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1. ALSUntangled #63: ketogenic diets

Author

Tulio E. Bertorini, Christopher J McDermott, Isaac Lund, Steven Novella, Gleb Levitsky, Gregory T. Carter, Ce Jackson, Merit Cudkowicz, Lyle Ostrow, Vinay Chaudry, Anne-Marie Wills, Kristiana Salmon, Richard Bedlack, Morgan Beauchamp, Mark B. Bromberg, Terry Heiman-Patterson, Dylan Ratner, Natasha J. Olby, Benjamin Barnes, Paul E. Barkhaus, Paul Wicks, Mark Terrelonge, Susan Steves, and Gary L. Pattee

Subjects
Neurology, business.industry, medicine.medical_treatment, medicine, Neurology (clinical), Amyotrophic lateral sclerosis, Bioinformatics, medicine.disease, business, Ketogenic diet
Abstract

ALSUntangled reviews alternative and off label treatments with a goal of helping patients make more informed decisions about them. Here we review ketogenic diets. We shows that these have plausible mechanisms, including augmenting cellular energy balance and reducing excitotoxicity, neuroinflammation and oxidative stress. We review a mouse model study, anecdotal reports and trials in ALS and other diseases. We conclude that there is yet not enough data to recommend ketogenic diets for patients with ALS, especially in light of the many side effects these can have.

Published
2021
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3. The Skeptics' Guide to the Future : What Yesterday's Science and Science Fiction Tell Us About the World of Tomorrow

Author

Dr. Steven Novella, Bob Novella, Jay Novella, Dr. Steven Novella, Bob Novella, and Jay Novella

Subjects
Science--Popular works, Science--Forecasting--Popular works, Technological forecasting--Popular works
Abstract

From the bestselling authors and hosts of'The Skeptics'Guide to the Universe,'a high-tech roadmap of the future in their beloved voice, cracking open the follies of futurists past and how technology will profoundly change our world, redefining what it means to be human.Our predictions of the future are a wild fantasy, inextricably linked to our present hopes and fears, biases and ignorance. Whether they be the outlandish leaps predicted in the 1920s, like multi-purpose utility belts with climate control capabilities and planes the size of luxury cruise ships, or the forecasts of the ‘60s, which didn't anticipate the sexual revolution or women's liberation, the path to the present is littered with failed predictions and incorrect estimations. The best we can do is try to absorb the lessons from futurism's checkered past, perhaps learning to do a little better.In THE SKEPTICS'GUIDE TO THE FUTURE, Steven Novella and his co-authors build upon the work of futurists of the past by examining what they got right, what they got wrong, and how they came to those conclusions. By exploring the pitfalls of each era, they give their own speculations about the distant future, transformed by unbelievable technology ranging from genetic manipulation to artificial intelligence and quantum computing. Applying their trademark skepticism, they carefully extrapolate upon each scientific development, leaving no stone unturned as they lay out a vision for the future.

Published
2022

4. Guía del universo para escépticos : Cómo saber lo que es real en un mundo cada vez más falso

Author

Steven Novella and Steven Novella

Abstract

En un mundo repleto de información falsa, prejuicios, mitos, engaños y conocimiento deficiente, nadie es poseedor de la verdad suprema ni cuenta con las respuestas definitivas a nuestras preguntas (ni siquiera Google). Sin embargo, el pensamiento lógico y escéptico es nuestra arma para combatir la argumentación falsa, el razonamiento disparatado y la superstición. Es un proceso difícil que requiere de toda nuestra atención, pero vaya que vale la pena. La Guía del universo para escépticos te explicará los principios del pensamiento escéptico y te enseñará cómo ha servido para desacreditar algunos de los más grandes mitos, falacias y teorías de la conspiración, desde la homeopatía y los ovnis hasta los fantasmas y los rayos N. De la mano de Steve Novella —y de sus inseparables cómplices Bob Novella, Cara Santa Maria, Jay Novella y Evan Bernstein— adquirirás habilidades esenciales para evitar el pensamiento supersticioso y desmentir a tus parientes, compañeros y vecinos que creen que la Tierra es plana y que nunca llegamos a la Luna. ¿Estás listo para poner en tela de juicio tus conocimientos actuales, tu percepción y tus creencias?'Completo, informativo e iluminador… una vacuna contra la fragilidad y las limitaciones de la cognición humana'. Neil de Grasse Tyson, autor de Astrofísica para gente con prisa

Published
2020

5. ALSUntangled No. 36: Accilion

Author

Gary L. Pattee, Muddasir Quereshi, Paul Wicks, Todd Levine, Chafic Karam, Edor Kabashi, Christen Shoesmith, Jonathan Goldstein, John T. Kissel, Jim Wymer, Fernando G. Vieira, Pamela Kittrell, Carmel Armon, Josep Gamez, Laurie Gutmann, Lisa Kinsley, Gleb Levitsky, Katherine Tindall, Janice Robertson, Yunxia Wang, Emma Fixsen, Carlayne E. Jackson, Stacy A. Rudnicki, Michael Benatar, Robert Bowser, Robin Conwit, Michael J. Strong, Bjorn Oskarsson, Rob Goldstein, Eric J. Sorenson, Alexander Sherman, Neta Zach, Kathy Mitchell, Peter M Andersen, Ahmad Ghavanini, Kristiana Salmon, Richard Bedlack, Nicholas J. Maragakis, Bonnie Gerecke, Jeffrey D. Rothstein, Leo McClusky, Paul E. Barkhaus, Efrat Carmi, Ginna Gonzalez, Jonathan Licht, Steve Perrin, Hiroshi Mitsumoto, Brett M. Morrison, Meraida Polak, Melanie Leitner, Tahseen Mozaffar, Lyle Ostrow, Orla Hardiman, Lorne Zinman, Daniel M. Pastula, Michael H. Rivner, Mazen M. Dimachkie, Steven Nash, Megan Grosso, Ashok Verma, James Heywood, Vivian E. Drory, Erik P. Pioro, Larry Phillips, Gregory T. Carter, Michael D. Weiss, Nazem Atassi, Jeffrey V. Rosenfeld, Khema Sharma, Yvonne Baker, Jon Baker, Christina Fournier, Kevin Boylan, Mark Bromberg, Tulio E. Bertorini, L. P. Rowland, Eric Valor, Sith Sathornsumetee, Rup Tandan, Colin Quinn, Jeremy M. Shefner, James A. Russell, Steve Kolb, Steven Novella, James Caress, Robert G. Miller, Mieko Ogino, George Sachs, Jonathan D. Glass, David Saperstein, Dan Moore, John Ravits, Terry Heiman-Patterson, Dallas Forshew, Catherine Lomen-Hoerth, Daniel MacGowan, Kate Dalton, Merit Cudkowicz, and Noah Lechtzin

