An Old Known Fact: Degenerative Diseases are Increasing

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Medicine is far from having decreased human sufferings as much as it endeavors to make us believe. Indeed, the number of deaths form infectious diseases has greatly diminished. But we still must die in much larger proportion from degenerative diseases.

Alexis Carrel, 1873-1944

I started reading the 1939 published book: Nutrition and Physical Degeneration by Weston Price. Price is a Canadian born American dentist, who closed his practice and travelled the world in search for the reasons of rocketing dental degenerative diseases. His book details the findings of his research.

Alexis Carrel is the 1912 Nobel prize winner in physiology or medicine.

A Welldell Berry Quote Against Reductionism

Here is the quote without any commnets:

Reductionism (ultimately, the empirical explanability of everything and a cornerstone of science), has uses that are appropriate, and it also can be used inappropriately. It is appropriately used as a way (one way) of understanding what is empirically known or empirically knowable. When it becomes merely an intellectual "position" confronting what is not empirically known or knowable, then it becomes very quickly absurd, and also grossly desensitizing and false.

Aiming for blood pressure targets lower than 140/90 mmHg is not beneficial

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This is the conclusion of a newly published Cochrane review. Data that support targeting lower targets with drugs just does not exist. As expected from a Cochrane review, they looked at patients’ relevant outcomes as total mortality, myocardial infarction, stroke, congestive heart failure, major cardiovascular events and end-stage renal disease.

You can read physicians comments on EvidenceUpdates.

This review makes me pounder the question whether ‘experts’ that come with guidelines are ‘why not’ person or ‘do no harm’ person?

I end with author’s conclusions:

Treating patients to lower than standard BP targets, ≤140-160/90-100 mmHg, does not reduce mortality or morbidity. Because guidelines are recommending even lower targets for diabetes mellitus and chronic renal disease, we are currently conducting systematic reviews in those groups of patients.

Randomized Controlled Trials are not Always Necessary, Observation May Suffice

I just listen to an interview with Professor Sir Michael Rawlins, Chair of UK’s National Institute for Health and Clinical Excellence. You can find it on itconversations. He goes over very interesting topics. Two of which are deciding on what services should a public health service provide and evaluating evidence.

In evaluating evidence, he raise the point to the needless divide between using observation and using randomized controlled trials (RCTs). Both are needed methods for evaluating evidence. However, RCTs can be unnecessary and even unethical to do. He mentions the example of ganciclovir used to treat cytomegalovirus retinitis in AIDS patients. Where although observational study showed efficacy, RCT was carried out. after a year the benefit was shown, but the non-treatment arm got blind! (I need more time to dig up this study) This is an article commenting on Sir Rawlins views.