric discharge through a tube containing low pressure neon and it will glow with that familiar orange-red glow, so evocative of late-night bars and sleazy movies.

A neon light uses a very high voltage to propel an electric current through a low-density gas of neon atoms held in a glass tube. Charges from the electrode at each end of the tube fly through the gas colliding frequently with neon atoms and transferring some of their energy to the neon atoms. This kicks the neon atoms into a higher energy, excited state, with an electron in a higher orbital than normal. This excited state does not last and as the electron loses energy the atom drops back to a lower energy state and releases a photon of light. The energy of this photon is equivalent to the energy fall and for neon atoms that coincides with an energy that produces a reddish glow.

Many people, unfamiliar with the noble gas group of the periodic table – the p-block, assume that all coloured fluorescent tubes used in signage are neon signs. However, there are two ways to produce other colours – paint a standard mercury tube with the colour you want or far more effectively use a different noble gas in the tube instead of neon, perhaps together with mercury vapour to give a stronger glow. Here’s a break down of the discharge colours for each noble gas.

Helium (He) – Orangey white, usually
Neon (Ne) – Orange-red glow
Argon (Ar) – Violet, pale lavender blue
Krypton (Kr) – Grayish dim off-white
Xenon (Xe) – Blue-grey
Radon (Rn) – radioactive, not used in lighting

Of course, it is not only the noble gases and mercury vapour that can be added to lighting tubes. Nitrogen produces a slightly pinker glow than argon, oxygen glows violet-lavender but dimly. Hydrogen glows lavender at low currents, but pinkish magenta above 10 milliAmps, while carbon dioxide produces a slight bluish-white. Mercury can be made to glow in the ultraviolet, and is used in so-called black lights. Sodium vapour at low pressure glows the bright yellow of street lighting, particularly in England. And, even water vapour produces a glow similar to hydrogen, only dimmer .

Breast is Best in Melamine Scandal

breastfeeding-baby The melamine in milk scandal continues to draw interest. You recall, across Asia, in particularly in China, infant formula milk was discovered to be contaminated with a starting material for making plastics and fire retardant materials, melamine. Thousands of babies were hospitalised with possible renal failure, and several died.

But, could some good have come out of this scandal? Apparently, breast-feeding rates have bounced back across Asia, according to some reports and a roundtable, Secure nutritious diet: Save children’s lives, organised jointly by Save the Children UK and others is using the melamine scare to help promote the breast is best message. It has been demonstrated time and again that breastfeeding reduces infant mortality rates particularly in the developing world. One wit even suggested that the melamine contamination was done deliberately to promote breastfeeding, a nonsense, obviously.

Others are now reporting that the formula manufacturers are hoping to restrict this renewed enthusiasm for breastfeeding by heavy promotion of their products even if they are in breach of WHO guidelines on marketing of breast milk substitutes.

Others benefiting from the melamine scandal, although not in the same cynical way are chemical analysis companies, who, according to the Boston Globe are seeing improved business as food safety scares raise the profile of state-of-the-art testing equipments, including melamine test kits. The Gainesville Sun even reported on a woman who had developed her own testing kit for melamine.

As was mentioned in a comment on a previous melamine post, the US FDA has updated its import alert on melamine: “Detention without physical examination of all milk products, milk derived ingredients and finished food products containing milk from china due to the presence of melamine and/or melamine analogs.”

Virtual Rehabilitation for MS Sufferers

I recently wrote about how social media might help scientists do their work, so a paper in IJWBS on how those on the receiving end of medical science – patients and healthcare practitioners – might benefit from web 2.0 caught my eye.

IT consultant Maire Heikkinen of University of Tampere, Finland, has focused on how the internet might be used in rehabilitation courses for sufferers of long-term neurological diseases including Multiple Sclerosis (MS).

