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March 18, 2007

BehindTheMedspeak: Duct tape and warts — time for a reassessment?

Hlohlh

Much excitement accompanied a 2002 report confirming the old wives' tale that duct tape is a highly effective wart removal remedy.

But a study published in November, 2006 in the Archives of Pediatrics & Adolescent Medicine, with about twice the number of subjects studied in the 2002 report, found that duct tape isn't any better than corn pads.

This comes on top of last year's meta-study, which compiled and analyzed data from 60 reports on a wide variety of removal techniques and concluded that simple salicylic acid skin soaks were the best, with a 73% cure rate.

All this, and more, was contained in Anahad O'Connor's February 27, 2007 New York Times Science section "Really?" feature, which follows.

    The Claim: Duct Tape Removes Warts

    The Facts: A small study in 2002 gave credence to an old remedy for an ugly problem when it stated that duct tape, that ever-popular emblem of inventiveness and quick fixes, was a highly effective treatment for warts.

    The practice is supposed to work because the tape, if left on long enough, irritates the skin, thereby causing an immune reaction that clears up the infections responsible for warts, which are most common in children. The 2002 study found that if applied for six days, duct tape worked more often than the usual technique: cryotherapy, or freezing.

    But many critics questioned the size of the study and its methodology, and this month they gained ammunition from a study that appeared in The Journal of Family Practice. [It was originally published in November, 2006 in the Archives of Pediatrics & Adolescent Medicine.]

    In the study, tape was applied to problem areas for seven days and then the spots were soaked in warm water and rubbed with pumice stones. This technique worked about 16 percent of the time, about the same as applying corn pads overnight with once-weekly soaks and rubs. The researchers looked at 103 children — twice the number of subjects in the 2002 study.

    Last year, another study went a step further by compiling and analyzing data from 60 studies that had looked at various removal methods. That study, published in the Cochrane Database of Systematic Reviews, found that simple skin treatments with salicylic acid were probably the best option. Applied regularly, the study found, they had a cure rate of about 73 percent.

    The Bottom Line: Duct tape may not be as effective as once thought.

....................

Here's a link to the abstract of the 2002 article in the Archives of Pediatrics & Adolescent Medicine that found duct tape to be effective; the abstract itself follows.

    The Efficacy of Duct Tape vs Cryotherapy in the Treatment of Verruca Vulgaris (the Common Wart)

    Objective: To determine if application of duct tape is as effective as cryotherapy in the treatment of common warts.

    Design: A prospective, randomized controlled trial with 2 treatment arms for warts in children.

    Setting: The general pediatric and adolescent clinics at a military medical center.

    Patients: A total of 61 patients (age range, 3-22 years) were enrolled in the study from October 31, 2000, to July 25, 2001; 51 patients completed the study and were available for analysis.

    Intervention: Patients were randomized using computer-generated codes to receive either cryotherapy (liquid nitrogen applied to each wart for 10 seconds every 2-3 weeks) for a maximum of 6 treatments or duct tape occlusion (applied directly to the wart) for a maximum of 2 months. Patients had their warts measured at baseline and with return visits.

    Main Outcome Measure: Complete resolution of the wart being studied.

    Results: Of the 51 patients completing the study, 26 (51%) were treated with duct tape, and 25 (49%) were treated with cryotherapy. Twenty-two patients (85%) in the duct tape arm vs 15 patients (60%) enrolled in the cryotherapy arm had complete resolution of their warts (P = .05 by {chi}2 analysis). The majority of warts that responded to either therapy did so within the first month of treatment.

    Conclusion: Duct tape occlusion therapy was significantly more effective than cryotherapy for treatment of the common wart.

....................

That was fun, eh?

Next, the abstract of the November, 2006 paper in the same journal that refuted the 2002 study.

    Efficacy of Duct Tape vs Placebo in the Treatment of Verruca Vulgaris (Warts) in Primary School Children

    Objective: To determine the efficacy of duct tape compared with placebo in the treatment of verruca vulgaris.

    Design and Setting: A randomized placebo-controlled trial in 3 primary schools in Maastricht, the Netherlands.

    Participants: One hundred three children aged 4 to 12 years with verruca vulgaris.

    Interventions: Duct tape applied to the wart or placebo, a corn pad (protection ring for clavi), applied around the wart for 1 night a week. Both treatments were applied for a period of 6 weeks. Patients were blinded to the hypothesis of the study.

    Main Outcome Measurement: Complete resolution of the treated wart.

