Clinical & Research
NIH Research Findings Featured in Special Issue of Nutrition
Written by Editor   
Tuesday, August 05, 2014 11:15 AM

Results of research conducted by the major institutions that compose one of the NIH-funded Botanical Research Centers are featured in a special supplement of the journal Nutrition.

Read more...
 
Truths About Fitness
Written by Editor   
Tuesday, August 05, 2014 10:39 AM

Success in the gym, as with most things in life, comes down to mastering the basics.  Take these ideas to heart and you’ll reap major benefits.  All you really have to do is focus on these simple concepts and you’ll see results.

Read more...
 
Probiotics Impact BP
Written by Editor   
Tuesday, August 05, 2014 10:29 AM

Probiotics cut blood pressure by roughly 4 mm Hg systolic and 2 mm Hg diastolic on average across clinical trials, a meta-analysis showed.

The effect was greater in hypertensive individuals and with multiple strains of gut microbiome-boosting bacteria. Overall, systolic pressure dropped by an average 3.56 mm Hg on probiotics, and diastolic pressure declined by an average 2.38 mm Hg, compared with control groups.  Those changes were on par with the impact of cutting more than 2g of salt intake per day and of resistance training exercise in recent meta-analyses, the researchers pointed out.

 "Even a small reduction of blood pressure may have important public health benefits and cardiovascular consequences."  The findings from the Heart Outcome Prevention Evaluation study showed that a modest reduction of systolic blood pressure by 3.3 mm Hg and diastolic blood pressure by 1.4 mm Hg was associated with a 22% reduction in relative risk of cardiovascular mortality, myocardial infarction, or stroke.

Read more...
 
Vegan Diet, Healthy Heart
Written by Editor   
Tuesday, July 22, 2014 02:38 PM

In a blog by Kim A. Williams, MD, the next president of the American College of Cardiology, Dr. Williams notes: Physicians want to influence their patients to make lifestyle changes that will improve their health, but sometimes the roles are reversed and we are inspired by patients. It was a patient's success reversing an alarming condition that motivated me to investigate a vegan diet.

Read more...
 
Research Update
Written by Craig Benton, DC   
Thursday, July 10, 2014 09:09 PM

This is from the New England Journal of Medicine.  Basically it states the steroid injections for lumbar spine stenosis did no better than a lidocaine injection.  ESI have shown to be effective with nerve root inflammation and with stenosis there is not a lot of inflamation but more likely fibrosis and scar tissue.

http://www.nejm.org/doi/full/10.1056/NEJMoa1313265

This one is a systematic review the highest evidence research available.  They took all the studies they could find and then evaluated them for the level of evidence of that particular manual procedure.  This is a really great study for DCs because it shows a moderate to strong level of evidence for the treatment of acute, subacute, and chronic lower back pain.  There are very few therapies that will get strong level of evidence for back pain.

Read more...
 
No Need for Routine Pelvic Exams
Written by Editor   
Wednesday, July 02, 2014 09:49 AM

Average-risk, asymptomatic women do not benefit from pelvic exams as part of routine care and face potential harms from false-positive results, according to a new clinical guideline.

When screening for cervical cancer, clinicians should limit the physical examination to visual inspection of the cervix and use of cervical swabs for cancer or human papillomavirus, said a panel of clinical specialists convened by the American College of Physicians (ACP).

Read more...
 
Cost-Effectiveness of Manual Therapy for the Management of Musculoskeletal Conditions: A Systematic Review and Narrative Synthesis of Evidence From Randomized Controlled Trials
Written by Editor   
Wednesday, July 02, 2014 08:26 AM

Preliminary evidence from this review shows some economic advantage of manual therapy relative to other interventions used for the management of musculoskeletal conditions, indicating that some manual therapy techniques may be more cost-effective than usual GP care, spinal stabilization, GP advice, advice to remain active, or brief pain management for improving low back and shoulder pain/disability.

Read more...
 
Not Even Exercise Will Undo the Harm of Sitting All Day
Written by Editor   
Tuesday, July 01, 2014 11:07 AM

A large review recently published in The Journal of the National Cancer Institute confirms what we’ve been hearing for years: Sitting can be fatal. It’s been linked to cancer, diabetes, and cardiovascular disease. 

