http://www.guerillahealthreport.com/ How 116 million CAM Patients and Practitioners Took Down the 800 Pound Health Media Gorilla, One Medical Journal Review at a Time Wed, 10 Mar 2010 3:39:29 +0000 en-us http://blog.guerillahealthreport.com/blog_view.php?bid=279 http://blog.guerillahealthreport.com/blog_view.php?bid=279 Tue, 09 Mar 2010 11:59:54 +0000 I was introduced to grounding therapy in 2002 by Dr. Jeff Spencer, the chiropractor for the US Postal Service and Discovery Channel Tour de France racing teams (which included seven-time winner Lance Armstrong). Dr. Spencer said he would attach the athletes to electrodes and ground the lead to something connected to the earth, much like an electrical circuit is "grounded" to create a safe flow of current. The effect on the body was increased rate of muscle recovery and decreased soft tissue healing times between stages. A new pilot study performed by researchers at the University of Oregon and UC Irvine examined the effect of grounding on a group of athletes they put through a bout of muscle-shredding eccentric exercise. The researchers performed a battery of tests before and at specific intervals after the exercise which included blood chemistry, salivary enzyme activity, MRI, and spectroscopy. The athletes were divided into a grounding group with their leads connected to a specialized conductive sheet attached to the earth and a control who were attached to electrodes with an un-grounded lead. Eight measures such as white blood cell count, enzyme indicators of muscle damage, visual analog pain scale, and pressure measurements on the muscles exercised were at least 10% different between the grounded and control groups. The authors concluded that, considering the apparent effect of the grounding treatment on the immune system in this pilot study, further research should be performed on this line of therapy. Dick Brown, Gaétan Chevalier, Michael Hill.(2010). "Pilot Study on the Effect of Grounding on Delayed-Onset Muscle Soreness." The Journal of Alternative and Complementary Medicine. 16(3): 265-273. doi:10.1089/acm.2009.0399. http://blog.guerillahealthreport.com/blog_view.php?bid=278 http://blog.guerillahealthreport.com/blog_view.php?bid=278 Mon, 08 Mar 2010 7:59:52 +0000 In a study conducted in conjunction with the Department of Veterans Affairs on a group of patients diagnosed with bipolar disorder, the preference for Complementary and Alternative Medicine (CAM) treatments appears to be independent of whether or not they feel their medical therapy is working. Previous studies have shown that high holistic therapy use is associated with people who find their medical treatments are ineffective at treating the problem. However, this is the first study to examine the attitude of patients diagnosed with a mental health issue towards CAM therapies, and they have found no link between the two. The researchers did discover that, while CAM use was more likely in patients who found psychotherapy ineffective at helping them deal with social, family, or work related issues, the two groups had no association with medication compliance. The researchers found that those who used oral (i.e. herbal) and cognitive (i.e. meditation) therapies were more likely to report their medication didn't help with manic or depressive symptoms and that those who meditated more often found their medications ineffective at addressing the issues of social, work, or family functioning. Patients who meditated also felt their medications didn't prevent reoccurrences of manic or depressive episodes. Christopher N. Jarman, Brian E. Perron, Amy M. Kilbourne, Carrie Farmer Teh. (2010). "Perceived Treatment Effectiveness, Medication Compliance, and Complementary and Alternative Medicine Use Among Veterans with Bipolar Disorder." The Journal of Alternative and Complementary Medicine 16(3): 251-255. doi:10.1089/acm.2009.0325. http://blog.guerillahealthreport.com/blog_view.php?bid=277 http://blog.guerillahealthreport.com/blog_view.php?bid=277 Fri, 05 Mar 2010 8:00:17 +0000 Osteoporosis and a low level of Vitamin D in the blood stream are usually found in patients with Multiple Sclerosis. The fat soluable vitamin is naturally produced by the body as a chemical reaction to ultra violet light, but because modern society tends to live, work, and play indoors, North American food agencies have recommended adding Vitamin D to cow's milk. Canadian researchers wanted to determine if people who avoid dairy, such as those with a cow's milk allergy, are more susceptible to MS because they are presumably consuming less supplemental Vitamin D. The researchers identified 6600 MS patients and compared them with 2500 spouses without MS. They used data from a national survey to determine the frequency of cow's milk allergy in both groups, but found no significant difference in the rates of dairy avoidance between the two groups. The authors concluded that avoiding milk during your lifetime isn't a risk factor for MS, which should make sense- dairy is effectively an inflammatory chemical, and the vast majority of people have some type of reaction to it. With so many alternative sources for vitamin D available (Cod Liver Oil, SUNSHINE), relying on a pro-inflammatory food as the primary delivery vehicle seems to be missing the point. Sreeram V. Ramagopalan, David A. Dyment, Colleen Guimond, Sarah-Michelle Orton, Irene M. Yee, George C. Ebers, A. Dessa Sadovnick (2010). "Childhood cow's milk allergy and the risk of multiple sclerosis: A population based study." Journal of the Neurological Sciences 291(1): 86-88. Sioka C, Kyritsis AP, Fotopoulos A. (2009). "Multiple sclerosis, osteoporosis, and vitamin D." J Neurol Sci. 2009 Dec 15;287(1-2):1-6. Epub 2009 Oct 