Confessions of a Quackbuster

This blog deals with healthcare consumer protection, and is therefore about quackery, healthfraud, chiropractic, and other forms of so-Called "Alternative" Medicine (sCAM).

Friday, November 25, 2005

What's so bad about chiropractic education?"

"What's so bad about chiropractic education?" (click to run)
by Allen Botnick DC
March 26, 2004

This is a complete PowerPoint presentation about corruption in chiropractic education.


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Monday, November 21, 2005

Three Cortislim Defendants to Give up $4.5 Million in Cash and Other Assets

Three Cortislim Defendants to Give up $4.5 Million in Cash and Other Assets

FTC’s Litigation Continues Against Four Remaining Defendants

Three defendants will give up $4.5 million in cash and other assets to settle Federal Trade Commission charges stemming from their roles in the marketing of CortiSlim and CortiStress, dietary supplements promoted for weight loss and disease prevention, respectively. The surrendered assets will include an investment partnership and related charitable foundation, a boat, a truck, and a variety of real estate interests. As part of the settlement, the defendants cannot seek a cash refund of state or federal taxes for 2003, 2004, or 2005 that were paid prior to the settlement. In its complaint, the FTC alleged that the defendants made false or unsubstantiated product claims and used deceptively formatted infomercials in pitching the dietary supplements.

The defendants in the settlement announced today, California-based Pinnacle Marketing Concepts, Inc. (“Pinnacle”) and its president, Thomas F. Cheng, and Utah-based Shawn M. Talbott, cannot make benefit or efficacy claims for any dietary supplement, food, drug, cosmetic, or device unless the claims are truthful and substantiated. Litigation continues against the four defendants who have not settled.

In September 2004, the Commission filed a complaint against Window Rock Enterprises, Inc.; Stephen F. Cheng; Infinity Advertising, Inc.; Gregory S. Cynaumon; and Shawn M. Talbott. The Commission later amended its complaint to add Pinnacle and Thomas F. Cheng as additional defendants. The FTC alleges that advertising claims about CortiSlim’s ability to, among other things, cause rapid, substantial, and permanent weight loss in all users were false or unsubstantiated, as were claims about CortiStress’s ability to reduce the risk of, or prevent, osteoporosis, obesity, diabetes, Alzheimer’s disease, cancer, and cardiovascular disease. The FTC also alleges that CortiSlim and CortiStress infomercials were deceptively formatted to appear as talk shows rather than advertisements. The advertising campaign for CortiSlim ran nationwide, including ads on broadcast and cable television, radio, print media, and the Internet.
The FTC announced two separate stipulated final agreements and orders for permanent injunction today, one with Pinnacle and its president, Thomas Cheng, who the FTC alleges participated in the marketing of Cortislim and CortiStress; and one with Talbott, who the FTC alleges formulated the two products and participated in the advertising. Both orders prohibit the making of certain claims about CortiSlim and CortiStress and require competent and reliable scientific evidence to support any other claims made about the products. The orders also bar misrepresentations of any tests or studies and prohibit claims about the performance, effects on weight, or other health benefits of any dietary supplement, food, drug, cosmetic, or device unless the claims are true, not misleading, and substantiated by competent and reliable scientific evidence. Finally, both orders prohibit the use of deceptively formatted television and radio advertisements and require the use of “paid advertisement” disclosures for television ads longer than 15 minutes and for radio ads longer than five minutes.

The settlement with Pinnacle and Thomas Cheng requires them to give up $3.4 million in assets: $700,000 cash; the net proceeds from an investment partnership and related charitable foundation; a $215,000 boat; a $40,000 truck; and a $450,000 property lien. If they are later found to have misrepresented their financial status, the two defendants would be liable for a $23.8 million judgment.

The settlement with Talbott requires him to give up $1.12 million in assets: $225,000 cash; $350,000 from equity in property in Centerville, Massachusetts, or title to the property; $38,700 from the sale of a timeshare in Hawaii or title to the timeshare; and cash equal to 80 percent of the current market value of a property in Lisbon, Ohio, or title to the property. If Talbott is later found to have misrepresented his financial status, he would be liable for a $3.5 million judgment.

Under the agreements, the defendants also assign to the FTC all claims they might have against the other defendants in this case, and they will not use their settlement with the Commission as a basis for seeking a cash refund of income taxes that they reported as paid. In addition, the agreements include standard record-keeping provisions and require the defendants to distribute copies of the orders to certain entities and individuals.

The Commission vote to authorize staff to file the stipulated final orders was 4-0. The stipulated final orders for permanent injunction were filed in the U.S. District Court for the Central District of California on September 20, 2005.

NOTE: These stipulated final orders are for settlement purposes only and do not constitute an admission of liability by the defendants. A stipulated final order acquires the force of law when signed by the judge.

Copies of the stipulated final orders are available from the FTC’s Web site at and also from the FTC’s Consumer Response Center, Room 130, 600 Pennsylvania Avenue, N.W., Washington, D.C. 20580. The FTC works for the consumer to prevent fraudulent, deceptive, and unfair business practices in the marketplace and to provide information to help consumers spot, stop, and avoid them. To file a complaint in English or Spanish (bilingual counselors are available to take complaints), or to get free information on any of 150 consumer topics, call toll-free, 1-877-FTC-HELP (1-877-382-4357), or use the complaint form at The FTC enters Internet, telemarketing, identity theft, and other fraud-related complaints into Consumer Sentinel, a secure, online database available to hundreds of civil and criminal law enforcement agencies in the U.S. and abroad.


Mitchell J. Katz or Jackie Dizdul
Office of Public Affairs
202-326-2161 or 202-326-2472


Peter Miller or Heather Hippsley
Division of Advertising Practices
202-326-2629 or 202-326-3285

( )

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Feds crack down on bogus weight loss products

Feds crack down on bogus weight loss products News Staff

We have all seen the ads for products that promise weight loss without diet or exercise. They're on late night infomercials, in newspapers and on the Internet. They all have one thing in common: they are too good to be true.

Now the federal Competition Bureau is cracking down on these companies.

The Bureau's Andrea Rosen says the problem of so-called health products making bogus claims is a big one, and one that's growing, she says, "because so many people are looking for miracle cures" for weight problems.

Rosen says Health Canada and the Competition Bureau have looked at over 700 cases related to this type of fraud, including one called the AbTronic and products like diet patches that claim they promise to melt off the pounds.

In the case of the AbTronic, the Competition Bureau stepped in and fined the manufacturer $75,000 for claiming the belt, which used electronic stimulation to purportedly develop abdominal muscles, would result in weight loss and improved muscle tone.

The distributor agreed shortly after to stop selling the products.

Rosen says the Bureau can step in when advertising laws are broken.

"As you know, the competition act has provisions against misleading advertising, including claims that are not supported by adequate and proper tests and that's what this is all about," Rosen told Canada AM.

"In order to make claims, you have to have adequate and proper tests, and in the cases of the Ab Energizer and the diet patch, the companies didn't have those kinds of tests available. So we asked them to take down the claims that they were making."

Rosen notes that with the volume of bogus health products being sold over the Internet and from small classified ads, much of the onus of responsibility still falls on the consumer.

"Consumers should do their homework -- buyer beware -- ask and get for the documentation behind a claim.

Rosen says that in order to educate consumers, the Competition Bureau has teamed up with the U.S. Federal Trade Commission to create a bogus website of their own to educate consumers on the typical signs of diet fraud.

The webpage, known as "Fat Foe", is a teaser and looks like many similar sites out on the Web trying to sell bogus diet products. The site appears to advertise a new product that guarantees fast, permanent weight loss of up to 10 pounds per week, with no diet or exercise necessary to lose.

"The site appears to be legitimate, and when consumers land on the site and try to buy the product, they learn that the product doesn't work."

When would-be consumers begin clicking through the site, they are greeted with a message that reads: "The ad to which you responded is a fake, posted by the Federal Trade Commission and the Competition Bureau of Canada to warn consumers about diet rip-offs."

The site then goes through Fat Foe's weight loss claims and explains why each of them is bogus.

