Hokum Locum

- 1 February 1992

John welch

Myocardial infarction (heart attack, coronary thrombosis) is commonly caused by a blood clot blocking one of the three coronary arteries supplying blood to the heart muscle. It is the commonest cause of death (4,000 p.a.) in New Zealand and other Western countries. Specialists have long wondered whether early administration of a fibrinolytic (blood clot dissolving drug) would reduce mortality.

At a recent conference in Atlanta, Georgia, Peter Sleight, professor of cardiovascular medicine at the University of Oxford, presented the results of the ISIS-3, the third international study of infarct survival. This study compared survival in 46,000 patients randomly assigned to one of three fibrinolytic agents: streptokinase, anistreplase, or tissue plasminogen activator (tPA).

The JSIS-3 trial showed no difference in the survival rates between the three drugs. This caused a furore, as US cardiologists routinely use tPA despite it costing ten times as much as the 30-year-old streptokinase and the absence of any clinical trials demonstrating any lasting superiority over streptokinase.

One of the expected side effects of fibrinolytic drugs is bleeding, in particular cerebral bleeds (brain haemorrhage, stroke). tPA was found to cause significantly more strokes than streptokinase.

Some of the audience perceived the results as being an attack on the American way of life, and one doctor questioned the relevance of the results to American practice. It later transpired that he held. stock options in the company manufacturing tPA.

Professor Sleight responded by “appearing at the lectern without his shoes and socks and explained that he was a visiting European ‘barefoot doctor”. This article (“The Battle Of The Clotbusters”) is well worth reading and appeared in the British Medical Journal Vol 302:1259-61.

ME Homeopathy

In Skeptic #19, I briefly reviewed the subject of chronic fatigue syndrome (CFS) or ME (myalgic encephalomyelitis). I was therefore interested to read an article in the Christchurch Press 19/10/91 with the heading “Study: anti-virus drug relieves ‘yuppie flu’”. The experimental drug, Ampligen, was given by injection to 92 patients, half of whom were given placebo. “As a result of Ampligen therapy, the typical patient went from needing help most of the time to only needing help now and then for sustained tasks, such as cutting the grass,” said a Dr Carter.

The findings were presented at a meeting of the American Society for Microbiology, a curious forum considering that CFS has no proven link with any infection. What is more curious is that Dr Carter is from the Hahnemann University. Skeptical readers will connect the name Hahnemann with homeopathy and all instantly becomes clear. Odds on, Ampligen is a homeopathic remedy. The fact that patients showed a marked improvement with it when treated in a double blind trial only serves to prove that the trial was anything but double blind, since homeopathic remedies, containing nothing active, are physically incapable of producing any effect, apart from placebo.

This study was also referred to in the NZ Doctor 21 Oct 91 but, to the best of my knowledge, 1 am the first to make the connection with homeopathy. Watch this space for future developments with respect to “Ampligen”, or as I call it, “Falsigen.”

Reading Glasses

Denis Dutton has kindly sent copies of the US National Council. Against Health Fraud (NCAHF), which contained an assessment of anew technique to overcome dyslexia. This was most helpful when I found an article in the Christchurch Press 30/8/91 extolling the virtues of “tinted lenses as a remedy for dyslexia and reading difficulties caused by visual problems.” They were being promoted here by Dr Peter O’Connor, an educational psychologist.

December 1991 Number 22 O’Connor was quoted as saying “the method appeared to help about 50% of people with reading disorders.” Fifty percent improvement is about what I would expect from the placebo effect, and do note the vague statement “appeared to help.” A local optometrist and psychologist has been selected to establish a South Island clinic.

These tinted lenses were developed by a US marriage guidance counsellor called Helen Irlen. They are being promoted by “Screeners,” charging up to US$60 for their services. The total cost of diagnosis and treatment is approximately US$600, with yearly follow-up. A computerized search of the scientific literature failed to find any references in support of this quack treatment which, like all quack remedies, depends on its promotion by unsupported testimonials and uncritical media reporting.

A professor of optometry concluded: “The use of coloured lenses is no more effective than a placebo and no beneficial effects persist over time.” World Weirdies Those readers planning to visit the US state of Colorado should take care when passing derogatory remarks about fruit and vegetables in that state. The Disparagement of Perishable Food Products Bill gives producers the legal right to sue anybody making unfounded remarks about food. As one senator said “It makes us look like a bunch of dorks.”

Reference: Ariadne New Scientist 18 May 1991

Readers will remember the woman who gave birth to a fish (Skeptic #19). From Bangladesh (Dominion 19/11/91) comes the story of a 13-year-old girl, Rahima, who had a spontaneous sex change during the evening of October 23rd. Doctors — obviously not skeptics — checked Rahima, now renamed Rahman, and told her parents that “he is a strong, healthy and normal boy.” They could not give any reason for the transformation. My astrologer tells me that Taurus excreta was ascendant so that would explain everything.

Glasnost has lead to increased reporting from the USSR. The Russians have found a new reason to continue their already heavy consumption of alcohol. Vodka exposed to “magnetic rays” will destroy cancer cells. Keen drinkers will be disappointed that only small doses are necessary but this will no doubt impress homeopaths.

In the diagnostic area, a Moscow woman developed x-ray vision. after an electric shock. I am unsure as to whether it is an advantage to “detect what people had for lunch” but doctors — obviously not skeptics — had tested her ability and pronounced it genuine. Experiments are progressing involving the administration of electric shocks to felines in an attempt to develop a true CAT scanner.

Dr John Welch is a medical officer with the RNZAF.