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September 2007

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Chiropractic Care May Help Adult ADHD

The above is the headline from a September 6, 2007 NewsMax article reporting on a pilot study, published in the August 23, 2007 Journal of Vertebral Subluxation Research.  The preliminary study showed that chiropractic care helped test subjects with adult ADHD.

In this study 9 patients ranging in age from 22 58 years were evaluated using a specific test known as the "Test of Variable of Attention" (TOVA).  The TOVA company who introduced the test describe the test on their website as "The T.O.V.A. is an objective, neurophysiological measure of attention, not a subjective rating of behavior. It is a 21.6 minute long, very simple "computer game" that measures your responses to either visual or auditory stimuli. These measurements are then compared to the measurements of a group of people without attention disorders."

The NewsMax article noted that In the United States, somewhere between 3-10 percent of children, and 1-6 percent of adults suffer from ADHD. 

The study was performed  in Lausanne, Switzerland by Yannick Pauli, DC, who is a chiropractor and the director of the "Centre Wellness NeuroFit", specializing in wellness neurology.  He described the study by stating, "In this pilot study, we used objective outcome measures to evaluate attention in nine adult patients before and after two months of wellness chiropractic care."

The results of the study showed that after 2 months of chiropractic care, all patients had a significant change in ADHD score and 88% completely normalized their ADHD score. All 9 patients experienced significant improvement in concentration and additionally, 77% and 66% of patients experienced significant change in reaction time and variability score, respectively.

Matthew McCoy, DC, editor of the Journal of Vertebral Subluxation Research, added his comments in the NewsMax article, "This preliminary study is exciting. It is part of an increasing amount of research suggesting that chiropractic care may be an effective natural choice for people suffering from ADD/ADHD. It offers the possibility of a new option for millions of children and adults that are seeking to manage their conditions naturally."

Dr. Pauli concluded, "Although the results are preliminary and more research is needed, the outcome of the study suggests that patients suffering from attention deficit benefited from chiropractic care."

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Adverse Drug Reactions Rise Sharply - Study Says

The above headline comes from the September 10, 2007 LA Times and is one of many articles reporting on a study published on the same day in the Archives of Internal Medicine.  The study data came from the Adverse Event Reporting System, which has been in operation since 1998.  This system collects all voluntary reports of adverse drug events submitted directly to the US Food and Drug Administration (FDA) or through drug manufacturers.

The results of this study showed that from 1998 through 2005 reported, serious adverse drug events increased 2.6-times from 34,966 to 89,842.  In addition, fatal adverse drug events increased 2.7-fold from 5519 to 15,107. The study noted that reported serious events increased 4 times faster than the total number of outpatient prescriptions during the same period of time.

Thomas J. Moore, the study's lead author and a senior scientist for drug safety and policy at the Institute for Safe Medication Practices of Huntington Valley, Pennsylvania, stated, "This is a direct set of data that shows that the system is failing and it is getting worse. We are in denial about drug safety." Moore continued, "The clear finding is that we are losing ground in terms of drug safety, and that ought to be of great concern."

Dr. Gerald Dal Pan, director of the FDA's office of surveillance and epidemiology tried to explain away the finding in a response in the LA Times when he said, "There are clearly other factors responsible for this increase, such as the increase in public attention to drug safety and use of the Internet to make it easier for the public to report adverse events to the FDA."

This report is bringing more political pressure from legislators for the FDA to take stronger action.  Senator Charles Grassley, of Iowa and an outspoken FDA critic said in a statement, "This report is another indication that the FDA's post-market review of drugs must be rigorous and timely. The FDA needs to commit itself to considering and acting on the additional data gathered from more adverse events being reported considering the deaths associated with these adverse drug events."

The conclusion  of the researchers in their study serves as a glaring reminder of the risks.  They state, "These data show a marked increase in reported deaths and serious injuries associated with drug therapy over the study period. The results highlight the importance of this public health problem and illustrate the need for improved systems to manage the risks of prescription drugs."

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Autism and Chiropractic Care

From the British publication, the Manchester Evening Star, comes an August 13, 2007 article about an eight-year-old boy Daniel, whose life has been changed for the better by chiropractic. 

The story starts with Daniels mother, Susan Crisp taking Daniel to the chiropractor (Evening Start picture right) and notes that Susan and her husband, Gary, firmly believe that this care has been key to the recent improvements they've seen in Daniels development. "His communication has improved tremendously," says Susan.