The researchers examined close to 70,000 cancer cases and found that sitting is associated with a 24% increased risk of colon cancer, a 32% increased risk of endometrial cancer, and a 21% increased risk of lung cancer.  The really bad news: You can’t exercise away the habit’s harmful effects. “Adjustment for physical activity did not affect the positive association between sedentary behavior and cancer.” Even participants who achieved the daily recommended levels of physical activity were at the same risk as those who spent their day sitting. “[The results] indicate that the increased risk of cancer seen in individuals with prolonged time spent sedentary is not explained by the mere absence of physical activity in those persons,” the researchers say.  Here are some of the reasons why:

Read more...
 
More Evidence Agricultural Pesticides Up Autism Risk
Written by Editor   
Friday, June 27, 2014 12:00 AM

A new study strengthens the evidence linking prenatal exposure to organophosphates and other commonly applied agricultural pesticides to the development of autism spectrum disorder (ASD) and developmental delay (DD).

"This is actually the third study to show some link with organophosphates and autism risk," principal investigator said.  "In that early developmental gestational period, the brain is developing synapses...and may well be where these pesticides are operating and affecting neurotransmission," she added in a statement.

Read more...
 
Calcium and Vitamin D Supplements May Be Too Much
Written by Editor   
Wednesday, June 25, 2014 11:47 AM

Calcium and vitamin D supplementation may cause hypercalciuria and hypercalcemia in some postmenopausal women, according to a randomized, double-blind, placebo-controlled study.

“Even a modest calcium supplementation of 500 mg/day may be too high for some women,” the authors note in a news release. They recommend measuring blood and urine calcium levels before beginning calcium and vitamin D supplementation and repeating the measurements within 3 months.

Read more...
 
Internal Carotid Artery Strains During High-Speed, Low-Amplitude Spinal Manipulations of the Neck
Written by Editor   
Wednesday, June 25, 2014 11:18 AM

This study showed that maximal ICA strains imparted by cervical spinal manipulative treatments were well within the normal ROM. Chiropractic manipulation of the neck did not cause strains to the ICA in excess of those experienced during normal everyday movements. Therefore, cervical spinal manipulative therapy as performed by the trained clinicians in this study, did not appear to place undue strain on the ICA and thus does not seem to be a factor in ICA injuries.

The primary objective of this study was to quantify the strains applied to the internal carotid artery (ICA) during neck spinal manipulative treatments and range of motion (ROM)/diagnostic testing of the head and neck.  

Read more...
 
Serious Adverse Events and Spinal Manipulative Therapy of the Low Back Region: A Systematic Review of Cases
Written by Editor   
Wednesday, June 25, 2014 11:15 AM

This systematic review describes case details from published articles that describe serious adverse events that have been reported to occur following SMT of the lumbopelvic region. The anecdotal nature of these cases does not allow for causal inferences between SMT and the events identified in this review.

The purpose of this study was to systematically search the literature for studies reporting serious adverse events following lumbopelvic spinal manipulative therapy (SMT) and to describe the case details.

Read more...
 
A Proposed Model With Possible Implications for Safety and Technique Adaptations for Chiropractic Spinal Manipulative Therapy for Infants and Children
Written by Editor   
Wednesday, June 25, 2014 11:10 AM

The literature showed that tensile strength differences have been observed between pediatric and adult specimens. A preliminary model of care including pediatric SMT technique adaptation based on patient age is proposed, which may possibly contribute to further knowledge of safety and clinical implications for SMT for children and infants.

A literature review of tensile strength of adults and pediatric human spine specimens was performed to gather information about biomechanical forces and spinal differences of adults and children and to synthesize these findings into a scaling model to guide safety and clinical decisions for spinal manipulative therapy (SMT) for children and infants.

Read more...
 
The Association Between Cervical Spine Manipulation and Carotid Artery Dissection: A Systematic Review of the Literature
Written by Editor   
Wednesday, June 25, 2014 10:45 AM

The incidence of ICA dissection after cervical spine manipulation is unknown. The relative risk of ICA dissection after cervical spine manipulation compared with other health care interventions for neck pain, back pain, or headache is also unknown.

Controversy surrounds the safety of cervical spine manipulation. Ischemic stroke secondary to cervical spine manipulation is a hypothesized adverse event.  The primary objective of this study was to determine the incidence of internal carotid artery (ICA) dissection after cervical spine manipulation in patients who experience neck pain and its associated disorders. The secondary objective was to determine whether cervical spine manipulation is associated with an increased risk of ICA dissection in patients with neck pain, upper back pain, or headaches.

