Memorial Day (2019):
In Memory of Those Who Have Fallen
Memorial Day (2019)
In Memory of Those Who Have Fallen
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.
A Risk-benefit Assessment Strategy to Exclude Cervical Artery Dissection in Spinal Manual-therapy
A Risk-benefit Assessment Strategy to Exclude Cervical Artery Dissection in Spinal Manual-therapy: A Comprehensive Review
SOURCE: Annals of Medicine 2019 (Mar 19): 1–10 [Epub]
Aleksander Chaibi & Michael Bjørn Russell
Head and Neck Research Group,
Research Centre, Akershus University Hospital,
Oslo, Norway.
Cervical artery dissection refers to a tear in the internal carotid or the vertebral artery that results in an intramural haematoma and/or an aneurysmal dilatation. Although cervical artery dissection is thought to occur spontaneously, physical trauma to the neck, especially hyperextension and rotation, has been reported as a trigger. Headache and/or neck pain is the most common initial symptom of cervical artery dissection. Other symptoms include Horner’s syndrome and lower cranial nerve palsy. Both headache and/or neck pain are common symptoms and leading causes of disability, while cervical artery dissection is rare. Patients often consult their general practitioner for headache and/or neck pain, and because manual-therapy interventions can alleviate headache and/or neck pain, many patients seek manual therapists, such as chiropractors and physiotherapists. Cervical mobilization and manipulation are two interventions that manual therapists use. Both interventions have been suspected of being able to trigger cervical artery dissection as an adverse event. The aim of this review is to provide an updated step-by-step risk-benefit assessment strategy regarding manual therapy and to provide tools for clinicians to exclude cervical artery dissection.
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Relationship Between Early Prescription Dispensing Patterns and Work Disability in a Cohort of Low Back Pain Workers’ Compensation Claimants
Relationship Between Early Prescription Dispensing Patterns and Work Disability in a Cohort of Low Back Pain Workers’ Compensation Claimants: A Historical Cohort Study
SOURCE: Occup Environ Med. 2019 (May 15) [Epub]
Nancy Carnide, Sheilah Hogg-Johnson, Mieke Koehoorn, Andrea D Furlan1, Pierre Côté
Institute for Work and Health,
Toronto, Ontario, Canada.
OBJECTIVES: To examine and compare whether dispensing of prescription opioids, non-steroidal anti-inflammatory drugs (NSAIDs) and skeletal muscle relaxants (SMRs) within 8 weeks after a work-related low back pain (LBP) injury is associated with work disability.
METHODS: A historical cohort study of 55 571 workers’ compensation claimants with LBP claims in British Columbia from 1998 to 2009 was conducted using linked compensation, dispensing and healthcare data. Four exposures were constructed to estimate the effect on receipt of benefits and days on benefits 1 year after injury: drug class(es) dispensed, days’ supply, strength of opioids dispensed and average daily morphine-equivalent dose.
RESULTS: Compared with claimants receiving NSAIDs and/or SMRs, the incidence rate ratio (IRR) of days on benefits was 1.09 (95% CI 1.04 to 1.14) for claimants dispensed opioids only and 1.26 (95% CI 1.22 to 1.30) for claimants dispensed opioids with NSAIDs and/or SMRs. Compared with weak opioids only, the IRR for claimants dispensed strong opioids only or strong and weak opioids combined was 1.21 (95% CI 1.12 to 1.30) and 1.29 (95% CI 1.20 to 1.39), respectively. The incident rate of days on benefits associated with each 7-day increase in days supplied of opioids, NSAIDs and SMRs was 10%, 4% and 3%, respectively. Similar results were seen for receipt of benefits, though effect sizes were larger.
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Our Blog is Just a Tool. Learn How To Use It Now.
Our Blog is Just a Tool.
Learn How To Use It Now.
SOURCE: A Chiro.Org Editorrial
Every Blog post is an announcement of new material that was just added to one of our many Sections.
I have been compiling (and archiving) peer-reviewed articles since early 1996, and to date we have over 5,000 Abstracts, and hundreds of Full-Text articles on a wide variety of subjects.
When enough material, relating to a particular topic was collected, it was gathered into a new Topical Page in one of our many Sections.
Each Topical page is located in the Section most associated with that topic. Thus, our Attention Deficit Page is located (is a part of) our Pediatrics Section You get the idea.