Subjects
Risk, 0301 basic medicine, Clinical Trials as Topic, Pathology, medicine.medical_specialty, business.industry, Amyotrophic Lateral Sclerosis, medicine.disease, 03 medical and health sciences, Treatment Outcome, 030104 developmental biology, 0302 clinical medicine, Neurology, medicine, Animals, Humans, Neurology (clinical), Amyotrophic lateral sclerosis, business, 030217 neurology & neurosurgery
Published
2016
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6. The Skeptics' Guide to the Universe : How to Know What's Really Real in a World Increasingly Full of Fake

Author

Dr. Steven Novella, Bob Novella, Cara Santa Maria, Jay Novella, Evan Bernstein, Dr. Steven Novella, Bob Novella, Cara Santa Maria, Jay Novella, and Evan Bernstein

Subjects
Science--Popular works, Errors, Scientific--Popular works
Abstract

An all-encompassing guide to skeptical thinking from podcast host and academic neurologist at Yale University School of Medicine Steven Novella and his SGU co-hosts, which Richard Wiseman calls'the perfect primer for anyone who wants to separate fact from fiction.'It is intimidating to realize that we live in a world overflowing with misinformation, bias, myths, deception, and flawed knowledge. There really are no ultimate authority figures-no one has the secret, and there is no place to look up the definitive answers to our questions (not even Google). Luckily, The Skeptic's Guide to the Universe is your map through this maze of modern life. Here Dr. Steven Novella-along with Bob Novella, Cara Santa Maria, Jay Novella, and Evan Bernstein-will explain the tenets of skeptical thinking and debunk some of the biggest scientific myths, fallacies, and conspiracy theories-from anti-vaccines to homeopathy, UFO sightings to N- rays. You'll learn the difference between science and pseudoscience, essential critical thinking skills, ways to discuss conspiracy theories with that crazy co- worker of yours, and how to combat sloppy reasoning, bad arguments, and superstitious thinking. So are you ready to join them on an epic scientific quest, one that has taken us from huddling in dark caves to setting foot on the moon? (Yes, we really did that.) DON'T PANIC! With The Skeptic's Guide to the Universe, we can do this together.'Thorough, informative, and enlightening, The Skeptic's Guide to the Universe inoculates you against the frailties and shortcomings of human cognition. If this book does not become required reading for us all, we may well see modern civilization unravel before our eyes.'-- Neil deGrasse Tyson'In this age of real and fake information, your ability to reason, to think in scientifically skeptical fashion, is the most important skill you can have. Read The Skeptics'Guide Universe; get better at reasoning. And if this claim about the importance of reason is wrong, The Skeptics'Guide will help you figure that out, too.'-- Bill Nye

Published
2018

7. ALSUntangled: Introducing The Table of Evidence

Author

Hubert Kwieciński, Dan Moore, Gary L. Pattee, Edor Kabashi, Chafic Karam, James Caress, Ashok Verma, Brett M. Morrison, Mieko Ogino, George Sachs, Orla Hardiman, Bonnie Gerecke, Vivian E. Drory, Hiroshi Mitsumoto, Gleb Levitsky, Josep Gamez, James Heywood, Nazem Atassi, Michael D. Weiss, Jeffrey V. Rosenfeld, Colin Quinn, Kathy Mitchell, Robin Conwit, Steven Novella, Mark B. Bromberg, Lewis P. Rowland, Jerry M. Belsh, Michael J. Strong, Todd Levine, Jonathan D. Glass, Yunxia Wang, Carlayne E. Jackson, Jon Baker, Muddasir Quereshi, Melanie Leitner, David Saperstein, Carmel Armon, Leo McClusky, Jonathan Licht, Terry Heiman-Patterson, Dallas Forshew, Laurie Gutmann, Pamela Kittrell, Jonathan Goldstein, Khema Sharma, Alexander Sherman, Efrat Carmi, Tahseen Mozaffar, James A. Russell, Merit Cudkowicz, Meraida Polak, Lorne Zinman, Michael Benatar, Jim Wymer, Christina Fournier, Noah Lechtzin, Eric Valor, Mazen M. Dimachkie, Steve Kolb, Megan Grosso, Katherine Tindall, Gregory T. Carter, Stacy A. Rudnicki, Lyle Ostrow, Eric J. Sorenson, Jeffrey D. Rothstein, Robert Bowser, Bjorn Oskarsson, Rup Tandan, Catherine Lomen-Hoerth, Daniel MacGowan, Peter M Andersen, Kate Dalton, Daniel M. Pastula, Craig Oster, Paul Wicks, Richard Bedlack, Michael H. Rivner, Nicholas J. Maragakis, John Ravits, Erik P. Pioro, Christen Shoesmith, John T. Kissel, Tulio E. Bertorini, Jeremy M. Shefner, Paul E. Barkhaus, Kevin Boylan, Jeff Dietz, Ginna Gonzalez, Sith Sathornsumetee, Larry Phillips, Steven Nash, Robert G. Miller, Janice Robertson, and Lisa Kinsley

