Wednesday, February 20, 2013

The use of the words "can" and "may"

Epidemiologic studies cannot always prove cause and effect.

One clinical study does not make the golden rule. It may prove a hypothesis but should the experiment should be repeatable, given the same settings.

With these two important research concepts, the public is advised to make sure that what he/she reads is thoroughly discerned. With technology at our fingertips, and an abundance of bloggers who blog for a living, I caution the public on information they capture and read on-line, especially within the realm of medical science. Medicine is NOT an exact science.

I blog about fellow bloggers who have no authority to write about a field they are unfamiliar or not professionally trained to provide an opinion about. This causes undue harm by providing wrongful "dis-information" to the public. To cite a clear example is a mom blog site where she promotes the use of a probiotic in order to increase platelet count in patients with dengue infection.

It is a fact that if patients are faced with a disease that has NO treatment, we will draw at straws in search of a cure. And while there is nothing wrong looking for a cure - desperate circumstances result in desperate measures. But desperation can be fatal for those who don't understand the science and just read the results.

The use of the words "can" and "may" should be the benchmarks for any claims made from researches or clinical trials.

An example is the current American Academy of Pediatrics Guidelines on Pesticides and Kids. While there are data on acute and chronic exposures to pesticides, the technical data report discusses ASSOCIATIONS, which does not mean cause and effect. There is an increasing amount of data in the literature linking chronic exposure of children to pesticides with neurodevelopmental problems or some form of cancer later on, but the literature provides data on the LINK and does not explicitly state a 100% cause and effect scenario. Cancer or neurodevelopmental disorders may emanate from other causes and not necessarily the pesticide exposure. While undue exposure to pesticides CAN increase the risk of chronic diseases in pediatrics, the amount of pesticide exposure or duration of pesticide exposure MAY be a contributing factor. The statement being made is to diminish the primary exposure through preventive measures (by providing less exposure to pesticides) so that we CAN minimize long-term problems.

Saying that taking probiotics CAN bring up the platelet count of patients in a study that is highly flawed is like putting the carriage in front of the horse. I don't know how much the mom blogger got paid for saying this, but it is highly controversial and highly unethical for a non-professional to endorse a product's clinical trial that has no foundation except that it was written (but not PUBLISHED) by three doctors.

At any rate, the internet is currently full of trash and the public has to be warned about all the information flying around. Only a handful are truly informative. Having to sift through which ones are useful MAY be the challenge here.

Remember, media will always attempt to appeal to the emotion rather than what is essentially true. Capturing what they want in 60 seconds or less is appealing to the attention-deficient audience they have.


A friendly tip - if you want to make money with a blog site, don't do it at the expense of the public's health. Just go put up a porn site.

Monday, February 11, 2013

Love in the right places - mi AMOUR

I was talking to a friend about love.

We have our life stories about love lost & then found. Or love at first sight and those happily ever afters. The Filipino primetime telenovelas or the classic drama anthology Maalala Mo Kaya usually turns a dramatic flare on life and love - sometimes with all the slapping, crying, killing, burying, more slapping, more crying, then always a happily ever after.

As real as it gets are the true-to-life dramas we encounter every day of our lives. The people we love (or hate) and live with. The family we cannot choose but have to carry the burden of being part of their insane life intertwining with our insane world. The boyfriend, girlfriend, partner, husband or wife who has gone astray and created a void in our lives. Or the loved ones who have moved on to the other side of the world and have left us to live life in solace.

There's no such thing as forever. I wish there were. Then there would be no more heartaches or painful goodbyes. But life is never fair. No one ever said that it would be. Even at the best days of our lives, there's always something bound to go wrong. One day, a love gone astray. One day, you just get the feeling that you've fallen out of love. One day, the moment is gone.

I share these random thoughts about love, not because Valentine's day is a few days away from my first blog (and probably only blog) in February, but because I know the feeling of falling in and out of love...of trying to find a fairy tale story to our lives because we all want a happily ever after ending...of being together and trying to make it work but not being happy with the one you fall in love with or vice-versa...of finding an excuse to being a hopeless romantic or staying single forever...

You see, love should not be sought. It seeks you. It's found not in the busy chat rooms of an internet or a dating service. It's not found in the people you meet at work or by chance meet up through casual introductions. It's not found in the people that are introduced to you by friends or by the giggly encounters in soirees or one-night stands. It's found in the right place - in your heart.

Love is always a work in progress. You go through difficult times together and the worst times are the real test of love.

I was watching "Amour" over the weekend. It's a French film nominated for this year's Oscar award. I have never felt so depressed after watching a movie as when I saw "Amour". The film is about two elderly couple, Georges and Anne, who are music teachers in their 80s. The couple live alone in an apartment in an upscale French neighborhood and are enjoying their octogenarian years. One day, Anne has a stroke and after a few days in the hospital, Georges brings her home to care for her. Both in their sunset years, their bond of love is severely tested when Anne's condition deteriorates and she is required to have an operation which leaves her paralyzed. Georges refuses to commit her to a nursing home and continues to care for her in spite of his own limitations in caring for her in his old age. His personal mission in life was to become her caretaker...and towards the end of the story the movie was really difficult to watch. It drained me emotionally and left me with the thought that things were to get worse until its inevitable ending. It wasn't one of those movies that you'd want to watch if you're looking for fairy tale endings and magic castles, because this film downright is an unsentimental drama tells you from the get go that you're going to watch a movie that has a tragic ending.

Sometimes love in the right places means just loving one through thick and thin. It's the most difficult choice we make in life, but it's the kind of love that will make us weather the worst of times.