Thursday, April 29, 2010

WebMD What a Bad Lifestyle Does to Your Life Span. Practice prevention.

What a Bad Lifestyle Does to Your Life Span

[Here is the article in its entirety. Think of what you could do with 12 more healthy years of life.]

What a Bad Lifestyle Does to Your Life Span
Smoking, Drinking, Poor Diet, and Lack of Exercise Combined Greatly Increase Risk for Early Death
By Katrina Woznicki
WebMD Health NewsReviewed by Elizabeth Klodas, MD, FACCApril 26, 2010 -- People who smoke, don’t exercise, eat poorly, and drink alcohol are three times more likely to die from cardiovascular disease and nearly four times more likely to die of cancer, a new study finds.

Such people also have an overall premature death risk equivalent to being 12 years older, when compared with people who do not engage in these four behaviors, according to the study, reported in the April 26 issue of Archives of Internal Medicine.

Many studies have examined the individual effects of smoking, physical inactivity, poor diet, and drinking alcohol, and have established that they are independently associated with poorer health. However, few studies have examined the combined influence of these behaviors. This is important because people often engage in multiple poor lifestyle choices that could shorten their life span.

“To fully understand the public health impact of these behaviors, it is necessary to examine both their individual and combined impact on health outcomes,” Elisabeth Kvaavik, PhD, of the University of Oslo in Norway and her colleagues write in the study.

The researchers interviewed 4,886 randomly selected people aged 18 or older in 1984 to 1985 who lived in the United Kingdom. A health behavior score was calculated by giving one point for each unhealthy behavior: smoking; eating fruits and vegetables less than three times a day; exercising less than two hours a week; and drinking more than 14 units of alcohol per week for women, and more than 21 units per week for men.

The average age of the participants was 43.7 years at study entry, and the group was split about equally between men and women. The participants were then tracked for the next two decades. Over the course of 20 years, 1,080 participants died -- 431 from cardiovascular disease, 318 from cancer, and 331 from other causes. The researchers found that compared with participants who did not have any unhealthy behaviors, the risk of death from all causes as well as from each cause increased substantially with each additional unhealthy behavior.

When looking at the behaviors individually, the study also showed that smoking was more strongly associated to cancer and other deaths, whereas physical inactivity was more strongly associated with death from cardiovascular disease.

“Modest but achievable adjustments to lifestyle behaviors are likely to have a considerable impact at both the individual and population level,” the researchers conclude.

Wednesday, April 28, 2010

Patient Money - Caring for Hips and Knees to Avoid Artificial Joints - NYTimes.com

Patient Money - Caring for Hips and Knees to Avoid Artificial Joints - NYTimes.com

Although the human body has an amazing capacity to repair itself, our joints are surprisingly fragile.

When the cartilage that cushions bones wears away, it does not grow back. Thinning cartilage contributes to osteoarthritis, also known as degenerative arthritis, a painful and often debilitating condition.

Over time, arthritic joints can become so sore and inflamed that they need to be replaced with mechanical substitutes. A result: more pain, at least in the short term, and big medical bills.

Fortunately, you can act to protect your joints now, to reduce your chances of needing to replace them later.

And protect you should. The cost for a new hip or knee — the joints most commonly replaced — is $30,000 to $40,000. If you have insurance, your total out-of-pocket costs will be much less, but may still be $3,000 to $4,000. And don’t forget to factor in all those days of work you will miss before you get your new prosthetic.

Creaky joints are a growing national problem. The population is getting older, more people are overweight, and an increasing number of children and young adults are playing serious sports and getting seriously injured — all factors that contribute to osteoarthritis.

[This article contains great advice that we have discussed before. To avoid all joints aging before their time; lose weight, get fit, and use your body appropriately. This means low impact SYMMETRICAL use of your joints. Recent studies, discussed in previous blogs, have demonstrated that a short leg or poor posture can cause increased stress on one side of your body, wearing down the joints and leading to early aging and degeneration. This is true for the joints of the back just as the knees and the hips. And back pain or neck pain can be just as debilitating and neck surgery or back surgery much, much more expensive, with much higher side effects and danger than hip or knee replacements.]