    Results: After 6 weeks, the wart had disappeared in 16% of the children in the duct tape group compared with 6% in the placebo group (P = .12). The estimated effect of duct tape compared with placebo on diameter reduction of the treated wart was 1.0 mm (P = .02, 95% confidence interval, –1.7 to –0.1). After 6 weeks, in 7 children (21%) in the duct tape group, a surrounding wart had disappeared compared with 9 children (27%) in the placebo group (P = .79). Fifteen percent of the children in the duct tape group reported adverse effects such as erythema, eczema, and wounds compared with 0 in the placebo group (P = .14).

    Conclusion: In a 6-week trial, duct tape had a modest but nonsignificant effect on wart resolution and diameter reduction when compared with placebo in a cohort of primary school children.

...................

Last but not least, the abstract of last year's Cochrane Database Meta-study.

    Topical Treatments for Cutaneous Warts

    Background: Viral warts are common and usually harmless but very troublesome. A very wide range of local treatments are used.

    Objectives: To assess the effects of different local treatments for cutaneous, non-genital warts in healthy people.

    Search strategy: We searched the Cochrane Skin Group Specialised Register (March 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2005), MEDLINE (1966 to March 2005), EMBASE (1980 to March 2005) and a number of other biomedical databases. The references of all trials and selected review articles were also searched. In addition, we contacted pharmaceutical companies involved in local treatments for warts and experts in the field

    Selection criteria: Randomised controlled trials of local treatments for cutaneous non-genital viral warts in immunocompetent (healthy) people.

    Data collection and analysis: Data was extracted and two authors independently selected the trials and assessed methodological quality.

    Main results: Sixty trials were identified that fulfilled the criteria for inclusion. The evidence provided by these studies was generally weak due to poor methodology and reporting.

    In 21 trials with placebo groups that used participants as the unit of analysis, the average cure rate of placebo preparations was 27% (range 0 to 73%) after an average period of 15 weeks (range 4 to 24 weeks).

    The best available evidence was for simple topical treatments containing salicylic acid, which were clearly better than placebo. Data pooled from five placebo-controlled trials showed a cure rate of 117/160 (73%) compared with 78/162 (48%) in controls, which translates to a risk ratio of 1.60 (95% confidence interval 1.16 to 2.23), using a random effects model.

    Evidence for the absolute efficacy of cryotherapy was surprisingly lacking. Two trials comparing cryotherapy with salicylic acid and one comparing duct tape with cryotherapy showed no significant difference in efficacy.

    Evidence for the efficacy of the remaining treatments reviewed was limited.

    Authors' conclusions: There is a considerable lack of evidence on which to base the rational use of topical treatments for common warts. The reviewed trials are highly variable in method and quality. Cure rates with placebo preparations are variable but nevertheless considerable. There is certainly evidence that simple topical treatments containing salicylic acid have a therapeutic effect. There is less evidence for the efficacy of cryotherapy, but reasonable evidence that it is only of equivalent efficacy to simpler and safer treatments. The benefits and risks of topical dinitrochlorobenzene and 5-fluorouracil, intralesional bleomycin and interferons, photodynamic therapy and other miscellaneous treatments remain to be determined.

....................

You want my bottom line?

Okay.

You really have much better things to do than spend this much time investigating wart remedies.

But I digress.

I doubt you've got corn pads or salicylic acid in your place but I'd put much higher odds on the chance there's a roll of duct tape around somewhere.

And one of my cardinal rules of medicine is that if something is harmless, then even if it may be less effective than something else, it's worth a shot.

So me, I'd go with a few rounds of duct tape before bringing out the heavy artillery and my wallet at Walgreen's.

March 18, 2007 at 04:01 PM | Permalink | Comments (9) | TrackBack

Most amusing ad of the month

Bhghkhg

That's it, above.

"Nobel Prize winning technology."

"Regenerates skin at the molecular level."

If I didn't know better I'd say there might be an element of hype in that copy.

March 18, 2007 at 03:01 PM | Permalink | Comments (3) | TrackBack

Exclusive: bookofjoe TechnoDolt™ investigation of URLs — and why they baffle me so

Forrestgump342_1

Consider the following URL:

http://online.wsj.com/article/SB117253501182519963-search.html?KEYWORDS=caffeine+content+cola&COLLECTION=wsjie/6month

With any luck, clicking on it will take you to Tara Parker-Pope's "Health Journal" feature in the February 27, 2007 Wall Street Journal.

