The Body of Evidence – Details, episodes & analysis

We wrap up the year with a new case challenge. A 38-year-old radiology technician has a strange rash just above… his buttocks! Who's to blame?

Was it the dog? Was it his job? Or is it the special person in his life?

Also: Chris learns about socks!

Yet also: we say the phrase "ass crack." We had to!

And also also: an important announcement.

Become a supporter of our show today either on Patreon or through PayPal! Thank you!

http://www.patreon.com/thebodyofevidence/

https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE

Email us your questions at thebodyofevidence@gmail.com.

Assistant researcher: Aigul Zaripova, MD

Theme music: "Fall of the Ocean Queen" by Joseph Hackl

Rod of Asclepius designed by Kamil J. Przybos

Chris' book, Does Coffee Cause Cancer?: https://ecwpress.com/products/does-coffee-cause-cancer

Obviously, Chris is not your doctor (probably). This podcast is not medical advice for you; it is what we call information.

Pain. Sometimes it's acute, sometimes it's chronic. It may come from an injury or just from wear and tear. Chris and Jonathan sit down to speak to Dr. Leon Tourian, who specializes in pain psychiatry at McGill University.

Can we objectively measure pain? Is there such a thing as normal pain? And what happens when chronic pain in our extremities is left untreated and our brain takes over?

Become a supporter of our show today either on Patreon or through PayPal! Thank you!

http://www.patreon.com/thebodyofevidence/

https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE

Email us your questions at thebodyofevidence@gmail.com.

Assistant researcher: Aigul Zaripova, MD

Theme music: "Fall of the Ocean Queen" by Joseph Hackl

Rod of Asclepius designed by Kamil J. Przybos

Chris' book, Does Coffee Cause Cancer?: https://ecwpress.com/products/does-coffee-cause-cancer

Obviously, Chris is not your doctor (probably). This podcast is not medical advice for you; it is what we call information.

What does the body of evidence say about rabies? Well, for one, it is the human disease with the worst case-fatality rate. Once you develop the symptoms, your outlook isn't good. But its long incubation period makes it easy to do something that may not be intuitive: to give the infected person a vaccine… after they've been bit.

Special guest star: Tobi.

Become a supporter of our show today either on Patreon or through PayPal! Thank you!

http://www.patreon.com/thebodyofevidence/

https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE

Email us your questions at thebodyofevidence@gmail.com.

Assistant researcher: Aigul Zaripova, MD

Theme music: "Fall of the Ocean Queen" by Joseph Hackl

Rod of Asclepius designed by Kamil J. Przybos

Chris' book, Does Coffee Cause Cancer?: https://ecwpress.com/products/does-coffee-cause-cancer

Obviously, Chris is not your doctor (probably). This podcast is not medical advice for you; it is what we call information.

References:

1) Information on the rabies vaccine: https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-18-rabies-vaccine.html

2) WHO expert consultation on rabies: https://iris.who.int/bitstream/handle/10665/272364/9789241210218-eng.pdf?sequence=1

It's a pseudoscience that seemed to work at first, but now the same researcher who "proved" that it worked has proven that it doesn't. Do we need to purge people of heavy metals to make sure they don't have heart attacks? No… but you won't believe the price tag we've had to pay to gain this wisdom.

Become a supporter of our show today either on Patreon or through PayPal! Thank you!

http://www.patreon.com/thebodyofevidence/

https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE

Email us your questions at thebodyofevidence@gmail.com.

Assistant researcher: Aigul Zaripova, MD

Theme music: "Fall of the Ocean Queen" by Joseph Hackl

Rod of Asclepius designed by Kamil J. Przybos

Chris' book, Does Coffee Cause Cancer?: https://ecwpress.com/products/does-coffee-cause-cancer

Obviously, Chris is not your doctor (probably). This podcast is not medical advice for you; it is what we call information.

References:

1) Editorial expressing concerns about TACT1: https://jamanetwork.com/journals/jama/fullarticle/1672219

2) Results from the TACT2 trial: https://jamanetwork.com/journals/jama/article-abstract/2822472

3) Editor's note on the whole saga: https://jamanetwork.com/journals/jama/article-abstract/2822475

4) Dr. Stephen Barrett's commentary on TACT1: https://quackwatch.org/chelation/research/tact/

Can cranberry juice help prevent UTIs… or will any liquid do? Also: a new drug has been tested to treat the symptoms of menopause and it looks pretty good. As Chris and Jonathan appraise these studies, you will learn about the importance of placebo arms in clinical trials.

Correction: it turns out that urine is not sterile. Even the bladder has bacteria in it! https://www.livescience.com/health/is-pee-sterile

Become a supporter of our show today either on Patreon or through PayPal! Thank you!

http://www.patreon.com/thebodyofevidence/

https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE

Email us your questions at thebodyofevidence@gmail.com.