2. http://blog.guerillahealthreport.com/blog_view.php?bid=276 http://blog.guerillahealthreport.com/blog_view.php?bid=276 Wed, 03 Mar 2010 10:40:13 +0000 The American Medical Student Association has compiled an online scorecard ranking the possible conflicts of interest between a university and the pharmaceutical/medical device industry. The grades have several criteria based on the existence of university policies that require disclosure of gifts, reimbursement for speaking engagements, acceptance of samples, and direct contact between sales representatives and clinic doctors. The Pharmfree scorecard evaluates 149 medical and osteopathic schools around the United States and "examines potential conflicts of interest created by industry marketing at the level of the individual physician and trainee." AMSA PharmFree Scorecard 2009. Reston, VA: American Medical Student Association 03.030.2010 http://blog.guerillahealthreport.com/blog_view.php?bid=275 http://blog.guerillahealthreport.com/blog_view.php?bid=275 Wed, 03 Mar 2010 10:26:16 +0000 European researchers have determined that Vitamin D reduces the risk of colorectal cancer, which effects over 140,000 Americans every year. In a four year study examining half a million people across 10 European nations, those with the highest concentrations of Vitamin D in their blood streams had a 40% less chance of developing colorectal cancer. Calcium intake was also associated with a lower cancer risk, which shouldn't be surprising because Vitamin D is often added to calcium supplements to help the body absorb the mineral. The body produces Vitamin D naturally through a chemical reaction in the blood stream when the skin is exposed to sunlight. In the winter months, supplementing with sources such as cod liver oil may help with certain health issues. A major study also recently linked vitamin D with a fewer cases of the flu. Mazda Jenab et al (2010). "Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations:a nested case-control study." BMJ 340:b5500, doi: 10.1136/bmj.b5500 (Published 21 January 2010) http://blog.guerillahealthreport.com/blog_view.php?bid=274 http://blog.guerillahealthreport.com/blog_view.php?bid=274 Wed, 03 Mar 2010 1:04:02 +0000 To the college kids pulling all-nighters, beware the cracks in the sidewalk! According to a recent report, injuries are twice as likely to happen if a person is physically and mentally exhausted. Vetter, Rheba E; Symonds, Matthew L (2010). "Correlations Between Injury, Training Intensity, and Physical and Mental Exhaustion Among College Athletes." Journal of Strength and Conditioning Research 24(3) - pp 587-596. doi: 10.1519/JSC.0b013e3181c7c2eb http://blog.guerillahealthreport.com/blog_view.php?bid=273 http://blog.guerillahealthreport.com/blog_view.php?bid=273 Mon, 01 Mar 2010 8:35:50 +0000 A study on four ultra-diluted homeopathic remedies showed promise for treating breast cancer. The remedies were applied to 2 different breast cancer cell lines and a control line, and the homeopathics were shown to selectively cause the cancer cells to die. Carcinosin, Phytolacca, Conium and Thuja caused a disruption in the replication processes of the cells similar to the activity that paclitaxel (Taxol), the most commonly used chemotherapeutic drug for breast cancer, uses without the toxic effect on normal cells. Frenkel M, Mishra BM, Sen S, Yang P, Pawlus A, Vence L, Leblanc A, Cohen L, Banerji P, Banerji P. (2010). "Cytotoxic effects of ultra-diluted remedies on breast cancer cells." International Journal of Oncology 36(2): 395-403. http://blog.guerillahealthreport.com/blog_view.php?bid=272 http://blog.guerillahealthreport.com/blog_view.php?bid=272 Fri, 26 Feb 2010 10:38:47 +0000 In an shocking press release, the CDC's Vaccine Advisory Committee has advised that nearly all Americans receive the flu vaccine. They state that infants under 6 months, patients with egg allergies, and those who have had severe reactions to past flu vaccines are exempt. No word on exemptions for those Americans with a fully functional immune system, although the panel did stop short of specifically mentioning adults 19-49 with no risk of contact with sick people. The vote from the Vaccine Advisory Panel was 11-0 in favor of the universal recommendation (with one abstention), which ignited "applause in the CDC auditorium where the meeting was held." Sanofi-Pasteur is, coincidentally, releasing a new version of their flu shot this year that costs twice as much as those currently on the market. As an added bonus, season flu vaccines are expected to contain strains of the H1N1 virus. Two doctors were interviewed for the story. Dr. Anthony Fiore works for the CDC where he develops seasonal influenza vaccine policy and has appeared on such programs as "A Cup of Health with the CDC" promoting seasonal influenza vaccines. He's authored 11 papers promoting the influenza vaccine over the last 3 years. Dr. Gregory Poland, who describes himself as a healer and a warrior, and states on the Mayo Clinic website (where he is employed) that he believes “Vaccines are the singularly most important medical technology ever devised." Disclosure: Gregory A. Poland, MD, has disclosed that he serves as the chair of a Data Safety Monitoring Board for a clinical trial of a novel influenza vaccine sponsored by Merck, and that he serves as the principal investigator of an influenza vaccine clinical trial sponsored by Protein Sciences Corporation. Dr. Poland also disclosed that he has participated in a one-time advisory group meeting entitled "Improving Influenza Prevention in Adults" on August 28, 2006, for GlaxoSmithKline, and a one-time advisory group meeting entitled "Evidence-Based Decision Making for Employee Influenza Vaccination" on September 16, 2006 