April 2009


Improved Hearing and Resolution of Ear Infections With Chiropractic Care - A Case Study

A case study research article published on March 25, 2009 in the scientific periodical, the Journal of  Pediatric, Maternal and Family Health, documented a case of improved hearing and the resolution of ear infections with chiropractic care. This case followed the progress of a  three year old girl who had right and left ear pain and hearing loss after three unsuccessful implantations of tympanostomy tubes as well as multiple medications.

The research article starts off by noting that ear infections are one of the most common diagnoses of children by pediatricians in the United States. According to the study, over one third (35%) of all pediatrician visits in the U.S. in 1990 and 46% of all three year-olds have experienced three or more episodes of this condition.

The case study author also reviewed the literature involving chiropractic care for children with ear infections. Dr. Crystal Brown, the author of the paper noted, "Numerous case studies and some clinical studies are revealing that there is a relationship between abnormalities in the spine, the nervous system and the various problems related to ear infections. These types of structural problems in the upper part of the neck cause a back-up of the lymphatics and problems with the tubes draining the middle ear. By removing the structural imbalance chiropractic helps these fluids drain, and improves nerve supply and range of motion."

In this case the young girl was first diagnosed with ear infections when she was one year old. For the next several years the child had repeated infections that were not helped by multiple rounds of oral antibiotics, ear drops and three separate insertions of tubes in the ears. This case reported that the little girl's health condition continued to get worse to the point where her preschool teacher even began noticing both hearing and speech problems. Hearing tests confirmed these findings and the third set of tubes were removed due to complications of excessive fluid accumulation, rupture of the eardrum, worsening speech disturbances and bilateral hearing loss.

At this point the girl's mother decided to try chiropractic care prior to another set of tubes. The child was examined and the finding of upper cervical (neck) subluxations was made. A course of specific adjustments was initiated to correct the subluxations.

After about one month of chiropractic the child improved dramatically including a normalizing of the audiology testing. The child reported an increase in hearing and told her mother, "I can hear again". The child's mother reported the child had less ear pain, was less irritable, and had better speech. It was even reported by the preschool teacher that the girl was more attentive.

Dr. Matthew McCoy, a chiropractor, public health researcher and editor of the journal that published the study commented, "With everything we know about the dangers of antibiotic abuse, chiropractic intervention makes perfect sense in the case of childhood ear infections. In fact, chiropractic is the treatment of choice for dealing with the structural and neurological aspects of ear infections. This child was experiencing speech, hearing and school challenges as a result of her ear infections and the medical intervention was not helping. It wasn’t until the chiropractic intervention that the child improved dramatically and in a very short time."


Taxes on Sugared Beverages Being Discussed to Help Obesity Problem

A perspective article published on April 8, 2009 in the New England Journal of Medicine (NEJM), raises the idea of adding an additional tax on high sugar drinks. The NEJM article notes that sugared drinks may represent the single largest contributor to the obesity epidemic in the United States. They identify drinks such as soda sweetened with sugar, corn syrup, or other sweeteners and other carbonated and uncarbonated drinks, such as sports and energy drinks.

The authors of the NEJM article note that there are some studies that do not connect these drinks with obesity. However, they dismiss these objections by noting, "Studies that do not support a relationship between consumption of sugared beverages and health outcomes tend to be conducted by authors supported by the beverage industry."

The NEJM article and several new articles in the general media report that currently 40 states now have taxes on soft drinks or snack foods, but that these taxes are small and do not affect the consumption of these beverages. However, ABC news reported in an April 8, 2009 news story that the governor of New York was proposing an 18 percent tax on sugared beverages.

The ABC article addresses the question if higher taxes would lower the consumption of sugared drinks by looking at the example of tobacco. Increased taxes on tobacco have been credited with dramatically lowering usage. They then claim that economic studies on soft drinks show that a 15 percent tax on sugared beverages should drop consumption by 12 to 15 percent, and higher taxes would have stronger effects.