Almost ALL of our Sections contain some, or many Topical collections. The LINKS Section is the most extreme example, because it contains 91 different topical pages.
All of the following are “active” Sections that are constantly adding new (and important) materials:
Alternative Healing Abstracts
Case Studies
Chiropractic Assistants
Chiropractic Research
Documentation
The LINKS
Medicare Info
Nutrition
Pediatrics
Radiology
Stroke and Chiropractic Page
What is the Chiropractic Subluxation?
These other valuable Sections are “archival” in nature, and contain valuable tools for you to use freely:
Free Images
New DC’s
Office Forms
R.C. Schafer’s Rehab Monographs
Search Section
How Blog Posts Work
The following is a Graphic “screen grab” of a Blog Post from our Home Page. (more…)
Patient-reported Improvements of Pain, Disability, and Health-related Quality of Life Following Chiropractic Care for Back Pain
Patient-reported Improvements of Pain, Disability, and Health-related Quality of Life Following Chiropractic Care for Back Pain – A National Observational Study in Sweden
SOURCE: J Bodyw Mov Ther. 2019 (Apr); 23 (2): 241–246
Gedin F, MSc; Dansk V, MSc; Egmar A-C, PhD; Sundberg T, PhD; Burström K, PhD
Health Economics and Economic Evaluation Research Group,
Medical Management Centre,
Karolinska Institutet,
Stockholm, Sweden
BACKGROUND: Chiropractic care is a common but not often investigated treatment option for back pain in Sweden. The aim of this study was to explore patient-reported outcomes (PRO) for patients with back pain seeking chiropractic care in Sweden.
METHODS: Prospective observational study. Patients 18 years and older, with non-specific back pain of any duration, seeking care at 23 chiropractic clinics throughout Sweden were invited to answer PRO questionnaires at baseline with the main follow-up after four weeks targeting the following outcomes: Numerical Rating Scale for back pain intensity (NRS), Oswestry Disability Index for back pain disability (ODI), health-related quality of life (EQ-5D index) and a visual analogue scale for self-rated health (EQ VAS).
RESULTS: 246 back pain patients answered baseline questionnaires and 138 (56%) completed follow-up after four weeks. Statistically significant improvements over the four weeks were reported for all PRO by acute back pain patients (n = 81), mean change scores: NRS -2.98 (p < 0.001), ODI -13.58 (p < 0.001), EQ VAS 9.63 (p < 0.001), EQ-5D index 0.22 (p < 0.001); and for three out of four PRO for patients with chronic back pain (n = 57), mean change scores: NRS -0.90 (p = 0.002), ODI -2.88 (p = 0.010), EQ VAS 3.77 (p = 0.164), EQ-5D index 0.04 (p = 0.022).
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The Placebo Effect in Alternative Medicine
The Placebo Effect in Alternative Medicine: Can the Performance of a Healing Ritual Have Clinical Significance?
SOURCE: Annals of Internal Medicine 2002 (Jun 4); 136 (11): 817–825
Ted J. Kaptchuk, OMD
Harvard Medical School,
Boston, Massachusetts, USA.
In alternative medicine, the main question regarding placebo has been whether a given therapy has more than a placebo effect. Just as mainstream medicine ignores the clinical significance of its own placebo effect, the placebo effect of unconventional medicine is disregarded except for polemics.
This essay looks at the placebo effect of alternative medicine as a distinct entity. This is done by reviewing current knowledge about the placebo effect and how it may pertain to alternative medicine. The term placebo effect is taken to mean not only the narrow effect of a dummy intervention but also the broad array of nonspecific effects in the patient-physician relationship, including attention; compassionate care; and the modulation of expectations, anxiety, and self-awareness.
Five components of the placebo effect — patient, practitioner, patient-practitioner interaction, nature of the illness, and treatment and setting — are examined. Therapeutic patterns that heighten placebo effects are especially prominent in unconventional healing, and it seems possible that the unique drama of this realm may have “enhanced” placebo effects in particular conditions. Ultimately, only prospective trials directly comparing the placebo effects of unconventional and mainstream medicine can provide reliable evidence to support such claims.
Nonetheless, the possibility of enhanced placebo effects raises complex conundrums. Can an alternative ritual with only nonspecific psychosocial effects have more positive health outcomes than a proven, specific conventional treatment? What makes therapy legitimate, positive clinical outcomes or culturally acceptable methods of attainment? Who decides?
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