for Novartis. Stobbe, M (2010). "Panel recommends annual flu vaccinations for all." The Washington Post Wednesday, February 24, 2010; 8:52 PM By MIKE STOBBE Louden K (2010). "CDC Advisory Committee Recommends Universal Influenza Vaccination." Medscape, published online http://blog.guerillahealthreport.com/blog_view.php?bid=271 http://blog.guerillahealthreport.com/blog_view.php?bid=271 Wed, 24 Feb 2010 8:04:20 +0000 Non-verbal communication studies have usually focused on facial expressions and body language, but a new study on the ability of touch to convey emotions reveals that recipients can understand the emotion from another person just by the way they're touched. In a study of the ability for touch to communicate eight distinct emotions: anger, fear, disgust, love, gratitude, sympathy, happiness, and sadness, subjects were able to correctly identify which feeling they were feeling, so to speak, with up to 70% accuracy. Other studies examining the relationship between touch and athletic performance, relationship stability, and willingness of students to volunteer for activities have shown touch to be a key indicator in creating an higher performing, stronger emotional bond with teammates, partners, and teachers. Carey, B. (2010). "Evidence That Little Touches Do Mean So Much." NYTimes Online 22 Feb 2010, published in print 23 Feb page D5. Hertenstein MJ, Holmes R, McCullough M, Keltner D. (2009). "The communication of emotion via touch." Emotion 9(4):566-73. http://blog.guerillahealthreport.com/blog_view.php?bid=270 http://blog.guerillahealthreport.com/blog_view.php?bid=270 Mon, 22 Feb 2010 9:38:15 +0000 A Senate committee has recommended the Type 2 Diabetes drug Avandia be removed from the market because of a recent report linking the drug to a higher risk of heart attacks and heart failure in patients. The medication was linked as the source of over 300 cases of heart failure and 500 heart attacks every month. Harris, G. (2010). "Research Ties Diabetes Drug to Heart Woes." NY Time Online http://blog.guerillahealthreport.com/blog_view.php?bid=269 http://blog.guerillahealthreport.com/blog_view.php?bid=269 Fri, 19 Feb 2010 8:03:34 +0000 Neurological training appears to be a key factor in preventing injuries, according to a review published in Medicine & Science in Sports & Exercise. Researchers examined 7 studies on proprioception- the body's sense of where it is in space- and analyzed the benefit of training on preventing leg, knee, and ankle sprains. The messages about the foot's position when a person jumps, for instance, is sent from the nerves in the foot and ankle to the brain, and the brain tells the foot and ankle if any adjustments are needed to safely land. The studies showed there was a higher probability that the person would stay injury-free if they trained this system regularly. Even a technique as simple as balancing on one foot was shown to significantly reduce the risk of ankle sprains. This is especially important information for those who live in icy climates and for the fall-prevention programs directed at seniors. HÜBSCHER, MARKUS; ZECH, ASTRID; PFEIFER, KLAUS; HÄNSEL, FRANK; VOGT, LUTZ; BANZER, WINFRIED (2010). "Neuromuscular Training for Sports Injury Prevention: A Systematic Review." Medicine & Science in Sports & Exercise. 42(3):413-421. doi: 10.1249/MSS.0b013e3181b88d37 http://blog.guerillahealthreport.com/blog_view.php?bid=268 http://blog.guerillahealthreport.com/blog_view.php?bid=268 Wed, 17 Feb 2010 4:38:36 +0000 The CDC in a flash of guestimating genius has decided that the number of H1N1 cases confirmed laboratory tests may under represent the actual number of people who had the swine flu in the US by up to 43 million. The rationale behind the "under-ascertainment" estimates stems from a study by the the CDC that found for every case of H1N1 reported from April to July, which was when the CDC stopped officially confirming cases, represented 79 total cases and "every hospitalized case reported may have represented an average of 2.7 hospitalized people." This study is in direct conflict with the data CBS News reported in October, when they investigated the results of samples sent for H1N1 verification and found that in up to 97% of the cases the patient didn't have the virus. In fact, in California alone, 86% of the samples weren't even flu at all. The CDC applies the same fuzzy logic when making recommendations about vaccination. 75% of the deaths from complications associated with the H1N1 virus were concentrated in the 18-64 year old range. However, the CDC's recommendation for vaccination extends beyond this group to infants over 6 months and those over 65, even though H1N1resistant antibodies have been found in most seniors and reports on children with H1N1 from the pediatricians caring for them say the risk is no worse than the seasonal flu. Seasonal influenza is responsible for an estimated 36,000 deaths in the United States annually. H1N1 has been responsible for an estimated 11,690. Centers for Disease Control (2010). "CDC Estimates of 2009 H1N1 Influenza Cases, Hospitalizations and Deaths in the United States, April 2009 – January 16, 2010." Sharyl Attkisson (2009) "Swine Flu Cases Overestimated? CBS News Exclusive: Study Of State Results Finds H1N1 Not As Prevalent As Feared." Oct. 21, 2009 http://blog.guerillahealthreport.com/blog_view.php?bid=267 http://blog.guerillahealthreport.com/blog_view.php?bid=267 Tue, 16 Feb 2010 8:44:29 +0000 Physicians rely on drug labels to tell them what they should be using the drugs for. However, not all of the important safety, dosage, and effectiveness information makes it onto the label. Drug labels are written by the drug companies, then negotiated and approved by the FDA. The article