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Today’s the Day

Happy 4th of July (2015)

Happy Independence Day!

Enjoy the Fireworks Over the Lady of Liberty in NYC


IN CONGRESS, July 4, 1776

The unanimous Declaration of the thirteen united States of America

When in the Course of human events, it becomes necessary for one people to dissolve the political bands which have connected them with another, and to assume among the powers of the earth, the separate and equal station to which the Laws of Nature and of Nature’s God entitle them, a decent respect to the opinions of mankind requires that they should declare the causes which impel them to the separation.

Continue reading Happy 4th of July (2015)

Consistency of Outcomes Between Doctors of Chiropractic Treating Patients With Acute Lower Back Pain

The Chiropractic Hospital-Based Interventions Research Outcomes Study: Consistency of Outcomes Between Doctors of Chiropractic Treating Patients With Acute Lower Back Pain

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2015 (Jun 24) ~ FULL TEXT

Jeffrey A. Quon, DC, MHSc, PhD, FCCS(C), Paul B. Bishop, DC, MD, PhD,
Brian Arthur, DC, MSc

Clinical Associate Professor, Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; Research Associate, Department of Orthopaedics, Division of Spine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; Research Associate, International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada. Electronic address: quon@mail.ubc.ca.


Introduction

Within mainstream health care, the customary management of low back pain (LBP) by primary care medical physicians is often not evidence based. Interestingly, clinical practice guidelines (CPG) for the treatment of acute mechanical LBP, for example, have been developed independently by multidisciplinary expert panels in 12 countries. [1-12] The recommendations from those guidelines have been further accompanied by rigorous systematic reviews of the evidence [13-15] rather than expert consensus alone, [1] and, to date, they have generally endorsed the use of the following conservative modalities:

(1) reassurance about the favorable natural history of acute LBP,

(2) early activation,

(3) time-limited nonsteroidal anti-inflammatory medication (barring contraindications), and

(4) spinal manipulative therapy (SMT).

Despite widespread dissemination of CPG for LBP, compliance with this knowledge in general and with the SMT component in particular has been limited among mainstream health care providers. This is particularly true among family medical physicians, [16-18] whose personal beliefs about effective LBP care are often discordant with what is known from external research evidence. [19, 20] Yet, ironically, family medical physicians account for most office visits for LBP in many North American jurisdictions. [21]

In the province of British Columbia, Canada, family medical physicians represent the most common portal of entry into the health care system for patients with LBP. In an earlier observational study of injured workers, only 6% of attending family physicians recommended guideline-concordant spinal manipulation for acute LBP, whereas 54% recommended guideline discordant passive physiotherapy even after 4 weeks postinjury. [16] In a subsequent randomized controlled trial (RCT), only 17% of family physicians ended up recommending guideline concordant spinal manipulation, even after receiving a copy of CPG for the management of acute LBP as well as letters at 3 stages of the patient’s clinical course, specifically urging compliance with the distributed information. [17]

As family medical physicians represent the initial contact point for many patients with LBP, they remain a key user group for evidence-based practice guidelines that promote the use of spinal manipulation. However, locally, referring physicians as well as staff physicians and surgeons within our own hospital-based spine clinic have routinely suggested that greater endorsement of doctors of chiropractic (DC) in general and spinal manipulation specifically is hindered by a lack of confidence in the consistency of quality and appropriateness of care between different providers in the community.

There are more articles like this @ our:

Low Back Pain and Chiropractic Page

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Back Pain in Adolescents With Idiopathic 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

Q&A With the First VA Chiropractic Residents

The Chiro.Org Blog


SOURCE:   Dynamic Chiropractic ~ July 1, 2015

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?

Continue reading Q&A With the First VA Chiropractic Residents

The True Face of Medicare Fraud

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.”

Continue reading The True Face of Medicare Fraud

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

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

The Chiro.Org Blog


SOURCE:   ACA News ~ JUne 2015

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

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

Can the Nervous System Be Hacked?

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…

DCs Treating the Multiple Sclerosis Patient

DCs Treating the Multiple Sclerosis Patient

The Chiro.Org Blog


SOURCE:   ACA News ~ May 2015

By Lori A. Burkhart


Multiple Sclerosis (MS) is the most common disabling neurological disease of young adults, according to the National Institutes of Health (NIH), most often appearing when people are between 20 and 40 years old. However, it can also affect children and adults over 40. The U.S. National Library of Medicine defines MS as an autoimmune disease that affects the central nervous system (brain and spinal cord). The myelin sheath, a protective membrane that wraps around the axon of a nerve cell, is destroyed in a patient with MS; this is caused by inflammation. That damage causes nerve signals to slow down or stop. MS affects women more than men.