Assistant researcher: Aigul Zaripova, MD

Theme music: "Fall of the Ocean Queen" by Joseph Hackl

Rod of Asclepius designed by Kamil J. Przybos

Chris' book, Does Coffee Cause Cancer?: https://ecwpress.com/products/does-coffee-cause-cancer

Obviously, Chris is not your doctor (probably). This podcast is not medical advice for you; it is what we call information.

References:

1) The network meta-analysis published in European Urology Focus on cranberries to prevent UTIs: https://www.sciencedirect.com/science/article/pii/S2405456924001226

2) The 2023 meta-analysis on cranberries for UTIs: https://www.cochrane.org/CD001321/RENAL_cranberries-preventing-urinary-tract-infections

3) Write-up on the recent meta-analysis in Medscape: https://www.medscape.com/viewarticle/its-juice-cranberries-uti-prevention-2024a1000ei4?ecd=mkm_ret_240814_mscpmrk-OUS_ICYMI_CA_etid6740662&uac=300018BV&impID=6740662

4) The OASIS 1 and 2 trials on elinzanetant for menopausal vasomotor symptoms: https://jamanetwork.com/journals/jama/fullarticle/2822766

The wellness industry has a very specific customer base in its crosshairs: women. And many journalists are covering this relationship in a dangerously superficial way. Underwater spinning? Fun! CBD-infused leggings? Why not? But there's a dark underbelly to the promises of wellness solutions, and journalist Rina Raphael has documented it diligently and with a great deal of compassion in her book, The Gospel of Wellness. Jonathan talks to her about how wellness is portrayed in the media and why women listen to its siren call.

Become a supporter of our show today either on Patreon or through PayPal! Thank you!

http://www.patreon.com/thebodyofevidence/

https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE

Email us your questions at thebodyofevidence@gmail.com.

Assistant researcher: Aigul Zaripova, MD

Theme music: "Fall of the Ocean Queen" by Joseph Hackl

Rod of Asclepius designed by Kamil J. Przybos

Chris' book, Does Coffee Cause Cancer?: https://ecwpress.com/products/does-coffee-cause-cancer

Obviously, Chris is not your doctor (probably). This podcast is not medical advice for you; it is what we call information.

Links:

1) Rina Raphael's Substack: https://welltodo.substack.com

2) Rina Raphael's book: https://www.goodreads.com/book/show/59808064-the-gospel-of-wellness

3) Rina Raphel's website: https://www.rinaraphael.com

What does the body of evidence have to say about kidney stones (and bladder stones)? You will learn about risk factors for stones; whether or not a low oxalate diet will help; and just exactly what insane stuff our ancestors used to do to help people pass their stones. There's mention of a "she-ass" and something invasive involving the bum. We're not even joking.

Become a supporter of our show today either on Patreon or through PayPal! Thank you!

http://www.patreon.com/thebodyofevidence/

https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE

Email us your questions at thebodyofevidence@gmail.com.

Assistant researcher: Aigul Zaripova, MD

Theme music: "Fall of the Ocean Queen" by Joseph Hackl

Rod of Asclepius designed by Kamil J. Przybos

Chris' book, Does Coffee Cause Cancer?: https://ecwpress.com/products/does-coffee-cause-cancer

Obviously, Chris is not your doctor (probably). This podcast is not medical advice for you; it is what we call information.

References:

1) Historical interventions for kidney and bladder stones: https://doi.org/10.1046/j.1464-410X.2002.02769.x

Risk factors for kidney/bladder stones:

2) https://doi.org/10.1016/j.eururo.2012.03.052

3) DOI: 10.1016/j.eururo.2012.03.052

4) https://doi.org/10.1007/s00240-020-01210-w 

5) https://doi.org/10.3390/healthcare11030424

6) https://doi.org/10.1016/j.juro.2010.11.073

7) https://doi.org/10.1016/j.euf.2023.10.001

8) DOI: 10.1089/end.2019.0557 

9) https://doi.org/10.1038/s41598-021-04251-2

10) What a staghorn calculus looks like: https://radiopaedia.org/articles/staghorn-calculus-kidney

11) CUA guidelines on how to manage kidney stones: https://www.cua.org/sites/default/files/Flipbooks/Guidelines/G40_en/mobile/index.html

You thought your toddler was a handful. Have you heard of the She-Hulk toddler? You will learn what GPA means in a patient chart and how menstruation can be used to judge the health of a country, while Chris tries to figure out what is wrong with this tiny but ferocious patient.

Also: an announcement that will change The Body of Evidence forever….

Warning: this episode contains medical discussion of genitals.

A Block: The Case of the She-Hulk Toddler

(0:58) She has the strength of two toddlers! Also, puberty seems to have kicked in. What is going on with her?

B Block: Announcement

(32:29) Chris and Jonathan announce something.

* Theme music: "Fall of the Ocean Queen" by Joseph Hackl

* Assistant researcher: Aigul Zaripova

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!

