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Monthly Archives: June 2015

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Back Pain in Adolescents With Idiopathic Scoliosis

By |June 30, 2015|Chiropractic Care, Scoliosis|

Back Pain in Adolescents With Idiopathic Scoliosis: Epidemiological Study for 43,630 Pupils in Niigata City, Japan

The Chiro.Org Blog


SOURCE:   Eur Spine J. 2011 (Feb);   20 (2):   274–279 ~ FULL TEXT

Tsuyoshi Sato, Toru Hirano, Takui Ito, Osamu Morita, Ren Kikuchi,
Naoto Endo, and Naohito Tanabe

Department of Orthopedic Surgery,
Niigata Prefectural Shibata Hospital,
Shibata, Japan.
tsuyoshis1@mac.com


There have been a few studies regarding detail of back pain in adolescents with idiopathic scoliosis (IS) as prevalence, location, and severity. The condition of back pain in adolescents with IS was clarified based on a cross-sectional study using a questionnaire survey, targeting a total of 43,630 pupils, including all elementary school pupils from the fourth to sixth grade (21,893 pupils) and all junior high pupils from the first to third year (21,737 pupils) in Niigata City (population of 785,067), Japan.

32,134 pupils were determined to have valid responses (valid response rate: 73.7%). In Niigata City, pupils from the fourth grade of elementary school to the third year of junior high school are screened for scoliosis every year. This screening system involves a three-step survey, and the third step of the survey is an imaging and medical examination at the Niigata University Hospital.

In this study, the pupils who answered in the questionnaire that they had been advised to visit Niigata University Hospital after the school screening were defined as Scoliosis group (51 pupils; 0.159%) and the others were defined as No scoliosis group (32,083 pupils). The point and lifetime prevalence of back pain, the duration, the recurrence, the severity and the location of back pain were compared between these groups.

The severity of back pain was divided into three levels (level 1 no limitation in any activity; level 2 necessary to refrain from participating in sports and physical activities, and level 3 necessary to be absent from school). The point prevalence was 11.4% in No scoliosis group, and 27.5% in Scoliosis group. The lifetime prevalence was 32.9% in No scoliosis group, and 58.8% in Scoliosis group. According to the gender- and school-grade-adjusted odds ratios (OR), Scoliosis group showed a more than twofold elevated odds of back pain compared to No scoliosis group irrespective of the point or lifetime prevalence of back pain (OR, 2.29; P = 0.009 and OR, 2.10; P = 0.012, respectively).

Scoliosis group experienced significantly more severe pain, and of a significantly longer duration with more frequent recurrences in comparison to No scoliosis group. Scoliosis group showed significantly more back pain in the upper and middle right back in comparison to No scoliosis group. These findings suggest that there is a relationship between pain around the right scapula in Scoliosis group and the right rib hump that is common in IS.


From the Full-Text Article:

Introduction:

Most patients with adolescent idiopathic scoliosis (AIS) visit the hospital when a trunk deformity, such as rib or lumbar hump and waist asymmetry, is pointed out either after the school screening or by family members, and it is rare for these patients to visit the hospital due to back pain. However, some adolescent patients with idiopathic scoliosis (IS) do complaint of back pain in outpatient clinics. Previously, it had been accepted that special attention should be paid to patients with scoliosis who experienced back pain, because it was thought that might be additional pathologies such as an occult syrinx, spinal cord tumors, or neuromuscular disorders [4, 6, 20].

There are more articles like this @ our:

Scoliosis and Chiropractic Page

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Q&A With the First VA Chiropractic Residents

By |June 29, 2015|News, Veterans|

Q&A With the First VA Chiropractic Residents

The Chiro.Org Blog


SOURCE:   Dynamic Chiropractic ~ July 1, 2015 ~ FULL TEXT

By Clinton Daniels, DC, MS, Amanda Dluzneiwski, DC, Derek Golley, DC,
Benjamin Liang, DC and Rachel Perrucci, DC


The Inaugural class of 2015 shares their residency experiences.


