The Body of Evidence

Chris and Jonathan speak to Dr. Swapnil Hiremath, a hypertension specialist and staff nephrologist at the Ottawa Hospital. As they discuss high blood pressure and how to treat it, they make their way to a highly contentious clinical trial, the Hygia trial, which allegedly compared two times of day when to take blood pressure medication. Its results are a little too perfect to be believed.   3:35 What is high blood pressure and what is “essential” hypertension? 8:34 The two numbers of blood pressure 10:45 How antihypertensive drugs work 13:38 How our body metabolizes a drug 17:30 The intense debate over when to take blood pressure medication 21:59 The contentious Hygia trial 32:47 Is the Hygia trial… the Hygia project? 35:02 Considering fraud 41:21 The best time to take medication 44:38 “One simple trick to reduce your risk of heart attacks by 60%!”   * Theme music: “Fall of the Ocean Queen“ by Joseph Hackl.   To contribute to The Body of Evidence, go to our Patreon page at: http://www.patreon.com/thebodyofevidence/.   Patrons get a bonus show on Patreon called “Digressions”! Check it out!     Links: 1) Swapnil Hiremath on Twitter: https://twitter.com/hswapnil 2) The nephrology journal club: https://www.nephjc.com/ 3) Swapnil Hiremath’s podcast: https://www.nephjc.com/freelyfiltered  

What does the body of evidence say on the topic of Botox injections? Plus: we address the confusion over bivalent COVID-19 booster shots, and we look at a trial of magic mushrooms for alcohol use disorder!   Block 1: (3:00) Botox: what it is and what botulism does to you   Block 2: (9:00) Botox: how Botox works on wrinkles, a comparison between formulations, what can go wrong, why repeated injections are needed, and the non-cosmetic uses of the botulinum toxin   Block 3: (23:08) Bivalent booster vaccines and the reactive, libertarian public health response   Block 4: (36:01) Magic mushrooms for alcohol use disorder     * Jingle by Jillian Correia of Roctavio Canada * Theme music: “Fall of the Ocean Queen“ by Joseph Hackl. * Assistant researcher: Nicholas Koziris   To contribute to The Body of Evidence, go to our Patreon page at: http://www.patreon.com/thebodyofevidence/.   To make a one-time donation to our show, you can now use PayPal! https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE   Patrons get a bonus show on Patreon called “Digressions”! Check it out!     References:   1) Our episode on sunscreen: https://bodyofevidence.ca/019-sunscreen-and-the-mmr-vaccine   2) The cosmetic benefit of botulinum toxin: https://doi.org/10.1067/mjd.2002.121356   3) Differences between formulations: https://doi.org/10.1046/j.1524-4725.2003.29017.x   4) The FDA’s black box warning for Botox: https://jamanetwork.com/journals/jama/article-abstract/184061   5) Antibody formation after Botox: https://doi.org/10.1002/mds.23254   6) Cochrane review of Botox for migraine: https://doi.org/10.1136/bmjopen-2018-027953   7) Cochrane review of Botox for cervical dystonia: https://doi.org/10.1002/14651858.CD003633.pub4   8) Botox for urgency urinary incontinence: https://www.nejm.org/doi/full/10.1056/nejmoa1208872#:~:text=In%20summary%2C%20we%20found%20that,improvements%20in%20quality%20of%20life   9) New clinical trial of psilocybin-assisted psychotherapy for alcohol use disorder: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2795625     Music Credits:   The following music was used for this media project: Music: Main Theme (The Grand Score) by Alexander Nakarada Free download: https://filmmusic.io/song/4960-main-theme-the-grand-score License (CC BY 4.0): https://filmmusic.io/standard-license Artist website: https://www.serpentsoundstudios.com/  

