dras knowledge

Tuesday, July 29, 2003

Krakauer's take on Mormon History

"...The centerpiece of the story is a grisly double murder committed in 1984 by Ron and Dan Lafferty, Mormon fundamentalist brothers who claimed to have killed at God's direct command. In Krakauer's expert hands, the bizarre details of this brutal crime play out against the equally bizarre history of the Church of Jesus Christ of Latter-day Saints (LDS) and its subsequent splintering into fundamentalist sects over the issue of polygamy -- a sacred doctrine put forth by Mormon founder Joseph Smith in 1830..."
http://search.barnesandnoble.com/booksearch/isbninquiry.asp?cds2Pid=1268&isbn=0385509510

I repond:
Is there an above average acceptance of CAM and/or presentation of fanatical craziness in Utah compared with other US communities (i.e. Bible belt, non-religion affiliated pioneer communities)? How about world communities (i.e. Islam)?

What are the specific aspects of the unique cultural background and/or religious beliefs in Utah that may contribute to an acceptance of CAM and/or fanatical craziness?

There's been much commentary, but little empirical analysis. A Doctoral thesis in the making here.

I suspect we can stay tuned for the like story about Singer-Swapp and another about Elizabeth Smart - both of these Utah tales have Mormon fundamentalist (better labeled as "religious fanaticism") foundations.

Readers should understand it may take more than information from novels written to entertain to draw any conclusions about Mormon fundamentalist or mainstream history, beliefs, or society.

Having taught community classes on CAM with an emphasis on scientific method in the state, and as a member of the predominant religious culture here since birth, I could ramble on about my observations and summations. I'll stop short at stating that people here of any background or belief system can learn to discern between medicine and quackery, and I've found nothing in the widely preached Mormon doctrine that would cause me to consider grasping any peddled alternative health remedy over established medical practice.

I'll hold to my conviction that no order of CAM is created, preached, or sanctioned by authorities of the LDS Church. Nor is any business venture. Unfortunately, we often tend to appear as a gullible people. I'm convinced this is because we don't practice what we preach.

Mormons are often people with deep Christian convictions, and therefore, religious emotion. There is no more powerful sales tool than emotion, and no more deep-rooted emotion than those associated with one's religion. A savvy salesperson only needs to strike the right cord. In my view, there are few things as unchristian as making a sale or taking advantage of someone through the association of the person's religious convictions.

BYW, I am currently reading "Complications" by Dr. Atul Gawande, I think many on this list would enjoy the author's perspective on today's medical system. Check out the reviews on B&N.

It saddens me to hear when LDS faithful include aspects of superstition in their beliefs and associate CAM with their religious conviction.

I remember 18 or so years ago that AMWAY commerce had become so popular in some LDS circles that merchandise was delivered and orders taken almost in conjunction with ancillary Church meetings. Some distributors would venture to infer that AMWAY type commerce was akin to Brigham Young's united order and was sanctioned by "The Brethren" who "wouldn't really come out and make a formal statement to this end, now would they." I still laugh at how silly this is and wonder if this was the closest I would ever came to meeting a real Dannite.

The LDS Church uses 100% volunteer, lay ministry for local congregations. My Bishop (Pastor over my congregation) is a land developer, my Stake President (a leader between regional leaders and Bishops) is an anesthesiologist. All but the smallest minority of leaders are sincere in their "calling" but all are human and fallible. LDS Church history is full of great spiritual leaders that fell into the trap of using their Church influence to further their personal ambitions. The Book of Mormon warns of this, as did Joseph Smith. Sometimes the influence is unintentional: "That Bro. Jones used to be a bishop, maybe we better try them ear candles he's selling," or worse "...that investment proposition of his must be on the up-and-up."

Joseph Smith said he saw an Angel. That's an extraordinary claim. Members of the LDS Church accept this. Maybe to some degree, some Church members are conditioned to accept the extraordinary, common to CAM claims. There are plenty of predators ready to exploit one's ire for the extraordinary. Joseph Smith organized a religion, its precepts being founded in the Old and New Testaments. Members should be very skeptical of anything requiring extraordinary acceptance, especially when it doesn't have a precise and firm basis in their established religious doctrine. That's why the AMWAY association with Church hierarchy concept is plain silly.