Subjects
PubMed, medicine.medical_specialty, Evidence-Based Medicine, Physical medicine and rehabilitation, Neurology, business.industry, Amyotrophic Lateral Sclerosis, Humans, Medicine, Table (landform), Neurology (clinical), business
Published
2014
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8. ALSUntangled No. 35: Hyperbaric Oxygen Therapy*

Author

Lisa Kinsley, Christen Shoesmith, Steven Nash, Peter M Andersen, John T. Kissel, Daniel M. Pastula, Josep Gamez, Nicholas J. Maragakis, Michael H. Rivner, Michael D. Weiss, Jeffrey V. Rosenfeld, James A. Russell, Kathy Mitchell, Steve Kolb, Melanie Leitner, Jim Wymer, Larry Phillips, Jon Baker, Jeffrey D. Rothstein, Erik P. Pioro, Katherine Tindall, Khema Sharma, Stacy A. Rudnicki, Jonathan D. Glass, James Caress, Janice Robertson, Meraida Polak, Tulio E. Bertorini, Paul Wicks, Yunxia Wang, Carlayne E. Jackson, L. P. Rowland, Megan Grosso, Bjorn Oskarsson, Carmel Armon, Leo McClusky, David Saperstein, Lorne Zinman, Laurie Gutmann, Gregory T. Carter, Robert Bowser, Gary L. Pattee, Kristiana Salmon, Brett M. Morrison, Richard Bedlack, Fernando G. Vieira, Orla Hardiman, Edor Kabashi, Sith Sathornsumetee, Vivian E. Drory, Jeremy M. Shefner, Emma Fixsen, Robert G. Miller, Steve Perrin, Michael Benatar, Hiroshi Mitsumoto, Alexander Sherman, Colin Quinn, Todd Levine, Neta Zach, Christina Fournier, Jonathan Goldstein, Lyle Ostrow, Mark Bromberg, Terry Heiman-Patterson, Dallas Forshew, Steven Novella, Mieko Ogino, George Sachs, John Ravits, Dan Moore, James Heywood, Merit Cudkowicz, Noah Lechtzin, Catherine Lomen-Hoerth, Daniel MacGowan, Kate Dalton, Ashok Verma, Yvonne Baker, Muddasir Quereshi, Kevin Boylan, Pamela Kittrell, Gleb Levitsky, Eric J. Sorenson, Robin Conwit, Rob Goldstein, Eric Valor, Rup Tandan, Nazem Atassi, Ahmad Ghavanini, Paul E. Barkhaus, Ginna Gonzalez, Efrat Carmi, Tahseen Mozaffar, Chafic Karam, Mazen M. Dimachkie, Michael J. Strong, Jonathan Licht, and Bonnie Gerecke

Subjects
Complementary Therapies, Male, 0301 basic medicine, Mice, Mice, Neurologic Mutants, 03 medical and health sciences, Clinical Trials, Phase II as Topic, 0302 clinical medicine, Hyperbaric oxygen, Animals, Humans, Medicine, Single-Blind Method, Amyotrophic lateral sclerosis, Hyperbaric Oxygenation, Clinical Trials, Phase I as Topic, business.industry, Amyotrophic Lateral Sclerosis, medicine.disease, Disease Models, Animal, Oxidative Stress, Treatment Outcome, 030104 developmental biology, Neurology, Anesthesia, Neurology (clinical), business, 030217 neurology & neurosurgery
Published
2016
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9. Clinical trials of integrative medicine: testing whether magic works?

Author

Steven Novella and David H. Gorski

Subjects
Complementary Therapies, medicine.medical_specialty, Psychotherapist, Science, Therapeutic Touch, MEDLINE, Alternative medicine, law.invention, Randomized controlled trial, law, Humans, Medicine, Molecular Biology, Randomized Controlled Trials as Topic, Clinical Trials as Topic, Integrative Medicine, Evidence-Based Medicine, Modalities, Magic (illusion), Traditional medicine, business.industry, Homeopathy, Evidence-based medicine, Chelation Therapy, United States, Clinical trial, Molecular Medicine, Integrative medicine, business
Abstract

Over the past two decades complementary and alternative medicine treatments relying on dubious science have been embraced by medical academia. Despite low to nonexistent prior probability that testing these treatments in randomized clinical trials (RCTs) will be successful, RCTs of these modalities have proliferated, consistent with the principles of evidence-based medicine, which underemphasize prior plausibility rooted in science. We examine this phenomenon and argue that what is needed is science-based medicine rather than evidence-based medicine.

Published
2014
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10. ALSUntangled No. 29: MitoQ

Author

Muddasir Quereshi, Bjorn Oskarsson, Peter M Andersen, Pamela Kittrell, Mark B. Bromberg, Gleb Levitsky, Richard Bedlack, Nicholas J. Maragakis, Leo McClusky, Michael J. Strong, Robin Conwit, Lewis P. Rowland, Efrat Carmi, Tahseen Mozaffar, Alexander Sherman, Mazen M. Dimachkie, Yunxia Wang, Megan Grosso, Brett M. Morrison, Carlayne E. Jackson, Eric J. Sorenson, Craig Oster, John Ravits, Meraida Polak, Orla Hardiman, Hubert Kwieciński, Terry Heiman-Patterson, Dallas Forshew, Christina Fournier, Jonathan Licht, Dan Moore, Carmel Armon, Gregory T. Carter, Gary L. Pattee, James Heywood, Katherine Tindall, Stacy A. Rudnicki, Edor Kabashi, Laurie Gutmann, Jonathan D. Glass, David Saperstein, Chafic Karam, Kevin Boylan, Daniel M. Pastula, Lorne Zinman, Lisa Kinsley, Eric Valor, Michael H. Rivner, Kathy Mitchell, Neta Zach, James A. Russell, Vivian E. Drory, Melanie Leitner, James Caress, Khema Sharma, Rup Tandan, Colin Quinn, Steven Novella, Ashok Verma, Larry Phillips, Catherine Lomen-Hoerth, Daniel MacGowan, Jim Wymer, Michael Benatar, Kate Dalton, Steve Kolb, Michael D. Weiss, Jeffrey V. Rosenfeld, Nazem Atassi, Robert Bowser, Jon Baker, Merit Cudkowicz, Noah Lechtzin, Jeffrey D. Rothstein, Paul Wicks, Steven Nash, Christen Shoesmith, John T. Kissel, Josep Gamez, Bonnie Gerecke, Hiroshi Mitsumoto, Janice Robertson, Paul E. Barkhaus, Ginna Gonzalez, Mieko Ogino, George Sachs, Todd Levine, Jonathan Goldstein, Jeremy M. Shefner, Tulio E. Bertorini, Robert G. Miller, Sith Sathornsumetee, Lyle Ostrow, Erik P. Pioro, and Jeff Dietz