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Sunday, November 20, 2005

Behind the Veil: A Muslim Woman Speaks Out

November 9, 2002

Behind the Veil: A Muslim Woman Speaks Out

AMSTERDAM - Ayaan Hirsi Ali had done well in the 10 years since she arrived in the Netherlands as a young refugee from Somalia and, until a few months ago, she lived a quiet life in her adopted land. Never did she intend to create a national commotion.

She studied Dutch, took on cleaning jobs, went to university and worked as a political scientist. She made a name for herself pressing for the emancipation of Muslim women and documenting how thousands, living even here, were subjected to beatings, incest and emotional and sexual abuse.

To the surprise of many, she became a leading voice condemning the government's support for multiculturalism, programs costing millions of dollars a year that she considers misplaced because they help keep Muslim women isolated from Dutch society.

Then Ms. Hirsi Ali, 32, began receiving hate mail, anonymous messages calling her a traitor to Islam and a slut. On several Web sites, other Muslims said she deserved to be knifed and shot. Explicit death threats by telephone soon followed. The police told her to change homes and the mayor of Amsterdam sent bodyguards. She tried living in hiding. Finally, last month, she became a refugee again, fleeing the Netherlands.

"I had to speak up," she said, in a telephone interview from her hiding place, "because most spokesmen for Muslims are men and they deny or belittle the enormous problems of Muslim women locked up in their Dutch homes."

Her ordeal has caused an outcry in the Netherlands, a country already uneasy with its recent waves of immigrants and asylum seekers, now representing almost 10 percent of the population. Many Dutch see the threats as an intolerable assault on the country's democratic principles. The threats have also intensified a fierce debate - one that can be heard these days across Europe - about what moral values and rules of behavior immigrants should be expected to share.

Though absent, Ms. Hirsi Ali seems very present here. Her portrait has appeared on magazine covers and television and there have been indignant newspaper editorials and questions in Parliament. Some have called her the Dutch Salman Rushdie. In paid advertisements, more than 100 Dutch writers have offered her support.

"I've made people so angry because I'm talking from the inside, from direct knowledge," she said. "It's seen as treason. I'm considered an apostate and that's worse than an atheist."

The theme of injustice toward women in Islamic countries has become common in the West, but it has gained fresh currency through Ms. Hirsi Ali's European perspective, her study of Dutch immigrants and her own life. Born in Mogadishu, she grew up a typical Muslim girl in Somalia. When she was 5, she underwent the "cruel ritual," as she called it, of genital cutting. When her father, a Somali opposition politician, had to flee the country's political troubles, the family went to Saudi Arabia, where, she said, she was kept veiled and, much of the time, indoors.

At 22, her father forced her to marry a distant cousin, a man she had never seen. But a friend helped her to escape and she finally obtained political asylum in the Netherlands.

She was shocked when, as a university student, she held a job as an interpreter for Dutch immigration and social workers and discovered hidden "suffering on a terrible scale" among Muslim women even in the Netherlands. She entered safe houses for women and girls, most of them Turkish and Moroccan immigrants, who had run away from domestic violence or forced marriages. Many had secret abortions.

"Sexual abuse in the family causes the most pain because the trust is violated on all levels," she said. "The father or the uncle say nothing, nor do the mother and the sisters. It happens regularly - the incest, the beatings, the abortions. Girls commit suicide. But no one says anything. And social workers are sworn to professional secrecy."

More than 100 women a year have surgery to "restore" their virginity, she estimates in her published work. While only 10 percent of the population is non-Dutch, this group accounts for more than 60 percent of abortions, "because the Muslim girls are kept ignorant," she said. Three out of five Moroccan-Dutch girls - Moroccans are among the largest immigrant groups - are forced to marry young men from villages back home, to keep them under control, she said.

A year or so ago, Ms. Hirsi Ali's case might not have attracted so much attention. But the mood in the Netherlands, as in much of Europe, changed after Sept. 11, 2001. In the month that followed, there was an unheard of backlash against the nearly one million Muslims living in the Netherlands, with more than 70 attacks against mosques. Sept. 11 also gave politicians licence to vent brewing animosities.

Among them was Pim Fortuyn, a maverick gay politician who was killed in May, apparently by an animal rights activist. He said out loud what had long been considered racist and politically incorrect - for example, that conservative Muslim clerics were undermining certain Dutch values like acceptance of homosexuality and the equality of men and women.

What Mr. Fortuyn did on the right, Ms. Hirsi Ali has done on the left. Many in the Labor Party, where she worked on immigration issues, were shocked when she told reporters that Mr. Fortuyn was right in calling Islam "backward."

"At the very least Islam is facing backward and it has failed to provide a moral framework for our time," she said in one conversation. "If the West wants to help modernize Islam, it should invest in women because they educate the children."

To do this, she argues for drastic changes in Dutch immigration policy. The government, she says, should impose Dutch law on men who beat their wives and daughters, even if the Muslim clergy say it is permissible. It should also end teaching the immigrants in their own language and stop paying for the more than 700 Islamic clubs, most of which, she said, "are run by deeply conservative men and they perpetuate the segregation of women."

Her views, and the death threats, have divided Muslims, who account for most immigrants here. Almost 20 Muslim associations have condemned the threats, but at the same time faulted her for criticizing Islam. Hafid Bouazza, a Dutch-Moroccan author who in the past has received letters saying he will burn in hell for his writing, said the threats were shocking. "No criticism of Islam is accepted from women," he said. "Muslim women are particularly vulnerable."

Others were bitter. Ali Eddaudi, a Moroccan writer and cleric living here, dismissed "all the fuss" over a Muslim woman who "panders to the Dutch."

Ms. Hirsi Ali agrees that the criticism is so intense in part because she is a woman. "I am a Muslim woman saying these things, and it has provoked a lot of hatred," she said.

One thing is certain: the death threats against Ms. Hirsi Ali have given more prominence to her ideas, which have now become the subject of intense debate among Dutch policy makers. The Dutch Liberal Party has invited her to become a candidate in the parliamentary elections next January.

She says she has accepted and hopes to return to the Netherlands, though she fears for her safety. "Either I stop my work, or I learn to live with the feeling that I'm not safe," she said. "I'm not stopping."


Ayaan Hirsi Ali links

BBC NEWS World Africa Moving stories: Ayaan Hirsi AliThe BBC is asking migrants how they got to the top of their field in a foreign land.Here, a Somali woman explains how she fights for human rights in the ...

Race Matters - Ayaan Hirsi AliRace Matters is intended to encourage and provide inspiration and tools for racialreconciliation, seeking divergent viewpoints and providing

Ayaan Hirsi AliKlik hier wanneer u niet binnen 5 seconden automatisch wordt doorverbonden metonze

TCS: Tech Central Station - Meet Ayaan Hirsi AliAyaan Hirsi Ali is especially critical of the lack of tolerance for dissenting... According to Ayaan Hirsi Ali, the emotions incited by her statements,

The mission of an ex-MuslimAyaan Hirsi Ali, now 33, was born in the Somali capital Mogadishu. ...real-k1.jpg Click to listen to Ayaan Hirsi Ali interviewed by Perro de Jong ...

Wikipedia: Ayaan_Hirsi_Ali

Dhimmi Watch: Hirsi Ali: "I am on a mission. And it's only just begun"An interview with the heroic ex-Muslim Dutch MP Ayaan Hirsi Ali. ... But AyaanHirsi Ali won't be mythologised. In the airy but necessarily dull canteen of

Dhimmi Watch: Hirsi Ali Interview: "We Must Declare War on ...Dutch member of parliament Ayaan Hirsi Ali has been threatened with death forwriting the film "Submission" -- which is heavily critical of Islam and for

Hirsi AliHirsi Ali, A. (VVD). personalia. titulatuur, naam; roepnaam. Hirsi Ali, drs. A.(Ayaan). geboorteplaats en -datum. Mogadishu (Somalië), 13 November 1969

NOVA - Ayaan Hirsi AliNOVA is het nieuws- en actualiteiten programma van de NPS en de Vara.

CBS News Slaughter And 'Submission' March 13, 2005 20:20:31Marmouch adds, "The whole thing is being politicized by Ayaan Hirsi Ali." She isseen as a traitor to Islam, the faith she rejected as a very young woman.

