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Off we go….

Well, I’m off to the annual meeting of the Society of Surgical Oncology in San Antonio, where, as usual, I hope to learn about the latest advances in cancer surgery and hang out with old friends. Unfortunately, that means I didn’t get around to writing a new post today, even though there is one development in the news that I really wanted to write about. Oh, well, if it still interests me, I’ll get to it tonight while sitting around in my hotel room. If not, it probably wasn’t that interesting in the first place!

In the meantime, today looks to me like a good time to do a lazy blogging trick to keep up the appearance that something is going on here on the ol’ blog when there really isn’t. I haven’t done it in a long time, though; so I don’t feel too guilty. That’s why I hereby declare this…open thread!

One suggested topic of discussion: Got any juicy links to stories or items for me to blog about? Feed the insatiable blogging maw if you can…

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

49 replies on “Off we go….”

Oh, fear not. I’m sure I’ll manage a post or two while I’m gone. Being in a strange city alone often leads to more hours than I’d like sitting alone in my hotel room working on grants, hence the request for links. I actually have a couple in mind, but I like to know if there’s anything out there I’ve missed.

Oh, I LOVE San Antonio. I would have gone there after graduating from U of M School of Nursing except that I met my husband and he wouldn’t go that far south (damn east coast yankee…)

If you have a chance, visit the Alamo, do the Riverwalk, and just enjoy the beauty of the area.

Another fan of San Antonio. I’ll second MI Dawn on the Riverwalk, it’s gorgeous. Even if it means we only get a rerun post, I’d still recommend it. Personally, I was surprised with how tiny the Alamo was. After all those “everything is bigger in Texas” commercials I didn’t expect the Alamo to be so, um…cute.

Probably not enough for a blog post, but I still want to comment on the recent commercials I’ve been hearing on the local Philadelphia radio stations. The integrative Medicine center at Jefferson hospital is running a high dose vitamin C trail for cancer patients. Bleck, there’s enough woo in my back yard, we don’t need cancer woo too.

Advancements in cancer surgery? Why waste your time with that when an overdose of vitamic C will cure everything!? =P

I get to wait while my PCP waits for the lab work to come back to renew my prescription for blood pressure meds.
Not really a blogging topic, except: if the bp med (a brand name I won’t mention) is controlling my blood pressure why bother with fresh lab work every year?
::shrug:::

Well… maybe not for a post but *certainly* for a laugh.

I’ve written about woo-spread, when alt med gurus venture into new areas of inexpertise, like psychology and economics ( a truly risible topic around here):

“Financial preparedness webcast event announced by the HealthRanger, Robert Scott Bell” ( NaturalNews, 3/1/11). A special 3 hour *audio* presentation on 3/20, streamed live, limited attendance, complete with web notes and chatroom for only $29 ($19, if you register early). He even quotes Damon Vickers, whose very tome sit on my desk ( I often receive pseudo of all stripes).

As you know, Gary Null *also* is a financial expert( having studied it prior to nutrition, he claims). At the depths of the recession( March 2009), he advised followers to sell stocks/ bonds and get their money out of banks.( Yes, the old “Sell Low” strategy). If people had followed his advice they would have lost( frankly, I did the reverse). He often features trendcaster, Gerald Celente. Enough said.

Here is an evil thought: what if one of these guys, grandiosely leading his burgeoning host of followers, decided to “play” a bit – oh, talk a certain stock up or down, advising people who regard him as a messiah about health *and* wealth, and then, reap the benefits. Both of these creatures have blasted particular companies ( Monsanto, Whole Foods, MS, anything Pharma) and praised others ( Whole Foods). Now it would take a lot to affect results ( see Jim Cramer) but, *remember* these guys aren’t exactly reality-based, maybe they, deluded Dunning-Kruger-wise and over-estimating their influence ( e.g. “millions of listeners), believe that they *could*.

