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Monthly Archives: October 2015

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FDA strengthens warning that non-aspirin NSAIDs can cause heart attacks or strokes

By |October 27, 2015|NSAIDs|

Source FDA

The U.S. Food and Drug Administration (FDA) is strengthening an existing label warning that non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) increase the chance of a heart attack or stroke. Based on their comprehensive review of new safety information, they are requiring updates to the drug labels of all prescription NSAIDs. As is the case with current prescription NSAID labels, the Drug Facts labels of over-the-counter (OTC) non-aspirin NSAIDs already contain information on heart attack and stroke risk. They will also request updates to the OTC non-aspirin NSAID Drug Facts labels.

Based on their review and the advisory committees’ recommendations, the prescription NSAID labels will be revised to reflect the following information:

  • The risk of heart attack or stroke can occur as early as the first weeks of using an NSAID. The risk may increase with longer use of the NSAID.
  • The risk appears greater at higher doses.
  • It was previously thought that all NSAIDs may have a similar risk. Newer information makes it less clear that the risk for heart attack or stroke is similar for all NSAIDs; however, this newer information is not sufficient for us to determine that the risk of any particular NSAID is definitely higher or lower than that of any other particular NSAID.
  • NSAIDs can increase the risk of heart attack or stroke in patients with or without heart disease or risk factors for heart disease. A large number of studies support this finding, with varying estimates of how much the risk is increased, depending on the drugs and the doses studied.
  • In general, patients with heart disease or risk factors for it have a greater likelihood of heart attack or stroke following NSAID use than patients without these risk factors because they have a higher risk at baseline.
  • Patients treated with NSAIDs following a first heart attack were more likely to die in the first year after the heart attack compared to patients who were not treated with NSAIDs after their first heart attack.
  • There is an increased risk of heart failure with NSAID use.

Chiropractic As Spine Care

By |October 26, 2015|Chiropractic Care|

Chiropractic As Spine Care:
A Model For The Profession

The Chiro.Org Blog


SOURCE:   Chiropractic & Osteopathy 2005 (Jul 6);   13:   9 ~ FULL TEXT

Craig F Nelson, Dana J Lawrence, John J Triano,
Gert Bronfort, Stephen M Perle, R Douglas Metz,
Kurt Hegetschweiler, and Thomas LaBrot

American Specialty Health, and
Palmer Centre for Chiropractic Research,
Palmer College of Chisopractic,
1000 Brady Street
Davenport, IA 52803, USA


BACKGROUND:   More than 100 years after its inception the chiropractic profession has failed to define itself in a way that is understandable, credible and scientifically coherent. This failure has prevented the profession from establishing its cultural authority over any specific domain of health care.

OBJECTIVE:   To present a model for the chiropractic profession to establish cultural authority and increase market share of the public seeking chiropractic care.

DISCUSSION:   The continued failure by the chiropractic profession to remedy this state of affairs will pose a distinct threat to the future viability of the profession. Three specific characteristics of the profession are identified as impediments to the creation of a credible definition of chiropractic: Departures from accepted standards of professional ethics; reliance upon obsolete principles of chiropractic philosophy; and the promotion of chiropractors as primary care providers. A chiropractic professional identity should be based on spinal care as the defining clinical purpose of chiropractic, chiropractic as an integrated part of the healthcare mainstream, the rigorous implementation of accepted standards of professional ethics, chiropractors as portal-of-entry providers, the acceptance and promotion of evidence-based health care, and a conservative clinical approach.

CONCLUSION:   This paper presents the spine care model as a means of developing chiropractic cultural authority and relevancy. The model is based on principles that would help integrate chiropractic care into the mainstream delivery system while still retaining self-identity for the profession.


From the FULL TEXT Article:

Background

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Chiropractic and Complementary and Alternative Medicine

By |October 25, 2015|Chiropractic Care, Complementary and Alternative Medicine|

Chiropractic and CAM Utilization: A Descriptive Review

The Chiro.Org Blog


Chiropractic & Osteopathy 2007 (Jan 22);   15:   2 ~ FULL TEXT

Dana J Lawrence and William C Meeker

Research Department,
Palmer College of Chiropractic,
1000 Brady Street,
Davenport, IA 52803, USA.
dana.lawrence@palmer.edu


OBJECTIVE:   To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions

DATA SOURCES:   A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations.

DATA SELECTION:   A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions.

DATA SYNTHESIS:   Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form.

RESULTS:   Thematic analysis of the paper topics indicated that there were 5 functional areas covered by the literature: back pain papers, general chiropractic papers, insurance-related papers, general CAM-related papers; and worker’s compensation papers.

CONCLUSION:   Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.


