April 2006
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Autism and Chiropractic, Studies Hold Hope
Two
separate papers published in two scientific journals hold hope for children
with autism through chiropractic care. One paper published in the
March 2006 issue of Clinical Chiropractic reviews past studies on
chiropractic and Autism. This paper recounts in clinical studies where
children with autism are helped with chiropractic care. Most of the
studies reviewed speak of problems in the upper cervical (neck) spine.
In addition to the Clinical Chiropractic paper, a study published in the March 9, 2006 Journal of Vertebral Subluxation (JVSR) compares two groups of children with autism and their response under chiropractic care. In this study 14 children diagnosed with autism were studied undergoing chiropractic care. Seven of these children received one form of chiropractic adjustments focusing on the entire spine while the other seven received a form of chiropractic adjustment focusing on the upper cervical spine.
The children in this study were diagnosed with autism at the Child Evaluation Center at the University of Louisville Medical School. The evaluation of any progress made was done by using the Autism Treatment Evaluation Checklist (ATEC) created by the researchers at the Autism Research Institute of San Diego, California. According to the JVSR study, the ATEC is a one-page questionnaire designed to be completed by parents, teachers, or caretakers. It consists of 4 subsets: I. Speech/Language Communication (14 items); II. Sociability (20 items); III. Sensory/Cognitive Awareness (18 items); and IV. Health/Physical/Behavior (25 items).
Each of the children in this study were scored according to the ATEC evaluation. Then, twice each week for the following 3 months, the children were checked and adjusted as indicated. Follow up ATEC evaluations were performed each month to monitor the progress.
The results showed that improvement of ATEC scores occurred in six of the seven children under upper cervical adjustment and in five of the seven children under full spine adjustment. The children in the upper cervical group did show greater score improvements overall. In this group, two of the children improved so much that they no longer met the criteria to be classified as autistic. Overall, the study noted that the most common clinical aspects of improvement were in communication, verbal skills, eye contact, mood, and physical sport skills.
Most Get Mediocre Health Care
The above headline came from a March 16, 2006, Associated Press story by Jeff Donn that appeared in many newspapers and online outlets. The article was based on a study published in the March 16th New England Journal of Medicine (NEJM) and starts out by noting that, "Americans -- rich, poor, black, white -- get roughly equal treatment, but it's woefully mediocre for all".
In
this study, researchers examined medical records and conducted phone
interviews with 6,712 randomly picked patients who visited a medical office
within a two-year period in 12 metropolitan areas from Boston to Miami to
Seattle. The survey questioned whether people got what researchers considered
to be the highest standard of medical treatment for 439 items measured for
both common chronic and acute conditions and disease prevention. They investigated
to see whether people got the right tests, drugs and medical
treatments.
The results of the study showed that overall patients received only 55 percent of recommended steps for what the researchers determined was top-quality medical care. Interesting and contrary to what researchers expected to find, the study results showed that Blacks and Hispanics as a group each got 58 percent of the best care, compared to 54 percent for whites. Finances did play a role in that households with an income over $50,000 got 57 percent, 4 points more than people from households of less than $15,000. Additionally, patients without insurance got 54 percent of recommended steps, just one point less than those with managed care. The study also showed that women came out just slightly ahead of men in receiving optimum care.
Dr. Donald Berwick, who runs the nonprofit Institute for Healthcare Improvement in Cambridge, Massachusetts, commented, "This study shows that health care has equal-opportunity defects." Dr. Steven Asch, at the Rand Health research institute, in Santa Monica, California, and study chief author agreed, "It doesn't matter who you are. It doesn't matter whether you're rich or poor, white or black, insured or uninsured. We all get equally mediocre care".
In the discussion the NEJM study speaks to the problems in the way medical care is rendered, "These results underscore the profound and systemic nature of the quality-of-care problem." The authors of the NEJM study concluded by stating, "In this study, we have now shown that individual characteristics that often have a protective effect do not shield most people from deficits in the quality of care. As the Institute of Medicine has concluded, problems with the quality of care are indeed widespread and systemic and require a system-wide approach."
Depression and Chiropractic: A Case Study
A case study of a patient
with lower back pain and depressive symptoms was published in the March 2006
issue of the scientific periodical, Clinical Chiropractic. In this
case, a 71-year-old female sought chiropractic care for low back pain of 12
years’ duration. The patient also noted that she was currently
experiencing depression and mood swings but did not have a history of
depression and had never been diagnosed with depression. Upon testing using
the Beck Depression Inventory version I (BDI-I), she did show positive for
mild depression.
Chiropractic care was initiated and continued over an 11 week period. The results were that the patient had a significant reduction in lower back pain as well as a reduction of her score for depression. The improvement on depression was documented using a follow up BDI test. She not only reported feeling better but also a more positive feeling about her overall well being.
The definition from the National Institute of Mental Health is ‘‘A depressive disorder is an illness that involves the body, mood and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. People with a depressive illness cannot merely ‘pull themselves together’ and get better. Without treatment, symptoms can last weeks, months or years. Appropriate treatment, however, can help people who suffer from depression.’’
The authors of this case study concluded, "This case is important because it illustrates the need for chiropractors to be aware of screening for depression and to be knowledgeable about the management of depression, especially in the elderly population."