The authors of the NEJM article summed up their conclusions by stating, "A penny-per-ounce excise tax could reduce consumption of sugared beverages by more than 10%. It is difficult to imagine producing behavior change of this magnitude through education alone, even if government devoted massive resources to the task. In contrast, a sales tax on sugared drinks would generate considerable revenue, and as with the tax on tobacco, it could become a key tool in efforts to improve health."


Chiropractic Rated Highest in Satisfaction for Back Pain in Consumer Reports Study

In April 2009 Consumer Reports released the results of a patient survey study, that will be published in their May 2009 paper edition, showing that chiropractic rated highest among patients in satisfaction of relief of back pain. Results of the study were reported on in several news articles including an April 6, 2009 WebMD article and an April 8, 2009 CBS news story.

The survey noted that 80% of US adults report having back pain some time in their life. Of those responding to the survey chiropractic received the highest grade with 59% saying that they were "highly satisfied" with their results. Physical therapy and acupuncture rated second and third with 55% and 53% respectively. In comparison, satisfaction with medical specialist and primary care medical physicians rated only 44% and 34% respectively.

CBS News medical expert Dr. Jennifer Ashton commented that the results of this study reflect what she is seeing in her practice. She noted that back pain is the most common ailment in the country and it is difficult to treat. Dr. Ashton stated that her patients are looking elsewhere, "They're staying away from things like medication, prescription drugs and surgery." Dr.  Ashton also warned against a "quick fix" to get rid of the pain. She noted,  "A lot of times that's prescription narcotics, which is actually probably the worst thing for you." She also warned, "Surgery is another option, but one that should be used as a last resort."

American Chiropractic Association President Glenn Manceaux, DC, responded in a press release, "For the treatment of back pain, few options are better than chiropractic. As shown in this latest survey, chiropractic spinal manipulation is an evidence-based and effective treatment for low-back pain and other musculoskeletal injuries. Coupled with the high levels of patient satisfaction, patients should turn to chiropractic as their first choice.”

Dr. John Maltby, President of the International Chiropractors Association added, "For well over 100 years chiropractors have been seeing a large number of patients suffering with back problems. And although chiropractic does not directly treat the pain, we do work to correct the underlying structural and neurological problem that in many cases is causing the problem. This study shows what we have known for a long time. Chiropractic get results and helps people lead normal and healthier lives."


Medical Errors Still Common in U.S. Hospitals

A number of news stories have reported on the April 2009 release of the HealthGrades "Patient Safety in American Hospitals Study". HealthGrades is the leading healthcare ratings organization, providing ratings and profiles of hospitals, nursing homes and physicians to consumers, corporations, health plans and hospitals

The new study reports that between 2005 and 2007, 913,215 total patient safety events were recorded among Medicare beneficiaries alone. This represents 2.3 percent of the nearly 38 million Medicare hospitalizations. These errors accounted for $6.9 billion in excess Medicare healthcare costs. Tragically researchers found 97,755 actual in-hospital deaths among patients who experienced one or more of the safety errors. Of these deaths, 92,882 could be directly attributable to a patient safety event and could have been avoided.

The study also showed a large discrepancy between hospitals noting that patients treated at top-performing hospitals had, on average, a 43% lower chance of experiencing one or more medical errors compared to the poorest-performing hospitals.

Overall progress has been made in some areas, while in others the risk is worse. The net effect is that the overall incidence rates remained essentially the same as last year's, with rates for seven indicators getting worse and eight improving.

Rick May, MD, senior physician consultant at HealthGrades and co-author of the study commented, "Patient safety incidents are one of the leading causes of death in the U.S. The sad fact is that many, if not most, of these errors are preventable. Patients shouldn’t die or experience unnecessary harm as a result of medical errors in hospitals.”

The researchers of this study summed up their concerns by stating, "Hospitals must continue to study patient safety, design, and enhance patient safety processes until there are zero events, and recognize that a 2% error rate can no longer be status quo."


