What I’m Reading – TCM and Western Medicine
Interesting Articles and Studies in the News
I’m always on the lookout for current research that relates to topics in TCM or western medicine that I often encounter in my practice. Here’s a brief look at what I’ve been reading recently, in case anything would also be of interest to you.
Integrative Medicine und Automimmune Syndromes:
„After a Sjögren’s Syndrome Diagnosis, This Cyclist Found Healing and Strength on Her Bike“
https://www.bicycling.com/culture/a44402540/how-cycling-changed-me-desiree-m-peterkin/
This article from Bicycling.com reports how an enthusiastic bikerider uses acupuncture and massage along with her western medicine therapies to manage her Sjogren’s Syndrome, so that she can continue to thrive on the bike, among other things.
“All I wanted was to get well enough to get back on my bike, and it was almost a year later in June 2017 that I was well enough to ride outside again.
My medical treatment plan has significantly helped me and includes infusions every six months. I also take daily medication, which has helped give me my life back.
Today, I’m able to do everything except run. The treatments don’t necessarily prevent as much as quell my symptoms a significant amount. My energy levels are mainly back to normal, but there are times when it drops due to fatigue, and I let it run its course. I also schedule regular appointments with my chiropractor, massage therapist, and acupuncturist to help me feel my best.”
Would you like to learn more about the use of acupuncture and massage in my practice?
“Vitamin D supplementation and major cardiovascular events: D-Health randomised controlled trial”
BMJ 2023; 381 doi: https://doi.org/10.1136/bmj-2023-075230 (Published 28 June 2023)
https://www.bmj.com/content/381/bmj-2023-075230
https://www.bmj.com/content/381/bmj-2023-075230
Previous studies have hinted at an association between Vitamin D levels and lower incidence of cardiovascular events like heart attack and stroke. A causal relationship has not yet been proven however — meaning, we can’t be sure that there aren’t some confounding variables just making it look like the Vitamin D itself is reducing the risk of the cardiovascular events. For example, could it be that people who exercise and eat well are less likely to experience a heart attack or stroke, and they just happen to be more likely to supplement their Vitamin D levels as well?
This study doesn’t definitively answer the question, but it is a step in the right direction. Key findings included:
- “The rate of major cardiovascular events was lower in the vitamin D group than in the placebo group (hazard ratio 0.91, 95% confidence interval 0.81 to 1.01), especially among those who were taking cardiovascular drugs at baseline (0.84, 0.74 to 0.97; P for interaction=0.12), although the P value for interaction was not significant (<0.05).”
- “Overall, the difference in standardised cause specific cumulative incidence at five years was −5.8 events per 1000 participants (95% confidence interval −12.2 to 0.5 per 1000 participants), resulting in a number needed to treat to avoid one major cardiovascular event of 172.”
- “The rate of myocardial infarction (hazard ratio 0.81, 95% confidence interval 0.67 to 0.98) and coronary revascularisation (0.89, 0.78 to 1.01) was lower in the vitamin D group, but there was no difference in the rate of stroke (0.99, 0.80 to 1.23).”
The distinction between knowing that a nutrient deficiency can cause a problem and knowing that supplementing that deficiency with a vitamin product is an important one. We’re not quite sure if Vitamin D supplementation lowers the risk of cardiovascular incidents, but we are pretty sure that having low Vitamin D levels in the blood is associated with both higher risk factors that could lead to stroke and heart attack (such as higher lipid levels) and with actual strokes and heart attacks themselves.