OpinionJournal - Featured ArticleBY AYAAN HIRSI ALI Tuesday, August 16, 2005 12:01 am EDT. In every society wherefamily affairs are regulated according to instructions derived from the

BBC NEWS World Europe Somali woman heads for Dutch parliamentAyaan Hirsi Ali recently came out of a seclusion prompted by death threats madeagainst her after she campaigned against what she called the oppression of ...

Islam Online- News SectionIn an interview with the Dutch daily Trouw on Saturday, January 25, Ayaan HirsiAli, 32, shocked as many as one million Muslims living in the Netherlands by

Ayaan Hirsi Ali pictures and the best sites at Celebrity LinkThe best Ayaan Hirsi Ali sites and pictures. Here you can find all the informationyou need about Ayaan Hirsi

Biography for Ayaan Hirsi AliAyaan Hirsi Ali - Filmography, Awards, Biography, Agent, Discussions, Photos,News Articles, Fan

Transatlantic Intelligencer: Ayaan Hirsi Ali on the "Left" and ...Ayaan Hirsi Ali on the "Left" and "Multiculturalism". The Somali-born Dutchparliamentarian Ayaan Hirsi Ali has long been the object of death threats from ...

Black Looks: Ayaan Hirsi AliMs Ayaan Hirsi Ali has been living under 24 armed guard ever since Dutch film maker... Listed below are links to weblogs that reference Ayaan Hirsi Ali:

Gene Expression: Ayaan Hirsi Ali interviewedAyaan Hirsi Ali is being interviewed on NPR's Talk of the Nation (in about 5minutes as I type this). The archive should be available by 6 PM EDT. ...

Global Voices Online » Blog Archive » Ayaan Hirsi Ali: Detention ...Somali/Dutch blog ayaan hirsi ali - has a report on the fire in a Netherlandsdetention center for illegal immigrants and drug dealers which resulted in the ...

Expatica's Dutch news in English: Hirsi Ali's neighbours go to ...AMSTERDAM - Neighbours of Ayaan Hirsi Ali are going to court to protest at whatthey claim is the unbearable disruption caused to their lives by the

Religion News Blog Site Search... Ashram Shamballa, Assisted Suicide, Astrology, Atheism, Attleboro Sect,Aum Shinrikyo, Australia, Avatar Group, Ayaan Hirsi Ali, Ayah Pin Sky Kingdom

Ayaan Hirsi Ali :: Dutch lawmaker continues criticism of IslamReligion news about religious movements, cults, sects and world religions, forcult experts and other > Simon & Schuster Canada > Ayaan Hirsi AliAyaan Hirsi Ali appearances, new releases, photos, bios, news, etc. at Simon &Schuster

Ayaan Hirsi Ali [dossier] brengt het emancipatieproces in Nederland in beeld. Belangrijkeonderdelen: nieuwsberichten, commentaren, links naar emancipatiesites

Zomergasten -> Afleveringen -> Ayaan Hirsi Ali -> Items -> SubmissionIn Zomergasten met Ayaan Hirsi Ali was de eerste vertoning van de film "Submission",... Ayaan Hirsi Ali: "Het is niet als een provocatie bedoeld.

Shaking Pillars of Islam - Los Angeles Times... a second knife into his victim, pinning to the chest a bloodstained messageto the woman who was the killer's nemesis: Dutch lawmaker Ayaan Hirsi Ali...

Pub Philosopher: Ayaan Hirsi Ali backs Denmark on free speechAyaan Hirsi Ali backs Denmark on free speech ... reports that Anders FoghRasmussen's tough stance on free speech has won support from Ayaan Hirsi Ali:

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From Tapes, a Chilling Voice of Islamic Radicalism in Europe

If I hadn't read so many of these vivid descriptions by terrorists, and seen the way they murder their hostages, I'd be shocked and amazed at reading the following article. Unfortunately this is totally normal for these fanatics. To their way of thinking, this is not at all unusual or fanatical.

I have seen a number of these films, some of them as long as 40 minutes. They are extremely shocking in their depiction of the coldness, savagery, and brutality of these radical Islamic terrorists. I will not post links to those sites, but the following blog does have a few links. Read and see at own risk:

The Jawa Report

This is what the free world is up against. It all started long before Bush or any other idiots complicated matters, and it won't end just because troops get pulled out of Iraq, or all Westerners leave Saudi Arabia, Afghanistan, or any other Muslim country.

From Tapes, a Chilling Voice of Islamic Radicalism in Europe

Published: November 18, 2005

MILAN - Playing an Internet video one evening last year, an Egyptian radical living in Milan reveled as the head of an American, Nicholas Berg, was sawed off by his Iraqi captors.

"Go to hell, enemy of God!" shouted the man, Rabei Osman Sayed Ahmed, as Mr. Berg's screams were broadcast. "Kill him! Kill him! Yes, like that! Cut his throat properly. Cut his head off! If I had been there, I would have burned him to make him already feel what hell was like. Cut off his head! God is great! God is great!"
Yahia Ragheh, the Egyptian would-be suicide bomber sitting by Mr. Ahmed's side, clearly felt uncomfortable.

"Isn't it a sin?" he asked.

"Who said that?" Mr. Ahmed shot back. "It is never a sin!" He added: "We hope that even their parents will come to the same end. Dogs, all of them, all of them. You simply need to be convinced when you make the decision."

Unconvinced, Mr. Ragheh replied: "I think that it is a sin. I simply think it is a sin."

The blunt exchange is contained in an 182-page official Italian police report that has not been made public, but is widely available in court circles and frames the judicial case against the two men. "The Madrid attack was my project, and those who died as martyrs were my dearest friends," Mr. Ahmed boasted in one intercepted conversation.

He and Mr. Ragheh, his 22-year-old disciple, will be tried in Milan in January under a contentious law passed after the Sept. 11 attacks in the United States that makes association with an international terrorist network a crime.

The indictment calls Mr. Ahmed an "organizer of the terrorist group responsible for the Madrid attacks," a "recruiter of numerous people ready to commit suicide attacks," and a "coordinator of terrorist cells" abroad. The police report charges that he used cassette tapes, cellphones, CD's and computers as recruitment tools, highlighting how the Internet potentially can transform any living room into a radical madrasa.

The report says he downloaded hundreds of audio and video files of sermons, communiqués, poetry, songs, martyrs' testimony, Koranic readings and scenes of battle and suicide bombings from Chechnya, Afghanistan, the Israeli-occupied territories, Lebanon, Bosnia, Kashmir and Iraq.

A onetime house painter who was able to take on new identities, hopscotch across Europe and dodge the police who had him on their watch lists, Mr. Ahmed is believed to have links to radicals in France, Italy, Belgium, the Netherlands, Germany and Saudi Arabia. The police report calls him a recruiter of suicide bombers for Iraq and at least one other terrorist operation, probably in Europe. For the Italians, Mr. Ahmed is emblematic of the new enemy in their midst.

A Spanish prosecutor is still investigating Mr. Ahmed's alleged role in the Madrid bombings. He cannot be prosecuted in Italy for a terrorist attack that took place in another country.

Portrait in Taps and Tapes

Substantial information about Mr. Ahmed surfaced after preliminary transcripts of some wiretaps and telephone conversations were disclosed last year, first in the Milan daily Corriere della Sera. But the police report offers a richer and more dramatic portrait of both Mr. Ahmed and the process of Islamic radicalization in the heart of Europe.

The detailed transcripts form the heart of the prosecutors' case; the prosecutors concede that there is minimal physical evidence.

Both defendants deny involvement in any terrorist plot. They are challenging the evidence, which is largely gathered from conversations translated from Arabic. All conversations monitored by the Italian police must be retranslated by special court interpreters, but they are more likely to speak classical Arabic rather than the Arabic of the streets.

"It's an important case but it's a difficult case," said Armando Spataro, a deputy chief prosecutor and head of the antiterrorism investigative unit in Milan. "There are no bombs. There was no attack in Italy. The case is based in large part on conversations, not on material proof."