Saturday, April 24, 2010

May is National Correct Posture Month: Did You See Your Chiropractor Today?

May is National Correct Posture Month: Did You Do Your Posture Exercise Today?

[This is a great article on the importance of posture in maintaining health. I particularly like that they emphasize that even doing good things, like vigorous exercise, with a poor posture results in uneven and accelerated wear on your body over time. Unfortunately, the exercises recommended in the article would be minimally effective at best in creating sustained postural improvement. In reality and according to multiple studies, chronic abnormal postures result in contracted ligaments and soft tissues and often abnormal bone growth. Correcting this condition is more like putting braces on your teeth. It requires sustained force over time. It is possible though, and its worth it.]

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1840024/?tool=pmcentrez

It is known that spinal function is directly related to spinal structure, as has been proven for the cervical and lumbar spinal regions.80–84 With mal-alignment in neutral posture, static and especially dynamic function from this mal-alignment dictates altered stress/strain relationships of associated spinal structures, including the bones,85–87 intervertebral discs,88–91 facet joints,92 musculotendinous tissues,93 ligamentous tissues,94 and neural elements.95–100Postural alterations are known to be associated with a plethora of human afflictions from general pain syndromes,101–109 to problems with specific joints such as the hip110–111 and the knee,112 to problems with specific spinal regions such as the flat-back syndrome,113 and cervical kyphosis,109 to local organ ailments such as uterine prolapse,114–115 gastric herniation,116 and respiratory function,117–119 to thinking,118,120 and even to morbidity and mortality.121–125 Improved posture alignment has been one of the most sought-after goals in the treatment of human ailments for ages; this continues today in all medical arenas, such as dentistry, physiotherapy, physiatry, surgery, and chiropractic.126–134Since traditional SMT has not been found to be associated with routine improvement in spinal alignment, its therapeutic effects are thought to be in reducing pain and facilitating increased spinal motion.135 Of interest, however, many monotherapies, have been found to have either limited effectiveness or complete lack of success in treating chronic low back pain. Bogduk136 has discussed that these monotherapies include analgesics, NSAIDs, muscle relaxants, antidepressants, physiotherapy, surgery, and manipulative therapy. In contrast, Gross et al.137 have reported that the multi-modal care of exercise combined with cervical manipulation provides better results than either procedure used alone. The criticism of monotherapies is taken into consideration by CBP® technique as it uses a multi-modality care regimen of SMT as well as mirror image® exercises, mirror image® adjusting and mirror image®/extension spinal traction procedures, other stretching procedures, and ergonomic counseling.

Wednesday, April 21, 2010

Prioritizing low-cost, simple health measures would save 2.5 million child lives a year - Science Daily

Prioritizing low-cost, simple health measures would save 2.5 million child lives a year

[Sorry for including this article as it has nothing to do with chiropractic, but, it is really inspiring. Researchers have determined that very low cost interventions could prevent up to 1/3 of child deaths. As a fan of World Vision and the sponsor of World Vision children, I was excited to hear about their newest initiatives, discussed in the article.]

ScienceDaily (Nov. 16, 2009) — Almost a third of the children under age five who die each year could be saved if governments rebalance health spending to ensure low-cost, simple interventions such as safe water and hygiene, bed nets and basic maternal and newborn care, aid agency World Vision said. Currently, 8.8 million children a year die before age five, most of preventable causes.....

Monday, April 19, 2010

More Kids Falling Prey to Sports Overuse Injuries - Chiropractic care cuts sport injuries - ScienceAlert

More Kids Falling Prey to Sports Overuse Injuries
http://www.sciencealert.com.au/news/20101904-20861.html

[Here is the good news, chiropractic can help.]

A new Macquarie University study involving two semi-elite Australian Rules football clubs has found that chiropractic treatment can significantly reduce the risk of players succumbing to hamstring injuries and lower limb muscle strain.

The study was undertaken by sports chiropractor Wayne Hoskins as the basis for his PhD project on hamstring injuries and has just been published in the journal BMC Musculoskeletal Disorders.

"Hamstring and lower limb muscle strains are the most common injuries in the AFL," Hoskins said. "The AFL's injury survey shows no change in injury rates in the last 15 years and management of these injuries has remained a source of frustration for players, clubs, medical staff and fans alike."