Fluoridated Water Increases Risk of Cancer in Boys
On April 6, 2006, WebMD reported on a study that is to be published in the May 2006 issue of Cancer Causes and Controls that shows a link between fluoridated water and an increased risk of of a deadly bone cancer. The results of this study were that boys who grew up in communities that added at least moderate levels of fluoride to their water got bone cancer, specifically osteosarcoma, more often than boys who drank water with little or no fluoride.
The
study did not find the same results in girls. The more fluoride in the
water during the years the boys experienced growth spurts, the higher the
risk of the deadly bone cancer.
Elise Bassin, DDS, author of the study and clinical instructor in oral health policy and epidemiology at Harvard said she "was surprised by the results." She continued, "Having a background in dentistry and dental public health, [I] was taught that fluoride at recommended levels is safe and effective for the prevention of dental [cavities]," Bassin says in the statement. "All of [our analyses] were consistent in finding an association between fluoride levels in drinking water and an increased risk of osteosarcoma for males diagnosed before age 20, but not consistently for girls."
The article noted that Osteosarcoma is about 50% more common in boys than in girls. Additionally, it was noted that boys tend to have more fluoride in their bones than girls. Also, fluoride collects in the bones, and it is more likely to accumulate in the bones during periods of rapid bone growth.
A nonprofit watchdog organization, called the Environmental Working Group, (EWG - www.ewg.org), says water fluoridation should stop until further research can refute or confirm Dr. Bassin's findings. Tim Kropp, PhD, a senior scientist at EWG told WebMD in an interview that, "About 65% of the U.S. water supply has added fluoride." He strongly suggested, "With evidence this strong, it only makes sense to act on it. Right now, it makes the most sense to put fluoride in toothpaste, and not into our water. It's not like this is a huge contaminant that will cost billions of dollars to fix. We can just stop adding it to our water it if we want to."
Pets and Dirt Good for Child's Immune System
A feature story in the March 19, 2006 issue of USA TODAY reported that exposure to pets, peanuts and intestinal worms might actually be good for children, because they program their developing immune system to know the difference between real threats and common exposures.
The
article begins by noting that this new thinking is opposite of the previous
conventional wisdom that said it was best to protect children from these
types of exposures. They now state just the opposite. Dr. Andy
Saxon of the University of California-Los Angeles, states, "What we've
learned is that it may, in fact, be important to be exposed early on to a
sufficient quantity of allergy-causing substances to train the immune system
that they are not a threat."
In the article Dr. Joel Weinstock of Tufts New England Medical Center added, "When you're born, Day Zero, your immune system is like a new computer. It's not programmed. You have to add software. Between the ages of zero and 12, you're learning to read, you're learning to write, and your immune system is learning to react to things. Part of that is learning to limit reactivity."
The article explains the new thinking on allergies by what is known as the "hygiene hypothesis". This hypothesis suggests that growing up in cities and suburbs, away from fields and farm animals, leaves people more susceptible to many immune disorders such as allergies and asthma. To strengthen this point Dr. Weinstock points to the difference between developed nations with urban communities and undeveloped, countries, "Hay fever is the most common allergy in the developed world," he says. "Yet, there are some countries in the world where doctors don't know what hay fever is."
The article added further evidence by reporting on a study by Dr. Dennis Ownby of the Medical College of Georgia. In his study Ownby followed 474 infants in the Detroit area from birth to age 7 at the Henry Ford Hospital in the hope of finding clues to why some would pick up allergies and others would not. The scientists on his team found that when they compared 184 children who were exposed to two or more dogs or cats in their first year of life with 220 children who didn't have pets, the children raised with pets were 45% less likely to test positive for allergies than other kids.
The article notes that this new thinking could have a profound effect and help millions. They report that more than 50 million people have allergic diseases, which are the sixth-leading cause of chronic illness in the USA. Additionally, they note that according to the National Institute of Allergy and Infectious Diseases (NIAID), costing the health system $18 billion a year.
Antibiotics in the First Year of Life Increase Risk of Asthma
From a March 13, 2006, Reuters Health release comes a report that children who are given antibiotics early in life increase their chance of asthma later. This finding is from a study by Dr. Carlo A. Marra and colleagues at the University of British Columbia in Vancouver published in the medical journal Chest. The study also suggests that the more antibiotics were used on a child, the higher the risk of asthma.
Dr.
Marra's group reviewed and combined data from seven studies analyzing the
possible relationship between children who received antibiotics in the first
year of life and those who did not. These studies included 12,082
children of whom 1817 had developed asthma. The data showed that the
children who had received antibiotics in the first year of life were twice
as likely to develop asthma as those who did not receive antibiotics.
In an interview with WebMD, Dr. Marra stated, "Antibiotic exposure during the first year of life does appear to be a risk factor for the development of childhood asthma, but because of limitations in the studies we reviewed we have to conclude that bigger and better studies are still needed."
Dr. Clifford Bassett, an allergy expert and professor of medicine at the State University of New York seemed to agree with these findings as he stated, "With the immune system, we're finding we may need to expose ourselves to bacteria and other endotoxins to boost or have our immune systems develop normally."
Dr. Marra concluded, "This is the best evidence we have right now, and the best evidence that we have looks like there is potentially an association. People should not be prescribing antibiotics unless they're really necessary."
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