Drug Research Rife with Conflicts of Interest

Several news stories and a white paper report, all address the subject of drug researchers having a conflict of interest due to the money from the drug companies, and the inability of the Food and Drug Administration (FDA) to adequately reform the situation. The Government Accountability Project released an April 2009 report called "The ABC's of Drug Safety", that questions the safety and results of drug trials.

According to their website, the Government Accountability Project (GAP) is a 30-year-old nonprofit public interest group that promotes government and corporate accountability by advancing occupational free speech, defending whistleblowers, and empowering citizen activists. Mark Cohen, GAP Executive Director and coauthor of the report, stated "The current clinical trial reform process is rife with conflicts of interest that put trial subjects at risk and produce suspect data on drug safety and efficacy. Making matters worse, federal oversight is wholly inadequate."

“The FDA system of ensuring drug safety is a work-in-progress,” stated Sheila Fleischhacker, author of the GAP report. “Some of the FDA’s new regulations are steps in the right direction, but the overall process still has too many gaps that put the public at risk."

One of the main problems noted is that while the drug companies have continued to grow, the FDA budget has continued to shrink. The GAP report noted that this has set up a situation where the FDA has been forced to "heavily rely on fees it receives from the very industry it is supposed to regulate.”

The executive summary of the GAP report also included a quote from Dr. Marcia Angell, former editor of the New England Journal of Medicine and a senior lecturer at the Harvard Medical School. Dr. Angell maintains that all clinical trials should be administered by the National Institutes of Health: “It is self-evidently absurd to look to investor-owned companies for unbiased evaluations of their own products. Yet many academic investigators and their institutions pretend otherwise, and it is convenient and profitable for them to do so.”

An article on April 10, 2009 from Reuters UK also looked at the conflict of interest by interviewing Dr. Bruce Psaty of the University of Washington, who published an article on using beta-blockers to treat high blood pressure. Since the article was favorable for the drug companies Dr. Psaty then noticed that the drug companies approached him to do more work. He recalled, "My family and I were invited to a first-class resort, where I presented the results at a sponsored conference." He then agreed to create a slide presentation but felt  "a kind of social duty to reciprocate both the kindness and the investment made by the sponsor in the slide set."

Dan Ariely, a behavioral economist at Duke University in North Carolina, stated in the Reuters UK article, "It's human instinct. If someone does something nice -- gives you $5 million in a research grant -- don't you want to do something nice back to them?"


Drug Company Merck Tried to Neutralize and Discredit Doctors Critical of Vioxx

In a court case in Australia, evidence came out that showed that the drug giant Merck created and disseminated a list of doctors who opposed their drug Vioxx. As reported in the April 6, 2009 British Medical Journal and in the April 1, 2009 issue of the newspaper, The Australian, Merck created a list of mainly researchers and academics who had been negative about the drug Vioxx or Merck. The inter-office emails then  recommended a course of action to either discredit or neutralize them.

The article in The Australian also noted that Merck allegedly used intimidation tactics against critical researchers, including dropping hints it would stop funding to institutions and claims it interfered with academic appointments. According to an email excerpt read to the Australian court, one Merck employee wrote in an email, "We may need to seek them out and destroy them where they live."

In The Australian article, plaintiff attorney Julian Burnside said internal emails in April 1999 from Merck staff showed the company was not happy with what some researchers and doctors were saying about the drug. "It gives you the dark side of the use of key opinion leaders and thought leaders ... if (they) say things you don't like to hear, you have to neutralize them," he said. "It does suggest a certain culture within the organization about how to deal with your opponents and those who disagree with you."

On September 30, 2004, Merck voluntarily withdrew Vioxx from the market because of concerns about increased risk of heart attack and stroke associated with long-term, high-dosage use. Vioxx was one of the most widely used drugs ever to be withdrawn from the market. In the year before withdrawal, Merck had sales revenue of US$2.5 billion from Vioxx.

In the United States the U.S. Attorney's office for the District of Massachusetts sent a letter in March 2009, informing the drugmaker it is a target of the grand jury investigation concerning Merck's research, marketing and selling activities regarding Vioxx.


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