Subjects
Pathology, medicine.medical_specialty, Ubiquinone, business.industry, Amyotrophic Lateral Sclerosis, Drug Evaluation, Preclinical, medicine.disease, Antioxidants, Disease Models, Animal, Oxidative Stress, Organophosphorus Compounds, Neurology, Animals, Humans, Medicine, Neurology (clinical), Amyotrophic lateral sclerosis, business
Published
2015
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11. ALS Untangled No. 20: The Deanna Protocol

Author

Muddasir Quereshi, Pamela Kittrell, Jonathan D. Glass, Efrat Carmi, David Saperstein, Lisa Kinsley, Mark B. Bromberg, Christina Fournier, James Heywood, Eric Valor, Leo McClusky, Rup Tandan, Lyle Ostrow, Eric J. Sorenson, Jim Wymer, Noah Lechtzin, Megan Grosso, Carmel Armon, Todd Levine, Paul E. Barkhaus, Laurie Gutmann, Nazem Atassi, Ginna Gonzalez, Mazen M. Dimachkie, Daniel M. Pastula, Steven Nash, Tahseen Mozaffar, James A. Russell, Robert G. Miller, Hubert Kwieciński, Dan Moore, Michael H. Rivner, Ashok Verma, Craig Oster, John Ravits, Steve Kolb, Jonathan Goldstein, Robert Bowser, Steven Novella, Gregory T. Carter, Michael Benatar, Tulio E. Bertorini, Larry Phillips, Yunxia Wang, Carlayne E. Jackson, Kathy Mitchell, Orla Hardiman, Janice Robertson, Sith Sathornsumetee, Jeffrey D. Rothstein, Melanie Leitner, Lewis P. Rowland, Vivian E. Drory, James B. Caress, Jeremy M. Shefner, Mieko Ogino, George Sachs, Alexander Sherman, Michael J. Strong, Catherine Lomen-Hoerth, Paul Wicks, Erik P. Pioro, Daniel MacGowan, Terry Heiman-Patterson, Kevin B. Boylan, Bjorn Oskarsson, Dallas Forshew, Jonathan Licht, Josep Gamez, Katherine Tindall, Kate Dalton, Gleb Levitsky, Richard Bedlack, Hiroshi Mitsumoto, Gary L. Pattee, Jeff Dietz, Stacy A. Rudnicki, Bonnie Gerecke, Edor Kabashi, Robin Conwit, Peter M Andersen, Nicholas J. Maragakis, Meraida Polak, Michael D. Weiss, Jeffrey V. Rosenfeld, Jon Baker, Christen Shoesmith, John T. Kissel, and Khema Sharma

Subjects
medicine.medical_specialty, business.industry, Amyotrophic Lateral Sclerosis, medicine.disease, Physical medicine and rehabilitation, Neurology, Dietary Supplements, Coconut Oil, Animals, Humans, Plant Oils, Medicine, Nutrition Therapy, Neurology (clinical), Amyotrophic lateral sclerosis, business, Protocol (object-oriented programming)
Published
2013
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12. ALSUntangled 38: L-serine

Author

John Ravits, Jonathan D. Glass, David Saperstein, Ahmad Ghavanini, Erik P. Pioro, Efrat Carmi, Tahseen Mozaffar, Bjorn Oskarsson, Steven Nash, Kristiana Salmon, Richard Bedlack, Christina Fournier, Muddasir Quereshi, Pamela Kittrell, Eric J. Sorenson, Michael Benatar, Todd Levine, Jim Wymer, Carmel Armon, Laurie Gutmann, Jonathan Goldstein, Peter M Andersen, Michael D. Weiss, Lisa Kinsley, Paul Wicks, Jeffrey V. Rosenfeld, Ceri Weber, Ashok Verma, Nazem Atassi, Robert G. Miller, Robert Bowser, Josep Gamez, Bonnie Gerecke, Nicholas J. Maragakis, Brett M. Morrison, Megan Grosso, Gary L. Pattee, Orla Hardiman, Janice Robertson, Jon Baker, Edor Kabashi, Gregory T. Carter, Vivian E. Drory, Neta Zach, Merit Cudkowicz, Noah Lechtzin, Colin Quinn, Catherine Lomen-Hoerth, Daniel MacGowan, Terry Heiman-Patterson, Dallas Forshew, Eric Valour, Kate Dalton, Jeremy M. Shefner, James Heywood, Gleb Levitsky, Alexander Sherman, Robin Conwit, Rob Goldstein, Michael J. Strong, Katherine Tindall, Jeffrey D. Rothstein, Stacy A. Rudnicki, James A. Russell, Steve Kolb, Jonathan Licht, Chafic Karam, Steve Perrin, Hiroshi Mitsumoto, Lyle Ostrow, Leo McClusky, Yunxia Wang, Carlayne E. Jackson, Daniel M. Pastula, Michael H. Rivner, Larry Phillips, Rup Tandan, Paul E. Barkhaus, Ginna Gonzalez, Tulio E. Bertorini, L. P. Rowland, Yvonne Baker, Sith Sathornsumetee, Kevin Boylan, Mark Bromberg, Dan Moore, Fernando G. Vieira, Kathy Mitchell, Melanie Leitner, Mazen M. Dimachkie, James Caress, Meraida Polak, Lorne Zinman, Veronica Peschansky, Christen Shoesmith, John T. Kissel, Khema Sharma, Steven Novella, Emma Fixen, Keeli Hope Denson, Mieko Ogino, and George Sachs

