BMJ 2011: 342: 59 – 114 (8th January)

We already knew that Wakefield’s infamous theory of ‘autistic enterocolitis’ triggered by the MMR was not borne out by further research.  We already knew that his supposed discovery of measles virus in the guts of autistic children was an artefact of dreadful laboratory technique.  We already knew that the children he reported on in his infamous Lancet study weren’t a random group of patients as was initially implied, but were referred to him by a lawyer with a view to starting a suit against the MMR manufacturers, thus making his ‘case series’ biased from the start.  Last summer, we found out that the pathology reports on the children’s gut biopsies hadn’t found the new type of inflammatory bowel disease that Wakefield claimed in the Lancet to have found.  And, of course, one of the longest GMC hearings ever found Wakefield to have acted unethically towards his patients, and struck him off.  So it seems a touch superfluous, at this point, to say that the final nail has now been placed in the coffin of Wakefield’s credibility, since that particular coffin lid did already seem fairly well fixed on.  But I was still absolutely fascinated by Brian Deer’s article on how Wakefield and the lawyer he was in cohorts with recruited the ‘Lancet 12’ from anti-vaccine groups and then misrepresented their case histories in the article in order to suit the anti-MMR case.  This is a huge medical scandal that has had horrific consequences, and, if the things Deer alleges against Wakefield are true, I’m very grateful to him for his hard work getting this out in the open, not to mention writing an extremely interesting article.

In other, less sensational but probably more medically necessary news: Be very wary of fevers in patients who’ve had recent chemotherapy – bear in mind that they might be neutropaenic, and that they might not think to mention the chemotherapy when you take a history.  If they have a past history of cancer, do double-check that they haven’t had recent chemotherapy.

Echinacea is probably not worth the bother of taking (I’m pretty sure it’s not worth the bother of trying to spell correctly).  The benefits are minimal, amounting to an average of half a day’s reduction in the duration of a cold, and most people (over 75%, to be more precise) did not consider that level of benefit to be worth the cost and side-effects.

And another reminder to be vigilant in picking up early signs of RA.  Today’s tip – squeeze the MCPs or MTPs together.  If that’s painful, be highly suspicious.

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About Dr Sarah

I'm a GP with a husband and two young children.
This entry was posted in BMJ, Natural Remedies, Rheumatoid arthritis, Rheumatology, Vaccines. Bookmark the permalink.

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