Read more...
 
Placebo
Written by Editor   
Wednesday, June 25, 2014 10:11 AM
An article titled “Heal Thyself”  explores how the way we think about medical treatments shapes their very real, very physical effects on our bodies rooted in science rather than philosophy. Specifically, the author brings to light a striking new dimension of the placebo effect that runs counter to how the phenomenon has been conventionally explained. She writes:
Read more...
 
Testosterone Carries Risk
Written by Editor   
Wednesday, June 25, 2014 07:43 AM

Testosterone products can cause venous thromboembolism (VTE) even in patients without polycythemia, the FDA warned amidst ongoing cardiovascular risk assessment.

Product labels will be required to carry a general warning about the risk of blood clots in the veins, in addition to the warning about those events as a possible consequence of polycythemia that is already included in the product information.

The agency said it was acting on postmarket reports of venous blood clots unrelated to polycythemia.  The label change wasn't related to ongoing investigation into arterial clot risk from testosterone products.  That investigation, started earlier this year, was sparked by studies reporting an increased risk of stroke, heart attack, and death among men taking testosterone.

Read more...
 
Knee OA, Keep on Walkin'
Written by Editor   
Wednesday, June 25, 2014 07:37 AM

Patients with knee osteoarthritis (OA) can decrease their likelihood of developing functional limitations by walking more, a study of older adults suggested.  Each additional 1,000 steps per day was associated with a 16% lower risk for later functional deterioration when assessed on an objective performance-based measure, and with an 18% decrease in risk on a self-report measure.

The OA Research Society International recommends exercise as a suitable nonpharmacologic treatment for patients with OA; however, a recent survey of U.S. primary care physicians found that fewer than one-third advise their OA patients to exercise.  But exercise is only one form of physical activity, physical activity can include energy output in ordinary, unstructured activities -- such as walking.

To examine the effects of walking on future functional disability, this study analyzed data from a subset of patients in the Multicenter Osteoarthritis (MOST) study who had been given an accelerometer-based activity monitor to wear for 7 consecutive days.

Read more...
 
How to Read and Understand a Scientific Paper: A Step-by-Step Guide
Written by Editor   
Wednesday, June 25, 2014 07:12 AM

Reading a scientific paper is a completely different process from reading an article about science in a blog or newspaper. Not only do you read the sections in a different order than they're presented, but you also have to take notes, read it multiple times, and probably go look up other papers in order to understand some of the details.   

To form a truly educated opinion on a scientific subject, you need to become familiar with current research in that field. And to be able to distinguish between good and bad interpretations of research, you have to be willing and able to read the primary research literature for yourself.   Like any skill it takes patience and practice.  Reading a single paper may take you a very long time at first, but be patient with yourself. The process will go much faster as you gain experience.

Read more...
 
NIH Task Force Report on Chronic Low Back Pain
Written by Editor   
Tuesday, June 24, 2014 05:03 PM

Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives.

A task force was convened by the National Institutes of Health (NIH) Pain Consortium, that included ACA member and research consultant Christine Goertz, DC, PhD, with the goal of developing research standards for chronic low back pain. The results include recommendations for definitions, a minimal dataset, reporting outcomes and future research.

The Research Task Force believes these recommendations will advance the field, help to resolve controversies, and facilitate future research addressing the genomic, neurologic and other mechanistic substrates of cLBP.

Read more...
 
Research: Chiropractic and Pregnancy
Written by Craig Benton, DC   
Tuesday, June 24, 2014 04:48 PM

A foundation for chiropractic progress video about chiropractic care for pregnancy and there is quite a bit of research on the subject.  I wonder how many Ob/Gyn are up on this stuff. 

Read more...
 
VIT D and Cancer Death Rates
Written by Editor   
Thursday, June 19, 2014 06:26 AM

Low levels of vitamin D were associated with higher cancer mortality in people with a history of cancer, a study found.  Inadequate vitamin D levels also were linked to an increase in all-cause mortality and cardiovascular mortality.  Researchers found that vitamin D reduced total cancer mortality by 12%, but did not affect total cancer incidence.  

"Overall, this finding may support the view that low vitamin D concentrations might be a marker for a poor health status rather than a cause of premature mortality."  

Read more...
 