But wait — click on this one:

http://online.wsj.com/article_print/SB117253501182519963.html

Takes you to the same place.

And that's not all — if you click here:

http://online.wsj.com/article/SB117253501182519963.html

you'll be rushed to the very same web page.

At no extra charge.

No salesman will call.

You need not accept any books you don't wish to receive.

And that's all I have to say about that.

March 18, 2007 at 02:01 PM | Permalink | Comments (0) | TrackBack

Magnetic Drying Rack — Episode 2: Flip Up and Fold Away

P31639_500

Episode 1 last Wednesday unleased a torrent of email that we're still wading through here at bookofjoe World Headquarters.

The most frequently heard refrain was, "We don't have room for a fixed rack — can't you find one that folds flat when not in use?"

Of course we can — with a crack research team like ours, how could we not?

From the website:

    Flip-Up Drying Rack

    Flip-up drying shelf dries clothes in half the time!

    Mesh surface lets air flow freely around clothes from all sides for fast drying.

    Clings to washer or dryer with powerful magnets, lifts upward and creates a flat surface for laying out sweaters, shirts, pants, skirts and undergarments (up to 4 lbs.) — then folds away flat!

    No tools required.

    Plastic and metal.

    2" x 20" x 22".

$24.98.

March 18, 2007 at 01:01 PM | Permalink | Comments (0) | TrackBack

An Indirect Animal — by E. M. Cioran

Ciorancover1


All men have the same defect: they wait to live, for they have not the courage of each instant. Why not invest enough passion in each moment to make it an eternity? We all learn to live only when we no longer have anything to expect, because we do not live in the living present but in a vague and distant future. We should not wait for anything except the immediate promptings of the moment. We should wait without the consciousness of time. There's no salvation without the immediate. But man is a being who no longer knows the immediate. He is an indirect animal.

March 18, 2007 at 12:01 PM | Permalink | Comments (0) | TrackBack

Tea Wand — 'A teapot in your teacup'

Teahbhb

From the website:

    Health Tea Wand™

    The Health Tea Wand is a hand-crafted glass straw that brews and filters tea leaves, herbs, and infusions through specially designed strainer holes in the convenience of a cup.

    Simply add hot water to loose tea, steep, build flavor and sip to the very last drop through your beautifully hand-crafted Health Tea Wand.

    Your portable wand is packaged in an indestructible, lightweight carrying case that contains a special compartment to transport your favorite teas.

    It provides all the benefits of a teapot in the convenience of a teacup while eliminating the need for filters and strainers.

....................

Vhvhvh

$19.95.

March 18, 2007 at 11:01 AM | Permalink | Comments (1) | TrackBack

Ghost Foods: Where is the raisin bread with icing of yesteryear?

Nhpj

Those old enough to recall the 20th century will remember that supermarket cinammon-raisin bread once came with wonderfully sweet white icing on top, making it the perfect food.

No longer.

It's been years since I've seen a loaf of raisin bread with icing in the supermarket.

At first I thought perhaps they'd just run out, but as days stretched into weeks into months and then years, I realized that somehow that exquisite food had been declared persona non grata in the bread aisle by the powers that be.

Alex Witchel, in an evocative essay which appeared in the February 28, 2007 New York Times Dining section, wrote about her "madeleine" issues; the piece follows.

    The Ultimate Cruelty: Abandoned by Ravioli

    IN New York things disappear all the time. Corner markets, tailors, opticians — one day they’re there, the next day they’re the branch of yet another bank you’ve never heard of. Just another fact of city life. But when food disappears ... well, that’s personal.

    At least 10 years ago — pre-Internet — I hunted for a vanished hot sauce all over town, not to mention Northern and Southern California, and never found it. It made me so angry, I can’t even remember its name.

    More recently, my search was for Celestial Seasonings Grandma’s Tummy Mint tea, a mix of peppermint and chamomile, which I drank for decades. After hitting every possible Duane Reade and Gristedes, I went online and discovered that my old reliable turned into Tummy Mint Wellness Tea. They’ve added fennel. I’ve lost interest.

    I’m also in mourning for Diet Mazola. Please don’t tell me I shouldn’t eat margarine. I like it — one of those childhood things. Lately I’ve been using Fleischmann’s Light, which itself has been missing these last two months. I went online and found that I can buy it from Amazon. Well, before I pay airfare for margarine, I’m going to have to look harder locally. It’s still on the company’s Web site. Maybe it’s not an endangered species. Yet.