While Orac is off learning the latest ways to cut cancer out of people, and more power to him, lurkers might enjoy Dana Ullman’s relatively fresh shot of wisdom, in homeopathic quantities, over at that “Pscesspool of Pseudo Pscience”, HuffPo. He plays off Oscar Fever (it’s a couple days old) to point out that the Royal Family has at times sought homeopathic help (“The King’s Homeopath”). In the comment section, the usual back-and-forth ensues between the usual suspects.

Or, maybe you have real work to do.

Travel safe Orac, and enjoy!

Although I don’t know why you spend so much time doing all that complicated and nasty doctor-y and science-y stuff. This guy heals people just by staring at them. Are you smart enough to get paid for staring? Didn’t think so:

http://www.braco.net/

Now, grow your hair (don’t forget some streaks of grey for added “wisdom”), look sort of like Fabio, stare at people, and watch the bucks roll in!

@ triskelethecat ( ” damn east coast yankee…”)

Awwwwwwwww, Dawn! We’re not *that* bad! Really, once you get past the insufferable self-regard and pretentiousness, you have to admit, we’re kinda fun!

Surgical conference? Why would you do that when you could just use Homeopathy? I mean real doctor stuff sounds hard and takes years and years of study and work, Homeopathy is easy and requires no work. It cures anything and has no side effects! Medical expert Dana Ullman patiently explains that you, as a denier of Homeopathy are doomed to obsolescence:

“These deniers are simply denying the proof all around them. They are medical dinosaurs, who like dinosaurs, are yelling and screaming loudly BEFORE their fall. Sweet dreams dinosaurs.­..wake up and smell the extinction­. “

http://www.huffingtonpost.com/social/hp_blogger_Dana%20Ullman/the-kings-homeopath_b_827499_79177316.html

Who knew?

Snicker. Yup, Dana Ullman is promoting a 200 year-old pre-scientific theory of disease and skeptics are the one’s who are dinosaurs.

I suppose there is nothing new in this instance Ullman’s hubristic arrogance, but it is so plainly backwards, so rediculously ironic it seems worth noting.

Oh, that DUllman! What a kidder!

Seriously, given how inbred the British Royal Family is, it’s a wonder they can make any decisions at all. Thank goodness they’re no longer in actual control of the realm.

“Homeopathy. The medical choice of persistently inbred European aristocracy.”

Just doesn’t sell the concept as well as DUllman thinks.

Prometheus

Hmm…I wonder how Ullman’s argument that homeopathy is the medicine of Royalty will affect the trope that “western medicine” is elitist?

@Prometheus — Forgive me if this occurred to absolutely everyone else on the thread, but your comment on the Royals reminded me that I’ve always loved Monty Python’s “Upperclass Twit of the Year” sketch.

I do often find it fun to troll about on HuffPo, though, doing battle with the forces of darkness, ignorance, and in many cases, sheer idiocy.

have fun Orac!

you all gotta go check out Pharyngula and the fox news clip of a kid who “heals” his friends. gah. that is one of my local news stations.

Some good news in the UK – already misleading claims by Alt Med are being challenged and banned by the Advertising Standards Agency. The Nightinglae Collaboration will hopefully ensure these are the first of many…

Claims of Quantumwave Laser to treat or heal a wide range of illnesses, such as cancer, AIDS and leukaemia – now banned
http://www.asa.org.uk/ASA-action/Adjudications/2011/3/The-Wellness-Tree-Ltd/TF_ADJ_49830.aspx

Medical Thermal Imaging 100% SAFE BREAST SCREENING recommended rather than mammograms by Homeopaths – now banned
http://www.asa.org.uk/ASA-action/Adjudications/2011/3/The-Homeopathic-Clinic/TF_ADJ_49823.aspx

@Denice Walter: oh, I know that. I married him, after all. But still, sometimes (especially after this past winter), I wonder, what is a nice girl from the midwest doing in a place like New Jersey? Especially when she could have been sensible and gone to live near the family members in Austin… (grin)

@ scote: I read that article “The King’s Homeopathy”…it appeared at the same time that Huffington Post headlined the Oscar wins for the “King’s Speech” movie. And, of course it generated some “interesting” posts.