What does the body of evidence say on the topic of vitamin supplements? We pilot a new format for the show and ask for your feedback! Let us know your thoughts on Facebook, Twitter, Patreon, or via email at thebodyofevidence@gmail.com   (6:34) The story of scurvy and how its cause, a vitamin deficiency, was harder to “science” than you may remember, with author Stephen R. Bown.    (22:48) The porous regulations that allow vitamin supplements to be sold and how Mel Gibson played a key role in this system, with health policy expert Timothy Caulfield.   (35:27) Chris and Jonathan explain what each vitamin does, what happens if you’re deficient, and whether or not vitamin supplements are necessary.     * Jingle by Joseph Hackl * Vox pop by Thanos Michailopoulos * Theme music: “Fall of the Ocean Queen“ by Joseph Hackl * Assistant researcher: Nicholas Koziris   To contribute to The Body of Evidence, go to our Patreon page at: http://www.patreon.com/thebodyofevidence/.   To make a one-time donation to our show, you can now use PayPal! https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE   Patrons get a bonus show on Patreon called “Digressions”! Check it out!     References:   1) Chris’ article “It Hasn’t Been a Good Year for Vitamin D”: https://montrealgazette.com/opinion/columnists/christopher-labos-it-hasnt-been-a-good-year-for-vitamin-d   2) Vitamin D supplementation and cardiovascular risk: https://jamanetwork.com/journals/jamacardiology/fullarticle/2735646   3) VITAL study: https://www.nejm.org/doi/10.1056/NEJMoa1809944   4) AMATERASU trial: https://doi.org/10.1001/jama.2019.2210   5) D2D study on vitamin D and type 2 diabetes: https://pubmed.ncbi.nlm.nih.gov/31173679/   6) The U.S. Preventive Services Task Force’s Final Recommendation Statement from June 2022: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/vitamin-supplementation-to-prevent-cvd-and-cancer-preventive-medication   7) Recommendation Statement as published in the Journal of the American Medical Association: https://jamanetwork.com/journals/jama/fullarticle/2793446     Music Credits: Peter Sandberg / Étude No 1 for String Quartet Christoffer Moe Ditlevsen / Rise to Power National Anthem Worx / Rule Britannia Silver Maple / Unspoken Bonnie Grace / We Still Have Courage   Wendy Marcini / The Cast Wendy Marcini / The Scam Christoffer Moe Ditlevsen / The Stakeout   Farrell Wooten / Margin of Error   All courtesy of www.epidemicsound.com  

The laying on of hands. The stethoscope. The “does it hurt when I press here.” We are all familiar with the physical exam a doctor does when investigating our symptoms. But in the 21st century, with access to ultrasound and MRI, are these old-fashioned techniques still relevant or just cool parlour tricks? Returning guest Niko joins Chris to discuss the evidence behind hands-on maneuvers taught to medical students to help diagnose a variety of conditions. Warning: you may be shocked.   JAMA’s series on the Rational Clinical Examination: https://jamanetwork.com/collections/6257/the-rational-clinical-examination   (4:44) Scenario #1: A torn meniscus or ligament in the knee   Lachman test: https://www.physio-pedia.com/Lachman_Test McMurray test: https://www.physio-pedia.com/McMurrays_Test   (17:20) Scenario #2: Carpal tunnel syndrome   Tinel’s test: https://www.physio-pedia.com/Tinel%E2%80%99s_Test Phalen’s test: https://www.physio-pedia.com/Phalen%E2%80%99s_Test   (24:29) Scenario #3: Meningitis   Brudzinski’s sign of meningitis: https://medlineplus.gov/ency/imagepages/19069.htm Kernig’s sign of meningitis: https://medlineplus.gov/ency/imagepages/19077.htm   (32:41) Scenario #4: Abdominal aortic aneurysm   (38:13) Scenario #5: Pneumonia   Whispered pectoriloquy: https://en.wikipedia.org/wiki/Whispered_pectoriloquy   (45:45) Scenario #6: Appendicitis   McBurney’s point: https://en.wikipedia.org/wiki/McBurney%27s_point Rovsing’s sign: https://en.wikipedia.org/wiki/Rovsing%27s_sign Psoas sign: https://en.wikipedia.org/wiki/Psoas_sign Obturator’s sign: https://en.wikipedia.org/wiki/Obturator_sign       * Theme music: “Fall of the Ocean Queen“ by Joseph Hackl. * Assistant researcher: Nicholas Koziris   To contribute to The Body of Evidence, go to our Patreon page at: http://www.patreon.com/thebodyofevidence/.   To make a one-time donation to our show, you can now use PayPal! https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE   Patrons get a bonus show on Patreon called “Digressions”! Check it out!