At a preliminary court hearing last May, Mr. Ahmed himself accused the police who prepared the intercepts of twisting his words. He denied ever saying he had a role in the Madrid bombings, explaining that the authorities "interpret this in their own way, at their convenience." His voice, he added, "could have been copied, through the computer." Mr. Ragheh's lawyer, Roberta Ligotti, said some of the tapes were unintelligible.

Mr. Ahmed's defense is complicated by the fact that he fired his court-appointed lawyer in October, and her replacement is still familiarizing himself with the case. Both men have also been questioned by the F.B.I. and the United States Attorney's Office in New York for potential terrorist links in the United States. Mr. Ahmed spoke in the intercepted conversations of plans for a chemical attack against American interests, and was questioned by American officials in Milan last summer.

On Nov. 9, three American officials questioned Mr. Ragheh.
"It was all very speculative questioning," Ms. Ligotti said. "I don't know what they're investigating him for in the United States, if he's been charged with something or just a witness."

Egyptian-born and educated, Mr. Ahmed was attached to an explosives brigade during his military service in Egypt, was linked to radical groups and spent time in a maximum security prison there for people involved in extremist activities, Egyptian officials told Italian investigators.

Hooked on the Internet

At the height of the nearly three-month investigation, the Italian police said they had a six-way monitoring system for Mr. Ahmed.

They installed devices on both his telephone and home computer, planted an in-house wiretap and video cameras in both his apartment and outside the building and trailed him round the clock. The cameras even recorded him praying. When Mr. Ahmed suddenly changed apartments, the police had to start over. At one point, 40 police officers a day were assigned to the case.

One of the most chilling aspects of the police report is that Mr. Ahmed apparently found the Internet more exhilarating than any drug.

He used a fictitious e-mail address in which he listed the month and the day of the Madrid attacks as his birthday and his place of birth as Centerville, Va.

The files he is charged with downloading range from the "complete story" compiled by a Saudi opposition group of the 1996 terrorist attack on the Khobar Towers in Saudi Arabia that left 19 Americans in the armed services dead to plaintive recitations by children to their fathers imprisoned in places like Guantánamo, Cuba, and Pakistan.

With his vast online library, Mr. Ahmed fought a virtual war for hours on end, sometimes throughout the night, educating himself and others.

"He used the Internet at all hours like a drug," Mr. Spataro said. "It's a much-needed link to the outside world for people like him."

Among the dozen files Mr. Ahmed apparently monitored in one predawn session in March 2004, for example, were video of battles in Chechnya and speeches by Osama bin Laden. One audio file attacked Jews and Christians and all who collaborate with them, another invited followers to wage holy war against infidels who follow the "laws of the devil."

A young girl on a third audio file asked if she could have a kamikaze belt so that she could "blow up" her body; a man on a fourth declared, "One day's resistance for the holy war is worth 1,000 years of life." Among the "poems for jihadists" was one that repeated over and over, "I am a terrorist; I am a terrorist."

The attraction to death was a constant feature. One evening, Mr. Ahmed opened a file named, "Allah has said that each person has tasted death," with links to subjects like "death is easy" and "the tomb."

A song Mr. Ahmed listened to one weekend went: "We are terrorists, we want to make it known to the world, from West to East that we are terrorists, because terrorism, as a verse of the Koran says, is a thing approved by God."

The sites are filled not only with calls for the destruction of Israel but also raw anti-Semitism. In one question-and-answer session with a Saudi sheik who is asked what suicide operations against Jews are allowed under Islamic law, the sheik responds that Jews are "vile and despicable beings, full of defects and wickedness." God, he added, "has ordered us to wage war against them."

Mr. Ahmed installed and demonstrated a computer program that allowed the simultaneous setting of alarms on multiple cellphones, the report said. The system masks the country of origin of the caller, underscoring the borderless nature of communications. "You must know," Mr. Ahmed said, "that in today's world everything is linked by a wire."

He erased potentially incriminating files, including 11 photographs and diagrams of explosive suitcases to be triggered by a cellphone and vests modified for suicide attacks. The Italian police recovered them.

There were cassette tapes and CD's to help rid Mr. Ragheh of fear as he trained for a suicide mission. "These are very special cassettes that show the path of the martyr and they will make everything easier when you feel them enter your body," Mr. Ahmed told Mr. Ragheh in one conversation. "But you must listen to them continuously."

One cassette in particular, he explained, "enters into your veins."

"In Spain they learned this by heart," he added. "And it gives you security and tranquillity. It takes the fear away."

Mr. Ragheh was entranced, saying, "Come on, come on, give one to me so that I may learn it."

Mr. Ahmed also said he would use his computer to create an appropriate martyr's portrait of Mr. Ragheh, "with the light behind you, with your angelic face."

"And you have the green background behind you and the moon above you." He promised to send the image by computer to Mr. Ragheh's family and to other young martyrs. There would also be a martyrs' video that would be taped the night before an attack.

'We Are Entering Rome'

The Italians began monitoring Mr. Ahmed shortly after the Madrid attacks, after the Spanish police found his cellphone number in the address book of two of the men suspected of involvement in the plot. A witness identified him as having visited the safe house near Madrid where the bombs were made just days before the attacks.

The police report contains dozens of pages of conversations that the police recorded and translated.

In one, Mr. Ahmed appeared to be recruiting people to carry out suicide attacks in Iraq and preparing a second attack, perhaps in Europe.

In another conversation, he branded President Bush as "the dog who is the son of all dogs." He said that the party of Spain's prime minister at the time, José María Aznar, deserved to fail in the election just days after the Madrid bombings and called the government of Prime Minister Silvio Berlusconi of Italy "dictatorial," expressing hope that "God will bring disaster upon it."

The Italian authorities had hoped to watch Mr. Ahmed much longer but felt compelled to arrest him after hearing particularly troubling phone conversations.

On May 24, 2004, Mr. Ahmed discussed an "operation" that had started four days before with a would-be suicide bomber living in Belgium named Mourad Chabarou. Mr. Chabarou said he would be "completely ready" in 25 days, and the two men planned to meet in Paris.

Then came a conversation that struck closer to home. "Rome, we are entering Rome, Rome, if God wishes we are entering, even entering Rome," Mr. Ahmed told Mr. Ragheh, the other potential suicide bomber, as if in a trance. "Rome, Rome, we are opening Rome with those from Holland. Rome, Rome, if God wishes, Rome is opening. It will be. It will be."

Italy, like Spain, had troops as part of the American-led coalition in Iraq, and after the Madrid bombings, the Italian authorities thought their country might be the next target. They also believed that Mr. Ahmed was about to flee, probably for Paris.

On June 7, 2004, Mr. Ahmed and Mr. Ragheh were arrested.

Mr. Ahmed knows that the contents of his conversations as well as of his computer will be used against him in the trial. Even as Mr. Ahmed sat in custody, the police were listening to him.

In a holding cell shortly after his arrest, he worried aloud to Mr. Ragheh that the police "will find the pages I downloaded."

He displayed none of the serenity he tried to impose on his disciples. He cursed whoever betrayed him to the police and predicted he would spend at least 30 years in prison.

"Things here are strange, they are strange, strange," he confided to a friend. "I do not understand a thing."

The friend tried to comfort him, saying: "Why do you torture yourself in this way? Leave everything in the hands of God."

But Mr. Ahmed seemed inconsolable, adding later in the conversation, "Believe me, I swear to you, I've had this feeling before and I haven't heard the voice of God."

In mid-October the two suspects, bearded and in jeans, were taken handcuffed under heavy guard to a Milan courtroom for what was supposed to have been the start of their trial. They chatted and joked with their lawyers from inside a large metal cage.

The trial was delayed for three months to give the judge, Luigi Domenico Cerqua, who has been ill, time to recover. The judge ruled in a case last May that Italy's terrorism law was written so narrowly that conviction was extremely difficult, adding to the prosecution's anxiety about the chances for a conviction, which could bring a maximum sentence of 15 years in prison.

In various interrogations, Mr. Ahmed has even denied knowing anything about computers and the Internet.

"I am weak in the language of the computer, even just to switch on the computer," he said. At another point he said that because he was from Egypt, "How can I learn the computer or the Internet?" He added, "It is not a sin not to know computers."