It is my understanding that some of the homeopathic drug pushers in the U.K. have the “Royal Warrant”. Apparently, if the Queen orders any of your products, such as biscuits or gifts for the Royal grandkids or homeopathic “medicines”, the purveyor contacts the Queens staff and receives the “Royal Warrant”. Kinda, sorta like a celebrity endorsement for display at your place of business.

More Royal trivia and minutiae:

Queen Victoria, by her use of ether gas for the birth of her last two children, raised some considerable debate about painless childbirth. Victoria and her husband Albert continued with the long-standing custom of the Royals to make use of homeopathic “medicine.” These two prodigious Royals produced enough children and grandchildren so that all reigning Royal families existing in Europe today…with the possible exception of the Grimaldis in Monaco, are related.

The Queen Mum who lived to age 101, was a proponent of homeopathy. She made use of “traditional” medicine however, when she had hip replacement surgeries at ages ninety-five and ninety-seven. I suspect that her habit of having a few gin and tonics at lunch worked better for her that homeopathy.

There’s hot debates going on in the U.K. recently: “Doctors Vote For NHS to Stop Funding Homeopathy” (Suite101.com).

Lilady & Scote – So Dana Ullman has now invoked the lamest possible Argument from Authority for homeopathy by using the endorsement of people who’s primary accomplishment has been the correct choice of parents. Also a family with a history of mental illness (George III) and an enthusiasm for fascism. In addition to Edward VIII’s admiration of Hitler, the Queen Mum was buddies with Oswald Mosley, head of the British Fascist Party. Throw in Prince Philip’s racism and it is obvious these are not people a decent person would want to be associated with. Of course Dunning-Kruger champ Charlie is a prime example of an arrogant twit who was born on third base and thinks he hit a triple.

My Canada does not include the British royal family.

Why does everyone always have to pick on New Jersey? It’s a lovely state with amazing produce, great beaches, and the best foods from both New York and Philadelphia.

I e-mailed you a bit about Federal Occupational Health pushing chiro woo about “inflammation” on federal employees. That’d make a good post 🙂

Will they ever stop?
As their “press conference” in NY failed so miserably, LKH and MH are taking their urban idiot theatre to the steps of the Supreme Court tomorrow to protest the Bruesewitz decision.
Someone should ask the good professor what her uncle did for a living – he was the head of the FDA!

@jojo: because we can? What can I say? I’m a Michigander now living in New Jersey via 5 years in Virginia married to a New Yorker (and worse, a Long Islander). New Jersey is very nice, I agree. There are some very green areas, nice farms and very nice people. But, if we didn’t love it, we wouldn’t make fun of it. 🙂

Have a great trip, Orac. It’s nice that you gave us permission to use you blog as “an open thread”…as if!!!

Kitto, I love the site with the new video of the Desiree Jennings’ dystonia “case”…it’s a hoot.

I wanted to know what Desiree has doing since her miraculous cure and clicked on one of my favorite sites “Rational-Wiki” for updates. Rational-Wiki site is a great (updated constantly) site about all the theories and conspiracies (political and medical), and other b-s that we discuss on this blog.

Yeah – I’d like to ask a couple of questions of you science inspired folks, and they’re these:
1) If you do get a reaction following vaccinations, in what sense, if any, is this “getting a mild dose of the disaese”? Or is this simply an allergic reaction following the introduction of a small quantity of foreign protein into the muscles?
2) If some vaccines are said to carry more risk than others, in terms of possible adverse reactions, why is this? And is there a distinction here between anti-bacterial and anti-viral vaccines?
I know you’ll let me know.
And, of course, I’m not a troll but a loyal reader 🙂

I recommend that restaurant on the river walk where they make guacamole right at your table side. I’d remember the name of the place had I not drank myself into a sweet place on pomegranate margaritas. As for links… How about telling us how the Westboro Baptist Asshole decision by SCOTUS is actually (kind of) a good thing for us opinionated folk?

I must have missed when Jay Gordon posted all the scientific evidence showing a connection between vaccines and autism – the papers he was going to dig up over the weekend. Any of of you notice when and where he posted his evidence? 😉

@AnthonyK:

If you do get a reaction following vaccinations, in what sense, if any, is this “getting a mild dose of the disaese”?