Subjects
0301 basic medicine, Risk, Clinical Trials as Topic, Amyotrophic Lateral Sclerosis, L serine, Biology, medicine.disease, Molecular biology, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Treatment Outcome, Neurology, medicine, Serine, Humans, Neurology (clinical), Amyotrophic lateral sclerosis, 030217 neurology & neurosurgery
Published
2016

13. ALSUntangled No. 37: Inosine

Author

Tulio E. Bertorini, L. P. Rowland, Paul Wicks, Steven Novella, Mark Bromberg, Sith Sathornsumetee, Lyle Ostrow, John Ravits, Sabrina Paganoni, Ginna Gonzalez, Edor Kabashi, Jonathan D. Glass, Josep Gamez, Tahseen Mozaffar, Robin Conwit, Richard Bedlack, Mazen M. Dimachkie, Michael Benatar, Eric J. Sorenson, Emma Fixsen, Yunxia Wang, Steve Kolb, Carlayne E. Jackson, James Caress, James Heywood, Nazem Atassi, Megan Grosso, Chafic Karam, Gregory T. Carter, Kevin Boylan, Orla Hardiman, Steven Nash, Kathy Mitchell, Dan Moore, Carmel Armon, Terry Heiman-Patterson, Dallas Forshew, Laurie Gutmann, Erik P. Pioro, Lisa Kinsley, Colin Quinn, Alexander Sherman, Janice Robertson, Kate Dalton, Larry Phillips, Peter M Andersen, Nicholas J. Maragakis, Katherine Tindall, Jon Baker, and Christen Shoesmith

Subjects
0301 basic medicine, Risk, Clinical Trials as Topic, business.industry, Amyotrophic Lateral Sclerosis, Pharmacology, medicine.disease, Inosine, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Treatment Outcome, Neurology, Medicine, Humans, Neurology (clinical), Amyotrophic lateral sclerosis, business, 030217 neurology & neurosurgery, medicine.drug
Published
2016

14. ALSUntangled No. 34: GM604

Author

Yvonne Baker, Alexander Sherman, Gary L. Pattee, Kevin Boylan, Edor Kabashi, Yunxia Wang, Craig Oster, John Ravits, Muddasir Quereshi, Carlayne E. Jackson, Christen Shoesmith, John T. Kissel, Pamela Kittrell, James Heywood, Mieko Ogino, Gleb Levitsky, Bonnie Gerecke, Bjorn Oskarsson, George Sachs, Eric Valor, Kristiana Salmon, Richard Bedlack, Neta Zach, Robin Conwit, Rob Goldstein, Ahmad Ghavanini, Rup Tandan, Fernando G. Vieira, Efrat Carmi, Janice Robertson, Katherine Tindall, James Caress, Megan Grosso, Eric J. Sorenson, Daniel M. Pastula, Michael H. Rivner, Jeffrey D. Rothstein, Stacy A. Rudnicki, Erik P. Pioro, Terry Heiman-Patterson, Dallas Forshew, Lisa Kinsley, Ashok Verma, Paul E. Barkhaus, Ginna Gonzalez, Larry Phillips, Leo McClusky, Jonathan D. Glass, Brett M. Morrison, David Saperstein, Jim Wymer, Jeff Dietz, Catherine Lomen-Hoerth, Tahseen Mozaffar, Gregory T. Carter, Orla Hardiman, Josep Gamez, Vivian E. Drory, Daniel MacGowan, Dan Moore, Colin Quinn, Chafic Karam, Kate Dalton, Tulio E. Bertorini, Nazem Atassi, Robert G. Miller, Peter M Andersen, Robert Bowser, Michael D. Weiss, L. P. Rowland, Michael J. Strong, Jeffrey V. Rosenfeld, Steven Novella, Nicholas J. Maragakis, Michael Benatar, Jeremy M. Shefner, Jon Baker, Jonathan Licht, Kathy Mitchell, Christina Fournier, Mark Bromberg, Mazen M. Dimachkie, Steven Nash, James A. Russell, Paul Wicks, Meraida Polak, Melanie Leitner, Lorne Zinman, Steve Kolb, Noah Lechtzin, Sith Sathornsumetee, Lyle Ostrow, Todd Levine, Jonathan Goldstein, Khema Sharma, Carmel Armon, Laurie Gutmann, and Steve Perrin

Subjects
0301 basic medicine, Compassionate Use Trials, Pathology, medicine.medical_specialty, Drug Evaluation, Preclinical, Pilot Projects, Drug Costs, 03 medical and health sciences, Mice, Mice, Neurologic Mutants, 0302 clinical medicine, Double-Blind Method, Medicine, Animals, Humans, Nerve Growth Factors, Amyotrophic lateral sclerosis, Randomized Controlled Trials as Topic, business.industry, Amyotrophic Lateral Sclerosis, medicine.disease, Peptide Fragments, Rats, Disease Models, Animal, 030104 developmental biology, Treatment Outcome, Neurology, Neurology (clinical), business, Oligopeptides, 030217 neurology & neurosurgery
Published
2016

