July 2008



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Infertility Helped With Chiropractic

In the scientific periodical the Journal of Clinical Chiropractic Pediatrics (JCCP), comes a study that involved the literature review of 10 different papers of the cases of 11 women who were suffering from infertility. The review, published in the bi-yearly JCCP March 2008 issue, reviewed the case studies of 11 women ages 22 to 42 who were diagnosed as suffering from Infertility.

According to the article, Infertility is defined as an inability to conceive after a year of unprotected intercourse or to carry a pregnancy to term."  The author of the review Stacy Bula D.C., notes that in the US infertility impacts six million women between the ages of 15 and 54.  According to the study the US Centers for Disease Control reported that in 2004 there were 127,977 artificial reproductive procedures performed to try to help women get pregnant. The study notes that although only 34% of the medical procedures attempted will result in a live birth, the costs can range up to $30,000 per menstrual cycle attempt.

In the cases reported in this literature review study, the cases of eleven female patients were reviewed from 10 separate documented case studies. Their histories included one natural childbirth, two miscarriages, two failed in-vitro fertilizations, and three failed artificial inseminations. In some of these cases the women sought chiropractic care for a variety of other problems in addition to infertility.  Some of the additional problems that brought the women to a chiropractor included, ulcerative colitis, lower back pain, neck pain, menstrual cycle problems, diabetes and joint pains.

The average age of the women in the various studies was 32.  In 10 of the 11 cases the women were actively trying to become pregnant and were unsuccessful.  Several had unsuccessfully tried more expensive and risky procedures.  The author noted that the standard medical care for infertility, "..can have serious health problems for both the mother and child."

The results from these various case studies showed that all 11 women got pregnant shortly after the start of chiropractic care.  The author of the review noted that 9 of the 11 did not receive any further medical care to become pregnant.  The care rendered in all of these cases was specific correction of vertebral subluxations using a variety of chiropractic analyses and techniques.  The author noted that correction of vertebral subluxations caused an improvement in function which allowed the women of these studies to become pregnant.

In her conclusion, Dr. Bula  stated, "The ten case studies examined in this paper suggest that regardless of the type of chiropractic technique used, when subluxations of the vertebral spine were adjusted there was a simultaneous improvement in function of the reproductive organs and related endocrine system."



You’ve Got Drugs

The National Center on Addiction and Substance Abuse (CASA) at Columbia University released a white paper report in July of 2008 titled, "You Got Drugs".  The paper, whose title is obviously a take-off on the popular movie, You Got Mail, is a report on the ease at which prescription drugs can be obtained by anyone, even minors, over the Internet.  The CASA report was also the subject of many articles in the press including several July 9, 2008 stories by the Associated Press, The New York Times and WebMD.

The white paper report starts off with a letter from CASA president, Joseph A. Califano, Jr., who notes that CASA, "..has been tracking the availability of controlled prescription drugs over the Internet. This work is designed to examine the online availability of dangerous and addictive prescription opioids like OxyContin and Vicodin, depressants like Valium and Xanax, and stimulants like Ritalin and Adderall."

The study finding noted that 85% of the sites selling controlled prescription drugs do not require a physician’s prescription from the patient. Of the remaining sites that do require a prescription, half of them allowed faxes which could be easily faked.  Sadly, the report also noted that there were no controls in place to block the sale of these drugs to children.

One of the difficulties noted in the report was that the websites selling these drugs open and close regularly making enforcement near impossible.  Michael Sanders, a spokesman for the US Drug Enforcement Administration explained, "One of the main problems is that the sites can literally open up for a week, close and open up under a different name."

Federal legislation is currently in discussion, and the report noted that 8 states have passed laws concerning online prescriptions. Other solutions addressed by the CASA report involve working with financial institutions to see if there could be a way to prevent credit card purchases.  Additionally, it is suggested that the large search engines can play a part by developing ways to restrict these bogus online pharmacies from showing up on search engines.

Probably the most telling number of this report is that an overwhelming majority of the drugs sold online do not come from legitimate sources.  CASA president, Mr. Califano noted, "This year CASA identified a total of 365 sites, including 206 advertising sites and 159 sites offering these drugs for sale. Only two of the selling sites were certified by the National Association of Boards of Pharmacy as legitimate Internet pharmacy practice sites; the other 157 were rogue sites."