Fasting and the Immune System
Written by Editor   
Thursday, June 19, 2014 06:12 AM

Fasting for three days can regenerate the entire immune system, even in the elderly, scientists have found in a breakthrough described as “remarkable.”

Although fasting diets have been criticized by nutritionists, research suggests that starving the body kick-starts stem cells into producing more white blood cells, which fight off infection.  The researchers say fasting “flips a regenerative switch” that prompts stem cells to create white blood cells, essentially restoring the immune system.  “It gives the OK for stem cells to go ahead and begin proliferating and rebuild the entire system.”  Prolonged fasting forces the body to use stores of glucose and fat but also breaks down a significant portion of white blood cells. During each cycle of fasting, this depletion induces changes that trigger stem cell-based regeneration of immune system cells.

Read more...
 
Almost 10% of US Adults Have Diabetes, 1 in 4 Is Unaware, Says CDC
Written by Editor   
Wednesday, June 18, 2014 12:00 AM

At least 29 million people in the United States — about 9% of the population — now have diabetes, and 1 in 4 does not know it, according to new data from the Centers for Disease Control and Prevention (CDC).

That figure, based on 2012 data, represents an increase of 3 million since 2010.

Among the report's other findings:

Read more...
 
More Protein Equals Lower Risk of Stroke?
Written by Editor   
Tuesday, June 17, 2014 07:45 AM

Greater dietary intake of protein was associated with a lower risk of stroke, a meta-analysis showed.  In pooled results of seven cohort studies, individuals who ate the most protein had a 20% lower relative risk of stroke compared with those who ate the least.  Dose-response analysis showed that an increased intake of 20 grams of protein per day was associated with a 26% reduction in the risk of stroke.  

"I think one of the most important things to keep in mind is that the body does recuperate and recover quicker if the nutritional status is adequate," the report notes.

Read more...
 
Multiple 60-Minute Massages per Week Offer Relief for Chronic Neck Pain
Written by Editor   
Wednesday, June 11, 2014 04:44 PM

Results of an NCCAM-funded study found that multiple 60-minute massages per week were more effective than fewer or shorter sessions for people with chronic neck pain, suggesting that several hour-long massages per week may be the best “dose” for people with this condition. 

Read more...
 
Diet and Cancer: Less Red Meat, More Fruit
Written by Editor   
Wednesday, June 11, 2014 07:05 AM

Dietary guidance to reduce cancer risk has "sufficiently compelling" evidence to recommend avoidance of red meat, limited intake of alcohol and dairy products, and increased consumption of fruits, vegetables, and soy products, authors of a review concluded.

The evidence encompasses a wide range of cancers, including prostate, breast, head and neck, colorectal, and pancreatic cancer. Based on findings from a World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) report, the data on causal influences of dietary factors are not necessarily conclusive in every case, but substantial enough to support all of the recommendations.

"Guidelines, up until now, have been extremely conservative, which is to say that unless something was nailed down very clearly -- like, cigarettes cause cancer -- by and large, the guidelines avoided it."  

"There are a lot of areas where we have a lot of evidence, and we need to start acting on that evidence now."

The authors undertook the review in an effort to address "areas in nutritional science in which scientific evidence has been insufficient for authorities to issue guidance with confidence."

Read more...
 
Feds Want Pregnant Women to Eat More Fish
Written by Editor   
Tuesday, June 10, 2014 11:53 PM

Most pregnant women in the U.S. aren't eating enough fish.  A recent survey that showed 50% ate less than 2 ounces per week and 75% consumed less than 4 ounces.  "A large proportion of pregnant women aren't eating enough fish, and they're missing out on the health and developmental benefits fish can provide."

Pregnant women should eat at least 8 ounces of fish each week, which puts a floor -- not just a ceiling -- on the amount of seafood these women should consume, the FDA and the Environmental Protection Agency (EPA) announced in a draft guidance.

Read more...
 
Exercise Boosts Gut Microbiome Diversity
Written by Editor   
Tuesday, June 10, 2014 11:12 PM

Being physically fit appears to boost the diversity of gut bugs, researchers found.

In a case-control study, Irish athletes had a far wider range of intestinal microbes than did matched controls who weren't athletes.  "Exercise seems to be another important factor in the relationship between the microbiota, host immunity, and host metabolism, with diet playing an important role," authors wrote.

Read more...
 
