new research

[Guest guest]

the study is reported in the current Alternative therapies journal.>>>>Todd they complete the study? if yes what did they find

Alon

[Guest guest]

, " Alon Marcus " <

alonmarcus@w...> wrote:

> the study is reported in the current Alternative therapies journal.

>

> >>>>Todd they complete the study? if yes what did they find

> Alon

 

didn't even start it yet, but based upon analysis of interrater reliability

research

in subjective areas of western medical diagnositcs, such as psychiatry, they

expect to find poor interrater reliability. However, they also plan to find lab

tests correlations for TCM illnesses (I am curious as to how they will confirm

the TCM dx if they can't get reliable agreement on diagnosis). The goal is to

provide objective parameters to TCM dx that will shore up the inherent

weaknesses of the ancient subjective method. The only comment I will make

is that once upon a time, the same exact thing was discovered about western

medicine. for example, interrater reliability in cardiac diagnosis by

stethoscope is quite low. which is why this method has been supplemented

with imaging and lab tests over the last 50 years. Old fashioned cardiologists

screamed bloody murder as it was proven over and over again that their

subjective methods were unreliable. sound familiar.

 

[Guest guest]

 

 

In the interest of correct use of language,

can you please clarify what you mean below

by " inherent weaknesses of the ancient

subjective method " . I'm not suggesting by

raising this question that the ancient subjective

method, whatever it is, does not have weakness

both inherent and otherwise.

 

But you use the phrase as if there were general

consensus of what it means, i.e., as if everyone

knows there are such inherent weaknesses and

what they are. And I'm not sure I do. So I

will appreciate it if you can spell out

what these ancient and inherent weaknesses are.

 

Ken

 

, "

<@i...> " <@i...> wrote:

> , " Alon Marcus " <

> alonmarcus@w...> wrote:

> > the study is reported in the current Alternative therapies

journal.

> >

> > >>>>Todd they complete the study? if yes what did they find

> > Alon

>

> didn't even start it yet, but based upon analysis of interrater

reliability research

> in subjective areas of western medical diagnositcs, such as

psychiatry, they

> expect to find poor interrater reliability. However, they also

plan to find lab

> tests correlations for TCM illnesses (I am curious as to how they

will confirm

> the TCM dx if they can't get reliable agreement on diagnosis).

The goal is to

> provide objective parameters to TCM dx that will shore up the

inherent

> weaknesses of the ancient subjective method. The only comment I

will make

> is that once upon a time, the same exact thing was discovered

about western

> medicine. for example, interrater reliability in cardiac

diagnosis by

> stethoscope is quite low. which is why this method has been

supplemented

> with imaging and lab tests over the last 50 years. Old fashioned

cardiologists

> screamed bloody murder as it was proven over and over again that

their

> subjective methods were unreliable. sound familiar.

>

 

[Guest guest]

Old fashioned cardiologists screamed bloody murder as it was proven over and over again that their subjective methods were unreliable. sound familiar.>>>Physical diagnosis has been shown to have poor interrater reliability in most studies even simple tests. That is why i am still convinced that no one could show such reliability on the pulse, especially if there is no calibration just before the test. ie a few minutes before

alon

[Guest guest]

http://madinamerica.com/new_research.htm

 

 

There are any number of web sites that provide reviews of new research articles

on schizophrenia. This page simply provides reviews of new articles related to

themes raised in Mad in America, particularly studies thar raise questions about

the merits of drug treatments. Readers should send in suggestions for articles

to be included here by e-mail.

 

1. V. Lehtinenin, " Two-year outcome in first-episode psychosis treated according

to an integrated model. Is immediate neuroleptisation always needed? " European

Psychiatry 2000, Aug; 15 (5):312-320.

 

This study by Finnish investigators compared outcomes for first-episode patients

who were all treated with comprehensive psychosocial care, but were randomized

into either an experimental group that was treated without neuroleptics (or a

minimal dose), or a control group treated with standard doses of the drugs. In

the experimental group, 42.9% of the patients did not receive any neuroleptics

at all during the two-year period (versus 5.9% in the control group.) They

concluded that " the main result was that the outcome of the experimental group

was equal or even somewhat better than that of the control group. "

 

This, then, is yet another study showing good outcomes in first-episode

patients treated with minimal or no neuroleptics.

 

 

 

2. John Geddes, " Prevention of Relapse in Schizophrenia, " New England Journal of

Medicine, 2000, 346 (1): 56-58.

 

In this review of a relapse trial comparing risperidone to haloperidol, the

author notes that one-year relapse rates were 34% for those treated with

risperidone, and 60% in the haloperidol patients, and concludes that this is

evidence of risperidone's efficacy in preventing relapse. However, there is a

missing piece in the author's review. What are relapse rates for patients

gradually withdrawn from their neuroleptics? Harvard researchers found that the

relapse rate for such patients was 35% over a six-month period, and that after

that initial six-month period, the risk of relapse was quite low. In other

words, risperidone in this trial produced relapse rates similar to rates seen in

patients gradually withdrawn from their drugs. Moreover, as the author notes in

this review, the drop-out rate in the trial was high. When this and other

limiting factors were considered, the author concludes, " the treatment benefit

associated with risperidone would probably be smaller in routine

clinical practice. " If so, that means that relapse rates with risperidone

would likely be higher than rates in patients gradually withdrawn from

antipsychotic medictions.