by Schwartz and Woloshin explains the process and the holes inherent in it. They give examples of how one drug that was shown to be equally effective at 4 mg as 8 mg but came with a higher rate of death at the larger dose. This mortality rate was missing from the label, missing from the journal article on the clinical studies (which actually recommended the 8 mg dose for difficult cases), but was contained in the 98 page document Novartis submitted to the FDA. In another example, a $750,000 a day direct-to-consumer advertising campaign for a sleep aid didn't put efficacy information on the label, and for good reason- the drug company sold $800 million worth and, around 3/4 of the way through the 400 page FDA document, the studies revealed "Lunesta patients still met criteria for insomnia and reported no clinically meaningful improvement in next-day alertness or functioning." Schwartz and Woloshin suggested that the FDA perform executive summaries of the documents that drug manufacturers provide, including tables of the results of clinical trials, highlight any uncertainties that the review panel might have about the drug, and explain whether approval was conditional on follow-up studies. They also recommended that the FDA adopt "Prescription Drug Facts Boxes," which would outline the highlights of the benefits and risks of each drug in an easy to understand manner. The FDA's Risk Advisory Committee agreed and passed the recommendation on to the FDA- as of press time the leadership hadn't made a decision on implementing the measures. L. M. Schwartz and S. Woloshin (2009). "Lost in Transmission — FDA Drug Information That Never Reaches Clinicians." New England Journal of Medicine Volume 361(18):1717-1720. http://blog.guerillahealthreport.com/blog_view.php?bid=266 http://blog.guerillahealthreport.com/blog_view.php?bid=266 Mon, 15 Feb 2010 7:58:14 +0000 Topiramate, a commonly prescribed drug for migrane headaches, has been shown to slow reaction time and affect how quickly children recognize patterns and process visual information. In a study of 12-17 year olds who were given 50 mg, 100 mg, and a placebo, the topiramate groups also reported a higher likihood of insomnia, fatigue, and dizziness. The risk of anorexia was 3-4 times higher in those taking the drug than those taking placebo. Despite this, the researchers concluded that "the tolerability profile, including cognitive adverse events (referring to the above symptoms), appeared to be acceptable." Six of the seven authors work for Johnson & Johnson Pharmaceutical Research and Development. J&J sell topiramate under the brand name Topamax, which only has FDA approval for use in adults. Gahan J. Pandina, Seth Ness, Elena Polverejan, Eric Yuen, Marielle Eerdekens, Robert M. Bilder, Lisa Ford (2010). "Cognitive Effects of Topiramate in Migraine Patients Aged 12 Through 17 Years." Pediatric Neurology 42(3): pp 187-195. http://blog.guerillahealthreport.com/blog_view.php?bid=265 http://blog.guerillahealthreport.com/blog_view.php?bid=265 Sun, 14 Feb 2010 9:38:26 +0000 The Winter Olympics are on again, and its time to sit back in awe at the amazing feats the human body can accomplish when it functions perfectly. Sometimes when I'm watching it seems like Olympic records are falling like snowflakes, and this time of year reminds me of that balance between the expectations of "Bigger, Faster, Stronger" and the amazing reality that athletes at trainers are achieving it every year. An article in the Journal of Applied Physiology estimates that human body is capable of running speeds between 35-40 mph. Jamaican sprinter Usain Bolt, the fastest human on the planet, can hit peak speeds of around 28 mph (45k). The researchers point to a mechanism inside the muscle fibers that may be the limit, but that's kind of the overall point, isn't it? Similar, "insurmountable" biological barriers existed when the fastest humans could only run 25, 26, and 27 mph. Peter G. Weyand, Rosalind F. Sandell, Danille Naomi Leoni Prime, and Matthew W. Bundle (2010). "The biological limits to running speed are imposed from the ground up." Journal of Applied Physiology, DOI: 10.1152/japplphysiol.00947.2009 http://blog.guerillahealthreport.com/blog_view.php?bid=264 http://blog.guerillahealthreport.com/blog_view.php?bid=264 Sat, 13 Feb 2010 10:40:05 +0000 Just over 1500 cases of mumps have been reported in New York and New Jersey between June and January, almost exclusively in a tradition-observant Jewish community and primarily among teenage boys. Nineteen hospitalizations were reported and no deaths have occured. 88% had received at least 1 dose of mumps-containing vaccine, and 75% had received 2 doses. Beginning on January 19, 2010, in Orange County, New York, public health officials began offering a third dose of MMR vaccine in three schools despite documentation of the highest level of 2-dose coverage among students in the area, the fact that the federal Advisory Committee on Immunization Practices doesn't recommend it, and no data exists on the effectiveness of a third dose in either reducing the risk for mumps or altering the course of an outbreak. The story from the CDC maintains "Although mumps vaccination alone was not sufficient to prevent this outbreak, maintaining high measles, mumps, and rubella (MMR) vaccination coverage remains the most effective way to prevent outbreaks and limit their size when they occur," and suggests the data they get from a third shot can be used to guide future options for similar outbreaks. However, much like the other diseases where incidence rate was already declining when the vaccine was introduced, the number of cases per week has dropped from a peak of 160 in mid-November to less than 20 before the