Since doctors of chiropractic are recognized as primary contact neuromusculoskeletal specialists, most will have patients with undiagnosed MS come into their practices. The DC will diagnose the patient, treat certain symptoms and make the appropriate referrals.


Diagnosis

Diagnosis of MS is complicated in that it can be severe or mild and can go into remission. NIH points out that initial symptoms often are double or blurred vision, red-green color distortion or blindness in one eye. Most MS patients experience muscle weakness in their extremities and difficulty with coordination and balance.

According to Larry Wyatt, DC, DACBR, FICC, professor and senior faculty, division of clinical sciences at Texas Chiropractic College, MS is diagnosed in a number of ways, as its clinical course is distinctive in each patient and there are different types of MS. Some patients with obvious MS are diagnosed by clinical signs and symptoms (i.e., attacks) alone. These patients will have MS attacks that often relapse for months or even years. In other patients further testing is necessary. Magnetic resonance imaging (MRI), often with gadolinium enhancement, is the mainstay of diagnosis in most cases. “Patients with MS will very often have multiple high-signal intensity lesions in the brain and/or spinal cord on T2-weighted images,” Dr. Wyatt says. “In addition, cerebrospinal fluid analysis for immunoglobulin content can be quite helpful. There is a specific set of criteria, called the McDonald Criteria, which outline the findings necessary for the diagnosis of the different forms of MS.”

Jason West, DC, DCBCN, a fourth-generation DC who operates a clinic in Pocatello, Idaho, says the majority of the diagnosis comes from the patient history, but he points out that usually when patients with MS come in, they already are diagnosed and they are unhappy with their medical treatment options. “If they weren’t diagnosed, one of the standards is to do an MRI and look for white lesions, and there is also a spinal tap to look for antibodies,” Dr. West says. “Usually these patients have a history of peripheral neuropathy or neurological disease or processes occurring.”


Symptom Management

Continue reading DCs Treating the Multiple Sclerosis Patient

Memorial Day (2015)
In Memory of Those Who Have Fallen

Memorial Day (2015)
In Memory of Those Who Have Fallen

The Chiro.Org Blog


The Bivouac of the Dead

The muffled drum’s sad roll has beat
The soldier’s last tattoo’
No more on life’s parade shall meet
That brave and fallen few;

On Fame’s eternal camping ground
Their silent tents are spread;
But Glory guards with solemn round
The bivouac of the dead.

Continue reading Memorial Day (2015)
In Memory of Those Who Have Fallen

Case Report of a Patient Presenting With Post-concussion Syndrome and Post-traumatic Stress Disorder

A Case Report on the Management of a Patient Presenting With Post-concussion Syndrome and Post-traumatic Stress Disorder, Using the Upper Cervical Chiropractic Technique

The Chiro.Org Blog


SOURCE:   Topics in Integrative Health Care 2015 (Mar 31);   6 (1)

Scott Bales, DC

180 Parsons Rd #11
Alliston, Ontario, Canada L9R1E8


Introduction:   This case report describes the chiropractic management of a patient with a history of multiple mild traumatic brain injuries, using Upper Cervical manipulative technique.

Clinical Features:   A 42 year old man presenting with symptoms of post-concussion syndrome, and diagnosed with post-traumatic stress disorder and depression.

Intervention and Outcome:   The Kale Upper Cervical Procedure was utilized to assess, monitor, and correct the effects of an upper cervical subluxation in a patient over an 8 week period. The patient reported significant improvement in symptoms of post- concussion syndrome, and small positive improvements in PTSD symptoms. Follow up at 11 months showed continued improvement in most symptoms.

Continue reading Case Report of a Patient Presenting With Post-concussion Syndrome and Post-traumatic Stress Disorder

The Alamo, Part 2: The Texas Medical Association
Continues to Suppress Chiropractic

The Alamo, Part 2: The Texas Medical Association
Continues to Suppress Chiropractic

The Chiro.Org Blog


SOURCE:   Texas Medicine ~ May 2015

By Kara Nuzback


Edited from their article:

The Affordable Care Act promotes collaboration and team treatment of patients. The Texas Medical Association agrees collaborative care is crucial, but the association wants to ensure physicians remain the head of the team. With the Texas Legislature in full swing, physicians face several bills that would challenge that leadership and expand the scope of practice for nurses, chiropractors, and other health professionals without a license to practice medicine.

Fort Worth pediatrician Gary Floyd, MD, says he started testifying before the legislature in defense of patients in the 1990s. Every session, a similar onslaught of bills arises from nonphysician practitioners aiming to expand their scope of practice.