Some symptoms of infectious diseases (fever, mucus production, etc) are actually the immune system reacting to the pathogens, so getting those symptoms in reaction to a vaccine is pretty much the same thing as getting the normal (wild-type) disease itself, since in both cases it’s the same thing happening (the immune system reacting to pathogens). If the vaccine causes symptoms different than the full blown disease then it’s not a “mild case of the disease”.

How about something on biofeedback/ neurobiofeedback?

I know little about it but have seen some pretty grandiose claims about it…

recommend that restaurant on the river walk where they make guacamole right at your table side. I’d remember the name of the place had I not drank myself into a sweet place on pomegranate margaritas

Found it, quite by accident before having read your comment. It was called Iron Cactus. Unfortunately, while it was cool to watch the waiter make the guacamole at the table from fresh avacados, I have to say: Iron Cactus’ guacamole was way too salty. I mean, holy crap!

Saw a post today about pediatricians refusing to see/ treat children who are not vaccinated. Might be interesting to see if more peds do this? Most of the comments were, of course, from the anti-vax folks. As a mom of a newborn, I don’t want your potential Rubella, Mumps or Whooping Cough anywhere near me esepcially at the peds office. Nor do I want an invite to your child’s stupid Chicken Pox birthday party.
http://thestir.cafemom.com/big_kid/116973/should_pediatricians_blackmail_parents_into

Wish cancer away!

http://www.cnn.com/2011/HEALTH/03/03/ep.seidler.cancer.mind.body/index.html

I know this topic (or at least similar topics) have been covered on RI before, but a few things bothered me about this. Its on CNN and they present it rather credulously, the usual tell both sides thing, it involves a famous person, probably the only reason it is getting news coverage in the first place, and it is dumber woo than usual. He wished away his cancer and in just 2 weeks it was gone? Wow, I’m sure no other cancer patients have ever tried to hope their cancer would go away…

Anthony K asks:

“If you do get a reaction following vaccinations, in what sense, if any, is this ‘getting a mild dose of the disaese’? Or is this simply an allergic reaction following the introduction of a small quantity of foreign protein into the muscles?”

Both can be true, depending on the vaccine.

For inactivated vaccines, the reaction is an immune reaction (not “allergic”, which generally implies delayed hypersensitivity). Attenuated vaccines, on the other hand, are similar in some ways to a “mild dose of the disease”. A true “mild dose of the disease” would be the result of either a low viral exposure or an insufficient level of neutralising antibodies from exposure to the same (or similar) disease.

Attenuated vaccines aren’t a “mild dose” (that would be more like the old technique of variolation) but a “full dose” of a virus (so far, all of the attenuated vaccines are viral) that is antigenically similar to the disease virus but is unable to cause the disease.

“If some vaccines are said to carry more risk than others, in terms of possible adverse reactions, why is this?”

This is a much more complicated question than it appears. Vaccines need to create an immune response suffient to provide long-lasting protection. This can often be a delicate balancing act, expecially with attenuated vaccines. As a result, some vaccines have more adverse reactions than others.

Some good examples are the mumps vaccine strains – of the three commonly used strains, the Urabe is the most effective but has the highest incidence of meningitis (about 1 in 150,000 – the mumps disease strain causes meningitis in 10%). The Jeryl Lynn strain (used in the US and UK) is less effective but also causes less meningitis (1 in 230,000). The Rubini strain (currently only used in Switzerland) is the least effective but also has the lowest incidence of side effects.

Other examples include the smallpox and yellow fever vaccine strains. Vaccinia (the smallpox vaccine strain virus) causes a lot of side effects and kills about 1 in a million people who receive it (for perspective, smallpox – during the last outbreak – killed 30% of its victims). The yellow fever vaccine strains (17D-204 and 17DD) rarely cause a yellow fever-like illness; CDC reported 7 cases between 1996 and 2001.

“And is there a distinction here between anti-bacterial and anti-viral vaccines?”