introduction of the third vaccine. P High, MHS, Ocean County Health Dept, EF Handschur, MPH, OS Eze, MD, B Montana, MD, C Robertson, MD, C Tan, MD, New Jersey Dept of Health and Senior Svcs. JB Rosen, MD, KP Cummings, MPH, MK Doll, MPH, JR Zucker, MD, CM Zimmerman, MD, New York City Dept of Health and Mental Hygiene; T Dolinsky, Rockland County Dept of Health; S Goodell, MPH, B Valure, Orange County Health Dept; C Schulte, D Blog, MD, E Rausch-Phung, MD, P Smith, MD, New York State Dept of Health. A Barskey, MPH, G Wallace, MD, P Kutty, MD, H McLean, PhD, K Gallagher, DSc, R Harpaz, MD, GL Armstrong, MD, L Lowe, MS, R McNall, PhD, J Rota, MPH, P Rota, PhD, C Hickman, PhD, WJ Bellini, PhD, Div of Viral Diseases, National Center for Immunization and Respiratory Diseases. I Ogbuanu MD, A Apostolou, PhD, EIS officers, CDC. (2010). "Update: Mumps Outbreak --- New York and New Jersey, June 2009--January 2010." Morbidity and Mortality Weekly Report February 12, 2010 / 59(05);125-129 http://blog.guerillahealthreport.com/blog_view.php?bid=263 http://blog.guerillahealthreport.com/blog_view.php?bid=263 Sat, 13 Feb 2010 9:29:22 +0000 Children who eat dinner with their families, get enough rest, and sit in front of a tv or computer screen for less than 2 hours a day reduce their risk for obesity by 40%, according to a report published by Pediatrics. The researchers measured over 8500 pre-schoolers and investigated three factors- eating 5 or more meals as a family, sleeping at least 10 1/2 hours a night, and spending no more than 2 hours a day playing video games, on the computer, or watching television. The scientists factored in the child's race/ethnicity, mother's obesity, and education, household income, and if the children lived in a single-parent household. They found that 14.5% of the preschoolers were exposed to all three routines while 12.4% were exposed to none. Nearly a quarter of the children who weren't exposed to the routines were obese, while around 14% of the children whose families ate together, enforced bed time, and limited screen time were. Importantly, the statistics showed that even enforcing any two of the behaviors lowered the risk of obesity almost as much as regularly performing all three. Sarah E. Anderson and Robert C. Whitaker (2010). "Household Routines and Obesity in US Preschool-Aged Children." Pediatrics doi:10.1542/peds.2009-0417 http://blog.guerillahealthreport.com/blog_view.php?bid=262 http://blog.guerillahealthreport.com/blog_view.php?bid=262 Thu, 11 Feb 2010 3:09:27 +0000 Brain and Development published an article that made me look twice. Entitled "Sonic hedgehog (SHH) mutation in patients within the spectrum of holoprosencephaly," the paper detailed the researcher's difficulty in mutating the SHH gene to repliate the problem of a brain which is not divided into right and left hemispheres. The SHH gene is linked to the birth defect, but attempts to alter the coding region of the gene in 37 individuals failed to result in a correlation between any variation of the gene and its expression. Back to the part that made me look twice- "Sonic hedgehog mutation." Yes, Sonic, as in the video game character. In 1978 Eric Wieschaus and Christiane Nusslein-Volhard published evidence of a gene that, when removed, gave the embryo a prickly, hedgehog appearance. Part of this work lead to the identification of the genes that made fly embryos develop, and they were awareded the Nobel prize in 1995. Two varients of the gene, desert hedgehog and indian hedgehog, were found in other mammals. Sonic hedgehog assists in the development of the first, most basic neurological components in human embryos. It's not the first gene given a funny name- a similar gene in zebra fish is named tiggywinkle hedgehog after Mrs. Tiggywinkle in the Beatrix Potter books, a protein that works against the Sonic hedgehog gene was named for Sonic's nemesis, Dr. Robotnik, and a protein in the retina of the eye was dubbed Pikichurin, after the Pokemon character Pikichu. Claudia Danielli Pereira Bertolacini, Antonio Richieri-Costa, Lucilene Arilho Ribeiro-Bicudo (2010). "Sonic hedgehog (SHH) mutation in patients within the spectrum of holoprosencephaly." Brain and Development 32(3): Pages 217-222. doi:10.1016/j.braindev.2009.02.014 http://blog.guerillahealthreport.com/blog_view.php?bid=261 http://blog.guerillahealthreport.com/blog_view.php?bid=261 Thu, 11 Feb 2010 10:47:22 +0000 A recent study on the effects of childhood obesity reports that people who were obese as children are twice as likely to die before the age of 55, and those with a higher glucose tolerance are 75% more likely to die before the same milestone. 5000 non-diabetic children were followed for 25 years and the researchers found that the body fat and glucose tolerence test scores in the highest quarter of children were related to early death at a rate that far outpaced the bottom 25%. High blood pressure and high cholesterol during childhood were not shown to be predictive factors for death before the age of 55. Glucose tolerence is increased by low activity levels and a diet high in sugar, caffiene, or artificial sweeteners like those found in low calorie foods. Paul W. Franks, Ph.D., Robert L. Hanson, M.D., M.P.H., William C. Knowler, M.D., Dr.P.H., Maurice L. Sievers, M.D., Peter H. Bennett, M.B., F.R.C.P., and Helen C. Looker, M.B., B.S. (2010). "Childhood Obesity, Other Cardiovascular Risk Factors, and Premature Death." New England Journal of Medicine 362(6):485-493. http://blog.guerillahealthreport.com/blog_view.php?bid=260 http://blog.guerillahealthreport.com/blog_view.php?bid=260 Wed, 10 Feb 2010 7:08:30 +0000 Dr. Howard Brody, Chair of the National Physician's Alliance Ethics Committee, submitted an editorial in The