NIH Lecture on Back Pain
Written by Craig Benton, DC   
Tuesday, June 10, 2014 03:41 PM

Manipulating the Pain: Chiropractic and Other “Alternative” Treatments for Back Pain

In this video which is about an hour long and by one of the leading researchers in back pain speaking to the National Institutes of Health on complementary medicine.  It was recorded in April 2014.

http://videocast.nih.gov/summary.asp?live=13877&bhcp=1

Briefly here are some of the facts:

Read more...
 
Site Matters in Arthritis
Written by Editor   
Thursday, June 05, 2014 08:19 AM

Osteoarthritis (OA) of the knee and hand differ in the main processes underlying disease development, with mechanical factors playing a larger role when the knee is affected, and systemic contributors being prominent for the hand.  

When OA was present in the knee, significant associations after adjustment for metabolic factors were seen for weight and fat-free mass factors considered surrogates for mechanical stress.  In contrast, after adjustment for weight, hand OA was associated with metabolic syndrome which was considered a surrogate for systemic factors.  

Read more...
 
Immediate Changes in Neck Pain Intensity, A Randomized Controlled Trial of Thoracic Thrust Manipulation vs Non–Thrust Mobilization
Written by Editor   
Thursday, June 05, 2014 07:59 AM

The purpose of this study was to compare the effects of thoracic thrust manipulation vs thoracic non–thrust mobilization in patients with bilateral chronic mechanical neck pain on pressure pain sensitivity and neck pain intensity.

Patients receiving thoracic spine thrust manipulation experienced a greater decrease in neck pain  than did those receiving thoracic spine non–thrust mobilization.  The results of this randomized clinical trial suggest that thoracic thrust manipulation and non–thrust mobilization induce similar changes in widespread pressure pain thresholds in individuals with mechanical neck pain; however, the changes were clinically small.

We also found that thoracic thrust manipulation was more effective than thoracic non–thrust mobilization for decreasing intensity of neck pain for patients with bilateral chronic mechanical neck pain.

Read more...
 
Women and OA: More Milk, Less Progression
Written by Editor   
Thursday, June 05, 2014 05:05 AM

An estimated 27 million Americans currently have osteoarthritis, and further dramatic increases are expected in the coming years as the population ages.  "Therefore, it is of great importance to identify modifiable risk factors for [osteoarthritis] progression."

Milk plays an important role in the maintenance of bone health, and one study of a supplement containing milk micronutrients and another cross-sectional study of diet and osteoarthritis suggested benefits for milk.

Women who drank milk regularly had less progression of knee osteoarthritis (OA), data from the Osteoarthritis Initiative showed.

Compared with women who never drank milk, whose decrease in joint space width was 0.38 mm over 4 years, those who drank up to six glasses per week had decreases of 0.29 mm, and those whose weekly consumption was seven glasses or more had decreases of 0.26 mm.  This finding was observed only in women; no dose-response relationship was seen for men.

Read more...
 
Lumbar Spine Surgery Results
Written by Craig Benton, DC   
Thursday, May 29, 2014 12:00 PM

Here is some research on the rates of reoperation of lumbar spine surgery patients.

Read more...
 
Heart Condition Rarely Assessed in Medical Pre-Sports Checkups
Written by Editor   
Thursday, May 29, 2014 10:52 AM

Routine pre-participation in sports testing infrequently tests African-American males for the presence of hypertrophic cardiomyopathy – a condition that can lead to sudden cardiac death, researchers said.  "Our data demonstrated that practitioners are not acting on the increased risk that an African-American male athlete has for sudden cardiac death as a result of hypertrophic cardiomyopathy."

In contacting primary care, urgent care, and pediatric providers from both densely Caucasian and African-American communities, electrocardiograms were performed in 23.6% of the clinics in densely African-American communities and in 20.4% of the densely Caucasian clinics.

Read more...
 
Participate in Chiropractic Research
Thursday, May 29, 2014 08:53 AM

I am Dr. Ward from Texas Chiropractic College (TCC).  We are trying to engage in a survey research study of African American use of Chiropractic and publish the findings in a journal.  Unfortunately, no one has taken the time to develop a demographic profile of this important population.   

We are looking to distribute a few stamped and self-addressed envelope surveys to doctors, to distribute to their African American chiropractic patients.  We are trying to get 20 doctors to participate total and 11 have already started helping us. I need to send surveys out to 8 more doctors and then I will have reached our recruitment goal for the study.  Any help is appreciated. 