As you may have read previously, a major step forward for the profession occurred in July 2014 when the Department of Veterans Affairs began piloting a chiropractic residency program at five locations.1-2 This program is the result of years of dedication and strategic planning by the VA chiropractic leadership, and is congruent with the VA’s mission to train providers to serve the VA and the nation at large.

As the inaugural class, we are honored to have participated in the first phase of the three-year pilot program.

In March 2015, we had the opportunity to gather for a VA meeting held in advance of the Association of Chiropractic Colleges /Research Agenda Conference in Las Vegas. At this meeting, we worked with representatives from VA Central Office, the five residency program directors, and representatives from each program’s academic affiliates: Logan University, New York Chiropractic College, Southern California University of Health Sciences and the University of Bridgeport.

After this, many of us attended the ACC/RAC conference itself, where we participated in workshops and observed several cutting-edge research presentations. In our interaction with many of the ACC/RAC attendees, we noted a tremendous amount of interest in the VA Chiropractic Residency Program. We received questions ranging from inquiries about our future career plans to how perspective residents may apply. The following are some of the most frequent questions we fielded, as well as personal residency experiences.


How long is the residency program and is it a paid position?

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The True Face of Medicare Fraud

By |June 19, 2015|News|

Source The Atlantic
By David A Graham

A $712 million bust, the biggest in U.S. history, shows that the people most likely to bilk the system are doctors and medical providers, not “welfare queens.”

A specter is still haunting American politics—the mythological specter of the welfare queen. Even after Clinton-era welfare reforms, and despite an ever-growing list of state restrictions on how public benefits can be used, Americans remain convinced that there’s waste, fraud, and abuse in the system, and that stronger controls would keep undeserving citizens from bilking the taxpayer. There is fraud, it’s true. But it’s not nearly large enough to make a dent in the federal budget, and it’s not freeloading welfare queens who are taking advantage of the system.

Nearly lost Thursday in the response to the atrocity in Charleston was Attorney Loretta Lynch’s announcement of arrests in what she called “the largest criminal healthcare fraud takedown in the history of the Department of Justice.” A total of 243 people were arrested and charged with stealing $712 million from Medicare. The arrests included 46 doctors, nurses, pharmacy owners, and other medical professionals. Facilities billed the federal government for therapy sessions where patients were actually just moved, never treated. In a particularly disturbing case, a Michigan doctor allegedly “prescribed unnecessary narcotics in exchange for patients’ identification information, which was used to generate false billings. Patients then became deeply addicted to the prescription narcotics and were bound to the scheme as long as they wanted to keep their access to the drugs.”

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Mild Traumatic Brain Injury and Concussion: An Invisible and Confusing Condition

By |June 5, 2015|Uncategorized|

Mild Traumatic Brain Injury and Concussion:
An Invisible and Confusing Condition

The Chiro.Org Blog


SOURCE:   ACA News ~ June 2015 ~ FULL TEXT

By James J. Lehman, DC, FACO


Traumatic brain injuries are perplexing and problematic — and they affect millions of Americans. It has been estimated that up to 3.8 million Americans incur mild traumatic brain injuries (MTBI) or concussions in sports-related activities and approximately 50 percent of the injured do not report the injury to a health care professional. [1] I suspect that millions of MTBI are not reported to health care providers as a result of sporting activities, motor vehicle accidents, work-related injuries and military operations. Another report claims that MTBI affects more than 1.125 million Americans.

Traumatic brain injury is frequently referred to as the silent epidemic because the problems that result from it (e.g., impaired memory) often are not visible. Mild traumatic brain injury (MTBI) accounts for at least 75 percent of all traumatic brain injuries in the United States.

According to existing data, more than 1.5 million people experience a traumatic brain injury (TBI) each year in the United States. These injuries may cause long-term or permanent impairments and disabilities. Many people with MTBI have difficulty returning to routine, daily activities and may be unable to return to work for many weeks or months. In addition to the human toll of these injuries, MTBI costs the nation nearly $17 billion each year. [2]

Some of the current definitions, position statements and evidence-based guidelines regarding concussion and mild traumatic brain injury are offered for your perusal and consideration. Sources discussing treatment, prevention and living with traumatic brain injuries are provided for those interested in more detail, continuing education credits and certification. The goal of this article is to make more visible your patients with obscure MTBI symptoms. I hope that this article will reduce confusion regarding the diagnosis and treatment of patients with MTBI and concussions.