New England Journal of Medicine which called for medical specialty associations to offer cuts to their own programs to save the Health Care Reform bill. Brody points out the difference between the cost of care in the most expensive regions of the country when compared to the least expensive mainly stems from a tendency to perform costly, ineffective procedures after ordering expensive, overly specific tests. He suggests that each professional association create a Top 5 list of the most expensive, yet according to the evidence not effective, billable items within that sub-specialty and commit to sacrificing those items in the name of lower costs for health care delivery. Brody uses arthroscopic knee surgery for arthritis and CT scans as examples of frequently performed procedures that haven't been shown to be any more effective than cheaper alternatives. Dr. Brody writes, "A profession that has sworn to put the patient’s interest first — to conduct itself as a profession and not merely as a business — cannot justifiably stand idly by and allow legislation that would extend basic access to care to go down to defeat while refusing to contemplate any meaningful measures it might take to reduce health care costs." Brody proposes that primary care physicians (a category which, it should be note, includes chiropractors) be exempt from the cuts because of the shortage of PCP's caused by the specialization trend within the medical profession. It's estimated that 30% of medical expenditures are wasted on non-beneficial measures. H. Brody (2010). "Medicine's Ethical Responsibility for Health Care Reform — The Top Five List." New England Journal of Medicine 362(4) PMID: 20032315. http://blog.guerillahealthreport.com/blog_view.php?bid=259 http://blog.guerillahealthreport.com/blog_view.php?bid=259 Tue, 09 Feb 2010 9:56:07 +0000 In the "Why didn't we think of this before" department, a recent study shows that shoppers are more likely to read the information in the Nutritional Facts panel if it's on the front of the package. The researchers report on multiple studies which reveal that most people use the package information when purchasing the product for the first time, and that more people say they look at the labels when asked than actually do. However, of the people who were spotted as label readers actually did examine the packages, they were more likely to use it when the nutritional information was on the front of the pack. Some current changes to the system being currently considered by the USDA include "Good, Better, Best" ranking, color coding "Good for You" foods, a number ranking system of nutrition value, and moving the Nutrition Facts panel to the front of the box. A wild guess that fresh fruits and vegetables will still rank pretty high, regardless of which new system they pick. Schor, Danielle; Maniscalco, Shelley; Tuttle, Michele M.; Alligood, Sarah; Reinhardt Kapsak, Wendy (2010). "Nutrition Facts You Can't Miss: The Evolution of Front-of-Pack Labeling: Providing Consumers With Tools to Help Select Foods and Beverages to Encourage More Healthful Diets." Nutrition Today. 45(1):22-32, doi: 10.1097/NT.0b013e3181cb4561 http://blog.guerillahealthreport.com/blog_view.php?bid=258 http://blog.guerillahealthreport.com/blog_view.php?bid=258 Tue, 09 Feb 2010 9:28:56 +0000 A survey of over 100,000 births in nine countries spanning from India to China showed the caesarian section rate from 2007-08 was 27.3%, with assisted delivery with foreceps or vacuum suction at 3.2%. In all cases of c-section and assisted delivery, the rates of maternal mortality, admission to intensive care unit [ICU], blood transfusion, hysterectomy, or internal iliac artery ligation were higher than for vaginal delivery. Obstetricians who performed the operation once labor had started, whether it was indicated or not, put their patients at a 14 times higher risk for these complications. This study re-enforces the WHO's stance for the last 25 years that caesarian sections should only be performed when medically indicated. They estimate that c-section should be a consideration in only 10-15% of births- the Asian study shows the current practice is still double that. Pisake Lumbiganon, Malinee Laopaiboon, A Metin Gülmezoglu, João Paulo Souza, Surasak Taneepanichskul, Pang Ruyan, Deepika Eranjanie Attygalle, Naveen Shrestha, Rintaro Mori, Nguyen Duc Hinh, Hoang Thi Bang, Tung Rathavy, Kang Chuyun, Kannitha Cheang, Mario Festin, Venus Udomprasertgul, Maria Julieta V Germar, Gao Yanqiu, Malabika Roy, Guillermo Carroli, Katherine Ba-Thike, Ekaterina Filatova, José Villar, for the World Health Organization Global Survey on Maternal and Perinatal Health Research Group (2010). "Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007–08." The Lancet 375(9713) Pages 490 - 499, 6 February 2010 doi:10.1016/S0140-6736(09)61870-5 http://blog.guerillahealthreport.com/blog_view.php?bid=257 http://blog.guerillahealthreport.com/blog_view.php?bid=257 Mon, 08 Feb 2010 12:15:50 +0000 Allergists use a screening tool called Phadiatop that tests for the presence of the allergic immune system protein called IgE. Reseachers used this system to divide 21 people with seasonal hayfever into an "allergic" and "non-allergic" group and treated them with acupuncture for 8 weeks. At the conclusion of the trial, both groups were asked to rate the severity of their symptoms on a questionaire and give blood samples so the scientists could measure the immune system activity. In addition to an improvement in activity, practical problems and nasal symptoms on the questionaire, Shiue and colleagues found that the genes involved in active immune response, the amount of regulatory cells that reign in the allergic reaction, and the amount of cellular destruction associated with symptoms of hayfever were different in the allergic group than the non-allergic group after acupuncture treatment. Horng-Sheng Shiue, Yun-Shien Lee, Chi-Neu Tsai, Yu-Mei Hsueh, Joen-Rong Sheu, Hen-Hong Chang (2010). "Gene Expression Profile of Patients with Phadiatop-Positive and -Negative Allergic Rhinitis Treated with Acupuncture." The Journal of Alternative and Complementary Medicine. 