Today, more than 2,500,000 people have MS, a disorder that affects different areas of the central nervous system and so leads to a wide range of symptoms from blurred vision and numbness to weak limbs, unsteadiness, and fatigue. Periods of relapse and remission are often characteristics of the disease but for other people the disease progressively worsens. Either way, it can limit everyday life seriously and makes for an uncertain future for sufferers and those close to them. “There is no known medical cure,” Heikkinen told Sciencebase, but medicine can help moderate the symptoms and prevent relapses, and rehabilitation can help people considerably.”

Getting hold of useful information about one’s disease, discussing problems, and following rehabilitation schemes, is Heikkinen explains an essential part of the process of healing.The rehabilitation for MS patients has traditionally been face-to-face courses and personal physiotherapy, but the internet has enabled some forms of online rehabilitation.

She has looked at the concept of a virtual community for rehabilitation and, in particular, the opportunities for sociability among participants. She found that peer support and the swapping of experiences were the most important part of the online activities. But, perhaps most intriguingly, the MS patients in her study seemed to have a higher trust level among themselves than is common in some online activities. The participants apparently preferred to get to know each other rather than operating anonymously as is common on other internet rehabilitation and support courses, those for cancer sufferers, she cites.

The internet course Heikkinen studied was “Power and Support from the Net”, which was organised by the Finnish MS Society. While there are those who claim that such virtual communities are somehow worth less than face-to-face contacts, others point out that circumstances and ill-health often prevent people from making direct social contact. It is the virtual nature of “online” that seems to offer a significant advantage in a virtual rehabilitation community, in that people are often more willing to discuss problems online than they would be in a face-to-face meeting.

There is evidence that being online is not the depressing default state that those railing against it would have us believe. Heikkinen’s study certainly suggests this is true with regard to outcomes for MS sufferers involved with PSN.

The internet was shown to be a suitable tool for arranging rehabilitation courses for MS sufferers, she says. The course team could build a virtual community at least for the duration of the course, but it will also be possible to continue the team after the course. The course may thus serve as an initiator for a longer-lasting virtual team that will exist for as long as the participants stay active.

Various researchers have outlined the benefits of online community in the past. Virtual communities are inherently social networks because at the base level they link together people, organisations and knowledge. They can become integrated into our daily lives and, as anyone with an active web 2.0 account knows, the internet can increase our contact with friends, relatives, and other contacts regardless of geography, time, or state of health. Fundamentally, adds Heikkinen, “When computer systems connect people and organisations, they form social networks.”

Maire Heikkinen (2009). Power and support from the net: usability and sociability on an internet-based rehabilitation course for people with multiple sclerosis Int. J. Web Based Communities, 5 (1), 83-104

Melamine in baby formula, an open secret

melamine-eggs Thousands of babies had apparently taken ill having drunk formula milk to which the organic compound melamine had been added. The melamine was being added by unscrupulous operatives somewhere in the milk supply chain, to artificially boost the nitrogen content of the product, and so spoof higher protein levels than are actually present.

Subsequently, lists of contaminated products appeared in the media and on the web and as the melamine scandal widened, the Chinese government issued an apology and promised to crack down on the problem.

However, with news this week that batches of eggs imported into Hong Kong from China have tested positive for melamine, which is suspected of causing kidney problems, it now appears that the compound is being added routinely to animal feed in China. According to the BBC, this news has been released into the Chinese state media by a government realising it has far less control over food standards that it ought to have.

The melamine scandal is not new. It is essentially an open secret in China that the compound is added to all kinds of foods, particularly animal feed and pet food to artificially inflate the protein readings at the so-called quality control stage. Melamine was at the heart of the petfood scandal in 2007, but that was simply the first time that the West learned of the problem. It seems obvious that melamine could have been in the food chain much longer than that.

But, whether the open secret of melamine in the food supply is actually as serious a problem as the media would have us believe is down to toxic dose. AP quotes Peter Dingle, a toxicologist from Murdoch University, Perth, Australia, who says that aside from the tainted baby formula that killed at least four Chinese infants and left 54,000 children hospitalized in September, it is unlikely humans will get sick from melamine. The amount of the chemical in a few servings of bacon, for instance, would simply be too low, he said. But he is not recommending that the practice continue unchecked. China should have cracked down sooner on feed companies he and others have said.