 

 

 

3. Philip Seeman, " Rapid Release of Antipsychotic Drugs From Dopamine D2

Receptors, " American Journal of Psychiatry, 1999, 156 (6):876-884.

 

This paper looks at the cause of extremely high relapse rates for patients

withdrawn from clozapine and quetiapine, which they note is " five times higher "

than relapse rates for patients withdrawn from typical neuroleptics. The

critical point here is that withdrawal from the atypicals may be even more

problematic than withdrawal from typical neuroleptics.

 

 

 

4. Simone Silvestri, " Increased dopamine D2 receptor binding after long-term

treatment with antipsychotics in humans: a clinical PET study, "

Psychopharmacology, 2000, 152 (2):174-180.

 

The researchers found that both typical and atypical antipsychotics caused a

significant increase in dopamine D2 receptors in the striatum, and that this

increase is associated with tardive dyskinesia. The atypicals, then, were found

to cause the same pathological changes in brain structure that made the older

drugs so problematic.

 

 

 

5. Paul Thompson, " Mapping adolescent brain change reveals dynamic wave of

accelerated gray matter loss in very early-onset schizophrenia, " PNAS, 2001, 98

(20):11650-11655.

 

The authors reported that adolescents diagnosed with schizophrenia suffered an

accelerated loss of gray matter in their brains over a five-year period in

comparison with healthy controls. (The brain scans showed gray matter loss in

the healthy controls over this period as well, but not to the same degree.) The

authors concluded that this was evidence of an underlying disease process

central to schizophrenia. However, another way to look at the data is that it

provides evidence that the drugs cause such accelerated loss of gray matter.

 

The children diagnosed with schizophrenia were treated with either clozapine or

risperidone, and prior to the study, had been treated with traditional

neuroleptics. To assess whether brain matter loss might be due to medications,

the researchers also gave clozapine and risperidone to group of adolescents who

were diagnosed as suffering from a milder psychosis. These adolescents lso

suffered an accelerated loss of gray matter over the five years, compared to

healthy controls, but just not to quite the same degree as the schizophrenia

patients. In other words, all children placed on the drugs showed an accelerated

loss of gray matter. Those who had prior exposure to neuroleptics and were more

severely ill simply suffered a greater degree of loss than those who were only

mildly ill. What is one to make of this data? The researchers concluded that

since the rate of loss wasn't equal in mildly ill and severely ill patients, the

loss must be due to an underlying disease process. But an

alternative explanation is simply that the drugs cause this brain damage, and

that it is more pronounced in patients who are already quite distressed (or who

had been previously exposed to typical neuroleptics.)

 

There is also more to be drawn from the study data. At the end of five years,

the schizophrenia patients had deteriorated in terms of a " global assessment of

function, " and the adolescents with a milder form of psychosis also hadn't

improved on this outcome measure either. Thus, none of the adolescents placed on

antipsychotic medications in this study fared well--they suffered an accelerated

loss of gray matter (for whatever reason), and their overall functioning either

deteriorated or remained roughly the same.

 

 

 

 

 

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[Guest guest]

1. _Scientists find why sunshine vitamin D is crucial_

(http://www.mdlinx.com/readArticle.cfm?art_id=3075255)

Reuters, 03/09/10

 

Vitamin D is vital in activating human defences and low levels suffered by

around half the world's population may mean their immune systems' killer T

cells are poor at fighting infection. The findings by Danish researchers

could help the fight against infectious diseases and global epidemics, they

said, and could be particularly useful in the search for new vaccines. The

researchers found that immune systems' killer cells, known as T cells, rely

on vitamin D to become active and remain dormant and unaware of the

possibility of threat from an infection or pathogen if vitamin D is lacking in

the

blood.

Geisler said there were no definitive studies on the optimal daily vitamin

D dose but experts recommend 25 to 50 micrograms.

2. T_ai Chi improves physical function in older Chinese women with knee

osteoarthritis_ (http://www.mdlinx.com/readArticle.cfm?art_id=3073738)

Journal of Clinical Rheumatology (JCR), 03/11/10

 

Ni GX et al. – Tai chi (TC) is proposed as a potential option for the

management of osteoarthritis (OA), however, its beneficial effect on patients

with knee OA has not been convincing. This study suggests that TC provides a

safe, feasible and useful exercise option for older Chinese female patients

with knee OA.

3. _Electroacupuncture in a case of postherpetic neuralgia with

involvement of the ophthalmic branch of the trigeminal nerve_

(http://www.mdlinx.com/readArticle.cfm?art_id=3077987)

Revista de la Sociedad Española del Dolor, 03/10/10

 

Prieto P et al. – Postherpetic neuralgia consists of chronic neuropathic

pain that appears as a complication of varicella–zoster virus infection and

is characterized by intense and episodic pain. The treatment of choice is

pharmacological but adequate therapeutic response is not always achieved,

either due to drug intolerance or to inadequate pain control. The authors

report the case of a woman with postherpetic neuralgia affecting the left

ophthalmic branch of the trigeminal nerve, in whom distinct drug treatments

failed to achieve adequate pain control. Given this situation,

electroacupuncture sessions were started, combined with pharmacological

therapy. The

frequency and intensity of the pain exacerbations progressively diminished,

allowing drug treatment to be discontinued. Electroacupuncture can constitute a

therapeutic alternative in patients with drug intolerance or inadequate

control of neuropathic pain with pharmacological treatment.