Brian Wingfield contributed reported from Milan for this article, and Elisabetta Povoledo from Rome.

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Health Canada Warning Consumers Not To Take Chinese Medicine 'Shortclean'

Health Canada Warning Consumers Not To Take Chinese Medicine 'Shortclean'
by Health Canada
Thursday, 17 November 2005

OTTAWA - Canada is warning consumers not to take the Chinese medicine Shortclean because it contains glibenclamide (glyburide) and phenformin, two prescription drugs that could pose a serious health risk for people with low blood sugar or diabetes. Shortclean has been promoted for the control of diabetes and as being derived from only natural ingredients.

Shortclean is not approved for sale in Canada and does not appear to be available to Canadians via the Internet. However, Canadians travelling overseas may have purchased this product for personal use and imported it into Canada.

The Department of Health in Hong Kong recently recalled Shortclean and advised the public against its use. Glyburide is a prescription drug, authorized for sale in Canada, that is used to lower blood sugar. It is safe and effective when used as labelled in approved medications and under medical supervision. People who have low blood sugar or those with diabetes can inadvertently receive significantly high amounts of glyburide by consuming Shortclean.

Similarly, Shortclean when used with other diabetes drugs could increase the effects of those drugs, leading to a dangerous drop in blood sugar.

Phenformin, the second drug ingredient found in Shortclean, was once used in the treatment of Type 2 diabetes. Phenformin was removed from the Canadian market in 1977, and is banned in several countries, including Hong Kong, Singapore, Germany, France and the United States. The bans resulted from numerous international reports of life-threatening lactic acidosis, an often fatal metabolic disorder in which an abnormal amount of lactic acid accumulates in the blood.

People with diabetes who use Shortclean as their only treatment will not be able to effectively monitor the undeclared and uncontrolled amounts of glyburide and phenformin. This could result in serious health risks that may lead to a life-threatening situation. Further, the label displayed on the product is advertised only in Chinese.

Pertinent information about dosage and side effects therefore may not be available to the consumer. Consumers should immediately stop using Shortclean and seek medical attention, especially if they are currently being treated with diabetes drugs.

Immediate medical attention should also be sought if consumers are experiencing symptoms of low or high blood sugar that include: rapid heartbeat, fatigue, blurred vision, headache, excessive hunger, excessive thirst, profuse sweating or confusion, numbness of the extremities, tingling of the mouth, difficulty breathing, seizures or loss of consciousness.

Canadians should only use drugs and natural health products that have been authorized for sale by Health Canada. Authorized drugs and natural health products will bear either an eight-digit Drug Identification Number (DIN), a Natural Product Number (NPN) or a Homeopathic Drug Number (DIN-HM). This authorization indicates that the products have been assessed by Health Canada for safety, efficacy and quality.

The public is encouraged to inform Health Canada if they are aware of the sale of Shortclean by calling the Health Products and Food Branch Inspectorate at 1-800-267-9675. To date, no adverse reactions from the use of Shortclean have been reported in Canada or internationally.

To report a suspected adverse reaction, please contact the Canadian Adverse Drug Reaction Monitoring Program (CADRMP) of Health Canada by one of the following methods: Telephone: 866-234-2345 Facsimile: 866-678-6789

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James Randi's SWIFT November 18, 2005

· A Set-Back for Homeopathy
· Florida – A State of Ignorance?
· In the Spirit of Jonathan Swift
· An Honest Juror Thwarted
· Welcome Response
· Faith Poll in Britain
· Interesting Observations
· The Omnitron is Still With Us
· In Closing...

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WHAT'S NEW Robert L. Park Friday, 18 Nov 05

WHAT'S NEW Robert L. Park Friday, 18 Nov 05 Washington, DC


The $16.5B NASA spending bill Congress sent to the President, with an extra $50M for Hubble repairs, is actually a little more than the President asked for. Michael Griffin has the final say on a Hubble repair mission, but he won't decide until after the shuttle flight set for May. Meanwhile, preparing for an unlikely Moon-Mars mission is costly. NASA says it will save $344M by halting life-sciences research on the ISS. That was about the only scientific research left. So what's this turkey for? A NASA spokesman told the Orlando Sentinel that lengthy visits to the station are the key to preparing astronauts for a return to the Moon. It seems more likely that research on the ISS was of little value anyway. This is one more sign that human spaceflight is headed for extinction.


Last week WN commented on the spectacle of televangelist Robertson calling down the wrath of God on a bucolic village in Pennsylvania. Kitzmiller v. Dover School District, which wound up testimony two weeks ago, turns on the issue of whether Intelligent Design is a scientific theory, as its proponents insist, or religion in drag. Several WN readers noted that this influential Christian evangelist has demonstrated that ID is religion. If Kitzmiller is appealed, as seems likely, WN urges that Robertson be called to testify.


A front page story in Monday's Wall Street Journal describes the spread of college courses questioning evolution. The driving force is the Templeton Foundation, which provides start-up funding for guest speakers, library materials, research and conferences. Between 1994 and 2002 Templeton funded nearly 800 courses. Over a 3-year period Guillermo Gonzalez at Iowa State collected $58,000 ID should be taught in college, but it should not be confused with science.


Earlier today, the Rev. George Coyne, the director of the Vatican Observatory said that "intelligent design" is not science and does not belong in science classrooms. This seemed to put the chief astronomer firmly on the side of Cardinal Poupard, head of the Pontifical Council for Culture and orthogonal to Austrian Cardinal Schoenborn, and perhaps to Pope Benedict XVI, as we saw last week.


A one year study, backed by NIH, found that the weight-loss drug Merida is more than twice as effective if accompanied by a program of diet and exercise. Why am I not surprised? This is, after all the Physics Plan, first proposed in WN six years ago: "Burn more calories than you consume and we guarantee you will lose weight," It is the only weight-loss plan endorsed by the First Law of Thermodynamics.


Opinions are the author's and not necessarily shared by the University of Maryland, but they should be.


Archives of What's New can be found at

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Couple free on bond following split verdict in child neglect case

Couple free on bond following split verdict in child neglect case

By Emanuella Grinberg
Court TV

Joseph and Lamoy Andressohn, a vegan couple convicted this week of child neglect, are free to walk the streets until their sentencing in December, a judge has ruled.

Miami-Dade Circuit Court Judge Stanford Blake ordered the Andressohns free on $75,000 bond Thursday. They had been under house arrest pending their conviction Monday on four counts of child neglect for malnourishing four children, ages 4 to 9.

A six-person jury also acquitted the couple of the more serious charge of aggravated manslaughter Monday for the death of their 6-month-old daughter, Woyah, who prosecutors said was starved to death with a raw-foods diet.

Attorneys representing Joseph, 36, and Lamoy, 30, also asked Blake to dissolve a contact order, which barred the couple from seeing their children, who were taken from them in 2003 and placed in the care of Joseph Andressohn's sister, who testified against them.

The couple caught their first glimpse in more than two years of their two oldest sons when the boys testified against them via closed-circuit camera.

While under house arrest, the Andressohns gave birth to another girl, Joyah, in June 2005. The child was subsequently removed from their care, but they were allowed visitation rights.

Prosecutors presented five days of evidence to bolster their theory that the Andressohns fed their children an insufficient diet of uncooked fruits, vegetables and liquid concoctions of wheatgrass, almond and coconut juice, in spite of signs that the children were severely underweight.

Sentencing is set for Dec. 15, when the judge will also rule on the contact order.

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How Google Tamed Ads on the Wild, Wild Web

How Google Tamed Ads on the Wild, Wild Web

Published: November 20, 2005

FIVE years ago, Web advertisers were engaged in an ever-escalating competition to grab our attention. Monkeys that asked to be punched, pop-ups that spawned still more pop-ups, strobe effects that imparted temporary blindness - these were legal forms of assault. The most brazen advertiser of all, hands down, was X10, a little company hawking security cameras, whose ubiquitous "pop under" ads were the nasty surprise discovered only when you closed a browser window in preparation for doing something else.

Today, Web advertisers by and large have put down their weapons and sworn off violence. They use indoor voices now. This is a remarkable change.