Chiropractic Helps Infants Sleep Better According to Pilot Study

A pilot study published in the March 2008 issue of the scientific periodical the Journal of Clinical Chiropractic Pediatrics (JCCP), showed that infants sleep better when under chiropractic care. This study was conducted in a chiropractic teaching clinic in Bournemouth, England and involved 117 infants who consecutively came in for chiropractic to the teaching clinic between June 2004 and January 2005.

In this study the parents of 117 infants who were brought in for chiropractic care, regardless of reason for care were asked to fill out a questionnaire on the children's sleep behaviors. The parents were asked to fill out these questionnaires on the 1st, 4th and 7th visits to the chiropractic clinic.

The amount and quality of sleep habits that were reported on by the parents and investigated by the researchers included, the total hours of sleep, the quality of sleep, and the time taken to settle into sleep.  The researchers then collected the results and looked to see if there were any changes in the infants sleeping habits as chiropractic care progressed.

The results showed a marked improvement in the quality of sleep as well as a decrease in the time it took for the infants to fall asleep.  The results did not show an increase in the total time they slept. At the first visit the parents reported that over 66% of the children in the study had difficulty falling asleep. By the 7th chiropractic visit the number of children who had difficulty falling asleep in the study had dropped to just 22%. 

The children also experienced a deeper sleep as a result of the chiropractic care. On the chiropractic first visit before care was initiated, it was reported that 36% of the children were restless sleepers, 25% of the children were light sleepers, and only 39% were experiencing deep sleep. By the seventh visit the number of restless sleepers had declined to just over 7%, the number of light sleepers had changed to 29% while the number of children experiencing deep sleep had grown dramatically to 63% of the children in the study.

The researchers noted that since the care took place over a 2 week period, that factors such as aging could be ruled out. In their conclusion the researchers stated, "This pilot study into the issue of sleep problems in children showed significant improvements (by parental report) in time taken to fall asleep, number of consecutive hours of sleep and depth and quality of sleep for children during a short course of chiropractic care."



AMA Supports Proposed Legislation to Make Home Births Illegal

ABC News reported on July 11. 2008 that the "American Medical Association has agreed to support proposed legislation that, some physicians say, could make make having a planned birth in one's home difficult, to virtually impossible."  Presently their is no legislation but the AMA is backing what is called "Resolution 205" which is a request to support the American College of Obstetricians and Gynecologists' (ACOG) position that home births are not safe.

American College of Obstetricians and Gynecologists (ACOG) spokesperson Gregory Phillips, stated clearly, the ACOG position, "We are against home births, period."  He continued in the ABC story by stating, "Women who give birth outside of a clinical setting risk putting themselves and their newborns at risk."

In opposition to this stand the American College of Nurse-Midwives has come out with a strong statement in support of planned home births. Jennifer Block, author of "Pushed: The Painful Truth About Childbirth and Modern Maternity Care, who also writes a column for the LA Times stated in her columns that in Britain they routinely ask expecting mothers if they would like to have their babies at home instead of in the hospital.  In her column Block noted that a hand-out is given to expecting mothers from Britain's National Health Service that says, "There is no evidence to support the common assertion that home birth is a less safe option for women experiencing uncomplicated pregnancies."

Block also noted in her column that last year a joint statement was issued by the Royal College of Obstetricians and Gynecologists and the Royal College of Midwives that said, "There is no reason why home birth should not be offered to women at low risk of complications, and it may confer considerable benefits for them and their families."

Ms. Block concludes her article by noting that she believes this entire issue is nothing more than a turf war by physicians not wanting to give up control. "The AMA's statement calls for legislation that could be used against women who choose home birth, possibly resulting in criminal child-abuse or neglect charges. The group says this is about safety, but with no credible research to back up its claim, this argument falls flat."

The various articles noted that the reaction by the American College of Obstetricians and Gynecologists' (ACOG) and the AMA came about due to a documentary film called "The Business of Being Born" by talk show host Ricki Lake, where she exposed the American system of birth as a business. Abby Epstein, the film's director stated in the ABC story, "What the film has done is to cause a lot of women to choose midwives over OBs -- especially younger women who've never heard of midwives," said Epstein. "We've received calls from midwives saying that their practices have doubled since our film was released. There's a lot of ego in this -- that one would want to choose a midwife over an MD. It's really a turf war going back 100 years between the medical establishment and midwives.  The trailer for the film can be seen on YouTube at the following address: http://www.youtube.com/watch?v=4DgLf8hHMgo



Drugs - First Option or Last Resort for ADHD?