However, if the melamine open secret is as big as it appears from the outside, it is unlikely to be stopped any time soon, particularly because of the heirarchical government system in China. “It could take five or even 10 years” before some companies stop adding the chemical to food products, Jason Yan of the US Grains Council is quoted by AP.

Where to find a four-leaf clover

TL:DR – You might consider yourself lucky to find a four-leaf clover, the aberration in this species of plant occurs in 1 in 10000 specimens. You have a chance of spotting one in a large, well-established patch of clover.

Three-leaf clovers are commonplace. The four-leaf clover is an uncommon variation of the common, three-leaved clover. According to tradition, such leaves bring good luck to their finders, especially if found accidentally. According to legend, each leaf represents something: the first is for hope, the second is for faith, the third is for love, and the fourth is for luck. Actively seeking out a four-leaf clover will not bring you good luck. In fact, there is no such thing as luck, so even if you accidentally find one it’s not going to change your life.

An anonymous visitor to the site emailed me: “I found a 5 leaf clover… do you know anything about it? Is it good luck or bad luck?”

It’s just a mutation, like the four-leaf clover, of course. The four-leaf mutation is quite rare occurring once in about 10,000 specimens. Five is rarer still. But, according to this site: Five-leaf Clovers bring extra good luck and attracts money.

Nice, I wonder why the banks don’t breed these things and hand them out to their managers.

Of course, there is no such thing as “luck” and no number of leaves on a member of the more than 300-strong species of plants in the pea family Fabaceae is going to change that. Clover (Trifolium), or trefoil, usually means three-leafed, hence the surprise when one finds a specimen with four, five or more leaflets. The world record clover is an uber clover with 21 leaflets, although the Guinness record site says 18. At the time of writing, Wikipedia had both figures on two different pages. Intriguingly, both the 18 and 21 leaflet specimens were found/grown by Shigeo Obara, a farmer in Japan’s Iwate prefecture.

Clover is found across the globe, most species are found in the temperate parts of the Northern Hemisphere, but many also occur in South America and Africa, particularly at high altitudes in the tropics. Clovers are small annual, biennial, and short-lived perennial herbaceous plants. To “be in clover” means to be living a carefree life of ease, comfort, and prosperity. But, if you’re due for a drug test make sure you haven’t been drinking milk from cows fed on clover. Clover has a small amount of morphine, which can end up in bottled milk. Eating clover itself can trigger blood and urine drug tests. It’s one more excuse for unlucky athletes caught abusing the system.

Any Irish shamrock (trefoil: God, Son, Holy Spirit) religious analogy doesn’t explain the luck associated with the clover’s fourth leaflet. If anything one would imagine that a fourth leaflet would represent something abhorrent added to the Holy Trinity of Catholicism, the Devil, perhaps, and so be bad luck. Although some say it is meant to represent God’s grace. According to the Wisegeek site, when Adam and Eve left the Garden of Eden, Eve is supposed to have carried a four leaf clover. “Curiously, the lore of the white clover plant is also associated with repelling snakes, though it didn’t seem to work in the Garden of Eden,” the site says. I suspect the snake-repellant aspect comes from the Irish St Patrick legend. Ireland famously has no snakes.

As mentioned above, one important aspect of the four-leaf clover myth is that for it to bring luck you must find it serendipitously, there’s no point in searching for one and certainly no point in buying one; several websites offer for sale hand-picked four-leaf clovers! However, if you were a child in the Middle Ages who found a four-leaf clover you would have been given the gift of being able to see fairies and plant sprites…

It seems that searching for four-leaf and beyond clovers is a perennial favourite among children and if it gets them out in to their gardens or the countryside on a long hike to search for the biggest then that’s no bad thing. Indeed, the exercise and fresh air will no doubt bring them luck by helping to stave off obesity and type 2 diabetes. Just don’t let them pick any dandelions…it’ll make them wet the bed, you know? [Not really, that’s Deceived Wisdom]

The original short version of this post originally appeared on Sciencebase – 2005-05-19. Updated 2017-06-21.

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