Thank you, Google.

Without intending to do so, the company set in motion multilateral disarmament by telling its first advertisers in 2000: text only, please. No banner ads, no images, no animation. Just simple words, which would go either at the very top of the page, above the search results or, alternatively, as the experiment evolved, at the far right. These "sponsored links" had to conform to strict limits on length and aggressiveness in punctuation and phrasing. If you wanted to claim in your ad that you were the "best," you had to display the third-party authority that authenticated the claim.

Google introduced these ads at the very moment when X10 ads were strewn like chewed gum on every square of sidewalk. X10's pop-unders were accepted at mainstream sites run by companies including Microsoft, Yahoo and The New York Times.

In a survey in mid-2001, X10's company Web site was the fourth-most visited in the online universe, though the statistics did not distinguish between voluntary and inadvertent visits. Its apparent success led some in the advertising industry to publicly endorse the loathsome pop-under. Brian McAndrews, the chief executive of the online ad agency Avenue A, was quoted in Advertising Age in 2001 as saying, "Just because something is intrusive doesn't mean it's bad."

This was the reigning orthodoxy when Google began its idiosyncratic foray into text-only advertising. Not everyone within Google was confident that an alternative model would fare well, or that Google would be able to accept advertising in any form without alienating its fans, who had enjoyed using its search service without encountering a single advertisement on the site during its first year of operation.

Knowing that an entirely free service was not likely to last, some Google users offered to subscribe for $10 or $20 a year, if spared exposure to commercial messages. Google executives seriously investigated an ad-free subscription model. In the meantime, the major online ad networks were knocking on its door, offering a turn-key advertising service. They would supply the paying sponsors and the banner ads; Google had only to sign on the dotted line.

Sergei Brin and Larry Page, the Google co-founders, were more receptive to internal suggestions that could not be found in a marketing textbook - like text-only ads. These could be created by a business of any size; the format would permit a business to try out hundreds, even thousands, of variations, statistically measure the results and see which ones drew clicks and which did not. This would please advertisers.

But what about this would please users, who were accustomed to 100 percent commercial-free search space? Google thought, or at least hoped, that its users would appreciate that the advertisements, by design, would be matched to the content of each search. Advertisers would not be permitted to buy a block of screen real estate, as was standard practice everywhere else. They would have to narrowly define who their intended customers were, by bidding for the privilege of having their ads displayed only when a particular keyword showed up in a search. At Goggle's insistence, the ads would sit apart from the search results and be easy to ignore.

Marissa Mayer, vice president for product development at Google, recalled concerns raised during internal discussion about the likelihood of encountering advertiser resistance to such an unfamiliar format. At one point near the time of the debut, one of her colleagues leaned over and predicted, "You wait, in a month we'll be selling banners."

It did take a little while before prospective sponsors were willing to try Google's text ads, but soon enough, they attracted the intrepid. Mr. Brin and Mr. Page deliberately offered advertisers instant gratification: pull out your credit card, plunk down a $50 deposit, send in four lines - and in a blink it would be out there, having been automatically processed without a pre-publication review by a humanoid. (Google's language police would follow up later, if need be.)

Ms. Mayer credits small companies for helping to draw the attention, and ad dollars, of Google's big accounts. Because of the sheer number of commercial sites run by small operators - like the one that has bought a sponsored link tied to the unappreciated sport of extreme ironing - their customers add up to a very large number.

Once upon a time, Goto, another pioneer in online ads that was renamed Overture and bought by Yahoo, thought that search result positions should be sold to the highest bidder. Bad idea. Users wanted the order of results determined by algorithm, unswayed by advertisers. That wish became the unwritten law for search. Today, Yahoo and MSN serve up text-only ads in the same peripheral locations on the page as Google, and use an almost identical format. Like Google, they also are fighting the good fight against pop-ups, and forbid advertisers from linking to pages that will bop the user in the nose. Google's model is copied for a simple reason: its ads produce profits that prove that size does not matter.

Some analysts view Google's embrace of text as temporary, predicting that the company will add image advertising to its site just as soon as it can build the infrastructure. Jordan Rohan, an Internet analyst at RBC Capital Markets, said that given the fact that Google serves up 100 million search-query results a day, were the company to add a single photo-quality image to each page, the bits for each page would increase a thousandfold and the resulting load would figuratively "break the Internet."

Is Google holding off on image ads because of inadequate infrastructure? No, responds Ms. Mayer. She says Google uses text for ads because of cognitive science: text has the highest information density and allows users to scan a lot of information at the highest speed, or, as she phrased it, "the bit rate on text is very fast." Anything that gets in the way of speed-reading must go. Google does not permit advertisers to use all-capital letters. (Studies have shown we read those 30 percent slower than properly capitalized words.) Ms. Mayer did allow for one theoretical exception to text ads in the future: when users search for videos. "For a query on videos for baking a cake, then, a video might be best," she said.

The online marketing agency Avenue A, which later became Avenue A/Razorfish, says that about 30 percent of the more than $400 million it will spend on behalf of its clients this year will be for text ads on search pages. Last month, Eric Schmidt, Google's C.E.O., said the company's profits jumped sevenfold in the third quarter, versus the period a year earlier, partly because larger companies were increasingly willing to spend their ad dollars on search-related advertising.

TRUE, major ad buyers still spend a majority of their client's online budgets on banners and display ads and, increasingly, on video commercials. But even in the deployment of these formats, one can see the effects of Google's civilizing influence: these advertisements, for the most part, eschew the strong-arm tactics of earlier times. David Hallerman, senior analyst at eMarketer, said, "Paid search has brought to the fore the cliché 'the consumer is in control,' and there is no going back."

Mr. McAndrews, the onetime defender of intrusive pop-unders, has taken note. He is now the head of aQuantive, the parent of Avenue A/Razorfish. When reminded last week of his past statement that intrusive-doesn't-mean-bad, Mr. McAndrews said, "I've evolved my thinking. The key is no longer intrusiveness; today the mantra is relevance." No ad is more relevant to a user than that linked to a Web search, he said.

As for the scrappy X10, it survives and still advertises on the Web. In fact, it advertises on Google. Search for "Web security camera," and you'll see its ad. But this bears no resemblance to its old pop-unders with the leggy female models. Today, X10 must sit quietly on the right with the other sponsored links, dressed inconspicuously just like its neighbors in plain text.

Randall Stross is a historian and author based in Silicon Valley.

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Risks and Benefits of DDT (from the Lancet)

This issue is one of the biggest scandals in the environmental activist community. They use the precautionary principle to NEEDLESSLY kill FIVE THOUSAND people every single day!

The principle, sometimes benignly known as "better safe than sorry," states that
"when an activity raises threats of harm to human health or the environment,
precautionary measures should be taken even if some cause and effect
relationships are not fully established scientifically." An unstated corollary
is "Precaution should be taken regardless of the risk of any precautionary
action." That is, trying too hard to err on the safe side can lead to doing
something less safe. This explains why Michael Crichton wrote in State
of Fear
: "The 'precautionary principle,' properly applied, forbids the
precautionary principle. It is self-contradictory." Source

Read and weep! These are real people dying needlessly:

Risks and Benefits of DDT (from the Lancet)

By Gilbert Ross, M.D.
Posted: Saturday, November 19, 2005

Publication Date: November 19, 2005

This letter appeared in the November 19, 2005 (#366) volume of the Lancet:

Bis(4-chlorophenyl)-1,1,2-trichloroethane (DDT) has been shown, over the past sixty years, to be one of the few affordable and effective tools against malarial vector mosquitoes, which account for over 300 million cases of disease and more than 1 million deaths every year. However, the Review by Walter Rogan and Aimin Chen (Aug. 27, p. 763), which aims to balance the risks and benefits of DDT, consists mainly of hypothetical concerns while the reality of human suffering gets short shrift.

Rogan and Chen discuss several possible toxic endpoints, including those involving neurobehaviour, cancer, and reproductive health. Yet they point to no evidence that DDT, used as a malaria preventive, causes actual harm to human beings. For each category of illness or dysfunction offered as support for their precautionary approach, there is either no or at best weak data to support a connection to DDT. Rogan and Chen concede that even the few studies that seem to point to a possible adverse effect -- shortened gestation and decreased time until weaning -- have not been associated with actual adverse health outcomes.