The above is the question being asked in a July 12, 2008 article on the Australian news website News.com.au. The article starts off by reporting that the Australian Federal Government has officially endorsed drugs, such as Ritalin, as the "first-line treatment" for children with ADHD.  The article also reports that the Australian government's recommendations say that, "Parents have also been warned to ignore alternative treatments, such as diet and exercise, which the guidelines claim have 'limited or no benefit' in treating ADHD".

This endorsement brought harsh criticism from many groups including the Australian Childhood Foundation, an advocacy group and charity that provides programs for children and parents. Their stated goal is to strengthen community responsibility for promoting the well-being and protection of all children throughout Australia. 

Dr Joe Tucci, CEO of the Australian Childhood Foundation noted in the article that it was dangerous to believe medication was the only answer, and commented, "It should be the last resort rather than the first. I think these guidelines will make over-prescription worse. The premise of prescribing medication as the first intervention ignores the causes of ADHD."

The recommendations for drugs first was due to a set of draft guidelines compiled by the Royal Australasian College of Physicians.  The guidelines do warn against giving toddlers Ritalin or longer lasting drugs such as Concerta.

Dr. Jeanne Ohm, a chiropractor and president of the International Chiropractic Pediatric Association also weighed in on the argument by stating: "Today, parents are becoming more informed about health care choices for their families and are no longer interested in using potentially harmful drugs as treatment. More and more parents are recognizing that making improvements in their families' lifestyle is a safer and more effective way of restoring health and well-being. Nutrition, exercise, emotional behavior modifications are safer modes of care that work with the body's ability to be well.

Dr, Ohm continued by adding, "Chiropractic care is another form of care gaining popularity with families because it works to reduce nerve system stress and enhance normal body function. In one large study evaluating more than 10,000 visits, parents reported chiropractic care for their children to be gentle, safe and effective. The preliminary results showed improved sleep, more pleasant behavior and an increase in immune system function in their children. I encourage parents to make informed health care choices for their children and to determine health care choices that support their children's natural, inherent ability for well-being."

Dr. Tucci argued that the research being done is only on drugs and is funded by drug companies, "The research has been mainly conducted by drug companies who have millions invested." He noted that no other research on other means of treatment is being conducted due to lack of funding, "Research into the other treatments isn't backed."

In an ironic admission, the chair of the ADHD guidelines working group, Associate Professor David Forbes agreed that not enough research had been done into alternative therapies.  However, he defended the working groups recommendations by saying, "No one is saying kids go on medication and stay on it," he said. "There wasn't the evidence to support a positive reaction (for diet and exercise)."

The article points out that the reality may be far different as children are being kept on these drugs for long periods.  Leanne Komaromi, a mother interviewed for the article summed up the reaction of many to the Australian Governments recommendations by saying, "Parents should look at alternatives rather than accepting the first thing the doctor says," she said. "My doctor would have kept Dominic on medication till kingdom come."



Doctors Have Conflict-Of-Interest

Several news stories reported on the ethical issue of doctors and researchers accepting large sums of money from drug companies for both research, and teaching about their drugs.  One such article from the June 26, 2008 issue of Business Week, titled, "Doctors Under the Influence?", started off by reporting that researchers who published an important antismoking research article in the journal, Annals of Internal Medicine, disclosed that they are paid by the manufacturers of smoking-cessation products for speaking and consulting.

Another story on the same subject of conflict-of-interest, titled, "Are Perks Compromising MD Ethics?" aired on June 26, 2008 on the CBS Evening News.  This story reported that according to a University of Quebec study, drug company payments to doctors go as high as $57 billion per year.  These payments include things such as consulting fees, speaking fees on drugs, and medical seminars on the benefits of drugs.

Lawmakers have begun to look at this issue. US Senator Charles Grassley of Iowa, commented to CBS, about the practice of doctors or researchers accepting money from drug companies,  "If they are being paid, it ought to be reported." The senator is also looking at the money being paid to researchers from top schools such as Harvard, Stanford and the University of Cincinnati. 

In citing one case, where a Harvard researcher failed to report $1.6 million in fees from drug companies who were the makers of drugs his research eventually promoted, the Senator stated that payments to researchers should raise red flags, "Well, it raises a flag to me that they might have something to hide," he said. "It raises a flag that the university doesn't care."

Sen. Grassley has proposed legislation that would require drug companies to report any payment over $500 made to a physician. That information would then be posted on a government website for all to see.  In an e-mail to BusinessWeek, the Senator urged, "The public relies on the advice of doctors and leading researchers. The public has a right to know about financial relationships between those doctors and the drug companies who make the pharmaceuticals prescribed by doctors."



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