16(1): 59-68. http://blog.guerillahealthreport.com/blog_view.php?bid=256 http://blog.guerillahealthreport.com/blog_view.php?bid=256 Mon, 08 Feb 2010 10:15:17 +0000 Health, as defined by Dorland's Medical Dictionary, is optimal physical, mental, emotional, social, and spiritual well-being, not just the absence of pain or disease. A review of studies on yoga and that multi-faceted concept of health was published in the Journal of Alternative and Complementary Medicine and found yoga to be superior to all other forms of exercise in every measure of health except those involving physical fitness. At first glance that may seem a little odd- that yoga wasn't better in than traditional excercise in helping people get physically fit. Why else would you exercise? The authors point out that when compared for issues like stress relief, decreasing the "fight or flight" nervous system response, and improving the regulation of the hormone system, yoga comes out on top. Alyson Ross, Sue Thomas (2010). "The Health Benefits of Yoga and Exercise: A Review of Comparison Studies." The Journal of Alternative and Complementary Medicine 16(1): 3-12. http://blog.guerillahealthreport.com/blog_view.php?bid=255 http://blog.guerillahealthreport.com/blog_view.php?bid=255 Thu, 04 Feb 2010 1:36:13 +0000 The Center for Disease Control recommended that all expectant mothers receive the H1N1 vaccine. Data from a UK study released by The Lancet suggests that the spontaneous abortion rate within 1 day of vaccination with the H1N1 vaccine will be 397 per 1 million. That means of the approximately 4.7 million births in the US (data projected from the National Vital Statsitics System from 2007) this year, 1707 expectant mothers will lose their babies as a direct result of the vaccine. Steven Black, Juhani Eskola, Claire-Anne Siegrist ,Neal Halsey , Noni MacDonald , Barbara Law, Elizabeth Miller, Nick Andrews, Julia Stowe, Daniel Salmon, Kirsten Vannice , Hector S Izurieta , Aysha Akhtar , Mike Gold , Gabriel Oselka , Patrick Zuber, Dina Pfeifer, Claudia Vellozzi (2009). "Importance of background rates of disease in assessment of vaccine safety during mass immunisation with pandemic H1N1 influenza vaccines." The Lancet 374 (9707) Pages 2115 - 2122. http://blog.guerillahealthreport.com/blog_view.php?bid=254 http://blog.guerillahealthreport.com/blog_view.php?bid=254 Thu, 04 Feb 2010 12:18:16 +0000 I have to disclose that I see about 95% of my new patients 3 times a week for the first three to four weeks because that's what I've seen in practice to be effective. Typically I notice the majority of symptoms will improve within the first 3-4 visits, and most patients are in the realm of little to no symptoms of the originial chief complaint by the time I re-examine them at their 12th visit. This decision has been based on what I was taught in school, in my associateships, and have seen for myself in practice. However, there is little published research on visit frequency, or "dose," of adjustments and the number needed on average to help a patient with a condition. Until now. 80 patients were seen once a week or twice a week for 8 weeks or given light massage at the same intervals. The group all suffered from chronic headaches related to their neck problems, and the group who received adjustments cut their headaches by half compared to those who received light massage and stayed at a lower pain score for longer after treatment had ended. The interesting part of the study was the small size of the dose effect between 8 and 16 sessions over 8 weeks. On a scale of 100, the twice per week group had an improvement of less than or equal to 5 points better than the once a week group. The abstract didn't reveal if this number approached statistical significance, but when dealing with research I'm more concerned about clinical signifigance- any consistant small improvement is worth it to help my patients. Mitchell Haas, Adele Spegman, David Peterson, Mikel Aickin, Darcy Vavrek (2010). "Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial." The Spine Journal 10(2) pp 117-128. http://blog.guerillahealthreport.com/blog_view.php?bid=253 http://blog.guerillahealthreport.com/blog_view.php?bid=253 Wed, 03 Feb 2010 9:47:29 +0000 Previous studies have found that lower income mothers have a tendency to formula feed their babies despite pro-breastfeeding campaigns on the health benefits of breast feeding by WIC programs, the WHO, and the American Academy of Pediatrics. A study of moms in San Francisco found that mothers of Asian/Pacific Islander ethnicity and those who thought breastfeeding would be painful or uncomfortable were more likely to be at risk of formula or mixed feeding infants who were 1-3 days old, while those mothers who had graduated college had the least risk amongst the factors measured in the study. Janet M. Wojcicki, Roberto Gugig, Cam Tran, Suganya Kathiravan, Katherine Holbrook, Melvin B. Heyman (2010). "Early Exclusive Breastfeeding and Maternal Attitudes Towards Infant Feeding in a Population of New Mothers in San Francisco, California." Breastfeeding Medicine 5(1): pp 9-15. doi:10.1089/bfm.2009.0003. http://blog.guerillahealthreport.com/blog_view.php?bid=252 http://blog.guerillahealthreport.com/blog_view.php?bid=252 Wed, 03 Feb 2010 9:25:36 +0000 When guys sit around watching