I’m not sure where the “here” refers, but there is a very large distinction between anti-bacterial and anti-viral vaccines. It’s generally easier to develop a vaccine against viruses because they usually have surface receptors that can be blocked by neutralising antibodies. Bacteria, on the other hand, can’t usually be neutralised – they are coated with antibody (“opsonised”) and targeted for destruction by macrophages and the like.

There are fewer bacterial vaccines in common use – some that people think of as “bacterial vaccines” are actually vaccines against bacteria toxins (e.g. diphtheria, tetanus). Pertussis and HiB vaccines are bacterial vaccines

Maybe this isn’t what Anthony K meant when he asked about a “distinction”. As I see it, the major distinction is that the bacterial vaccines tend – because they usually need to have more antigens – to cause more reaction and they tend to be less effective. Still, when you’re dealing with serious illnesses, some protection is better than none.

Prometheus

Good grief bluedevil, my brain hurts after reading that now. I think the only way to Oracize that article is to “like” all the comments that debunk/disagree with it, which I did. Unfortunately there aren’t many.

Well done Promethius! I would add a few comments for Anthony K. Streptococcus pneumomiae…a bacterial disease also has a protective vaccine recommended by the CDC for immunizing infants and young children against this deadly bacteria.

The vaccine against smallpox is an attenuated strain of cowpox, which provides cross immunity against smallpox.

Anthony K. you might want to spend some interesting time on the internet viewing chapters of the “CDC Pink Book”. It is the bible used by public health doctors and nurses for the most up-to-date information on vaccine preventable diseases.

lilady,

The smallpox vaccine strain (Vaccinia) has significant genetic differences from the currently circulating strains of cowpox. This may be because the “cowpox” strain the Jenner used in 1796 wasn’t a true cowpox virus (the virus’ natural host is rodents, not cows, so there may have been other poxviruses infecting cows at that time) OR because the vaccine strain – Vaccinia – has diverged from the original cowpox strain over the past 205 years because of their different evolutionary paths.

Even when referring to Edward Jenner’s original experimental strain, the virus he used wasn’t an “attenuated” cowpox, it was cowpox (see above for caveats), which is an attenuated strain of poxvirus (compared to the smallpox virus – Variola).

Prometheus

@ Prometheus: I was re-vaccinated (during the run-up to WMD scare after 9-11), with Dryvax “live” vaccinia virus; thanks for the correction of mislabeling it as attentuated.

I was part of a a small group of “volunteer” health care workers in my state who received the vaccine; we then returned to our local County Health Departments and vaccinated several more nurses in the Division of Infectious Diseases Control. Shortly thereafter we vaccinated a select number of nurses and doctors from area hospitals.

Dryvax was manufactured by Wyeth Labs from the 1930s through the mid 1980s. The supply of the lyosolized vaccine that we used was forty years old. Dryvax is a live vaccinia virus manufactured in cow lymph with a seed virus from the New York City Board of Health and known as “NYCBOH Live Vaccinia Virus”

Dryvax was tested for it strength and the dried powder was repackaged in new vials. The newly manufactured glycerin based diluent was was put into vials as well, for reconstituting the vaccine before use. New bifurcated “scratching” implements were manufactured for individual vaccination drawn from the multi-dose reconstituted Dryvax Vaccine vial. At the time of the WMD “scare”, Dryvax vaccine was the only smallpox vaccine available in the United States. Other countries in Europe had “smallpox” vaccine in small quantities as “leftover” vaccine from years before, prior to the declaration of the WHO that smallpox was no longer an infectious disease threat in the world. I do not know what type of virus was used in these smallpox vaccines.

ACAM 2000 Smallpox is now available in the United States, for vaccinations of certain armed services members and for those who work in high security labs; it apparently is protective against the monkeypox virus as well. ACAM is described as a “clone” of Dryvax using the live NYCBOH vaccinia virus.

At the time I was re-vaccinated I attended a seminar and all the attendees were amazed to hear the experiences of an older retired physician who actually worked in the Asian subcontinent during the 1960s-1970s and cared for actual smallpox-infected patients and participated in the efforts to contain-by-vaccinating the remaining pockets of the world where smallpox was endemic.