Bloodless Concussion: The Misunderstood Injury

Some 11 years ago, an excellent review, Bloodless Concussion: The Misunderstood Injury, pointed out that approximately two-thirds of all chiropractic physicians practicing in the United States are licensed to diagnose and treat patients as portal-ofentry health care providers. Consequently, they can assume a major role in evaluating, diagnosing and treating concussions, particularly head injuries that affect the spine and related extremities. The review by David Martinez, DC, focused on concussion and MTBI primarily related to sports injury and chiropractic medicine. He mentioned that it is difficult to diagnose concussion and oftentimes perceived as unimportant because no blood or other obvious clinical signs are visible. [3]


Brain Injuries and Consciousness

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Can the Nervous System Be Hacked?

By |June 4, 2015|Research|

Source NY Times

Vagus nerve stimulation that affects the immune system has wide implications for non-drug therapy in conditions such as Rheumatoid Arthritis.

By

One morning in May 1998, Kevin Tracey converted a room in his lab at the Feinstein Institute for Medical Research in Manhasset, N.Y., into a makeshift operating theater and then prepped his patient — a rat — for surgery. A neurosurgeon, and also Feinstein Institute’s president, Tracey had spent more than a decade searching for a link between nerves and the immune system. His work led him to hypothesize that stimulating the vagus nerve with electricity would alleviate harmful inflammation. “The vagus nerve is behind the artery where you feel your pulse,” he told me recently, pressing his right index finger to his neck.

The vagus nerve and its branches conduct nerve impulses — called action potentials — to every major organ. But communication between nerves and the immune system was considered impossible, according to the scientific consensus in 1998. Textbooks from the era taught, he said, “that the immune system was just cells floating around. Nerves don’t float anywhere. Nerves are fixed in tissues.” It would have been “inconceivable,” he added, to propose that nerves were directly interacting with immune cells.

Nonetheless, Tracey was certain that an interface existed, and that his rat would prove it. After anesthetizing the animal, Tracey cut an incision in its neck, using a surgical microscope to find his way around his patient’s anatomy. With a hand-held nerve stimulator, he delivered several one-second electrical pulses to the rat’s exposed vagus nerve. He stitched the cut closed and gave the rat a bacterial toxin known to promote the production of tumor necrosis factor, or T.N.F., a protein that triggers inflammation in animals, including humans.

“We let it sleep for an hour, then took blood tests,” he said. The bacterial toxin should have triggered rampant inflammation, but instead the production of tumor necrosis factor was blocked by 75 percent. “For me, it was a life-changing moment,” Tracey said. What he had demonstrated was that the nervous system was like a computer terminal through which you could deliver commands to stop a problem, like acute inflammation, before it starts, or repair a body after it gets sick. “All the information is coming and going as electrical signals,” Tracey said. For months, he’d been arguing with his staff, whose members considered this rat project of his harebrained. “Half of them were in the hallway betting against me,” Tracey said.

Inflammatory afflictions like rheumatoid arthritis and Crohn’s disease are currently treated with drugs — painkillers, steroids and what are known as biologics, or genetically engineered proteins. But such medicines, Tracey pointed out, are often expensive, hard to administer, variable in their efficacy and sometimes accompanied by lethal side effects. His work seemed to indicate that electricity delivered to the vagus nerve in just the right intensity and at precise intervals could reproduce a drug’s therapeutic — in this case, anti-inflammatory — reaction. His subsequent research would also show that it could do so more effectively and with minimal health risks.

Tracey’s efforts have helped establish what is now the growing field of bioelectronics. He has grand hopes for it. “I think this is the industry that will replace the drug industry,” he told me. Today researchers are creating implants that can communicate directly with the nervous system in order to try to fight everything from cancer to the common cold. “Our idea would be manipulating neural input to delay the progression of cancer,” says Paul Frenette, a stem-cell researcher at the Albert Einstein College of Medicine in the Bronx who discovered a link between the nervous system and prostate tumors.

Read more…