15. ALSUntangled No. 16: Cannabis

Author

Daniel M. Pastula, Jim Wymer, Michael H. Rivner, Mazen M. Dimachkie, James A. Russell, Steve Kolb, Gary L. Pattee, Muddasir Quereshi, Kathy Mitchell, Noah Lechtzin, Pamela Kittrell, Leo McClusky, Larry Phillips, Melanie Leitner, Hubert Kwieciński, Nicholas Marigakis, Dan Moore, Robert Bowser, Janice Robertson, Yunxia Wang, Carlayne E. Jackson, Todd Levine, James Heywood, Steven Nash, Steven Novella, Carmel Armon, Tahseen Mozaffar, Eric J. Sorenson, Catherine Lomen-Hoerth, Tulio E. Bertorini, Orla Hardiman, Daniel MacGowan, Kate Dalton, Jeremy M. Shefner, Vivian E. Drory, Robert G. Miller, Terry Heiman-Patterson, Dallas Forshew, Megan Grosso, Jonathan Goldstein, John Ravits, Sith Sathornsumetee, George Sachs, Paul Wicks, Jonathan D. Glass, David Saperstein, James Caress, Josep Gamez, Jeffrey D. Rothstein, Hiroshi Mitsumoto, Erik P. Pioro, Jeff Dietz, Michael J. Strong, Lewis P. Rowland, Alexander Sherman, Michael Benatar, Jonathan Licht, Meraida Polak, Michael D. Weiss, Jon Baker, Lisa Kinsley, Katherine Tindall, Stacy A. Rudnicki, Kevin Boylan, Ashok Verma, Robin Conwit, Peter M Andersen, Christen Shoesmith, John T. Kissel, Khema Sharma, Nazem Atassi, Bjorn Oskarsson, Rup Tandan, Richard Bedlack, Ginna Gonzalez, and Bonnie Gerecke

Subjects
medicine.medical_specialty, biology, Cannabinoids, business.industry, Amyotrophic Lateral Sclerosis, Marijuana Smoking, General Medicine, biology.organism_classification, medicine.disease, Neurology, Humans, Immunologic Factors, Medicine, Neurology (clinical), Cannabis, Amyotrophic lateral sclerosis, business, Psychiatry
Published
2012
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16. Clinical findings in MuSK-antibody positive myasthenia gravis: A U.S. experience

Author

Sharon P. Nations, Gil I. Wolfe, Mazen M. Dimachkie, Richard J. Barohn, Tulio E. Bertorini, Laura Herbelin, Steven Novella, Jaya Trivedi, Jonathan Goldstein, Luis A. Chui, Ronan J. Walsh, Angela Young, Shin Oh, April McVey, Lawrence H. Phillips, Ted M. Burns, Anthony A. Amato, Mamatha Pasnoor, John T. Kissel, Gwendolyn C. Claussen, Tahseen Mozaffar, and Marcel Hungs

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Physiology, medicine.drug_class, medicine.medical_treatment, Severity of Illness Index, Disease-Free Survival, Medical Records, Cellular and Molecular Neuroscience, Atrophy, Physiology (medical), Internal medicine, Myasthenia Gravis, Severity of illness, medicine, Humans, Receptors, Cholinergic, Age of Onset, Child, Aged, Retrospective Studies, Plasma Exchange, biology, Electromyography, business.industry, Remission Induction, Immunoglobulins, Intravenous, Receptor Protein-Tyrosine Kinases, Retrospective cohort study, Middle Aged, Thymectomy, medicine.disease, United States, Myasthenia gravis, Surgery, Treatment Outcome, biology.protein, Prednisone, Corticosteroid, Female, Immunotherapy, Neurology (clinical), Age of onset, Antibody, business
Abstract

We performed a retrospective chart review on 53 muscle-specific kinase antibody (MuSK-Ab)-positive myasthenia gravis (MG) patients at nine university-based centers in the U.S. Of these, 66% were Caucasian, 85% were women, and age of onset was 9-79 years. Twenty-seven patients were nonresponsive to anticholinesterase therapy. Myasthenia Gravis Foundation of America improvement status was achieved in 53% patients on corticosteroids, 51% with plasma exchange, and in 20% on intravenous immunoglobulin (IVIG). Thymectomy was beneficial in 7/18 patients at 3 years. Long-term (> or =3 years) outcome was very favorable in 58% of patients who achieved remission and/or minimal manifestation status. Overall, 73% improved. There was one MG-related death. This survey reinforces several cardinal features of MuSK-Ab-positive MG, including prominent bulbar involvement and anticholinesterase nonresponsiveness. Facial or tongue atrophy was rare. Most patients respond favorably to immunotherapy. The best clinical response was to corticosteroids and plasma exchange, and the poorest response was to IVIG. Long-term outcome is favorable in about 60% of cases.

Published
2010
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17. ALSUntangled 15: Coconut Oil

Author

Meraida Polak, Daniel M. Pastula, Michael H. Rivner, James Heywood, James A. Russell, Todd Levine, Orla Hardiman, Steve Kolb, Kevin Boylan, Michael Benatar, Larry Phillips, Michael J. Strong, Steven Novella, Muddasir Quereshi, Vivian E. Drory, Jonathan Goldstein, Ginna Gonzalez, Jonathan Licht, Noah Lechtzin, Kathy Mitchell, Jim Wymer, Melanie Leitner, Pamela Kittrell, Peter M Andersen, Robert G. Miller, George Sachs, Terry Heiman-Patterson, Dallas Forshew, Lisa Kinsley, Paul Wicks, Robert Bowser, Nazem Atassi, Megan Grosso, Tahseen Mozaffar, Lewis P. Rowland, Michael D. Weiss, Hubert Kwieciński, Dan Moore, Alexander Sherman, Janice Robertson, Catherine Lomen-Hoerth, Jon Baker, Eric J. Sorenson, Daniel MacGowan, Kate Dalton, Bonnie Gerecke, Rup Tandan, Gary L. Pattee, James Caress, Katherine Tindall, Leo McClusky, Stacy A. Rudnicki, Carmel Armon, Khema Sharma, Christen Shoesmith, John T. Kissel, Hiroshi Mitsumoto, Ashok Verma, Nicholas Marigakis, Yunxia Wang, Robin Conwit, Carlayne E. Jackson, Jeremy M. Shefner, Bjorn Oskarsson, Richard Bedlack, Mazen M. Dimachkie, Erik P. Pioro, Jeff Dietz, Steven Nash, Jeffrey D. Rothstein, Josep Gamez, John Ravits, Tulio E. Bertorini, Sith Sathornsumetee, Jonathan D. Glass, and David Saperstein

