November 2008



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Bipolar Disorder and Depression Helped with Chiropractic - A Case Study

A case study published in the October 20, 2008 issue of the scientific periodical, the Journal of Vertebral Subluxation Research, followed the documented progress under chiropractic care of a 52 year old man suffering from bipolar disorder and jerky involuntary movements, chiefly of the face and extremities. He had chosen not to take medications for this condition. His disorder rendered him incapable of holding a job.

The patient in this case study did not seek chiropractic care for his bipolar disorder or involuntary movement problems, but rather for lower back pain and diffuse upper back and neck pain. He was also suffering from anxiety attacks and had 6 or 7 such attacks in the previous two weeks before starting chiropractic care.

A chiropractic examination on this patient showed numerous postural irregularities as well as abnormal muscle tone along the spine. X-rays taken on this patient showed a loss of the normal curve in the neck as well as arthritic changes. Similar findings were noted in the lower back region as well.

A determination of vertebral subluxations was made and a series of specific chiropractic adjustments was initiated. On the first visit the patient was asked to fill out a "Short Form Health Survey" known as "SF-36", which assesses both mental and physical status. The normal value for both the physical and mental assessments should be 50.  However, when assessed, this patient's physical status was scored a 57 while his mental status scored only 16.

One week after initiating chiropractic care the patient commented that his depression was improving. He described his condition as being, “more lethargic instead of suicidal, deep blues.”  After two weeks of care he reported that he had not had any more anxiety attacks or involuntary facial movements. One visit later he was reassessed using the SF-36 survey, which showed that he had improved to 61 on the physical portion and up to 21 for the mental assessment.

After 6 months of care his mental SF-36 assessment had improved up to as high as 49, just one point short of the normal 50.  In addition, he did see significant improvements in both his lower back pain and his neck problems.



Flu Vaccine Benefits  for Seniors Overstated According to Study

Several articles appeared in a number of publications over the past month questioning the effectiveness of the flu vaccine for the elderly. One such article in the October 25, 2008 Daily Press from Richmond, Virginia noted that the flu vaccine may not give the benefits that were previously advertised.

The article reports that Lone Simonsen, a researcher from George Washington University believes the skepticism concerning the vaccinations is long overdue. She commented, "If I could have it my way, we would start by going back and looking at the basic premise for flu vaccination of seniors."  In the article Simonsen, a former epidemiologist for the National Institute of Allergy and Infectious Diseases, noted that the flu vaccination rate among U.S. seniors has risen over the past 25 years up to 65 percent in 2007. However, over that same period of time, hospitalizations and deaths caused by flu or pneumonia have declined only marginally in the  65-and-over population.

The article references a study published in the August 2, 2008 scientific Journal, Lancet. In that study researchers looked at the cases of 3,519 patients older than 65 who had been admitted to the hospital with pneumonia either just prior to, or during the 2000-2002 flu season. The results of that study showed that those who had been immunized against flu were no less likely to develop pneumonia requiring hospitalization than those who had not been vaccinated.

A second study published in the June 2008 issue of the American Journal of Respiratory and Critical Care Medicine also reached the same conclusion. The author of that study reported that deaths due to flu in their study showed that 8% had been vaccinated while 15% had not.  However, he noted that this difference was not due to the vaccination but rather to what he called the "healthy user effect". This was described in the article as, "Seniors who get vaccinated against flu tend to be younger, healthier, more active and better able to take care of themselves."

The conclusion of the study in the Lancet stated, "The effect of influenza vaccination on the risk of pneumonia in elderly people during influenza seasons might be less than previously estimated."  Likewise the conclusion of the study published in the American Journal of Respiratory and Critical Care Medicine stated, "Previous observational studies may have overestimated mortality benefits of influenza vaccination."



One Third of British Children Suffer Back Pain

Several articles in British news publications in October 2008 reported that a survey conducted by the British Chiropractic Association (BCA) showed that nearly one third of six to seven-year-olds complain of back pain. In the October 15, 2008 issue of the British publication the "Telegraph" and the October 17, 2008, Daily Express" the culprit for such a high rate of back problems in children is identified as lifestyle.

A combination of slumping in front of the TV, lazier lifestyles and heavy school bags are given the blame in these articles. The BCA reported that 45 per cent of children spent the majority of their time off playing computer games or watching TV, while 10% of eight and nine year olds said they didn't do any sport at all. The BCA also noted that 72% of children said they carried around heavy books and sports equipment in their back packs, but only a third said they wore their back packs on both shoulders to distribute the weight evenly.

The articles report that according to the BCA, six years ago 29 per cent of  all 11 to 18-year-olds said they spent part of the day suffering back pain. Now they note that by age 11, as many as 45 per cent of children have suffered some kind of back pain.

British Chiropractic Association spokesperson, Tim Hutchful, stated, "With children as young as six now ­complaining from back pain, this survey clearly highlights the alarming rate at which back pain is growing within the UK." He continued by adding a word of advice, "There are simple steps parents can take such as checking that children aren’t carrying around unnecessary items in their bags and encouraging them to use a rucksack worn correctly on both shoulders. But we are in no doubt that lack of exercise is children’s number one enemy.”



