Thursday, May 07, 2015
Today is fun day for poking holes in popular health myths. My pervasive skepticism is getting a lot of support at the moment. All the research reports below are from "JAMA Internal Medicine", a most prestigious medical journal
Wow! How the statin worm has turned!
The cholesterol fanatics were until very recently so evangelical about statins that they were urging for them to be put into the water supply. Just the title of the article below would have been unthinkable two years ago. There are a few of us who have been saying for years what a deadly hoax the statin craze was but we were like climate skeptics against global warming: The whole establishment was against us. The conclusion below? Even very ill people were on balance better off WITHOUT statins.
The whole point of the article is something that is still sometimes denied: The often severe side effects of statins and the severe impact of those side effects on the patient's quality of life (QOL). A lot of apparent Alzheimer's cases have been in reality sufferers from statin side-effects
Safety and Benefit of Discontinuing Statin Therapy in the Setting of Advanced, Life-Limiting Illness: A Randomized Clinical Trial
By Jean S. Kutner et al.
Importance: For patients with limited prognosis, some medication risks may outweigh the benefits, particularly when benefits take years to accrue; statins are one example. Data are lacking regarding the risks and benefits of discontinuing statin therapy for patients with limited life expectancy.
Objective: To evaluate the safety, clinical, and cost impact of discontinuing statin medications for patients in the palliative care setting.
Design, Setting, and Participants: This was a multicenter, parallel-group, unblinded, pragmatic clinical trial. Eligibility included adults with an estimated life expectancy of between 1 month and 1 year, statin therapy for 3 months or more for primary or secondary prevention of cardiovascular disease, recent deterioration in functional status, and no recent active cardiovascular disease. Participants were randomized to either discontinue or continue statin therapy and were monitored monthly for up to 1 year. The study was conducted from June 3, 2011, to May 2, 2013. All analyses were performed using an intent-to-treat approach.
Interventions: Statin therapy was withdrawn from eligible patients who were randomized to the discontinuation group. Patients in the continuation group continued to receive statins.
Main Outcomes and Measures: Outcomes included death within 60 days (primary outcome), survival, cardiovascular events, performance status, quality of life (QOL), symptoms, number of nonstatin medications, and cost savings.
Results: A total of 381 patients were enrolled; 189 of these were randomized to discontinue statins, and 192 were randomized to continue therapy. Mean (SD) age was 74.1 (11.6) years, 22.0% of the participants were cognitively impaired, and 48.8% had cancer. The proportion of participants in the discontinuation vs continuation groups who died within 60 days was not significantly different (23.8% vs 20.3%; 90% CI, −3.5% to 10.5%; P = .36) and did not meet the noninferiority end point. Total QOL was better for the group discontinuing statin therapy (mean McGill QOL score, 7.11 vs 6.85; P = .04). Few participants experienced cardiovascular events (13 in the discontinuation group vs 11 in the continuation group). Mean cost savings were $3.37 per day and $716 per patient.
Conclusions and Relevance: This pragmatic trial suggests that stopping statin medication therapy is safe and may be associated with benefits including improved QOL, use of fewer nonstatin medications, and a corresponding reduction in medication costs. Thoughtful patient-provider discussions regarding the uncertain benefit and potential decrement in QOL associated with statin continuation in this setting are warranted.
Hurrah for peanuts! (Goober nuts; ground nuts)
"Prospective Evaluation of the Association of Nut/Peanut Consumption With Total and Cause-Specific Mortality" by Luu, Blot et al. (Yes. They are real names) reports that you live longer if you eat more peanuts. The study was methodologically strong but the effects were trifling -- rather like saying that if you eat a lot of peanuts you will live longer by one week. With the large sample sizes, the effects were statistically significant but they were not significant in any other way. Eat as few or as many peanuts as you like. I guess that's good news for people with peanut allergies.
A jarring note about this study is that the journal editor (Mitchell H. Katz) put up a note that showed no awareness at all of how small the effect size was. He claimed it as a great health recommendation for peanuts. Amazing. I guess medical researchers have got used to reporting trifling effects.
Vegetarians have healthier bottoms
We read: "Vegetarian diets are associated with an overall lower incidence of colorectal cancers. Pescovegetarians in particular have a much lower risk compared with nonvegetarians. If such associations are causal, they may be important for primary prevention of colorectal cancers."
How splendid to see in the medical literature for once that proper caution: "If such associations are causal". The study is worth noting for that alone. The effects noted were however very small so it's not worth going vegetarian in order to dodge bowel cancer.
An apple a day does NOT keep the doctor away
Sad news for apple growers, I guess. "Association Between Apple Consumption and Physician Visits" reports: "Evidence does not support that an apple a day keeps the doctor away; however, the small fraction of US adults who eat an apple a day do appear to use fewer prescription medications". The data were derived from a large and well-sampled subject pool so the findings are pretty conclusive, at least for the USA.
I have kept the best 'til last
"Responses of Specialist Societies to Evidence for Reversal of Practice" is worthwhile just for the title. Medical backflips are so common that they can now be studied as a subject of interest by themselves. The authors found that specialists were quick to adopt poorly founded practices and slow to let them go.
