BS: robomatic in hospital

Subject: RE: BS: robomatic in hospital
From: MaJoC the Filk
Date: 26 Sep 22 - 08:11 AM

> Anyone who is ill should consult their doctor.

Hear, hear.

> It is more guesswork than your average shmoe may realize.

But informed guesswork, with many years' training and experience behind it. Don't knock experience as a research tool.

Engage rant mode: It always saddens me that people will ignore someone who is honest enough to admit the element of doubt in scientific theories and results, while swallowing, whole and without hesitation, something that's stated with certainty by someone whose qualifications begin and end with "wot some bloke said in the pub yesterday", or (worse) blindly follow the top hit on Google .... "garbage in, Gospel out", an' all that.

Subject: RE: BS: robomatic in hospital
From: Steve Shaw
Date: 26 Sep 22 - 08:41 AM

Flu jabs (I'm having mine in the next half-hour as it happens) are not predicated on guesswork. They are based on highly-informed predictions as to which strains will be prevalent in the coming season.

Probiotics may do no harm except to your wallet. The jury is very much out on whether they are even slightly effective, or not effective at all. These things are easy to research for yourself. Of course, if you want to believe in them, good for you. But don't forget what "believe" actually means.

Subject: RE: BS: robomatic in hospital
From: Steve Shaw
Date: 26 Sep 22 - 12:22 PM

Our flu jab contains an extra ingredient for over-65s that makes it "take" better. It works against four strains of the virus. I used to get flu a lot, maybe once every couple of years, but I haven't had it since I started having the jab about ten years ago. Clearly some brilliant, er, guesswork going on there! Next stop covid booster, then next stop shingles jab. I feel like a pincushion.

Subject: RE: BS: robomatic in hospital
From: Steve Shaw
Date: 26 Sep 22 - 12:39 PM

And for the fans of probiotics, this makes for a rather sobering read:

"Probiotics: elixir or empty promise?"

(The Lancet Gastroenterology & Hepatology)

Just a few points, though it isn't a long read:

Evidence for the efficacy of probiotics is weak or, in some cases, non-existent.

Probiotics are classed as food, not medicines, so are not subject to anything like the same regulation, if at all, and are not subject to clinical trials.

Some probiotics in some people may actually interfere with the gut flora recovery process after illness or antibiotic use.

There is limited evidence that probiotics may help to reduce diarrhoea in some people after antibiotic treatment, but consistent evidence is thin.

The suggestion is that a healthy, varied diet may be a better way forward.

A number of medical websites suggest that while probiotics are probably harmless, you shouldn't waste your money!

Subject: RE: BS: robomatic in hospital
From: Helen
Date: 26 Sep 22 - 02:50 PM

Perhaps it would be useful to provide the link to the article you want people to read.

Subject: RE: BS: robomatic in hospital
From: Stilly River Sage
Date: 26 Sep 22 - 03:47 PM

robomatic, I congratulate you on escaping the expensive ambulance ride. The bills from those companies are the subject of many medical cost stories on NPR and other places.

robomatic's thread has nearly been hijacked by the anti-Moseley Steve. A physician looking into various aspects of medical topics of interest to viewers doesn't make him a bad doctor. There was so much response to his fasting program that he followed it up with more research and a book. So sue him.

Helen, I also like the programs that I've seen from Moseley. I followed the general pattern of alternate day fasting in his Eat, Fast, and Live Longer to finally get back to what I consider my "normal" weight. It was a logical approach that didn't require plans or special foods, just common sense and six months of dedication to the project and a lot of exercise to round it out. My GP knew I was going to work on this ever since I had the thyroid diagnosis. I haven't seen Moseley's gut program but will look into it. My gastroenterologist recommends fiber and probiotics. (She's rather insistent about fiber!) I'm coming up on my fourth colonoscopy next year (five years apart) and have been meaning to find out if her recommendation is more refined than in the past. I also have a copy of David Sedaris' Let's Explore Diabetes with Owls to give her - he has a hilarious essay about his first colonoscopy.

Keeping my gut happy has been something I didn't pay as much attention to as I should have over the years, but this year I also decided to make fruits and vegetables a bigger part of my diet, eating less bread (though I do love it!) and meat in dishes, rarely a cut of meat on the plate (steak and potatoes, a whole chicken breast, etc. are rarely on the menu.) I eat more fish. My gut seems to be happier. As I mentioned at the top of the thread, my next door neighbor was rushed to the hospital a couple of times and ended up with surgery to remove a blockage. Serious stuff there, and something to be avoided at all costs. Robo got lucky if they only treatment he needs is what he had so far.