The authors call for data from trials. But what sort of trials would suit them when 5,000 die every day, and the weapon to prevent these needless deaths has been known to be effective since the 1940s?

Rogan and Chen's only evidence of harm comes from animal experiments, yet they state that "Various reproductive and hormonal endpoints have been examined...and although associations have been recorded, causal links have not been confirmed," and "In people, DDT use is generally safe."

Should our concerns not be, mainly, with people? Especially when the people being discussed are dying on such a scale from a preventable disease? If this were a laboratory experiment, some debate on the issue might be tolerated. But when on one side of the scales are studies which "are not so flawed that the findings can be dismissed," while on the other side are millions of sick and dead African children, this academic discussion is unacceptable in a scholarly journal.

[1] Rogan WA, Chen A. Health Risks and Benefits of bis(4-chlorophenyl)-1,1,1-trichloroethane (DDT). The Lancet 2005; 366:763-773.

Gilbert Ross, M.D.
Executive and Medical Director
American Council on Science and Health
New York, NY

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Friday, November 18, 2005

Green Medicine Event Concludes in Cuba

"...analysis on the therapeutical effects of homeopathy,...." ??? There aren't any beyond placebo!

Green Medicine Event Concludes in Cuba

Havana, Nov 17 (Prensa Latina) After several days of interesting analysis on the therapeutical effects of homeopathy, the 5th Continental Congress on Natural Products and Medicine is winding up this Thursday at Havana’s International Conference Center.

Antioxidant action and the treatment of diseases produced by some virus and parasites were among the main issues tackled by experts from more than 10 countries attending the meeting.

Other topics included economic benefits, security and low toxicity of natural-origin compounds.

Stigmatized by some and supported by others, natural medicine is a truly controversial issue among the international scientific community.

Although some experts acknowledge there is no scientific evidence on its curative potentials, this technique has acquired great international popularity.

Cuban product Vimang, sold in over 20 nations due to its anti-oxidant, anti-inflammatory, and immunological properties, and Trofin, a natural tonic with positive results in fighting anemia, were presented during the event.

The forum included master classes and round table discussions and was sponsored by the International, Central American and Caribbean Confederation on Natural Medicine.


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Thursday, November 17, 2005

Spinal manipulation: Its safety is uncertain

CMAJ • January 8, 2002; 166 (1)
© 2002 Canadian Medical Association or its licensors


Spinal manipulation: Its safety is uncertain
Edzard Ernst
Professor Ernst is with the Department of Complementary Medicine, School of Sport and Health Sciences, University of Exeter, Exeter, UK.

Correspondence to: Prof. Edzard Ernst, Department of Complementary Medicine, School of Sport and Health Sciences, University of Exeter, 25 Victoria Park Rd., Exeter EX2 4NT, UK; fax 44-(0)1392-424989;

Spinal manipulation entails a range of manual manoeuvres that stretch, mobilize or manipulate the spine, paravertebral tissues and other joints in order to relieve spinal pain and improve locomotor function. Spinal manipulation is practised by chiropractors, osteopaths, physicians and physiotherapists, mostly to treat musculoskeletal problems such as back and neck pain.1 The popularity of chiropractic services in the general population is high: 7% of people in the United States visited a chiropractor at least once in 1997, and as many as 33% in the United Kingdom did so in 1996.2 The safety of spinal manipulation, therefore, is an issue that requires regular and rigorous assessment.

In particular, manipulation of the upper spine has been associated with serious adverse events. A recent retrospective case–control study from Ontario yielded perhaps the most conclusive findings so far.3 It showed that, among people younger than 45 years, the odds of experiencing a vertebrobasilar accident (VBA) was increased 5 times if they saw a chiropractor within the week before the event (odds ratio [OR] 5.03 for chiropractic visits of any type [95% confidence interval (CI) 1.32–43.87, p = 0.006] and OR 5.52 for chiropractic visits with a cervical diagnosis [95% CI 1.03–72.02, p = 0.009]). Of the 582 cases of VBA included in this study, 57 were associated with visits to chiropractors. The authors concluded that these results were "consistent with a positive association in young adults" but warned that potential sources of bias have to be considered.

Yet unbiased findings are incredibly hard to come by. Our group recently conducted a survey of all neurologists in Britain.4 Our main research question was whether they had seen cases of serious neurological complications occurring 24 hours after cervical spinal manipulation during the past year. Twenty-four respondents had observed 35 such cases, none of which had been reported. Ten cases were of vascular accidents. Sadly, survey data are never free from bias, and we would certainly not claim that our results are conclusive.

Case reports can be valuable in several respects. Their important disadvantage is that they may indicate only the tip of a much bigger iceberg of problems, particularly as no reliable system exists to record adverse events comparable, for instance, to post-marketing surveillance of drug therapies. Recent reports (published since 1995) of complications associated with spinal manipulation include dissection of the vertebral and internal carotid artery, epidural hematoma, intracranial aneurysm, cauda equina syndrome, contusion of the spinal cord, myelopathy, radiculopathy and peripheral nerve palsy.5 Unfortunately such case reports, even though valuable for pointing us to potential problems, do not bring us closer to defining the incidence of adverse effects of spinal manipulation.

Clearly, the best way forward is to look at prospective studies. Six such reports were found in a recent systematic review;6 in total they included over 2000 patients. Not a single case of a serious adverse event was reported. However, about 50% of the patients experienced mild and transient adverse effects (e.g., local discomfort, headache, tiredness and radiating discomfort) after the procedure.

These studies exemplify the difficulties in systematically collecting prospective information about adverse effects and complications of spinal manipulation. In the 2 largest prospective studies (involving 1058 and 625 patients respectively), loss at follow-up was a potentially serious problem.7,8 Their design was such that adverse events after one treatment were assessed at each subsequent consultation. Almost by definition, patients who experienced a severe adverse effect would simply not return for such a follow-up visit. It is therefore hardly surprising that only mild complaints were registered in these studies.6 To date, no prospective investigation of adverse events of spinal manipulation is available that has overcome this problem. The pessimist (and in matters of safety one is wise to take the pessimist's view) therefore suspects that the existing data are accurate only for minor complaints.

Current chiropractic practice seems to take little account of these problems. Either the fact that about 50% of patients will experience mild adverse events is completely ignored or these events are labelled as necessary experiences on the patient's path to clinical improvement. Critical statements about the value of spinal manipulation get denounced as "misleading" or "deceitful."9 Patients continue to be advised that chiropractic is devoid of risks (unpublished data). Early warning symptoms of vascular accidents are often ignored; in their systematic review of the subject, Hurwitz and Morgenstern10 stated that, "in many cases, the manipulator failed to cease treatment even after the patient experienced signs and symptoms of vertebrobasilar ischemia (e.g., dizziness, vertigo, nausea, loss of consciousness)." One gets the impression that the risks of spinal manipulation are being played down, particularly by chiropractors. Perhaps the best indication that this is true are estimates of incidence rates based on assumptions, which are unproven at best and unrealistic at worse. One such assumption, for instance, is that 10% of actual complications will be reported. Our recent survey, however, demonstrated an underreporting rate of 100%.4 This extreme level of underreporting obviously renders estimates nonsensical.

What is the message for primary care physicians? On the one hand, there is little evidence to demonstrate that spinal manipulation has any specific therapeutic effects.11 On the other hand, there is convincing evidence to show that it is associated with frequent, mild adverse effects6 as well as with serious complications of unknown incidence.3,4,5 Therefore, it seems debatable whether the benefits of spinal manipulation outweigh its risks.12 Specific risk factors for vascular accidents related to spinal manipulation have not been identified,10 which means that any patient may be at risk, particularly those below 45 years of age.3 Definitive, prospective studies that can overcome the limitations of previous investigations are now a matter of urgency. Until they are available, clinicians might tell their patients to adopt a cautious approach and avoid the type of spinal manipulation for which the risk seems greatest: forceful manipulation of the upper spine with a rotational element.


Competing interests: The author has been trained in spinal manipulation and has previously used it in clinical practice.