Susan Crisp chronicled Daniel's progress by stating, "He has started putting three or four words together and it is not in response to questions from us. It's spontaneous. At one time, if he wanted something out of the fridge he would drag me to it and point. Now he'll say, `Mummy, I want'. "He doesn't seem so closed in as he once was and is interacting more with his three older sisters."

The article reported on another instance where a television reporter Quentin Willson had done a story on his own son's improvement with chiropractic.  The article noted that it was this television story that prompted Susan to take her son, Daniel to see a chiropractor.  Susan recalled, "It was a coincidence that I saw it. I had the TV on and it really caught my eye because there were so many similarities between what he was talking about with his son and Daniel."  She continued, "It stayed on my mind. I told Gary about it and we felt we should give it a try. We thought, `If nothing happens, that's the worst that can happen'. At the time, Daniel was walking on his tip-toes and his feet were pointing inwards when he walked - which can be symptoms of autism. I was worried about it and we thought that the chiropractic might be able to help with his posture."

Daniel's success adds weight to two separate papers published in two scientific journals in March of 2006 where studies documented a significant improvement in autistic children under chiropractic care.  In one of those studies involving 14 children, 12 showed significant improvement and  two of the children improved so much that they no longer met the criteria to be classified as autistic.

The British article concludes with comments from Daniel's mother, Susan, where she notes how he enjoys the care, "But it's not just a matter of Daniel enjoying it. Within four to six weeks we noticed a huge improvement in his condition. "We took him in June and by August people who don't see him regularly commented that his speech had come on tremendously. He started to initiate sentences - it was a real surprise, to us." She concluded by saying, "The chiropractic was like turning a key, opening the door and it all came out of him. "It's not a cure but it can alleviate some of the difficulties."

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Direct-to-Consumer Prescription Drug Advertising Up in U.S.

A study published in the August 16, 2007 issue of the New England Journal of Medicine, (NEJM) notes that in spite of increasing criticisms direct-to-consumer advertising of prescription drugs continues to increase in the US. The study starts off with some background information and states, "Evidence suggests that direct-to-consumer advertising of prescription drugs increases pharmaceutical sales and both helps to avert under-use of medicines and leads to potential overuse."

The results of this study showed that total spending on pharmaceutical promotion grew from $11.4 billion in 1996 to $29.9 billion in 2005.  During that time spending by drug companies on direct-to-consumer advertising increased by 330%.  The study noted that in most cases direct-to-consumer campaigns generally begin within a year after the approval of a product by the US Food and Drug Administration (FDA). Even with this tremendous increase in spending, the study noted that, "the number of letters sent by the FDA to pharmaceutical manufacturers regarding violations of drug-advertising regulations fell from 142 in 1997 to only 21 in 2006."

The NEJM study was also reported on by several news outlets, however, most were not in the United States. One report in the US by HealthDay News on August 15, 2007 questions direct-to-consumer advertising of prescription drugs. Presently only the United States and New Zealand allow drug makers to advertise prescription medications directly to consumers.

Study author Julie M. Donohue, assistant professor of health policy and management at the University of Pittsburgh Graduate School of Public Health, states, "Direct-to-consumer advertising spending is increasing in terms of its share of total marketing budget, but it's still a smaller share relative to promotion aimed at influencing prescribers."  Donohue continued, "It's been 10 years since the FDA clarified its policy with respect to broadcast advertising and unleashed direct-to-consumer advertising on television, which was new. We wanted to see, in the wake of the Vioxx withdrawal and an increased focus on the safety of drugs and a focus on drug costs in light of the implementation of the new Medicare drug benefit, what industry and the FDA were doing with respect to advertising."

An  August 15, 2007 article in "The Canadian Press" on this study noted that such advertisements are currently not permitted in Canada but that there are legal challenges to allow this type of advertising.  The Canadian article noted that earlier this year a report published by the U.S. Institute of Medicine recommended that the US Food and Drug Administration, bar drug companies from advertising prescription drugs in the first two years after they come to market.  The reasoning is that during that 2 year period a drug will start to be broadly used and therefore rare side-effects not seen in clinical trials can become evident.

However, study author Donohue expresses skepticism that any change will take place in the conclusion of her study when she states, "Spending on direct-to-consumer advertising has continued to increase in recent years
in spite of the criticisms leveled against it. Our findings suggest that calls for a moratorium on such advertising for new drugs would represent a dramatic departure from current practices."