What does the body of evidence say on the topic of sexually transmitted infections? Plus: should you worry about monkeypox, and what is going on with mysterious cases of liver inflammation in children?   Block 1: (2:15) STIs: nomenclature, HIV, rising cases   Block 2: (8:57) STIs: why cases are increasing, who should be screened, treatment options, antibiotic resistance, confections, cold sore outbreaks   Block 3: (23:29) Monkeypox   Block 4: (36:45) Mysterious liver inflammation in children and possible link to COVID-19     * Jingle by Joseph Hackl * Theme music: “Fall of the Ocean Queen“ by Joseph Hackl. * Assistant researcher: Nicholas Koziris   To contribute to The Body of Evidence, go to our Patreon page at: http://www.patreon.com/thebodyofevidence/.   To make a one-time donation to our show, you can now use PayPal! https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE   Patrons get a bonus show on Patreon called “Digressions”! Check it out!     References:   1) Public Health Agency of Canada’s 2018 report on sexually transmitted infections in Canada: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/report-sexually-transmitted-infections-canada-2018.html   2) Summary table from the California Public Health Department about recommended STI screening in different groups: https://bit.ly/3sFxeJ0   3) Uptake of STI screening: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5814a2.htm & https://pubmed.ncbi.nlm.nih.gov/29985985/   4) CDC treatment guidelines and recommendations on co-treatment: https://www.cdc.gov/mmwr/volumes/69/wr/mm6950a6.htm   5) Acyclovir for treatment of genital herpes: https://pubmed.ncbi.nlm.nih.gov/6088819/   6) Topical antivirals for cold sores: https://pubmed.ncbi.nlm.nih.gov/9134943/   7) Episode 61 of our podcast on HIV: https://bodyofevidence.ca/061-hiv-and-covid-19-therapies   8) Episode 72 of our podcast on liver disease: https://bodyofevidence.ca/072-liver-disease-sleep-disorder-grab-bag   9) Jim Downs’ article in The Atlantic on tiptoeing around the issue of monkeypox and men who have sex with men: https://www.theatlantic.com/ideas/archive/2022/05/monkeypox-outbreak-spread-gay-bisexual-men/643122/     Music Credits:   Dead Spaces by Tim Kulig Link: https://filmmusic.io/song/9319-dead-spaces License: https://filmmusic.io/standard-license   The Legion by Alexander Nakarada Link: https://filmmusic.io/song/4912-the-legion License: https://filmmusic.io/standard-license  

The Body of Evidence is releasing an episode of HFMA’s Voices in Healthcare Finance podcast, which features an interview with Dr. Christopher Labos on the topic of weight bias in healthcare, including what health indicators to focus on instead of weight and how to help patients who are at risk improve their health outcomes without explicit or implicit fat shaming.   If you enjoy Voices in Healthcare Finance, you can find the show and subscribe to it here: https://hfma.podbean.com/     To contribute to The Body of Evidence, go to our Patreon page at: http://www.patreon.com/thebodyofevidence/.   Patrons get a bonus show on Patreon called “Digressions”! Check it out!