"The study lasted an entire season and involved 59 players from two VFL clubs," Hoskins said. "The group which included chiropractic management had a four per cent chance of a hamstring injury and a four per cent chance of a lower limb muscle strain. The group which received the traditional management only had a 17 per cent chance of hamstring injury and a 28 per cent chance of a lower limb muscle strain."

In addition, the chiropractic group missed just four matches during the season through hamstring or lower limb muscle strains. The group not receiving chiropractic treatment missed 14 matches through hamstring injury and 21 matches through lower limb muscle strain.

The group receiving chiropractic treatment also had significant reductions in non-contact knee injuries, low back pain, and improvements in physical components of health, although this was not the goal of treatment.

[Here is the bad news, the incidence of sports injuries in children is increasing for a variety of reasons, see article. One thing that seems obvious is that coaches have to be made aware of ways to minimize injury through more balanced training, literally, of both sides of the body equally, and of how to prevent the most common injuries of their particular sport. Chiropractic can help prevent sports injuries and chiropractors can provide advice on ways to minimize risks of particular sports.]

"There are a lot of factors behind the increase in overuse injuries, but the number one thing is specialization. Kids are being forced to choose one sport and they're playing it year-round," said Dr. James Andrews, an orthopedic surgeon, president of the American Orthopaedic Society for Sports Medicine and co-chairman of the Stop Sports Injuries campaign.

According to the Stop Sports Injuries campaign, the sports with the highest risk of overuse injuries for children are: baseball, basketball, cheerleading, dancing, football, gymnastics, running, soccer, softball, swimming, tennis and volleyball. Orthopedic surgeons are now seeing two trends: a rapid increase in the number of youth sports injuries and a drop in the age of young athletes with overuse injuries.

Signs that parents should look for that might indicate an overuse injury include:

Favoring one side of the body over the other.
Appearing to be in pain when using a certain body part.
Trouble sleeping.
Headaches.
Stiffness in muscles or joints.

"Parents need to get involved and to listen to their kids. They also need to be knowledgeable about their child's sports and what the risks are," advised Andrews. He said parents also need to realize that a minor injury when a child is young can lead to a major one as the child grows older.

Friday, April 16, 2010

Leg length inequality can bring on joint pain and back pain- Kilgore News Herald

Leg length inequatlity can bring on joint pain - Kilgore News Herald

[Here is a succinct answer to a great question. We frequently see individuals with leg length difference so large that uneven joint degeneration can be observed. Many abnormal postures caused by unequal leg length then lead to degeneration in the spine. At Banic Chiropractic, we measure the leg length difference, provide very inexpensive custom height heel lifts and/or orthotics to correct the problem. Then we fix the posture through our unique treatment of chiropractic adjusting, postural exercise, and traction - which is like the way braces realign the teeth.]

Leg length inequality can bring on joint pain
YOUR HEALTH DR. DONOHUE

DEAR DR. DONOHUE: I've been jogging with a group of men, all of whom are in their 50s, for a couple of years. This year, my knees have been giving me trouble. In talking with the other joggers, some say it could be that there's a difference in the length of my legs. Is this for real? How do I get them measured? What do I do if they aren't the same size? -- B.B.

ANSWER: Everyone has legs of slightly different size, just as arms are not the same length. If the difference causes no pain, you can ignore it.

However, it can cause problems. It can lead to low back pain, arthritis of the knees and hips, and hip bursitis. The unequal legs cause the generation of great pressure when the feet strike the ground, and the abnormal pressure load exists for both the longer and the shorter leg. The inequality also causes the pelvis to twist and brings on back pain. Furthermore, when standing, unequal legs distort posture, and that can produce back and joint pain.

The inequality doesn't have to be all that great. In a recently published article on knee osteoarthritis, a difference of 1 centimeter (twofifths of an inch) was linked to knee arthritis. I have to let you know that other authors define significant inequality at half an inch to four-fifths of an inch.

To measure your legs, you need an assistant. Make a mark on the top part of both legs in exactly the same place. Make another mark at the same place on the ankles. Lie down and have your assistant do the measuring with a tape measure. For a really precise measurement, X-rays of the legs provide reliable figures.

