A Happy Holiday – mostly

I wish you all a very happy and prosperous 2011.

Christmas for us came and went quite pleasantly.  We went to stay with family, had a chance to visit a number of good friends and do some interesting stuff that we don’t often get to.  New Year was almost a non-event:  we just rented some DVDs and stayed home.  What made it all rather better than usual for me is that I didn’t suffer the downer that normally comes with the season.  In fact I felt really good the whole time which is quite exceptional.  Even when a new lump started growing it took the wind out of my sails only briefly; I’m not even 100% sure that it is a melanoma lump but I’ll have to wait another 3 weeks before getting an expert opinion.  Meanwhile I’m due for a CT scan at the end of this month which I hope will reveal nothing new.

There was one event that caused me considerable sadness.  K‘s mum died of melanoma after a relatively brief battle.  She was diagnosed first about 9 months ago and things have gone downhill rapidly since then.  I had never met her but the speed of her decline and death is shocking to me.  It must be a whole lot worse for K and her family.  My heart goes out to them.

The next few blog entries I plan to devote to an overview of the 8-week course I took late last year on mindfulness as a preventative for anxiety and depression.  It took me a couple of days to come up with a point-form digest by going through the course notes and my own scribblings.  We covered a lot of stuff in those 8 sessions and several very valuable points stuck with me.  I’m going to try to pass some of the enlightenment along.

News Roundup

You may recall an article about John Ioannidis quoting his opinion that 90% of all published clinical studies are basically junk.  Another article penned by the man himself discusses the way in which publication practices distort science (PDF) and a third (from J Gen Intern Med. 2010 Sep;25(9):914-9. Epub 2010 Apr 28) analyzes a bunch of articles about hormone replacement therapy (HRT) concluding:

There is a considerable body of editorializing articles favoring HRT use and very few of these articles report conflicts of interest. Full disclosure of conflicts of interest is needed, especially for articles without primary data.

The peer review and prestigious journal publishing systems are clearly letting us down.  Unfortunately it is about all we’ve got so let us hope that there will be some improvements.  Hard to feel very optimistic, though.

A recent New Scientist article (Dec. 13 2010, issue 2790) takes an in-depth look at clinical trials and the placebo effect.  The author argues that it is too easy, in many cases, for participants in a clinical trial to “break” the blinding of the trial by figuring out whether they are getting real drugs or just a placebo.  Obviously this has some pretty serious implications for the results of said trials:

… I am sure most prescription drugs are more effective than placebos. But when the differences between drug and placebo are small, and the drugs produce easily noticeable side effects, it is possible that there may be no real drug effect. We may be fooling ourselves with clinical trial methods that don’t do what they are supposed to – and wasting billions on worthless medications.

The long term solution may be to use active placebos:

My active-placebo proposal is that the ingredients of placebos be chosen to mimic the side effects of the drug being tested and […] they should be disclosed when clinical trials are published.

All sounds very sensible and adds yet more weight to the argument that the whole process of how useful drugs come out of clinical trials may be much less certain than we have been led to believe.

Nevertheless, we must find hope where we can.  In the pharmacology corner we have:

• Drugs are being developed to work in combination with PLX4032
• Lowering the amount of the MIC-1 protein may stop melanoma tumour growth
• Raising the amount of another protein may have the same effect

Meanwhile, mindfulness and meditation continue to infiltrate the western way of life:

• The Globe & Mail asks, Stressed Out?  Try Mindfulness Meditation
• The Guardian suggests Try Something Quietly Profound
• And a note on why trying not to think about something may backfire; much better to face your troubles directly, if you can

Finally, here is a list of the top 25 foods for longevity.  No hamburgers on it:  what a surprise.