What does the body of evidence say on the topic of MSG? Plus: we dig into a new study that alleges that artificial sweeteners are associated with a higher risk of cancer (but But BUT!), and will we keep boosting people against COVID every four months?   Block 1: (2:05) MSG: what it is, where it comes from, and where it is used   Block 2: (8:41) MSG: what it tastes like, the story of how it was maligned, and whether or not it causes harm   Block 3: (27:26) New study on artificial sweeteners and cancer, and its pitfalls   Block 4: (39:11) Forever boosters for COVID-19     * Jingle by Jillian Correia of Roctavio Canada * Theme music: “Fall of the Ocean Queen“ by Joseph Hackl. * Assistant researcher: Nicholas Koziris   To contribute to The Body of Evidence, go to our Patreon page at: http://www.patreon.com/thebodyofevidence/.   To make a one-time donation to our show, you can now use PayPal! https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE   Patrons get a bonus show on Patreon called “Digressions”! Check it out!     References:   1) The original paper on “Chinese-restaurant syndrome:” https://doi.org/10.1056/nejm196804042781419   2) The Colgate University article on Dr. Howard Steel: https://news.colgate.edu/magazine/2019/02/06/the-strange-case-of-dr-ho-man-kwok/   3) This American Life’s episode on Dr. Steel and Dr. Kwok: https://www.thisamericanlife.org/668/the-long-fuse   4) The only other scientific paper penned by Dr. Kwok: https://doi.org/10.1016/s0022-3476(67)80272-5   5) Study on intravenous administration of MSG: https://doi.org/10.1126/science.163.3869.826   6) Study #1 on MSG and flushing: https://doi.org/10.1016/s0190-9622(86)70161-8   7) Study #2 on MSG and flushing: https://doi.org/10.1093/jn/130.4.1058s   8) Study on MSG and headaches: https://doi.org/10.1186/s10194-016-0639-4   9) The FDA’s findings on MSG: https://www.fda.gov/food/food-additives-petitions/questions-and-answers-monosodium-glutamate-msg   10) Adam Ragusea’s video on MSG: https://youtu.be/E-POAKKH5IM   11) New study on artificial sweeteners and cancer risk: https://doi.org/10.1371/journal.pmed.1003950   12) Second COVID booster has ‘marginal benefits’ in small study: https://www.medscape.com/viewarticle/972198   13) Jonathan’s article on a pan-coronavirus vaccine: https://www.mcgill.ca/oss/article/covid-19/future-proof-coronavirus-vaccine     Music Credits:   Shine Of Happiness by MusicLFiles Link: https://filmmusic.io/song/7537-shine-of-happiness License: https://filmmusic.io/standard-license  

Paul Ingraham shares his journey from woo believer to skeptic in massage therapy. Topics include tone policing, evidence-based vs science-based medicine, and navigating snark in healthcare. The discussion delves into Bayesian statistics, professionalism in healthcare, and the challenges of evidence-based medicine. A fascinating look at the evolution of skepticism and the importance of critical thinking in healthcare.

Fingers on buzzers! It’s the first (and possibly last) episode of What’s in a Name: Medical Edition! Join host Jonathan and his three contestants in figuring out the origin of common words used in biology and medicine! It’s fun, we swear!   In the hot seat: social media manager Melissa, medical resident Niko, and cardiologist Chris!   Who will win? Who will lose? Will their egos recover? Do points even matter? What are the rules again? You’ll hear about biceps, botulism, and that disease that got its name from a really old poem!   It’s What’s in a Name: Medical Edition!   Recorded in late December, 2021.   To contribute to The Body of Evidence, go to our Patreon page at: http://www.patreon.com/thebodyofevidence/.   To make a one-time donation to our show, you can now use PayPal! https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE   Patrons get a bonus show on Patreon called “Digressions”! Check it out!   Music Credits: Dark Secrets (DECISION) by Sascha Ende® Link: https://filmmusic.io/song/246-dark-secrets-decision- License: https://filmmusic.io/standard-license  

Jonathan and Chris talk to Dr. Barbara Hofer and Dr. Gale Sinatra, the authors of the book Science Denial: Why It Happens and What to Do About It. It’s a course in skepticism 101 as they discuss decision-making, doing your own research, and the post-truth era.   1:46 Why write a book about science denial now? 4:50 Irrational decision-making 6:17 Politicizing science and manufacturing doubt 16:30 Just asking questions and doing your own research 22:51 How to refute misconceptions and a note on the backfire effect 30:43 Patience and empathy in the time of the pandemic 32:38 Algorithmic literacy 33:55 Are the deniers aware of the true reasons for their science denial? 36:00 The post-truth era 39:32 Solutions for harm reduction     * Theme music: “Fall of the Ocean Queen“ by Joseph Hackl.   To contribute to The Body of Evidence, go to our Patreon page at: http://www.patreon.com/thebodyofevidence/.   Patrons get a bonus show on Patreon called “Digressions”! Check it out!     Links: 1) The book Science Denial: https://www.sciencedenialbook.com/ 2) The Debunking Handbook: https://www.climatechangecommunication.org/wp-content/uploads/2020/10/DebunkingHandbook2020.pdf