“A lot of them are reaching beyond what they’ve been educated and trained to do, and beyond what their skill sets allow them to do,” he said. “That puts patients in danger.”

These medical professionals also put their own licenses at risk, he says. “When you over-reach, you get in trouble,” he added.

Dr. Floyd does not downplay the need for nurses and other midlevel professionals, but he emphasizes the importance of physician supervision. “They are part of a physician-led health care team,” he said. “We strongly believe that is the best model for delivering care.”


That roughly translates into: They can only do what WE permit, and no more!


This section is quite revealing:

Chiropractors:

TMA has gone up to bat against the Texas Board of Chiropractic Examiners (TBCE) in the past to fight rule changes that would expand chiropractors’ scope.

In 2006, TMA took TBCE to court to invalidate the board’s adoption of rules that would have allowed chiropractors to make diagnoses and perform needle electromyography (EMG) and spinal manipulation under anesthesia (MUA). In 2012, an appellate court invalidated TBCE’s rules allowing EMG and MUA, but it said it had no jurisdiction to consider the diagnosis rule. TMA appealed the diagnosis decision to the Texas Supreme Court the same year, but in 2013, the high court decided not to hear the case. The issue of chiropractors diagnosing medical conditions is not yet resolved.

Continue reading The Alamo, Part 2: The Texas Medical Association
Continues to Suppress Chiropractic

Happy Mother’s Day! (2015)

Happy Mother’s Day!

The Chiro.Org Blog



Women are the backbone of Civilization

Navigating HIPAA in the Electronic Age:
What DCs Must Know

Navigating HIPAA in the Electronic Age:
What DCs Must Know

The Chiro.Org Blog


SOURCE:   ACA News ~ March 2015

By Gina Shaw


It has been nearly 20 years since the Health Insurance Portability and Accountability Act of 1996 (HIPAA) was passed and more than five years since its privacy protections for health care consumers were significantly strengthened by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, as more healthcare transactions became electronic.

But even so, many clinicians — especially those in smaller, often non-hospital-affiliated practices such as chiropractic — may not be up to speed on what they need to do to protect their patients’ privacy in the electronic age and comply with laws like HIPAA and HITECH, says Steven Baker, DC, DABFP, DABCO, a councilor with the Council on Chiropractic Education.

“Pretty much every office has a HIPAA form that they have their patients sign, saying here’s what we can do with your information,” he says. “But often they have just picked it up from a practice management group, and they may not really know what’s on that form or what it obligates them to do.”

So here are a few things every doctor of chiropractic (DC) and chiropractic office staffer should know about electronic privacy:



1.   Do the laws apply to you?

Most health care practitioners are considered “covered entities” under HIPAA and HITECH — but not necessarily all. Healthcare providers are considered covered entities if they electronically transmit “PHI” — protected health information. You can collect individually identifiable health information without transmitting it electronically, although that’s becoming rare these days.

Learn more about HIPPA @ our:

HIPAA Compliance Page

Continue reading Navigating HIPAA in the Electronic Age:
What DCs Must Know

Tylenol Is Ineffective For Treating Low Back Pain or Disability.

The Limits of Tylenol for Pain Relief

The Chiro.Org Blog


SOURCE:   New York Times ~ April 1, 2015

By Nicholas Bakalar


Acetaminophen, also known as paracetamol (Tylenol) is widely recommended for the relief of back pain and the pain of knee and hip arthritis. But a systematic review of randomized trials has found that it works no better than a placebo.

Australian researchers reviewed three randomized trials that compared acetaminophen with a placebo for the relief of spinal pain, and 10 trials that compared their use for easing the pain of osteoarthritis. All together, the analysis included 5,366 patients. Acetaminophen was given orally in doses between 3,000 and 4,000 milligrams a day, except for one study in which a dose of 1,000 milligrams was administered intravenously.

The review, published online in BMJ (British Medical Journal), found high quality evidence that Tylenol is ineffective in treating low back pain or disability. It also found evidence that the drug quadruples the risk of an abnormal liver function test, but the clinical significance of that finding is unclear.

[Editor’s Note:   Actually, reports as far back as 2001 suggest that 36 percent of acute liver failures are linked to acetaminophen use. Would you like to guess what it costs for a liver transplant, plus the added costs of anti-rejection drugs for a lifetime?   Another review in the American Journal of Medicine estimates that 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications (internal bleeding) and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone.   The figures for all NSAID users would be overwhelming, yet the scope of this problem is generally under-appreciated, and under-reported.]

There are more articles like this @ our:

Iatrogenic Injury Page

Continue reading Tylenol Is Ineffective For Treating Low Back Pain or Disability.