Intestinal Infections May Kill 300 Per Day In Hospitals

A November 11, 2008, report from the Association for Professionals in Infection Control and Epidemiology, (APIC) suggests that there could be more than 7,000 infections and 300 deaths in U.S. hospitals on any single day from the drug resistant intestinal bacteria clostridium difficile, also called C. difficile. Several news publications ran stories on November 11, 2008 based on this report including the Chicago Tribune, MSNBC, and ABC News.

The stories note that as many as 13 out of every 1000 hospitalized Americans were infected with the C. difficile bacteria. This number is between 6.5 to 20 times higher than previously estimated. The infections are being blamed on overuse of antibiotics and improperly cleaned hospital rooms.

Dr. William R. Jarvis, the study’s lead author commented, "Hopefully this will be a wake-up call about the importance of preventing this organism." He also noted that the incidence may actually be higher than his study suggests. He said, "Not only is it under-recognized and not tested for, but even when it's tested for, you have a 25 percent chance you're going to miss it."

Epidemiologist Dr. L. Clifford McDonald, the CDC’s expert on C. diff, said, "It’s important data that confirms that there’s an awful lot of this, that’s the bottom line." He noted that the high use of antibiotics is a key factor in the spread of such resistant bacteria like C. diff. “We’ve long been encouraging the public not to demand antibiotics as a solution to all of their problems,” McDonald said. “This brings it home to roost, doesn’t it?”

Dr. Stuart Johnson, an associate professor of medicine at Loyola University’s Stritch School of Medicine, who was not involved in the research, voiced his comments to the Chicago Tribune article by adding, "This confirms what many of us have suspected: that this is a very widespread problem in virtually all hospitals."

Dr. Jarvis concluded the ABC News story on this problem by saying, "I think it's a combination of factors. One is that we know that our population is aging, and elderly patients are at the highest risk. We know that antibiotic use is increasing, that's a risk factor for this. And we know that there's been the introduction of a more virulent strain, which was first recognized up in Montreal, Canada, in Quebec."



Straighten Up Ireland

The November 11, 2008 issue of the Irish Times ran a story about a new program being instituted in Ireland by the Chiropractors Association of Ireland called "Straighten Up Ireland". This program consists of a three minute exercise program designed to correct problems in posture that can lead to spinal problems.

The article's author, Clodagh Mulvey states, "With specialist knowledge of neurology, physiology and spinal adjusting techniques, chiropractors use carefully controlled and directed pressure 'adjustments' to restore proper spinal function and reduce blockages to the vital nervous system."

Dr. Attracta Farrell, president of the Chiropractors Association of Ireland (CAI), noted the importance of good posture at an early age to minimize future problems.  He listed one cause of poor posture by saying, "Schoolbags have two straps, but most teenagers carry heavy bags on one shoulder. This makes one shoulder lower than the other and, over time, can lead to damage of the muscles and joints."

Dr. Michele Rice a medical general practitioner, was interviewed for the article and stated, "As a GP, I see lots of musculo-skeletal problems in children - usually to do with how they carry school bags and for girls it's due to their breasts and fast growth. It's important that girls are fitted properly for bras to prevent rounding of the shoulders." She continued, "Chiropractors, physiotherapists and doctors are all singing from the same hymn sheet when it comes to posture."

The Straighten Up Ireland program consists of educational programs in schools, that promote good posture through exercise and not slouching. Sister Mary Corr, principle of St Raphaela's national school in Stillorgan, Dublin, noted in the article the importance of educating young children physically, as well as academically, morally and spiritually. Her school is one of the many that will host the  Straighten Up Ireland program. She commented, "Good posture at this stage will instill more confidence in the children for life and will help them to enjoy being in their bodies."



Serious Drug Reactions Hit New Record High

Articles on October 22 and 23, 2008 from the Associated Press and the Los Angeles Times respectively, reported on the findings in a paper from the Institute for Safe Medication Practices. The report starts off on an ominous note by revealing that, "A record number of deaths and serious injuries associated with drug therapy were reported to the U.S. Food and Drug Administration (FDA) in the first quarter of 2008.

The study noted that in the first three months of 2008 there were a total of 20,745 serious injuries and deaths associated with drug therapy. Of these 4824 resulted in death. According to the Institute for Safe Medication Practice, this represents nearly a threefold increase in deaths over the previous quarter and a 38% increase in injuries from the previous year's quarterly average.

Ironically, the anti smoking drug Chantix (varenicline) accounted for the highest number of serious injuries, with heparin coming in second. Other drugs that made the list of the top ten include, Fentanyl, Interferon Beta, Inflixmab, Etanercept, Clopidogrel, Pregabalin, Acetaminophen, and Oxycodone.

Thomas J. Moore, a senior scientist with the Institute for Safe Medication Practices (ISMP), stated, "Knowing which drugs are causing injuries and how many people are being hurt is the raw material we need to fashion sound measures to promote patient safety."'

The ISMP clearly noted the intent of the report by stating, "These findings come from a program being developed by the Institute for Safe Medication Practices (ISMP) to improve patient safety through increasing our understanding of how and why drug-related injuries and medication errors occur. The results come from analyzing new adverse drug events reports submitted to the FDA."



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