If there is a difference between your legs, you can even things out with a heel lift, a shoe lift or specially made orthotics.

Let's not go overboard with this. The causes of knee pain are many, and a better approach to your knee pain would be a consultation with your family doctor.

Wednesday, April 14, 2010

Knee Braces Ease Osteoarthritis Knee Pain WebMD - At Banic Chiropractic Clinic we use this principle to alleviate back pain.

Knee Braces Ease Osteoarthritis Pain

Knee braces basically help realign the knee; taking pressure off of damaged areas to relieve pain and restore function. Bracing is one of a number of noninvasive ways to treat knee OA and/or delay the need for joint replacement surgery.

New research presented at a media briefing Tuesday in New York City suggests that Peterson is not the only one to find relief from knee bracing. In a new study, 49 people with knee OA aged 45 to 87 who wore a knee brace had less pain, stiffness, and disability after six months of use.

Benefits of a Brace

Thirty-one percent of study participants said they took fewer over-the-counter (OTC) anti-inflammatory drugs, and 35% were taking fewer prescription anti-inflammatory drugs after six months of wearing the brace. Researchers plan to follow up on these individuals for up to two years to see who goes on to have joint replacement surgery.

But so far, so good. "The less knee misalignment the patient had, the less disability they experienced, and they saw an improvement in pain, stiffness, and function," said study researcher J. Richard Steadman, MD, founder of the Steadman Phillipon Research Institute in Vail, Colo., at the media briefing.

[The statements above are no surprise, studies have found the exact same results in the spine. Large misalignments of the spine and posture lead to predicable patterns of Osteoarthritis OA over time. The OA occurs, not only in spinal joints, but in hip and knee joints also. This is due to unequal loading through the joints as they carry the weight of the body each and every day of your life. And the greater the weight, the faster the OA will appear. At Banic Chiropractic, we use the only proven method to realign the posture, sustained mechanical traction. This method is like wearing a brace, or braces on your teeth, in that it stresses the body into a normal position and holds that position long enough to make a permanent change. After repeated times doing this, this posture is more balanced, leading to less stress on the joints of the spine and legs. My biggest pet peeve is when people tell me they BELIEVE in Chiropractic. You don't have to BELIEVE in it, there is AMPLE scientific evidence.]

USA Today 'Very little progress' made against serious hospital infections

Report: 'Very little progress' made against serious hospital infections

[I feel bad continuing to post about this subject but the studies just keep rolling out, this time from the US Department of Health and Human Services. This is yet another reminder that our health must be our highest priority. Small healthy choices everyday create a lifestyle of health which you will benefit from now and 30 years from now. One of the essential components of healthy living is maintaining balanced upright posture to reduce wear on your spinal discs and the joints of your entire body. Balanced posture will also reduce aberrant nerve signaling throughout your body as your brain sends strength and energy out to all the tissues of the body and receives messages in response. See your chiropractor, care for body with diet and exercise, and don't take elective surgeries lightly.]

The nation's hospitals are failing to protect patients from potentially fatal infections despite years of prevention campaigns, the government said Tuesday.

The Health and Human Services department's 2009 quality report to Congress found "very little progress" on eliminating hospital-acquired infections and called for "urgent attention" to address the shortcomings — first brought to light a decade ago.

Of five major types of serious hospital-related infections, rates of illnesses increased for three, one showed no progress, and one showed a decline. As many as 98,000 people a year die from medical errors, and preventable infections — along with medication mixups — are a significant part of the problem.

Monday, April 12, 2010

Chiropractic treatment of developmental delay syndromes, dyspraxia, dyslexia, and ADHD / ADD - Research from JMPT PubMed

[While there are a few case studies already in the literature that describe amazing results in children for syndromes such as attention deficit hyperactivity disorder, the following study has a very large sample size. After chiropractic treatments, all157 kids participating in the study were found to improve concentration and performance at school and home, control impulsivity, and to maintain focus and attention. We have also had terrific results in pediatric patients we have cared for. Please read the abstract below for more details. As a mother, I can imagine how difficult it is to watch your child struggle with a developmental delay. I have done some reading on the current medical regimen required for many of these kids and found it quite depressing. Ritalin was found to cause growth restrictions and to control symptoms only in the short-term while not providing long-term benefits. The chiropractic case studies I have read resulted in complete elimination of symptoms. Thank god my kids are healthy in this regard but based on the science I have seen, I do not think I am holding up false hope regarding Chiropractic care. See the article at the very bottom for an explanation you might share with your medical doctor. The authors of the second article are esteemed in medicine and chiropractic, personal friends, and perform their chiropractic treatments the exact same way we do.]