Subjects
food.ingredient, business.industry, Amyotrophic Lateral Sclerosis, Coconut oil, General Medicine, medicine.disease, food, Neurology, Coconut Oil, medicine, Animals, Humans, Plant Oils, Neurology (clinical), Food science, Amyotrophic lateral sclerosis, business
Published
2012
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18. Considering prior plausibility in clinical trials does not mean ignoring scientific evidence

Author

Steven Novella and David H. Gorski

Subjects
medicine.medical_specialty, Clinical Trials as Topic, Integrative Medicine, Psychotherapist, Traditional medicine, business.industry, Alternative medicine, Homeopathy, Evidence-based medicine, Reiki, humanities, Scientific evidence, law.invention, Clinical trial, Randomized controlled trial, law, Molecular Medicine, Medicine, Humans, Integrative medicine, business, Molecular Biology
Abstract

The response of Rutten et al. to our recent article [1], in which we contend that it is unscientific and unethical to test highly implausible treatments such as homeopathy and reiki in randomized clinical trials (RCTs), represents a common and misguided complaint by advocates of alternative medicine against interpreting clinical trials through the lens of prior plausibility. It is a complaint that is, from a scientific viewpoint, unjustified and relies on a misunderstanding of the history of science, a straw man characterization of arguments for science-based medicine, and an incorrect interpretation of Bayes’ theorem applied to clinical trials of homeopathy.

Published
2014

19. ALSUntangled No. 26: lunasin

Author

Jim Wymer, Christina Fournier, Robert Bowser, Lyle Ostrow, Paul E. Barkhaus, Ginna Gonzalez, Hubert Kwieciński, Dan Moore, Muddasir Quereshi, Catherine Lomen-Hoerth, Daniel MacGowan, Pamela Kittrell, Josep Gamez, Eric J. Sorenson, Kate Dalton, Todd Levine, Eric Valor, Ashok Verma, Tulio E. Bertorini, Mark B. Bromberg, Merit Cudkowicz, Noah Lechtzin, Michael J. Strong, Efrat Carmi, Mazen M. Dimachkie, Rup Tandan, Bjorn Oskarsson, Mieko Ogino, Tahseen Mozaffar, James A. Russell, George Sachs, Jonathan Goldstein, Hiroshi Mitsumoto, Steven Novella, Jonathan Licht, Terry Heiman-Patterson, Dallas Forshew, James Heywood, Richard Bedlack, James Caress, Sith Sathornsumetee, Steve Kolb, Kevin Boylan, Nazem Atassi, Yunxia Wang, Carlayne E. Jackson, Paul Wicks, Gary L. Pattee, Meraida Polak, Chafic Karam, Gleb Levitsky, Lorne Zinman, Craig Oster, Carmel Armon, Edor Kabashi, Robin Conwit, John Ravits, Laurie Gutmann, Janice Robertson, Erik P. Pioro, Brett M. Morrison, Orla Hardiman, Leo McClusky, Vivian E. Drory, Jeff Dietz, Colin Quinn, Jonathan D. Glass, Jeremy M. Shefner, Robert G. Miller, David Saperstein, Michael D. Weiss, Jeffrey V. Rosenfeld, Megan Grosso, Jon Baker, Gregory T. Carter, Kathy Mitchell, Melanie Leitner, Michael Benatar, Bonnie Gerecke, Lisa Kinsley, Khema Sharma, Steven Nash, Christen Shoesmith, John T. Kissel, Jeffrey D. Rothstein, Peter M Andersen, Nicholas J. Maragakis, Katherine Tindall, Stacy A. Rudnicki, Daniel M. Pastula, Michael H. Rivner, Larry Phillips, Lewis P. Rowland, and Alexander Sherman

Subjects
Adult, Male, Pathology, medicine.medical_specialty, business.industry, Amyotrophic Lateral Sclerosis, Anti-Inflammatory Agents, Middle Aged, medicine.disease, Neurology, medicine, Soybean Proteins, Humans, Female, Neurology (clinical), Amyotrophic lateral sclerosis, business, Aged, Phytotherapy, Plant Proteins
Published
2014

20. Rituximab in the management of refractory myasthenia gravis

Author

Nazlee Zebardast, Steven Novella, Huned S. Patwa, and Jonathan Goldstein

Subjects
medicine.medical_specialty, Physiology, medicine.medical_treatment, Anti-Inflammatory Agents, Gastroenterology, Disease-Free Survival, Drug Administration Schedule, Cellular and Molecular Neuroscience, Antibodies, Monoclonal, Murine-Derived, Refractory, immune system diseases, Physiology (medical), Internal medicine, Myasthenia Gravis, medicine, Humans, Immunologic Factors, Receptors, Cholinergic, Acetylcholine receptor, Retrospective Studies, business.industry, Antibodies, Monoclonal, Immunoglobulins, Intravenous, Receptor Protein-Tyrosine Kinases, Immunosuppression, Retrospective cohort study, Middle Aged, medicine.disease, Response to treatment, Myasthenia gravis, Surgery, Treatment Outcome, Monoclonal, Prednisone, Rituximab, Female, Neurology (clinical), Cholinesterase Inhibitors, business, medicine.drug, Pyridostigmine Bromide
Abstract

Myasthenia gravis (MG) is an immune-mediated disorder with a variable response to treatment. In this study, patients with refractory MG who were treated with rituximab were identified. A review of patients referred to the Yale Neuromuscular Clinic was performed. Patients with refractory MG who were treated with rituximab were reviewed for response to treatment. Patients who had muscle-specific kinase (MuSK(+)) or acetylcholine receptor (AChR(+)) antibodies were included. Six patients were identified who met the criteria described. All patients tolerated rituximab without side effects and had a reduced need for immunosuppressants and/or improvement in clinical function. Patients with refractory MG appeared to respond to rituximab in this small, retrospective study. This result suggests that a larger, prospective trial is indicated.