It's a good lesson in always questioning authority. Authorities are often wrong. The questioning has to be reasonable, however. An insistence on seeing the evidence is what is needed. If you don't know much about statistics but want to read articles in medical journal, just remember the official rule of thumb: Hazard ratios of less than 2.00 are not sound evidence. The hazard ratios in the studies mentioned above were all MUCH weaker than that. None of them even rose as high as 1.00. Amazing.
Baltimore: Local grocers Under Fire for Supporting National Guard
When the National Guard was trying to tame the situation in Baltimore earlier this week, Whole Foods and Five Guys decided to show appreciation for their efforts by providing free food. Good deed, right?
Not according to leftists. Salon’s Joanna Rothkopf reported, “All Baltimore City public schools were closed on Tuesday in response to violent protests breaking out across the city in response to Freddie Gray’s death. About 84 percent of students in city’s public schools receive free or reduced-price lunches, according to the school district’s website. The closings mean that these students were unable to access these lunches, and churches and community centers have been scrambling to fill the gap. That’s why it was so shocking to hear that Whole Foods and Five Guys had taken the initiative to provide free food for National Guard soldiers instead of for thousands of high-need children.”
The reaction forced Whole Foods to remove a social media posting thanking the Guard for their work along with a photograph of the food. The local grocery told ABC News, “We removed the post because it did not accurately reflect all our local stores are doing to feed people across this city, especially children. Again, we love our community, and will continue to support our city in the days to come, as we always do, and extend our heartfelt sympathy to those affected.”
Is there anything the Leftmedia won’t do if it involves slandering our troops?
Parade of Tax Cheats Just Happens to Be Led by Democrats
The average taxpayer finally logged enough work hours and made enough money just a few days ago to completely pay the burden of taxes on Tax Freedom Day, calculated by the non-partisan Tax Foundation to be April 24 this year. For 114 days, the average working American had their wealth confiscated to fund the various forms of government. That average taxpayer label, however, doesn’t seem to apply to a growing number of Democrats who are tax cheats or delinquent in paying their “fair share.”
The parade of hypocritical miscreants includes the mouthy and condescending race-baiter “Reverend” Al Sharpton. He is among those trumpeting advice on “race relations,” and he’s quite effective in extorting major corporations. He also happens to owe more than $4.5 million in state and federal tax liens.
“Shakedown” Sharpton fits much better than a title usually reserved for men of God, as this racial reverend gets paid to withhold his two minutes of hate against corporate giants like Sony, AT&T, Verizon, Pfizer, General Motors, Honda, McDonald’s, Walmart, Pepsi and the list goes on.
But race bait isn’t his only specialty; class warfare is a familiar tune, as well. “Makers versus takers! [Republicans] give tax cuts and loopholes to the rich and act like it’s acceptable,” he declared in one disgusting spew. Of course, he wants more money taken from workers to fund abled-bodied welfare rots in places like Ferguson and Baltimore.
Joining Shakedown Sharpton is fellow MSNBC talkinghead Melissa Harris-Perry, perhaps remembered best as the Tampon-earring-wearing angry female who showed her support of the urine-and-feces-throwing pro-abortion crowd protesting in the Texas Capitol in summer 2013. We can now add the moniker “tax cheat” to her résumé. In April of this year, the IRS filed a $70,000 tax lien against Harris-Perry and her husband.
“Paying into the collective pot is part of our duty as citizens,” Harris-Perry once declared from her soapbox. “I don’t get to opt out of paying taxes.” That doesn’t mean she didn’t try.
Two more MSNBC talkinghead tax delinquents are Touré Neblett and Joy Reid. Touré owes the U.S. government $59,000 and Reid owes $5,000.
“Regressive taxation & tax-avoidance … has fueled inequality more than hard work,” Touré tweeted in just one among many tirades blasting the GOP for not taxing the wealthy more.
And leading the parade of tax cheats is none other than George Soros, global billionaire and primary source of wealth for hard-Left causes.
It seems Soros has been taking “legal” advantage, according to his tax attorney James Sitrick, of a deferral. Defending his employer and propagator of fascism, Sitrick declared that if Soros “couldn’t legally do it, he wouldn’t do it!”
So how much does Soros, friend of Obama and every other wealth-redistributing leftist, owe in taxes?
After Congress closed a hedge fund loophole in 2008, the 84-year-old billionaire is expected to pay an estimated $6.7 billion on deferred income amassed through his hedge fund, Soros Management Fund, by 2017.
Yep, one of the largest donors to those whose philosophy is that of Karl Marx — “from each according to his ability to his need” — kept from the taxman almost $7 billion of his “fair share.” Legal? Probably. Hypocritical? Definitely. Soros, Democrats and leftist TV talkingheads screech for more government spending with law-abiding, average workers footing the bill.
Words can’t adequately capture the level of hypocrisy consistently on display from Big Government statists who want to grow dependents rather than individuals who stand on their own. Just during the tenure of Barack Obama and his Hope ‘n’ Change™ cult, the levels of recipients of welfare, food stamps, unemployment and disability insurance have all risen to historical highs.
Sigmund Freud, the Austrian neurologist famed for psychoanalysis, nailed the progressives who run the Democrat Party in this observation: “He does not believe that does not live according to his belief.”
Leftists have no belief beyond those that increase their hordes of mindless followers. Their actions prove the policies put into place are to create a class of dependents who are to be controlled while exempting themselves from oppression.
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Posted by JR at 12:35 AM