J Manipulative Physiol Ther. 2009 Oct;32(8):660-9.

Developmental delay syndromes: psychometric testing before and after chiropractic treatment of 157 children.
Cuthbert SC, Barras M.

Chiropractic Health Center, Pueblo, CO 81004, USA. cranialdc@hotmail.com

Abstract
OBJECTIVE: This study presents a case series of 157 children with developmental delay syndromes, including the conditions such as dyspraxia, dyslexia, attention-deficit hyperactivity disorder, and learning disabilities who received chiropractic care. CLINICAL FEATURES: A consecutive sample of 157 children aged 6 to 13 years (86 boys and 71 girls) with difficulties in reading, learning, social interaction, and school performance who met these inclusion criteria were included. INTERVENTION AND OUTCOMES: Each patient received a multimodal chiropractic treatment protocol, applied kinesiology chiropractic technique. The outcome measures were a series of 8 standardized psychometric tests given to the children by a certified speech therapist pre- and posttreatment, which evaluate 20 separate areas of cognitive function, including patient- or parent-reported improvements in school performance, social interaction, and sporting activities. Individual and group data showed that at the end of treatment, the 157 children showed improvements in the 8 psychometric tests and 20 areas of cognitive function compared with their values before treatment. Their ability to concentrate, maintain focus and attention, and control impulsivity and their performance at home and school improved. CONCLUSIONS: This report suggests that a multimodal chiropractic method that assesses and treats motor dysfunction reduced symptoms and enhanced the cognitive performance in this group of children.

J Manipulative Physiol Ther 2004 (Oct); 27 (8): e14 ~ FULL TEXT

Bastecki AV, Harrison DE, Haas JW

OBJECTIVE: To discuss the case of a patient who was diagnosed with attention-deficit/hyperactivity disorder (ADHD) by a general practitioner and was treated with chiropractic care.

CLINICAL FEATURES: A 5-year-old patient was diagnosed with ADHD and treated by a pediatrician unsuccessfully with methylphenidate (Ritalin), Adderall, and Haldol for 3 years. The patient received 35 chiropractic treatments during the course of 8 weeks. A change from a 12 degrees C2-7 kyphosis to a 32 degrees C2-7 lordosis was observed after treatment. During chiropractic care, the child's facial tics resolved and his behavior vastly improved. After 27 chiropractic visits, the child's pediatrician stated that the child no longer exhibited symptoms of ADHD. The changes in structure and function may be related to the correction of cervical kyphosis.

CONCLUSION: The patient experienced significant reduction in symptoms. Additionally, the medical doctor concluded that the reduction in symptoms was significant enough to discontinue the medication. There may be a possible connection that correction of cervical kyphosis in patients with ADHD may produce a desirable clinical outcome.


From the Full-Text Article:

Discussion

There exists in the current biomedical literature an ideal cervical spinal model, [17] which was used as a goal of care in this case study. It is generally known in neurosciences and anatomy that the central nervous system is the master control system of the human body. It controls and coordinates all body and cellular functions. When we look at the literature today, there has been a significant amount of information published about the mechanical forces and tension placed on the spinal structures and cord tracts in various postures. [25-36]

Breig [26] showed the changes in spinal cord biomechanics from abnormal postural positions. We propose that these changes in spinal canal and thus spinal cord position can cause such pathologic states as edema, hypoxia, blood loss, and cellular death. [28-36] It has been reported by some researchers that abnormal putamen and lenticular magnetic resonance imaging and positron-emission tomography have been observed in children with ADHD. [37, 38] The previous refrences [28-36] may give insight to these abnormal scans. The underlying cause of the mechanical and thus physiologic changes in the spinal cord, brainstem, and higher brain centers are related to the abnormal static postural positions of the skull relative to the thorax. [26]