Subject: RE: BS: robomatic in hospital
From: Steve Shaw
Date: 26 Sep 22 - 04:16 PM

I didn't bring up Mosley! Note the correct spelling, by the way. His programmes are entertaining and doubtless contain some good ideas, and his producers/scriptwriters would never allow any wacky or damaging content, but they are not predicated on real science. Fine to take what you like from them. Also fine to question his lack of rigour. You can actually do both, I've found, and indeed I do. By the way, on 22 September, in two posts, I fully supported robo's doctors as they are the guys on the spot who know best what they're dealing with. I should think that Mosley and his shows are generally irrelevant with regard to that....yet I'm the hijacker!

Just google it, Helen.

Subject: RE: BS: robomatic in hospital
From: Helen
Date: 26 Sep 22 - 05:09 PM

Very interesting article. It's a very short article but I think it is worth reading the whole article and not the bits and pieces one person has chosen to quote from it.

Essentially, the way I read it is that the author surmises that there needs to be further research especially in finding ways to personalise treatments for the most effective results.

This sentence is interesting because it suggests that "trans-poo-sion" (a comical play on words combining "poo" and "transfusion" which I first heard in a medical documentary) appears to have effective results:

"While likely to be considerably less appealing, the group who received autologous faecal microbiota transplantation recovered their microbiota the quickest, with the composition of the microbiota returning to normal within days."


Editorial| Volume 4, ISSUE 2, P81, February 01, 2019

Probiotics: elixir or empty promise?

    The Lancet Gastroenterology & Hepatology

Published:February, 2019DOI:https://doi.org/10.1016/S2468-1253(18)30415-1

The gut microbiota has been implicated in diseases ranging from obesity to Parkinson's disease and depression. Little wonder then that commercial probiotics have gained widespread popularity and are now estimated to command a US$37 billion market worldwide. But with research into the microbiome still in its infancy, increasing evidence suggests that both commercial and clinical use of probiotics is outpacing the science.

Evidence from clinical trials is mixed and often of low quality, but findings from meta-analyses suggest that probiotics can provide benefits in the treatment of some conditions, such as infectious and antibiotic-associated diarrhoea. As such, taking probiotics after antibiotic treatment is an increasingly common practice. However, two studies recently reported in Cell question whether taking highly concentrated supplements of so-called good bacteria aids the recovery of normal gut flora.

Suez and colleagues investigated the recovery of the gut microbiota after antibiotic treatment and found that probiotics might perturb rather than aid this process. The probiotics rapidly colonised the gut but prevented the normal microbiota from repopulating for up to 5 months. While likely to be considerably less appealing, the group who received autologous faecal microbiota transplantation recovered their microbiota the quickest, with the composition of the microbiota returning to normal within days. Furthermore, Zmora and colleagues showed that colonisation occurred in highly individualised patterns, with some people's gastrointestinal tracts rejecting probiotics and others allowing colonisation by the probiotic strain, meaning that many individuals taking probiotic supplements are simply wasting their money.

Two large-scale clinical trials recently reported in the New England Journal of Medicine suggest that the situation in infectious diarrhoea might also be more complex than previously believed. Freedman and colleagues did a randomised controlled trial of a probiotic containing Lactobacillus rhamnosus and Lactobacillus helveticus in children presenting to the emergency department with gastroenteritis. Contrary to expectations, they found that the probiotic did not prevent development of moderate-to-severe gastroenteritis within 14 days after enrolment. In a separate study, Schnadower and colleagues found similar results with L rhamnosus GG alone. Both trials used probiotics that are available over the counter in North America and showed no significant difference from placebo in the duration of diarrhoea and vomiting, number of unscheduled health-care visits, or length of absence from day care. These results cannot be generalised to other probiotic strains or preparations, but they do show that we have some way to go in elucidating which probiotics might provide benefits in which clinical settings.

Importantly, patients with gastrointestinal conditions are not the only ones taking probiotics. 3·9 million people in the USA alone regularly take probiotic supplements, with promised benefits ranging from improved digestion and immune function to improved mental health and prevention of heart disease. However, evidence for these benefits is lacking, and because probiotics are often sold as supplements, manufacturers in many countries are not required to provide evidence of their safety and efficacy to regulatory bodies. The ubiquity of probiotic products would suggest that, at worst, they are harmless. Nevertheless, some safety concerns have been raised, including the risk of contamination, possibility of fungaemia or bacteraemia (particularly in immune-compromised, elderly, or critically ill individuals), small intestinal bacterial overgrowth, and antibiotic resistance. Adding to concerns, clinical trials of probiotics have not consistently reported safety outcomes.

