Consumer Health Digest #19-32
Your Weekly Update of News and Reviews
August 11, 2019
Consumer Health Digest is a free weekly e-mail newsletter edited by William M. London, Ed.D., M.P.H., with help from Stephen Barrett, M.D. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making. Its primary focus is on health, but occasionally it includes non-health scams and practical tips.
Burns reported after vaginal steaming. A gynecologic reconstructive surgeon has reported the first documented case of a 62-year-old woman who sustained severe burns after following these instructions from a traditional Chinese doctor for vaginal steaming treatment: (a) mix an herbal medicine blend in a pan of boiling water, (b) place the pan on the rim of the toilet bowl, (c) sit on the toilet seat for 20 minutes. The woman repeated the treatment on two occasions one day apart in an attempt to reduce her severe vaginal prolapse. She then sought emergency department care for burns to her uterine cervix and vaginal mucous membranes. [Magali R. Second-degree burn sustained after vaginal steaming. Journal of Obstetrics and Gynecology Canada 41(6):838-839, 2019] Vaginal steaming (also known as v-steaming) has been used traditionally in some Asian and African cultures but is now a popular health spa treatment. It has been promoted by actress Gwyneth Paltrow, her lifestyle brand Goop, and US model Chrissy Teigen. "Vaginal cleansing" and other alleged benefits of v-steaming remain unproven. Women's health experts advise against using the procedure. [Warnings after woman is burned by 'vagina steaming.' BBC News, Aug 8, 2019]
Doubts raised about clinical trial of acupuncture for angina. Edzard Ernst, MD, PhD and Steven Novella, MD have raised doubts about a randomized clinical trial to examine the safety and efficacy of acupuncture as an adjunctive therapy for patients with chronic stable angina (chest pain due to impaired blood supply to the heart). The study included 398 patients who were treated three times a week for four weeks or placed on a wait-list during the study. Researchers compared (a) acupuncture at supposedly relevant acupoints on supposedly correct meridians, (b) acupuncture at supposedly irrelevant acupoints on incorrect meridians, (c) sham acupuncture, and (d) a wait-list control group in terms of frequency of angina attacks every four weeks during a sixteen-week period. Researchers found that patients who received acupuncture at supposedly relevant acupoints had fewer angina attacks than patients in the other groups while adverse events were only mild or moderate. [Zhao L. and others. Acupuncture as adjunctive therapy for chronic stable angina: a randomized clinical trial. JAMA Internal Medicine, July 29, 2019] Although the results appeared to be positive, Dr. Ernst says there are many reasons to be skeptical:
- The study was concluded 4 years ago; why is it published only now?
- The primary outcome measure was entirely subjective; an objective endpoint would have been valuable.
- Patient blinding was not checked but would have been important.
- The discussion is devoid of any critical input; this is perhaps best seen when looking at the reference list. The authors cite none of the many critical analyses of acupuncture.
- The authors did actually not use normal acupuncture but electroacupuncture. One would have liked to see a discussion of effects of the electrical current versus those of acupuncture.
- The therapists were not blinded (when using electroacupuncture, this would have been achievable). Therefore, one explanation for the outcome lies in the verbal/nonverbal communication between therapists and patients.
- Acupuncture was used as an add-on therapy; patients in the acupuncture group might have been more motivated to take their prescribed medications.
- The costs for 12 sessions of acupuncture would have been much higher (in the UK) than those for an additional medication.
- The practicality of consulting an acupuncturist three times a week needs to be addressed.
- The long-term effects of acupuncture on angina pectoris (which is a long-term condition) are unknown.
[Ernst E. Acupuncture for angina pectoris! Too good to be true? Edzardernst.com, July 30, 2019] Agreeing with all of the above Dr. Novella commented:
The current study is a great example of what we typically see—there is always wiggle room in the methodology for a little bit of bias, sufficient to explain the results. After decades and thousands of acupuncture studies, there is simply no reason for these methodological flaws, which have all been pointed out numerous times before. Unless, of course, they are a feature and not a bug. The really rigorous studies of acupuncture tend to be negative, and consistently show no effect from needle position or penetration. The totality of the clinical evidence strongly favors the conclusion that acupuncture is a theatrical placebo will little actual specific therapeutic effect. [Novella S. Study on acupuncture for angina. Science-Based Medicine, July 31, 2019]
"Functional neurology" chiropractor suspended. The College of Chiropractors of British Columbia has suspended Daniel Sullins pending completion of three investigations into his "brain balancing" chiropractic practice of "board certified functional neurology." The College expressed concern that Sullins' practice poses a real risk to the public. Sullins has advertised that he's helped patients with conditions such as ADHD and childhood speech disorders that chiropractors in British Columbia are specifically banned from claiming to treat. [Lindsay B. 'Brain balancing' B.C. chiropractor suspended amid 3 investigations. CBC News. Jun 20, 2019] Sullins has filed a petition in B.C. Supreme Court challenging the suspension. [Lindsay B. Police visited clinic of 'brain balancing' B.C. chiropractor, court documents show. CBC News. July 30, 2019]
Classic criticism of homeopathy posted. Homeowatch has posted the full text of a 40-page booklet, "Modern Homeopathy: Its Absurdities and Inconsistencies," which was published in 1894 and offered to doctors for distribution to patients. Even though medical science was in its infancy, the booklet's author was able to explain why homeopathy's basic premises were nonsensical and its medicines were inert. He also described how a homeopathic hospital discharged and readmitted its sickest patients so frequently that its death rates (per 100 admissions) could be misleadingly reported as lower than those of other hospitals.
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