Mechanical compression of nerves can result in microvascular permeability changes in the endoneural capillaries and lead to neural edema and changes in impulse propagation. [28-36] Additionally, it has been shown that gradual decompression of nerve roots can restore the intrinsic blood flow. [36] Because the parents reported no other major traumatic injuries to the child other than a difficult birth, we propose that the cause of the abnormal spinal configuration was a result of difficult labor. Because of the vast amount of information concerning abnormal nerve function caused by mechanical stress in neck flexion (kyphosis), [26, 39, 40-45] it stands to reason, because his neck configuration was kyphotic, that the child's nervous system was not functioning properly. Through the restoration of normal biomechanical structure and curvature, these abnormal stresses and strains were removed from the cord, which led to the improvement in function.

There exists a large amount of literature on ADHD. This literature is generally pharmacologic and behavioral in nature. Many theories of causality and subsequent treatment have been put forth. However, because chiropractors are not authorized in most states to prescribe drugs, the pharmacologic information has little bearing for chiropractors. The chiropractors who treat patients with ADHD should, however, familiarize themselves with the current diagnostic and treatment protocols used by physicians. Medication may have an effect on treatment outcomes and may be an important factor in proper management of this condition. [1-15] It should be noted that these references are nowhere near a complete review of the literature on ADHD.

It is possible that the farther we move from the Harrison ideal spinal model, [17] the greater the neurologic stress from abnormal stress and strain on the spinal cord. [26] Restoring the cervical lordosis could be the most critical aspect of any chiropractic care protocol or clinical intervention. With specific mirror image adjusting, mirror image traction, and mirror image postural exercise, cervical curve restoration is now a possible outcome. [18-21]

Several limitations of this study include: (1) a possibility that there was spontaneous remission of the ADHD symptoms and that chiropractic care had no relevance to the symptom remission; (2) the patient may have been misdiagnosed by the medical doctor; and (3) the patient's parents may not have been reporting the retrospective symptoms accurately, giving a false sense of improvement. Because this is a case report, further research is needed to determine the true effects of CBP protocol on patients suffering with ADHD.


Conclusion

This case study shows that spinal correction using the CBP approach may have effects much greater than relief of musculoskeletal conditions. Altered spinal biomechanics associated with abnormal posture clearly relate to significant neurological stress and malfunction. This is particularly evident when considering the effects on the brainstem and the autonomic nervous system. Thus, even in obscure cases with systemic, organic, or chemical dysfunction like ADHD, we suggest optimal spine equals optimal health.

Monday, April 5, 2010

Society for Maternal-Fetal Medicine: Statewide effort slashes number of early induced and caesarean scheduled births

Society for Maternal-Fetal Medicine: Statewide effort slashes number of early scheduled births

[I was very interested to see this statewide effort centered around one of my biggest pet peeves. I know multiple women who took great care of themselves during pregnancy but then chose to have scheduled delivery around their due date because their doctor was "going out of town" or they had relatives coming into town. These are all people that live in the Seattle area and this was just recently. I was completely aghast that the medical professionals would endorse inducing labor before the body is naturally ready. Well thankfully, I am not the only one that feels this way. In the study below, they find "Elective induction leads to more unplanned Caesarean sections in first time birth women and to increased postpartum complications for both first time and multiple birth women. Elective Caesarean section has increased maternal and neonatal risks." The entire state of Ohio has finally responded to studies like this and "successfully reduced the number of scheduled near-term births—either by cesarean delivery or induction of labor—without a medical or obstetric indication from 1 in 4 to less than 1 in 20. You are likely to know someone offered a scheduled birth. Tell them the facts or send them to me!]

Jay Iams, MD, for the Ohio Perinatal Quality Collaborative unveiled the details of a statewide effort in Ohio that successfully reduced the number of scheduled near-term births—either by cesarean delivery or induction of labor—without a medical or obstetric indication from 1 in 4 to less than 1 in 20 (P<0.05).