While the logic behind probiotics might seem sound, it is clear that we have a long way to go before understanding the complexity of the microbiota and the effects—both good and bad—that probiotics might have. All individuals have a unique gut microbiome, and the effects of different bacteria on different people are likely to be highly variable; as such, probiotic use might even need to be personalised for optimal benefits. Commercially available products might not contain the correct strains or quantities of bacteria to provide benefits, and most probiotic supplements contain only single strains, vastly oversimplifying the complexity of the microbiota. While taking a supplement for improved health is certainly an attractive prospect, those looking to aid their gut microbiota might be better served by consuming a healthy, varied diet. In the meantime, rigorous clinical trials are needed to substantiate potential health benefits and to confirm whether probiotics are elixirs or just empty promises.

For the study by Suez and colleagues see Cell 2018; 174: 1406–23
For the study by Zmora and colleagues see Cell 2018; 174: 1388–405
For the study by Freedman and colleagues see N Engl J Med 2018; 379: 2015–26
For the study by Schnadower and colleagues see N Engl J Med 2018; 379: 2002–14


Copyright © 2019 Dennis Kunkel Microscropy/Science Photo Library
Article Info
Publication History
Published: February 2019
Identification

DOI: https://doi.org/10.1016/S2468-1253(18)30415-1
Copyright
© 2018 Elsevier Ltd. All rights reserved.
ScienceDirect

Subject: RE: BS: robomatic in hospital
From: Stilly River Sage
Date: 26 Sep 22 - 05:09 PM

This is where we disagree: but they are not predicated on real science. You seem to suggest anything you don't agree with isn't real science, and that is a recurring theme in your posts over the years. Mosely/Mosley is a typo, don't bother to try to turn that into your argument. You should have done Helen the courtesy of posting the link to your article, considering the number of times you criticize others for not posting sources.

Subject: RE: BS: robomatic in hospital
From: Steve Shaw
Date: 26 Sep 22 - 06:52 PM

Then you made the exact same typo three times in one post! :-)

I don't disagree with Mosley's programmes. Not at all. In fact, I've watched a good few, though not all. When he gets a small group of people to take part in his latest study, for example, it's interesting but it's not science. The sample sizes are way too small and the "experiments" are carried out over far too short a time. He knows it too. At best, they may suggest something of interest that requires further study. That's all fine, though I wouldn't risk staking my life on his conclusions. It's entirely up to the viewers whether or not they take a dispassionate view of his findings, or, alternatively, decide whether he's saying what they want to hear. I'm not saying anything derogatory here. I'm simply describing the limitations of popular science. And I tend not to shout at you when I disagree with you.

Subject: RE: BS: robomatic in hospital
From: Steve Shaw
Date: 26 Sep 22 - 07:10 PM

"Very interesting article. It's a very short article but I think it is worth reading the whole article and not the bits and pieces one person has chosen to quote from it."

Yes it is. I did point you to it, not wanting you to think that I'd only mention the juicy bits, and, by the way, contrary to what you say, I didn't quote from it. You're both quite good at misrepresentation today! I think the bottom line from the Lancet piece is that probiotics don't come out of it very well at all. You'll find similar demurrals in other sources too (though not, of course, the ones that are there to push probiotics). As I said, because they are classed as foods, not medicines, they escape rigorous examination of their claims and are not subject to clinical trial. Of course, not everything that isn't clinically trialled is bad. If you like taking them and believe they're doing you good, that's great. As for me, I'd rather spend the considerable money they cost on nice food. I've just come off two weeks of one gram of flucloxacillin four times a day, as well as a short bout of intravenous antibiotics. That was a heavyweight assault on my gut (which, in spite of decades of good living, is generally in remarkably robust working condition) and I felt it at times. I found that eating mild-flavoured and easy-to-digest foods did the trick. But that's not science, that's just me, and we're all different.

Subject: RE: BS: robomatic in hospital
From: Donuel
Date: 26 Sep 22 - 09:22 PM

Good discussion despite some usual narcissist symptomology. In fact, arrogance can serve as a sounding board or devil's advocate that can stimulate thought. There is a most elite arrogant lake Superior and the water is unbelievably old but fresh.