Jonathan and Chris speak to Dr. Andrea Love, a microbiologist, immunologist, science communicator, and the director of the American Lyme Disease Foundation. The tick-borne illness known as Lyme disease is everywhere: on the news, on social media… but is it really near you? Dr. Love separates facts from fiction when it comes to Lyme disease, both the acute infection and the alleged chronic condition.

Correction (2024/07/24): Dr. Love wanted to correct a statement she made. She said that tick-borne relapsing fever does not occur in the U.S., but she meant that it did not occur in the eastern U.S. It does occur in western U.S. states but is caused by a different Borrelia species and spread by different ticks, so there is no overlap with Lyme disease. 

* 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!

1) Andrea Love's Substack, Immunologic: https://www.immunologic.org

2) American Lyme Disease Foundation website: https://aldf.com

What does the body of evidence say on malaria? Your favourite travel destination may be a malaria hot zone: we discuss how to prepare. Plus: a strange FDA application to use MDMA to treat PTSD, and have statins been overprescribed?

A Block: Malaria

(0:58) History; the parasite's life cycle; how many people are affected by malaria; symptoms; how to diagnose it; how to treat it; prevention.

B Block: Ecstasy for PTSD

(35:46) An advisory committee for the FDA has raised many concerns about a company's application to use MDMA (ecstasy, molly) as part of psychotherapy for post-traumatic stress disorder.

C Block: Statin Overprescription

(46:08) A new risk calculator is classifying fewer people as needing statins.

* Theme music: "Fall of the Ocean Queen" by Joseph Hackl

* Assistant researcher: Aigul Zaripova

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!

Chris' book, Does Coffee Cause Cancer?: https://ecwpress.com/products/does-coffee-cause-cancer

References:

1) WHO fact sheet on malaria: https://www.who.int/news-room/fact-sheets/detail/malaria

History of malaria:

2) https://doi.org/10.3390/ijerph7020675

3) https://doi.org/10.1007/s11230-004-6354-6

4) DOI: 10.1111/j.1365-2141.2008.07085.x

5) https://doi.org/10.1179/135100003225002952

6) https://doi.org/10.1038/hdy.2011.16

7) doi: 10.1038/s41598-018-19554-0 

8) https://www.ncbi.nlm.nih.gov/books/NBK215638/ 

9) Plasmodium parasite life cycle: https://www.cdc.gov/dpdx/malaria/index.html 

Malaria epidemiology:

10) https://www.canada.ca/en/public-health/services/catmat/canadian-recommendations-prevention-treatment-malaria/chapter-1-introduction.html 

11) https://www.who.int/news-room/fact-sheets/detail/malaria 

12) https://apps.who.int/malaria/maps/threats/#

13) https://www.who.int/publications/i/item/9789240086173 

14) DOI: 10.15585/mmwr.mm7236a1  

15) https://emergency.cdc.gov/han/2023/han00496.asp 

16) https://www.canada.ca/en/public-health/services/catmat/appendix-1-malaria-risk-recommended-chemoprophylaxis-geographic-area.html 

How to diagnose malaria:

17) https://www.cdc.gov/dpdx/resources/pdf/benchAids/malaria/Pfalciparum_benchaidV2.pdf 

18) https://www.cdc.gov/dpdx/resources/pdf/benchAids/malaria/Pvivax_benchaidV2.pdf 

19) https://www.cdc.gov/dpdx/resources/pdf/benchAids/malaria/Povale_benchaidV2.pdf 

20) https://www.cdc.gov/dpdx/resources/pdf/benchAids/malaria/Pmalariae_benchaidV2.pdf 

How to prevent malaria:

21) https://www.who.int/groups/vector-control-advisory-group/summary-of-new-interventions-for-vector-control/lethal-house-lures 

22) DOI: 10.1016/S0140-6736(24)00004-7

23) https://www.bbc.com/news/world-africa-68037008

24) DOI: 10.1056/NEJMoa2026330

25) DOI: 10.1016/S1473-3099(23)00368-7

26) DOI: https://doi.org/10.1016/S1473-3099(22)00442-X

27) Dr. Andrea Love's article about DEET and insect repellents for Immunologic: https://immunologic.substack.com/p/essential-oils-are-not-chemical-free?publication_id=2109759&post_id=145493032&isFreemail=true&r=5o22t

28) Ada McVean's article about insect repellents for the McGill OSS: https://www.mcgill.ca/oss/article/health-technology/why-mosquitos-bite-you-and-how-make-them-stop

29) FDA advisers vote against medical use of ecstasy: https://www.science.org/content/article/fda-advisory-panel-rejects-mdma-ptsd-treatment

30) Elizabeth Conney's STAT article on new cardiovascular risk calculator for statin prescriptions: https://www.statnews.com/2024/06/10/cardiovascular-disease-statins-aha-guidelines/

It's Not Twitter But It'll Do:

1) Jonathan's interview on the Rethinking Wellness podcast: https://rethinkingwellness.substack.com/p/why-you-probably-dont-have-a-leaky