MMA fights, not a whole lot of thought is given to "How" a knock-out punch is delivered; they just know someone got tattooed. But when you think about the physiology behind that strike, two things have to happen simultaneously- the fighter has to generate a large amount of force, which stiffens the muscles in the arm, while simultaneously relaxing it in order to allow the arm to move quicker than the opponent can react. How do you simultaneously contract and relax a muscle? Five elite fighters were measured while they delivered a high strike force into a heavy punching bag. What the researchers found was the punch actually began in the core of the body, stiffening the stabilization muscles, while the muscles in the traveling arm stayed relaxed right up until the point of impact. The relaxed arm travels faster because the muscles are more flexible and not fighting against themselves to stretch quickly. However, if fighter doesn't learn how to contract the arm right before the point of impact, the opponent gets hit with what amounts to a well-toned wet noodle. By contracting the muscles in the arm just before landing the punch, the force delivered by the stiffened limb is significantly harder and can be the kind that sends their opponent to the canvas. The physiologists called this a "double peak" of contract, relax, contract and suggested pulse-type training would be the most effective at delivering high strike force punches. McGill, SM, Chaimberg, JD, Frost, DM, and Fenwick, CMJ. (2010). "Evidence of a double peak in muscle activation to enhance speed and force: an example with elite mixed martial arts fighters." J Strength Cond Res 24(2): 348-357 http://blog.guerillahealthreport.com/blog_view.php?bid=251 http://blog.guerillahealthreport.com/blog_view.php?bid=251 Tue, 02 Feb 2010 2:50:57 +0000 A treatment called Photodynamic therapy has been gradually accepted as a treatment option for cancer patients since it was introduced in the 1980's. The concept uses a chain reaction instigated by a light-reactive chemical placed on the surface of a treatment area. When the light beam excites the compound, the energy is transferred from the chemical to the oxygen molecules near them, which causes a selective destruction of tissue near the area. Researchers wanted to know if the treatment would work for tumors that had metastasized to bone tissue and found that, not only did it help destroy the foreign tissue within the bone, but part of the reaction alos served to strengthen the bony cross bridges that make up the molecular support of the vertebrae. That's pretty much a perfect scenario, isn't it? Killing cancer cells and rebuilding the tissue back stronger than it once was? My only concern is that the stronger bone could be a result of the decrease of osteoclast activity. Our bones have two types of cells that rebuild them- osteoblasts and osteoclasts. Osteoblast lay down the calcium and osteoclasts break down old bone so new, stronger bone can take its place. Stronger doesn't necessarily mean the cells have a higher calcium content; stronger means more flexible, sturdy, and dynamic like living tissue should be. The problem with osteoporosis drugs like PhosphaMax is that it stops osteoclasts from working and leaves patients with heavily calcified but brittle bones- their bones aren't able to flex like healthy ones do and they end up becoming a higher risk for fracture. It's my hope that more research will be done on the photodynamic effect on bones so we can better understand how this process works. 272-277 Emily Won, BASc; Margarete K. Akens, PhD; Michael R. Hardisty, MASc; Shane Burch, MD; Stuart K. Bisland, PhD; Albert J. M. Yee, MD; Brian C. Wilson, PhD; Cari M. Whyne, PhD (2010). "Effects of Photodynamic Therapy on the Structural Integrity of Vertebral Bone." Spine 35(3) pp. 272-77. http://blog.guerillahealthreport.com/blog_view.php?bid=250 http://blog.guerillahealthreport.com/blog_view.php?bid=250 Mon, 01 Feb 2010 10:21:53 +0000 I was having the "Dogma of Biology" discussion with a friend last week and she laid down the phrase "Genetics loads the gun, and the environment pulls the trigger." It was the first thing I thought about when I read the following in Journal of the Neurological Sciences: "...head trauma is one environmental factor that can have a profoundly deleterious effect on those genetically at risk for, or with milder clinical phenotypes of, this disease." A "genetic" disease called adreno-leukodystrophy which has an adult version called adrenomyeloneuropathy. Adreno-leukodystrophy usually affects young boys and quickly progresses from neurologically related psychological symptoms to death in an average of three years. The adult version begins as a spastic paralysis and loss of sensation that can progress over decades. Scientists have pinpointed the gene they think is responsible for both manifestations, but then something like this comes up. The researchers examined five cases of moderate to severe head trauma instigating the childhood version of adreno-leukodystrophy, two of which were men who had already progressed into the adrenomyeloneuropathy phase. How physical damage to the brain can instigate certain genes to switch "on" or "off" wasn't discussed in the abstract, but the research is certainly evidence that the mere existence of a genetic marker for a disease doesn't guarantee someone will have the symptoms, and even physical trauma can have the power to alter our genes from expressing themselves properly. Gerald V. Raymond, Roberta Seidman, Teshamae S. Monteith, Edwin Kolodny, Swati Sathe, Asif Mahmood, James M. Powers (2010). "Head trauma can initiate the onset of adreno-leukodystrophy." Journal of the Neurological Sciences 290(1) pages 70-74.