See for example:
- Zhou R, Wang M, Huang H, Li W, Hu Y, Wu T. Lower Vitamin D Status Is Associated with an Increased Risk of Ischemic Stroke: A Systematic Review and Meta-Analysis. Nutrients. 2018 Feb 28;10(3):277. doi: 10.3390/nu10030277. PMID: 29495586; PMCID: PMC5872695.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872695/
- Brøndum-Jacobsen P, Benn M, Jensen GB, Nordestgaard BG. 25-hydroxyvitamin d levels and risk of ischemic heart disease, myocardial infarction, and early death: population-based study and meta-analyses of 18 and 17 studies. Arterioscler Thromb Vasc Biol. 2012 Nov;32(11):2794-802. doi: 10.1161/ATVBAHA.112.248039. Epub 2012 Aug 30. PMID: 22936341. https://www.ahajournals.org/doi/10.1161/ATVBAHA.112.248039?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
Advances in Breast Cancer Screening:
AI use in breast cancer screening as good as two radiologists, study finds
https://www.theguardian.com/society/2023/aug/02/ai-use-breast-cancer-screening-study-preliminary-results
AI use in breast cancer screening as good as two radiologists, study finds
https://www.theguardian.com/society/2023/aug/02/ai-use-breast-cancer-screening-study-preliminary-results
Published in the Lancet Oncology Journal, this was the first randomized controlled trial (RCT) conducted to determine whether AI can accurately diagnose breast cancer in mammogram. Previous studies were carried out retrospectively, assessing scans that had already been evaluated by radiologists. This study prospectively compared screening by AI followed by one to two radiologists and standard screening conducted by two radiologists.
Key findings included:
- AI-supported screening among 39 996 participants resulted in 244 screen-detected cancers, 861 recalls, and a total of 46 345 screen readings. Standard screening among 40 024 participants resulted in 203 screen-detected cancers, 817 recalls, and a total of 83 231 screen readings.
- Cancer detection rates were 6·1 (95% CI 5·4–6·9) per 1000 screened participants in the intervention group, above the lowest acceptable limit for safety, and 5·1 (4·4–5·8) per 1000 in the control group—a ratio of 1·2 (95% CI 1·0–1·5; p=0·052).
- The rate of false positives was 1.5% in both study arms, indicating that AI identified a lesion as cancerous, and it really was cancerous, about as often as human evaluators.
- In the intervention group, 184 (75%) of 244 cancers detected were invasive and 60 (25%) were in situ; in the control group, 165 (81%) of 203 cancers were invasive and 38 (19%) were in situ.
- The screen-reading workload was reduced by 44·3% using AI.
The import of this interim study is that “AI-supported mammography screening resulted in a similar cancer detection rate compared with standard double reading, with a substantially lower screen-reading workload, indicating that the use of AI in mammography screening is safe.” If confirmed by longer-term studies, AI could potentially be used to reduce the burden of screening on understaffed radiology departments in many countries, thereby speeding the diagnostic process for patients.
‘The lead author, Dr Kristina Lång, from Lund University in Sweden, said: “These promising interim safety results should be used to inform new trials and programme-based evaluations to address the pronounced radiologist shortage in many countries, but they are not enough on their own to confirm that AI is ready to be implemented in mammography screening.
‘“We still need to understand the implications on patients’ outcomes, especially whether combining radiologists’ expertise with AI can help detect interval cancers that are often missed by traditional screening, as well as the cost-effectiveness of the technology.” ‘
This article was published in The Guardian, but the abstract of the actual study can be viewed online at:
https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(23)00298-X/fulltext
Upcoming posts
The following topics will be covered in upcoming blog posts. Until then, I invite you to read about other topics covered in TCM or see what else has been discussed on my blog.
- Autoimmune
- Chronic Fatigue Syndrome (ME/CFS)
- Diagnosis – East and West
- Skin Conditions
- Support During and After Radiation / Chemotherapy
- Menstrual Problems
- Migraines
- Mental and emotional complaints
- Pain
- Stress and burnout
- Urogenital
- Digestive Problems
Upcoming Blog Posts
The following topics will be covered in upcoming blog posts. Until then, I invite you to read about other topics covered in TCM or see what else has been discussed on my blog.
- Autoimmune
- Chronic Fatigue
- Diagnosis – East and West
- Skin Conditions
- Cancer (Adjunctive Therapy)
- Menstrual Problems
- Migraines
- Mental and emotional complaints
- Pain
- Stress and burnout
- Urogenital
- Digestive Problems
- Post-viral Syndrome
Questions?
Tuesday: 9:00 – 18:00
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Thursday: 9:00 – 18:00
Friday: 9:00 – 13:00
09183 / 949 0588