Janice Lyons site (non-LDS affiliated) is a great resource for addressing CAM from a religious viewpoint: http://www.cinam.net/

The LDS church puts absolutely everything on-line on the WWW, from conference addresses right down to the entire Sunday School manual I use to teach my seven year olds.

Monday, July 07, 2003

Comment of compounded drugs

There is some contraversy over "compounding" drugs by independant pharmacies. Laws don't regulate the final products. Following the date of this post, press reportes of mistakes, fraud, and death have occured as a result of independant pharmacist compounding.-dras

Compounded drugs are not name-brand prescriptions available through chain drugstores. The drugs are customized medications, usually mixed in independent pharmacies that do not have to follow the same safety procedures as big drug-makers. Retail pharmacies can compound drugs only for prescriptions -- they cannot be distributed wholesale.

Compounding that is NOT alt-med might be when one dilutes the eye-dropper bottle of albuteral with saline or sterile water to create single dose vials, then adds concentrate inhalants, thus avoiding the cost of manufacturer single-dose vials and multiple prescriptions. Also, I suspect prescription meds can be "doctored-up" (ie flavored, crushed, etc.) to avoid NDC set prices.

Also, can the argument be made that any legislation is more about protecting Big Pharm's patents and payments, and less about protecting the consumer? Or more about preventing death from overly dilute drugs, or contamination by compounding under less than factory conditions?
http://www.iacprx.org
http://www.asipp.org/Steroids/FDA%20takes.htm
Linked from asipp: http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2002/06/23/MN12273.DTL&type=printable

Thursday, July 03, 2003

The demise of bone marrow transplants for breast cancer

The July 3 (2003) issue of New England Journal of Medicine (NEJM) includes two new studies and an editorial on the use of autologous bone marrow transplantation (AMBT) to treat late-stage breast cancer. In the 1990’s, ABMT for late stage breast cancer came into widespread use without evidence that it works better than conventional chemotherapy. This happened as a result of government mandates, court rulings, aggressive promotion by special interest groups, and reporting from certain news media. The message was conveyed that this is an effective treatment; often the side-effects of the highly toxic treatment were understated.
Several large studies were delayed because women declined to enroll in clinical trials, thinking ABMT was already the proven, gold standard. Of five studies finally reported in l999, four had negative findings with respect to ABMT, and the one that had positive findings was later determined to be bogus.
Subsequently, demand for this treatment apparently declined dramatically because the treatment has been discredited. ABMT for late-stage breast cancer continued to be used on a case-by-case basis mainly because there are mandates to cover it in effect in about a dozen states, and under some tax funded benefits plans. It is important to note ABMT is used to treat other specific conditions for which there is evidence it works better than conventional therapy.
The two studies in Thursday’s NEJM show conflicting results:
· One by Tallman et al. concludes "The addition of high-dose chemotherapy and autologous hematopoietic stem-call transplantation to six cycles of adjuvant chemotherapy with CAF [this stands for the names of three therapies] may reduce the risk of relapse but does not improve the outcome among patients with primary breast cancer and at least 10 involved axillary lymph nodes. Conventional-dose adjuvant chemotherapy remains the standard of care for such patients."
· One by Rodenhuis et al. concludes "High-dose alkylating therapy improves relapse-free survival among patients with stage II or III breast cancer and 10 or more positive axillary lymph nodes. This benefit may be confined to patients with HER-2/neu-negative tumors."
Thus, one study confirms conventional chemotherapy as the standard of care for patients with late stage breast cancer, while the other suggests some benefit for ABMT in terms of time to relapse but not mortality in a highly targeted group of women. The accompanying editorial appears to a number of readers to tilt more to the second study.

Observers make the point that these studies were done comparing ABMT to outmoded therapy. Others observe that there is nothing in the new studies to outweigh the large body of evidence arguing against it, and nothing in the new studies to outweigh the toxicity of ABMT.
The studies are available at www.nejm.org.