    Because these things happen, you know. In America, I believe, it’s called business. Even though I take it as a personal insult when foods I love are not selling, a company has no qualms about pulling the plug.

    I discovered this a few years ago when, in a fit of pique, I tracked down some poor man at the Sara Lee Bakery Group and demanded to know where the brownies had gone (with that inimitable thatch of chocolate icing) and even more important, what had happened to that banana cake with the banana frosting that you could peel off and eat first — unless your mother caught you first.

    The executive patiently explained that once supermarkets expanded to include their own bakeries, people stopped buying frozen cakes. The brownies were gone, but if I wanted to eat the banana cake regularly, he said, I could move to Green Bay, Wis., or Peoria, Ill., where, God bless them, the townsfolk still buy enough to make it worth the company’s while to supply them.

    My most recent food loss was the broccoli rabe ravioli at Citarella. About 18 months ago it disappeared, just like that. This made for a problem in my house, where it has been a staple for years. I served it with grilled fish, and instead of tomato sauce, I tossed it with black pepper-infused olive oil. Other kinds of ravioli don’t work as well in this combination: artichoke is too bland, vegetable too sweet, spinach and cheese too cheesy.

    The beauty of the broccoli rabe was that the bitterness of the green offset the cheese. And the pasta was the perfect foil to the fish, making it a meal instead of a punishment. (If you have a kid who eats fish and salad and goes to bed happy, give $100 to the charity of your choice. You’re blessed.)

    But one day that ravioli was gone. Every week, I asked the managers where it was. None of them knew. I went to branches on the East Side and the West Side and in the Village. Nothing.

    And you know what? I let it go. I did not call Joe Gurrera, the owner, and rail against the heavens. I looked at my pants and figured there was enough pasta in the world without this one kind. I needed to shake my obsession with specificity. I had to accept that everything in the world changes — except me.

    I recalled a colleague, now retired, who once confided that she loved Citarella’s smoked salmon ravioli so much she used to eat it raw, because she couldn’t even wait for the water to boil. Well, that was a little gross. (To each her own margarine.) But that variety was discontinued years ago, so I looked to her as a role model of strength and fortitude. If she could part with her obsession, so could I.

    And I did. Until one day last June, when the broccoli rabe ravioli reappeared, just like that. I couldn’t believe it. I grabbed a package and took it home. Perfect.

    My curiosity got the best of me, and I called Mr. Gurrera. “It was raviolini before,” he told me. “The small squares. You see it’s bigger now? Now it sells.”

    I’m embarrassed to say I hadn’t realized the difference. It tasted the same — that’s all I cared about.

    With my item newly stocked, I went looking for my Boyajian Black Pepper Oil. Citarella? Gone. Zabar’s? Gone. Fairway? Gone.

    No! All that time I had behaved so well. I weathered my loss like a grown-up. And now this. I was inconsolable.

    My husband went online (boyajianinc.com), and I was soon the proud owner of two bottles. I went back to Citarella for the ravioli.

    Out of stock. Not forever, I was assured. Just for now.

    You know, when they say New York is a tough town, they’re not kidding.

....................

Readers are invited to weigh in about their most beloved ghost foods.

March 18, 2007 at 10:01 AM | Permalink | Comments (11) | TrackBack

Speaking/Photo Travel Alarm

Hililjl

From the website:

    Recording/Photo Travel Alarm Clock

    Wake up to a familiar voice, not an annoying buzzer

    Compact folding travel alarm includes a built-in digital microchip that records a 10-second "message from home" and plays it back anytime at a push of a button or as the "alarm"!

    Recording will be preserved even if the four button batteries (included) are dead or removed.

    Change the recording whenever you like.

    Frame will hold a memorable 2-5/32" x 3" picture to go along with the voice.

    4" x 2-1/2" x 3/4" thick when closed.

    Matte plastic housing.

    5/8"-tall LCD digits.

....................

Though not explicitly stated above, "recording will be preserved" even if you are "dead or removed."

I'm just saying.

In a science fiction novel by Greg Egan I recently finished, set around 2050, people have a revved-up iteration of this device: it's a cube which generates an interactive 3-D image of the person you choose.

The individual responds to you in her or his real voice and reacts to what you say with conversational replies and facial expressions that match what the person would have said and looked like if they were alive and there with you.

I want one of those.

Alas, you'll have to settle for this distant forbearer.

$9.97.

March 18, 2007 at 09:01 AM | Permalink | Comments (1) | TrackBack

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