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Chiropractors Help Pregnant Women With Pain

The above headline comes from the August 14, 2007 issue of the Dallas Morning Star. In this article, Special Contributor Kathleen Green, starts off by stating, " Moms-to-be once resigned themselves to nine months of misery. But, frankly, they've had enough."  She continues, " More women are exploring options and seeking alternatives to ease back pain, headaches, exhaustion and much more. One place many are finding relief is at a chiropractor's office." 

The article follows several chiropractors and their pregnant patients and views their reasons for choosing chiropractic and their results. One such patient was  Teresa Seymour, who started chiropractic treatment during her first pregnancy with her daughter who is now 2 years old.  Teresa said, "If there were times when I could feel that I was starting to get sore in the back, I would go to the chiropractor." During her second pregnancy, she reported, "Just picking up my daughter could knock a hip a little bit the wrong way and kind of pinch a nerve," she says. "I went to [my chiropractor], and he'd adjust my back and my hips." 

The article interviews Dr. Ken Wilson, a chiropractor who sees a lot of pregnant women in his practice and estimates that about 20 percent of his patients are pregnant.  He stated, "My focus has changed more to pregnant moms and kids nowadays. My wife had to go through the constant low back [pain] and headaches and really being uncomfortable all of the time. I wanted to help her personally."

Chris Burfield, an educational director with Dr. Wilson added, "When spinal bones get pulled out of place, those bones push up against or irritate the nerves. Those nerves will start to send pain signals off to the brain to let the brain know there's a problem."

 Sara Townsley, a former high school science teacher received chiropractic care two years ago during her first pregnancy. She recalled, "If I do a lot of cleaning, like bathroom cleaning where I'm bending over, when I'm pregnant, that's usually when I have my sciatica."  She continued,  "Ella [her daughter] really sat on my hips, and it helped to have them aligned regularly to relieve some pressure and nerve pinching."

The article also interviews a medical physician,  Dr. Walter Evans, an obstetrician-gynecologist in private practice at Presbyterian Hospital of Dallas. According to the article, Dr. Evans acknowledges a chiropractor's potential in prenatal care, sometimes referring patients with lower back pain to chiropractors. He states, "I've had good luck working with some chiropractors with patients who have low back pain during pregnancy."

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Medicare to Stop Paying for Hospital Errors

Several news outlets including an August 19, 2007 article in the New York Times has reported that a U.S. governmental change will have a profound change on Medicare and those who use it.  As of October 1, 2008, Medicare will no longer pay hospitals for treatment for problems caused by what they termed "preventable medical errors".  This change will stop payment for care for such things as injuries, as well as bedsores, pressure ulcers; injuries caused by falls, and infections resulting from the prolonged use of catheters in blood vessels or the bladder.

The articles tout this change as a potentially large savings to the Medicare system and to patients. They also speculate that private insurance companies may also follow the lead of Medicare and institute similar policies. Herb B. Kuhn, acting deputy administrator of the Centers for Medicare and Medicaid Services explained the reasoning by saying, "If a patient goes into the hospital with pneumonia, we don’t want them to leave with a broken arm."

The Times article reports that according to the U.S. Centers for Disease Control and Prevention (CDC) approximately 1.7 million patients develop infections in hospitals each year, and the CDC estimates that those infections cause or contribute to the death of 99,000 people a year which is about 270 a day.

Lisa McGiffert, a Senior Policy Analyst for "Consumers Union", a Non Profit Publisher of Consumer Reports, weighed in by stating, "Every year, millions of Americans suffer needlessly from preventable hospital infections and medical errors. These new rules are a good beginning for Medicare to use its clout to mobilize hospitals to improve care and keep patients safe."  Ms. McGiffert commented in the Times article, “Medicare is using its clout to improve care and keep patients safe. It’s forcing hospitals to face this problem in a way they never have before.”

Other officials who applaud the upcoming change include Christine K. Cahill, a registered nurse who used to inspect hospitals for the California Department of Public Health.  She said: “This is a great start. Infection-control specialists have been screaming for 20 years that federal and state officials should pay more attention to this problem because hospital infections hurt patients and cost money.”

The Times article does note that patients will not get stuck with the bill if Medicare refuses to pay for care related to preventable errors.  The article notes that the new rules states, "The hospital cannot bill the beneficiary for any charges associated with the hospital-acquired complication."

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