Using a variety of education and intervention tools, 20 level 2 and 3 maternity hospitals—which handle about half of the state's births—shared their methods during the 14-month study. As a result, the rate of scheduled births between 36.1 and 38.6 weeks without medical necessity declined from 25% to below 5%. Inductions without medical necessity also declined from a 12-month mean of 13% to 8% (P<.0027), and fewer infants born at 36 to 38 weeks' gestation were admitted to the neonatal intensive care unit.

The Ohio Perinatal Quality Collaborative; Iams J. A statewide initiative to reduce scheduled births without appropriate indication [abstract]. Am J Obstet Gynecol. 2009;201(6 suppl):S19. Abstract 33.

J Obstet Gynaecol Can. 2009 Dec;31(12):1124-30.

Outcomes of elective labour induction and elective caesarean section in low-risk pregnancies between 37 and 41 weeks' gestation.
Dunne C, Da Silva O, Schmidt G, Natale R.

Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.

OBJECTIVE: To compare maternal and neonatal outcomes after elective induction of labour and elective Caesarean section with outcomes after spontaneous labour in women with low-risk, full-term pregnancies. METHODS: We extracted birth data from 1996 to 2005 from an obstetrical database. Singleton pregnancies with vertex presentation, anatomically normal, appropriately grown fetuses, and no medical or surgical complications were included. Outcomes after elective induction of labour and elective Caesarean section were compared with the outcomes after spontaneous labour, using chi-square and Student t tests and logistic regression. RESULTS: A total of 9686 women met the study criteria(3475 nulliparous, 6211 multiparous). The incidence of unplanned Caesarean section was higher in nulliparous women undergoing elective induction than in those with spontaneous labour (P < 0.001). Postpartum complications were more common in nulliparous and multiparous women undergoing elective induction (P < 0.001 and P < 0.01, respectively) and multiparous women undergoing elective Caesarean section, (P < 0.001). Rates of triage in NICU were higher in nulliparous women undergoing elective Caesarean section (P < 0.01), and requirements for neonatal free-flow oxygen administration were higher in nulliparous and multiparous women undergoing elective Caesarean section (P < 0.01 for each). Unplanned Caesarean section was 2.7 times more likely in nulliparous women undergoing elective induction of labour (95% CI 1.74 to 4.28, P < 0.001) and was more common among nulliparous and multiparous women undergoing induction of labour and requiring cervical ripening (P < 0. 001 and P < 0.05, respectively). CONCLUSION: Elective induction leads to more unplanned Caesarean sections in nulliparous women and to increased postpartum complications for both nulliparous and multiparous women. Elective Caesarean section has increased maternal and neonatal risks.

Thursday, April 1, 2010

Empower your patients through education!

[Thank you Ann for helping me to clarify my thoughts on interventions by medical professionals. You could say my biggest issue is the continuing paternalistic attitude that is shrouded in this new holistic movement. A couple of examples, in regard to Vitamin D supplementation, which every doctor has gotten on the bandwagon about, including mine. Here is what they should be sharing with you instead of just selling you the supplement;] Many scientists now believe we need 1,000 IU per day of vitamin D (IU = international units, a measure of vitamin potency) to avoid deficiency. For reference, a salmon serving contains about 360 IU, a glass of fortified milk about 100 IU, an egg 25 IU, and a tablespoon of cod liver oil 1300+ IU.

In comparison, full-body sunbathing for a period of time that will just make you turn pink will produce 10,000-20,000 IU of vitamin D, equivalent to 100 to 200 glasses of fortified milk. Given such copious production, relatively casual sun exposure (arms, etc) should meet vitamin-D needs.

Remember, however, that no vitamin D will be generated in short-daylight months above certain latitudes. In these periods to avoid vitamin-D deficiency - especially if you don’t like oily fish or are lactose intolerant - you will need to consume a supplement or use a UVB-emitting tanning bed. Studies have shown that individuals who use such a tanning bed in winter have serum levels of 25-hydroxyvitamin D (the marker for vitamin-D status) that is 90% higher than controls.

The importance of solar-produced vitamin D was underscored in a study that evaluated vitamin-D status in a submarine crew after two months of acute sun deprivation. Although the crew consumed a vitamin-D fortified diet, their levels of this nutrient plummeted.)