Thanks Prometheus, lilady, and Matthew: I’m much clearer now (I think). The answers to my “simple” questions are actually very complicated. Phew! I just wondered if I was being stupid.

@ AnthonyK: We in the health care profession have trouble keeping it all straight as well. I’m recently retired as a public health nurse…I was “better” at vaccines when I worked at my local health department, fielding questions from the public and physicians.

In a prior post I suggested to you that you visit the Pink Book—keying in the specific infectious disease that is preventable by immunizations. It is available on the internet. The VIS (Vaccine Information Sheets) for each vaccine preventable disease are also on the internet, as is “Immunize.org”, “MMWR” (Morbidity and Mortality Weekly Reports); new MMWRs are posted each Friday morning. The “Emerging Infectious Disease Journal” (monthly) has some very interesting articles about “common” infectious diseases and some very detailed articles about diseases indigenous to remote areas of the world. The “ACIP” (Advisory Committee on Immunization Practices) meets quarterly to make recommendations to the CDC about vaccines; their recommendations are all on their web site All the web sites are divisions under the CDC “umbrella.”

I hope that my postings aren’t too confusing for you.

Lilady – no, not at all. The anti-vax morons tend to make things out as simple, but reality isn’t like that. Tell me, as a former nurse, dealing with vaccinations, how many times did you actually witness an adverse reaction to the injections you administered, and what happened as a result? I’m guessing 1-10 times, and not serious. But you’ll know.
Isn’t it odd, this commenting thing, where I’ll completley trust what you tell me, even though there’s no prospect we’ll ever meet?
Orac’s great, isn’t he?

At AnthonyK: I’ve really never seen an adverse reaction. I’ve gotten calls from parents about transient fevers and a bit of crankiness within a few hours of receiving an immunization. But, don’t forget the local health departments are the “go-to” information agencies, fielding calls from the public about immunizations received in private doctor’s offices. With mass immunizations clinics following a food-borne outbreaks of diseases or at very large seasonal flu vaccine clinics, I don’t recall any immediate reactions. There were probably somewhat delayed reactions such as tenderness at the site. Don’t forget that parents and patients are provided with the VIS for the immunizations they are about to receive and mild reactions are explained…as are more serious ones that might require medical attention.

Also, before immunizations are given, patients are provided with a questionnaire to list any reactions to any immunizations given in the past, recent administration of vaccines, blood products, steroids, etc. which might effect the efficacy of immunizations or indicate that a true serious reaction has occurred in the past.

I suspect that parents and patients do their own research on the internet; now if we could only get them to visit internet sites with reliable information….

@ Anonymous: Thanks for the Quackometer blog. It is very interesting, especially the comments.

Lilady,

I missed the smallpox revaccination push because I wasn’t felt to be in “harm’s way” and because I had been vaccinated as a child.

It’s fascinating to hear that they were using such old stock (but not surprising, when I thought on it – there hasn’t been much demand since the 70’s). The poxviruses are amazing in their ability to remain infectious for prolonged periods, even without careful storage, especially for an enveloped virus.

The discovery that Vaccinia wasn’t genetically identical to cowpox wasn’t unexpected, given how long the two have been “raised apart”. We will never know how many different poxvirus strains were used in early vaccination, since the production of vaccine by serial passage in cows wasn’t started until the late 1800’s, I believe. Up ’til then, it was largely done by finding a cow with characteristic lesions of cowpox. Vaccinia has only recently been maintained in tissue culture.

BTW, I can’t claim to have given a lot of vaccines (or any), but I was in the service and stood in lines where lots of vaccines were given. The only immediate reaction I saw (even when we were given yellow fever, cholera and plague vaccines) was fainting (which occasionally happened prior to receiving the vaccination). People who claim that they or their child “immediately” had seizures (or developed autism) need to explain how the vaccine reached the rest of the body (i.e. not just the arm, thigh or buttock) so quickly.

Prometheus

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