1. Bronfort G. Spinal manipulation. Neurol Clin North Am 1999;17:91-111.
2. Ernst E. Prevalence of use of complementary / alternative medicine: a systematic review. Bull World Health Org 2000;78:252-7.
3. Rothwell DM, Bondy S, Williams I. Chiropractic manipulation and stroke: a population-based case–control study. Stroke 2001;32:1054-60.[Abstract/Full Text]
4. Stevinson C, Honan W, Cooke B, Ernst E. Neurological complications of cervical spine manipulation. J R Soc Med 2001;94:107-10.[Abstract]
5. Ernst E. Life-threatening complications after spinal manipulation. Stroke 2001;32:809-10.[Full Text]
6. Ernst E. Prospective investigations into the safety of spinal manipulation. J Pain Symptom Manage 2001;21:238-42.[Medline]
7. Leboeff-Yde C, Hennius B, Rudberg E, Leufvenmark P, Thunman M. Side effects of chiropractic treatment: a prospective study. J Manipulative Physiol Ther 1997;20:511-5.[Medline]
8. Senstad O, Leboeuf-Yde C, Borchgrevink C. Frequency and characteristics of side effects of spinal manipulative therapy. Spine 1997;22:435-41.[Medline]
9. Rosner AL. Evidence-based clinical guidelines for the management of acute low back pain: response to the guidelines prepared for the Australian Medical Health and Research Council. J Manipulative Physiol Ther 2001;24:214-20.[Medline]
10. Hurwitz EL, Morgenstern H. The effects of comorbidity and other factors on medical versus chiropractic care for back problems. Spine 1997;22:2254-63.[Medline]
11. Ernst E. Does spinal manipulation have specific treatment effects? Fam Pract 2000;17:554-6.[Medline]
12. Ernst E, Assendelft WJJ. Chiropractic for low back pain: We don't know whether it does more good than harm [editorial]. BMJ 1998;317:160.[Full Text]

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Cuba Demonstrates Its (un)Scientific Expertise in Natural Medicine

This should be more accurately entitled:

Cuba Demonstrates Its (un)Scientific Expertise in Natural Medicine

Cuba Demonstrates Its Scientific Expertise in Natural Medicine

Havana, Nov. 16 (AIN) Cuban medical practitioners are exhibiting their proficiency in the field of natural medicine at the first Ibero American Congress on Natural Medicine and Products underway in Havana.

In seminars and workshops, the participants are exchanging ideas on the application of therapeutic approaches that include acupuncture, homeopathy, ozone therapy, yoga, the production of medicines from vegetables.

The event began on Monday and will run until Friday at Havana's International Convention Center with the participation of 163 specialists and health promoters from Ecuador, Mexico, Uruguay, El Salvador, Guatemala, Spain, France, Colombia and Cuba.

Dr. Elisa Aznar Garcia, president of the Confederation of Natural Medicine for Central America and the Caribbean, and the organizer of the conference, said that Cuba is willing to host the World Congress on Natural Medicine in 2008. The conferences are held every two years.

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Consumer Health Digest #05-46

Consumer Health Digest #05-46
Your Weekly Update of News and Reviews
November 15, 2005
Current # of subscribers: 10,893

Consumer Health Digest is a free weekly e-mail newsletter edited by Stephen Barrett, M.D., and cosponsored by NCAHF and Quackwatch. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making.


FTC, FDA warn "natural" hormone sellers.

The Federal Trade Commission has sent warning letters to the operators of 34 Web sites that sell "natural" alternatives to hormone replacement therapy. [FTC warns Web sites peddling hormone replacement therapy alternatives to review their claims. FTC news release, Nov 10, 2005] The letters stated that the FTC is not aware of any reliable scientific evidence to support the claims that such products (a) prevent, treat, or cure cancer, heart disease, or other diseases or (b) prevent osteoporosis (bone loss) or increase bone density. Simultaneously, the FDA notified the following sellers that their claims were illegal: All Natural Pain Relief Inc.; Bio-Health;; CHS International Research Ltd.; ComCore 21 Corporation; Greatest Herbs on Earth; HMS Crown, Inc.; Healthworks 2000; Healthy Days, Inc.; Heba Laboratories, LLC; Herbal Fields Supplements; Nutriteam, Inc.; One Life USA; Suzanne's Natural Foods; and The Way Up; Tip Top Vitamins. [FDA issues warning letters to marketers of unapproved 'alternative hormone therapies.' FDA news release, Nov 10, 2005] The FTC has not identified the companies that received its warnings.


Berkeley manager indicted.

Steven Pugh, who managed a Berkeley Premium Nutraceuticals warehouse, has been indicted for obstruction of justice. The company is best known for its television commercial in which "Smiling Bob" touts Enzyte pills for "natural male enhancement." The indictment accused Pugh with receiving or hiding a substantial quantity of Rovicid from FDA inspectors in May 2004. [McNair J. Berkeley manager indicted on felony: Obstruction charge claims he hid product. Cincinnati Enquirer, Sept 25, 2005] Earlier this year, Berkeley was raided by federal officials who searched three of its Cincinnati-area offices and froze one of its bank accounts. [McNair J. Feds raid maker of Enzyte: Accounts frozen at 'male-enhancement' pill company. Cincinnati Enquirer, March 17, 2005] Rovicid is a vitamin/herbal concoction claimed to promote better heart health.


Mesotherapy causes severe skin infections.

The U.S. Centers for Disease Control and Prevention has reported an outbreak of severe skin infections among people who received mesotherapy administered by an unlicensed practitioner. [Outbreak of mesotherapy-associated skin reactions: District of Columbia Area, January-February 2005. Mortality & Morbidity Weekly Report 54:1127-1130, 2005] Mesotherapy involves local subcutaneous injections of minute quantities of various substances (e.g., vitamins or plant extracts) for cosmetic purposes (e.g., fat and wrinkle reduction or body contouring) or relief of musculoskeletal pain. Several months ago the American Society of Plastic Surgeons warned that mesotherapy had not been proven safe and effective. [Mesotherapy not proven as a safe alternative to liposuction: Plastic Surgeons warn against unknown dangers. ASPS news release, April 18, 2005]


Dietitians update fluoridation endorsement.

The American Dietetic Association has updated its longstanding position statement on fluoride and health. The statement concludes: " Dietetics professionals should routinely monitor and promote the use of systemic and topical fluorides, especially in children and adolescents. The American Dietetic Association strongly reaffirms its endorsement of the appropriate use of systemic and topical fluorides, including water fluoridation, at appropriate levels as an important public health measure throughout the life span." [Palmer C and others. Position of the American Dietetic Association: the impact of fluoride on health. Journal of the American Dietetic Association 105:1620-1628, 2005]


Recidivist con man fined again.

Peter Foster, an Australian who probably holds the world record for the number of diet-pill-related criminal convictions, has been ordered to pay $150,000 as part of a $1 million settlement in yet another scheme. For a detailed report about his activities, see


Doctor who facilitated dubious cancer treatment surrenders license.

Lois March, M.D., an ear, nose, and throat specialist who practices in Cotrell, Georgia, has surrendered her medical license to settle charges that she improperly helped Dan Raber, an unlicensed person who treated patients for cancer. Georgia's Composite Board of Medical Examiners had accused March of providing pain management to several patients whom Raber treated with a bloodroot paste, including one man whose flesh was eaten so badly from his shoulder that the bone was exposed. The board's accusation is posted at Press reports indicate that the FDA raided Raber's farm earlier this year.


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Stephen Barrett, M.D.
Board Chairman, Quackwatch, Inc.
NCAHF Vice President and Director of Internet Operations
P.O. Box 1747, Allentown, PA 18105
Telephone: (610) 437-1795 (health fraud and quackery) (under construction) (guide to autism) (pending) (legal archive) (under construction) (guide to chiropractic) (under construction) (guide to dental care) (under construction) (under construction) (guide to homeopathy) (under construction) (guide to infomercials) (under construction) (multi-level marketing) (naturopathy) (nutrition facts and fallacies) (under construction) (National Council Against Health Fraud) (consumer health sourcebook)

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