[Here is another example; I have heard frequently of women discussing a family history or personal risk of Osteoporosis with their physician. Often they are prescribed a myriad of Calcium, Magnesium, Vitamin D supplements, told to eat Calcium rich food, recommended expensive prescription medications, etc... They should be empowered to really take control of their health with advice like the following]; Nonpharmacological approaches to improve bone health and reduce osteoporosis. Schwab P, Klein RF.
PURPOSE OF REVIEW: With an aging population, osteoporosis has become a public health concern and an area of increased awareness among both patients and medical practitioners. Timely screening and pharmacologic treatment of low bone mass effectively reduces fracture risk. Nonpharmacologic interventions, however, deserve equal emphasis both in the prevention and treatment of osteoporosis. RECENT FINDINGS: Recent advances in bone biology have established that exercise in the form of short, repetitive mechanical loading leads to the greatest gains in bone strength. As demonstrated by both observational and randomized exercise intervention trials, these gains are best achieved in childhood but can be maintained in adulthood with continued regular weight-bearing exercise. In the later years, evidence supports the implementation of balance training to decrease fall risk, especially in elderly patients with low bone mass. Following an osteoporotic fracture, a multidisciplinary rehabilitation program with an emphasis on early mobilization, fall prevention, use of orthoses, and noninvasive surgical procedures is emerging as a promising approach. SUMMARY: Clinically, these findings should imply greater emphasis on high impact exercise during skeletal growth and on maintenance of weight bearing and balance training in the later years. Future research should examine the effect of these interventions on fracture prevention.

[There are many, many more examples where individuals seeking advice receive a diagnosis or magic bullet type pill/ supplement when what they could really benefit from is to be empowered by education, after all, why seek out an expert]

Chiropractic Wellness - Picking our brains: How strong is the mind-body link? New Scientist

Picking our brains: How strong is the mind-body link?

[A central tenant in chiropractic care is that the treatments influence parasympathetic and sympathetic nerves to the organs as well as the sensory and motor nerves to the musculoskeletal system. As research continues to demonstrate the influence of Chiropractic on blood pressure (decreases it), gastric motility, immune function and more, we will surely hear more and more about the influence of the Chiropractic adjustment on the vagus nerve.]

Picking our brains: How strong is the mind-body link?
01 April 2010 by Linda Geddes
Magazine issue 2754.

Could we ever learn to think ourselves well?

Many of these effects seem to be mediated by the immune system. Severe stress has been shown to reduce immune cell activity, both in the test tube and in people. There seem to be several ways in which the brain influences the immune system, from chemical mediators to direct neural control. One branch of the vagus nerve connects the brain to a key regulator of immune functioning, says Kevin Tracey of the Feinstein Institute for Medical Research in Manhasset, New York. "Signals that originate in the brain travel down the vagus nerve where they change the behaviour of immune cells in the spleen," he says (Nature, vol 420, p 853).

Tracey's team has since found that electrically stimulating the vagus nerve decreases inflammation, a state of immune system high-alert implicated in a large number of diseases, including cancer. They suspect there may be other nerve-immune links that have the effect of "turning up" inflammation.

If we can't consciously control the immune system, we might at least be able to manipulate it with drugs or perhaps via the vagus nerve.


http://www.planetc1.com/cgi-bin/n/v.cgi?c=1&id=1169752898

There is a nerve that runs from the lower part of your brain (the brainstem) down to your heart. This nerve is called the vagus nerve or the pneumogastric nerve (cranial nerve X). It is the only nerve in your brain that extends down through your neck and into your abdominal region. You certainly don't want to have spinal stress anywhere in your neck. Would you believe that medical doctors use to cut the vagus nerve out of the body for treating things such as peptic ulcers? You'd think maybe they would have been doing that a long long time ago, in the dark ages of medicine, but the procedure was popular up until the mid-1990s as a treatment for peptic ulcers. The procedure was called a vagotomy and it became obsolete after was discovered that Helicobacter pylori, a microorganism that can thrive in the highly acidic environment of the stomach, was responsible for most peptic ulcers. It makes you wonder how many other surgical procedures will become obsolete as we continue to discover new things about the human body.