From the FULL TEXT Article:

Background

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Chiropractic Use of Somatosensory Evoked Potentials (SEPs) in Research

By |October 23, 2015|Chiropractic Research, Education|

The Origin, and Application of Somatosensory
Evoked Potentials as a Neurophysiological Technique to Investigate Neuroplasticity

The Chiro.Org Blog


SOURCE:   J Can Chiropr Assoc. 2014 (Jun);   58 (2): 170–183 ~ FULL TEXT

Steven R. Passmore, DC, PhD, Bernadette Murphy, DC, PhD,
and Timothy D. Lee, PhD

McMaster University
University of Ontario,
Institute of Technology


Somatosensory evoked potentionals (SEPs) can be used to elucidate differences in cortical activity associated with a spinal manipulation (SM) intervention. The purpose of this narrative review is to overview the origin and application of SEPs, a neurophysiological technique to investigate neuroplasticity. Summaries of:

1) parameters for SEP generation and waveform recording;
2) SEP peak nomenclature, interpretation and generators;
3) peaks pertaining to tactile information processing (relevant to both chiropractic and other manual therapies);
4) utilization and application of SEPs;
5) SEPs concurrent with an experimental task and at baseline/control/pretest;
6) SEPs pain studies; and
7) SEPs design (pre/post) and neural reorganization/neuroplasticity; and
8) SEPs and future chiropractic research are all reviewed.

Understanding what SEPs are, and their application allows chiropractors, educators, and other manual therapists interested in SM to understand the context, and importance of research findings from SM studies that involve SEPs.

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Low Back Pain in Primary Care

By |October 17, 2015|Chiropractic Care, Chronic Pain, Low Back Pain|

Low Back Pain in Primary Care: A Description of 1250 Patients with Low Back Pain in Danish General and Chiropractic Practice

The Chiro.Org Blog


SOURCE:   Int J Family Med. 2014 (Nov 4);   2014:   106102 ~ FULL TEXT

Lise Hestbaek, Anders Munck, Lisbeth Hartvigsen,
Dorte Ejg Jarbøl, Jens Søndergaard, and Alice Kongsted

Department of Sports Science and Clinical Biomechanics,
University of Southern Denmark,
5230 Odense, Denmark
l.hestbaek@nikkb.dk


Study Design.   Baseline description of a multicenter cohort study.

Objective.   To describe patients with low back pain (LBP) in both chiropractic and general practice in Denmark.

Background.   To optimize standards of care in the primary healthcare sector, detailed knowledge of the patient populations in different settings is needed. In Denmark, most LBP-patients access primary healthcare through chiropractic or general practice.

Methods.   Chiropractors and general practitioners recruited adult patients seeking care for LBP. Extensive baseline questionnaires were obtained and descriptive analyses presented separately for general and chiropractic practice patients, Mann-Whitney rank sum test and Pearson’s chi-square test, were used to test for differences between the two populations.

There are more articles like this @ our:

Low Back Pain and Chiropractic Page

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Altered Central Integration of Dual Somatosensory InputAfter Cervical Spine Manipulation

By |October 9, 2015|Chiropractic Care, Spinal Manipulation, Subluxation|

Altered Central Integration of Dual Somatosensory Input After Cervical Spine Manipulation

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2010 (Mar);   33 (3):   178–188 ~ FULL TEXT

Heidi Haavik Taylor, PhD, BSc, Bernadette Murphy, PhD, DC

Director of Research,
New Zealand College of Chiropractic,
Auckland, New Zealand.
heidi.taylor@nzchiro.co.nz


OBJECTIVE:   The aim of the current study was to investigate changes in the intrinsic inhibitory interactions within the somatosensory system subsequent to a session of spinal manipulation of dysfunctional cervical joints.

METHOD:   Dual peripheral nerve stimulation somatosensory evoked potential (SEP) ratio technique was used in 13 subjects with a history of reoccurring neck stiffness and/or neck pain but no acute symptoms at the time of the study. Somatosensory evoked potentials were recorded after median and ulnar nerve stimulation at the wrist (1 millisecond square wave pulse, 2.47 Hz, 1 x motor threshold). The SEP ratios were calculated for the N9, N11, N13, P14-18, N20-P25, and P22-N30 peak complexes from SEP amplitudes obtained from simultaneous median and ulnar (MU) stimulation divided by the arithmetic sum of SEPs obtained from individual stimulation of the median (M) and ulnar (U) nerves.

RESULTS:   There was a significant decrease in the MU/M + U ratio for the cortical P22-N30 SEP component after chiropractic manipulation of the cervical spine. The P22-N30 cortical ratio change appears to be due to an increased ability to suppress the dual input as there was also a significant decrease in the amplitude of the MU recordings for the same cortical SEP peak (P22-N30) after the manipulations. No changes were observed after a control intervention.

There are more articles like this @ our:

What is the Chiropractic Subluxation Page and the:

Chronic Neck Pain and Chiropractic Page

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