Robo did you lose the tube?

Subject: RE: BS: robomatic in hospital
From: Helen
Date: 27 Sep 22 - 04:43 AM

Do you seriously think that the academic reputation of the scientists on Dr Mosley's shows would be placed in jeopardy by simply relying on a small trial sample which is shown for illustrative purposes only. The scientists have already done the real-life studies. That's why they are invited to participate on the shows.

Subject: RE: BS: robomatic in hospital
From: Steve Shaw
Date: 27 Sep 22 - 05:30 AM

Give us some examples.

As I said, the producers/scriptwriters are not going to permit unfounded claims to be made that could be harmful to some viewers. But there is a world of difference between interesting findings from short-term, small-scale, made-for-telly delvings and rigorous, peer-reviewed science. There's nothing wrong with Michael's little sorties into the ins and outs of human behaviour, etc., but he would tell you that you shouldn't try to take more from them than is justified by the limited approach. That's all. I'm not saying it's not valuable or that he's a charlatan. Not a bit of it. But he's there to inform a little bit and to entertain a lot. He's very good at it. If they put me up there with exactly the same material, the viewing figures would be nil.

Subject: RE: BS: robomatic in hospital
From: MaJoC the Filk
Date: 27 Sep 22 - 10:27 AM

Calm down, folks. I hereby offer a parallel example from my own experience:

Many, many moons ago, our doctor in Nottingham suggested I try eliminating four things from my diet to help my eczema, of which one was cows' milk ("try goats' milk instead"), and another was orange juice. More recently, my eczema flared summat rotten, and I was sent to the specialist (in Oxford, near where we now live). I mentioned the ban on cows' milk. When he finished laughing, the specialist said: "Doctors like to give patients impossible challanges: you'll never eliminate cows' milk, as it's in so many products. But carry on drinking goats' milk if you like the taste."

I've come to the conclusion that (eg) giving up cows' milk gives one something to do, so one feels a bit more in control; and if it doesn't work, there's not much lost. (Eczema is one of those conditions where correlation between cause and effect is problematical at best, except for the disastrous effects of biological washing powder.) And I do prefer the taste, as it happens, but I'm happy enough to drink cows' milk when our fridge runneth over with it, and the goat's run dry.

Meanwhile, back at the Subject: Best of health, robo.

Subject: RE: BS: robomatic in hospital
From: Steve Shaw
Date: 27 Sep 22 - 10:43 AM

I'll drink oat milk 'til it comes out of my ears and I'll have it on my Shreddies and use it to make my porridge, but I must have full-fat cows' milk in my flat whites and semi-skimmed in my tea. So our transaction with cows' milk has lessened severely down the years, and I must say I feel better for it. But that's not science or a recommendation - that's just me!

Stuff such as orange juice is loaded with sugars, natural though such sugars are. Recently I've taken to peeling tangerines by the three and whizzing them, pith, pips and all, with my hand blender in a jug. A bit of added water to make it a longer drink and it's delicious, and I'm getting all the fibre! When my kidneys were damaged by dehydration a few weeks ago, I took to doing this instead of just scoffing the tangerines as is in order to up my fluid intake. I must say, I much prefer it to bought orange juice...

Subject: RE: BS: robomatic in hospital
From: Donuel
Date: 28 Sep 22 - 11:40 AM

Meat, cheese and all the white carbs (rice, potato...) except eggs are the constipating foods. That is if low residue = constipating.

Subject: RE: BS: robomatic in hospital
From: Steve Shaw
Date: 28 Sep 22 - 11:48 AM

I eat all that stuff all the time and I never, repeat never, get constipated. As potatoes are high-fibre and ninety-odd percent water, perhaps you could explain to us how they would get you constipated.

Subject: RE: BS: robomatic in hospital
From: Steve Shaw
Date: 28 Sep 22 - 12:17 PM

Er, a bit less water than I said...

Subject: RE: BS: robomatic in hospital
From: robomatic
Date: 29 Sep 22 - 06:07 PM

Just came from my first checkup after leaving the hospital. The medical professional is having me meet with some specialists before letting me get a Covid booster, not that they are anti-booster, they want to let the pro assess the overall situation. They also recommended adding ground flax seed to my diet, for aiding digestive 'throughput'.

Subject: RE: BS: robomatic in hospital
From: Helen
Date: 29 Sep 22 - 07:16 PM

Thanks for the update, robomatic. Hopefully you are on the mend.