Published
2009

21. Phase II trial of CoQ10 for ALS finds insufficient evidence to justify Phase III

Author

Richard Buchsbaum, Ezgi Tiryaki, Terry Heiman-Patterson, Jacqueline Montes, Edward J. Kasarskis, John L.P. Thompson, Petra Kaufmann, Lisa S. Krivickas, Gilberto Levy, Carmel Armon, Jeremy M. Shefner, Richard J. Barohn, Steven Novella, Carlayne E. Jackson, Alexandra I Barsdorf, R. Arbing, Hiroshi Mitsumoto, Catherine Lomen-Hoerth, Erik P. Pioro, Jonathan S. Katz, Rup Tandan, Robert L. Sufit, Bruce Levin, Yvonne D. Rollins, Stacy A. Rudnicki, Kourosh Rezania, Alan Pestronk, and Darleen Vecchio

Subjects
Male, Pathology, medicine.medical_specialty, Neuromuscular disease, Time Factors, Ubiquinone, Bioinformatics, medicine.disease_cause, Severity of Illness Index, Article, Antioxidants, law.invention, Medication Adherence, chemistry.chemical_compound, Randomized controlled trial, Double-Blind Method, law, Severity of illness, High doses, Medicine, Humans, Amyotrophic lateral sclerosis, Coenzyme Q10, business.industry, Amyotrophic Lateral Sclerosis, Middle Aged, medicine.disease, Clinical trial, Treatment Outcome, Neurology, chemistry, Clinical Trials, Phase III as Topic, Female, Neurology (clinical), business, Oxidative stress, Follow-Up Studies
Abstract

Amyotrophic lateral sclerosis (ALS) is a devastating, and currently incurable, neuromuscular disease in which oxidative stress and mitochondrial impairment are contributing to neuronal loss. Coenzyme Q10 (CoQ10), an antioxidant and mitochondrial cofactor, has shown promise in ALS transgenic mice, and in clinical trials for neurodegenerative diseases other than ALS. Our aims were to choose between two high doses of CoQ10 for ALS, and to determine if it merits testing in a Phase III clinical trial.We designed and implemented a multicenter trial with an adaptive, two-stage, bias-adjusted, randomized, placebo-controlled, double-blind, Phase II design (n = 185). The primary outcome in both stages was a decline in the ALS Functional Rating Scale-revised (ALSFRSr) score over 9 months. Stage 1 (dose selection, 35 participants per group) compared CoQ10 doses of 1,800 and 2,700 mg/day. Stage 2 (futility test, 75 patients per group) compared the dose selected in Stage 1 against placebo.Stage 1 selected the 2,700 mg dose. In Stage 2, the pre-specified primary null hypothesis that this dose is superior to placebo was not rejected. It was rejected, however, in an accompanying prespecified sensitivity test, and further supplementary analyses. Prespecified secondary analyses showed no significant differences between CoQ10 at 2,700 mg/day and placebo. There were no safety concerns.CoQ10 at 2,700 mg daily for 9 months shows insufficient promise to warrant Phase III testing. Given this outcome, the adaptive Phase II design incorporating a dose selection and a futility test avoided the need for a much larger conventional Phase III trial.

Published
2009

22. Use of Fiberoptic Endoscopic Evaluation of Swallowing (FEES) in Patients with Amyotrophic Lateral Sclerosis

Author

Huned S. Patwa, Steven Novella, and Steven B. Leder

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Biofeedback, Speech and Hearing, Bolus (medicine), Swallowing, Fiber Optic Technology, Humans, Medicine, Endoscopy, Digestive System, Amyotrophic lateral sclerosis, Aged, Aged, 80 and over, medicine.diagnostic_test, business.industry, Amyotrophic Lateral Sclerosis, Gastroenterology, Middle Aged, medicine.disease, Dysphagia, Surgery, Endoscopy, Clinical trial, Otorhinolaryngology, Pharynx, Female, medicine.symptom, Deglutition Disorders, business
Abstract

This study investigated the use of fiberoptic endoscopic evaluation of swallowing (FEES) to both diagnose pharyngeal dysphagia and make treatment recommendations in 17 consecutive patients with a new diagnosis of amyotrophic lateral sclerosis (ALS) and complaints of dysphagia. Ten of 17 (59%) patients exhibited pharyngeal dysphagia with aspiration or aspiration risk with clear liquids, i.e., 5 of 8 (63%) limb and 5 of 9 (56%) bulbar. If depth of bolus flow was a problem, thickened liquids and single, small bolus sizes were recommended. If bolus retention was a problem, a small clear liquid bolus after each puree or solid bolus was recommended to aid pharyngeal clearing. Five of 17 (30%) patients required multiple FEES evaluations because of disease progression. For the first time in patients with ALS, FEES was shown to be successful in assessing preswallow anatomy and physiology, diagnosing pharyngeal dysphagia, and providing objective data for appropriate therapeutic interventions to promote safer oral intake. Visual biofeedback provided by FEES was successful for both patient and family education and to investigate individualized therapeutic strategies that, if successful, can be implemented immediately. Serial FEES allows for objective monitoring of dysphagia symptoms and timely implementation of diet changes and/or therapeutic strategies to continue safer oral intake and maintain optimum quality of life.

Published
2004
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23. Suboptimal Optics: Vision Problems as Scars of Evolutionary History

Author

Steven Novella

Subjects
Optics, medicine.anatomical_structure, genetic structures, business.industry, medicine, Human eye, sense organs, Biology, business, Contingency, Ecology, Evolution, Behavior and Systematics, eye diseases, Education
Abstract

The human eye is an excellent example of suboptimal bottom-up design resulting from the constraints of evolutionary historical contingency. The resulting suboptimal optics manifests in a number of medical ophthalmological disorders.

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