Read more...
 
Nerve Stimulator Eases Chronic Headache
Written by Editor   
Wednesday, May 28, 2014 11:44 AM

Patients with intractable headache pain who underwent occipital nerve stimulation reported a marked reduction in severity and frequency within the first month after implantation, researchers said.  "Occipital nerve stimulation significantly reduces headache severity and frequency in men and women at this pain managment practice," the group wrote. "Findings support further advances in the use of occipital nerve stimulation for medically intractable headaches."

The authors pointed out that 23% of U.S. adults complain of chronic recurring headaches and that the cost of treating this condition is estimated to exceed $1 billion annually. Neuromodulation uses electrical stimulation to block pain signals, the authors explained.

Read more...
 
A Senior in Motion Stays In Motion
Written by Editor   
Wednesday, May 28, 2014 11:39 AM

Vulnerable seniors were more likely to maintain their ability to get up and move around after taking part in a moderate-intensity physical activity program compared with participation in health education workshops, researchers reported. "Over the long haul, reducing sedentary behavior in middle age would mitigate issues seen in the study," The study author said. But in the grand scheme of things "Exercise is the silver bullet" for good health.

Read more...
 
Light Drinking May Cut Stroke Risk
Written by Editor   
Wednesday, May 28, 2014 11:37 AM

Drinking a little bit of alcohol each day might reduce stroke risk, but heavier drinking appears to be a hazard, a meta-analysis showed.

A dose-response analysis suggested that imbibing up to 20 to 30 grams of alcohol (or about one-and-a-half to two standard drinks) per day was associated with reduced risks of total stroke, ischemic stroke, and fatal stroke. But any potential benefit disappeared and possible harm -- including a greater risk of hemorrhagic stroke -- emerged with consumption exceeding 40 to 45 grams (or about three standard drinks) per day.

Read more...
 
The ART of the Physical Examination
Written by Editor   
Thursday, May 22, 2014 04:31 AM

Some in healthcare are concerned with a growing phenomenon that some prominent medical educators say has become increasingly commonplace as medicine becomes more technology driven – the waning ability of doctors to use a physical exam to make an accurate diagnosis.

In most hospitals today, the average amount of time a busy intern spends with a patient is 4 minutes.  No longer are tests ordered based on the results of a careful physical exam and history,  but the technological tests become the primary source of information on the patient. It's backward now, and the process is driving up healthcare costs and subjecting patients to the risks posed by sometimes unnecessary, risky procedures. The current system is so ridiculous and inefficient and expensive that we're going to have to go back to doing some of the old stuff.  Doctors trained outside the U.S. are much better clinically than young American doctors. They are trained -- or forced by circumstance -- to rely less on technology and more on physical diagnosis skills.

Read more...
 
Sleep Apnea: Skipping Sleep Lab Found Cost-Effective
Written by Editor   
Wednesday, May 21, 2014 12:00 AM

Home management of obstructive sleep apnea (OSA) appeared cost-effective in a VA trial.  Sending patients home with the testing and CPAP titration devices saved an average of $564 in costs per patient compared with laboratory based diagnosis and titration.

The Veterans Sleep Apnea Treatment Trial had previously demonstrated, as have multiple other randomized controlled trials, that the outcomes are equivalent between portable sleep testing and auto-CPAP titration carried out at home and lab-based polysomnography and titration.

In this VA study, the biggest difference in cost was accounted for by the testing itself ($914 home versus $2,043 in-lab), whereas equipment and follow-up management were a little more costly with home management.

Read more...
 
New Framework for Considering Obesity
Written by Editor   
Monday, May 19, 2014 08:19 AM

Endocrinologists are redefining obesity and the way physicians manage it.  The American Association of Clinical Endocrinologists (AACE) released a novel "framework" for diagnosing and managing obesity at its annual meeting.

The new model, developed in conjunction with the American College of Endocrinology (ACE), moves away from an approach centered on body mass index (BMI) approach toward a complications-centered approach.  The framework will redefine obesity so that it doesn't come down to a single number, such as BMI, but instead focuses on complications.

Read more...
 
Exercise and the Heart: Setting Limits
Written by Editor   
Friday, May 16, 2014 03:41 PM

Exercise is good for the heart, but too much of a good thing could be bad for healthy adults and patients with cardiovascular disease, according to two observational studies that suggest a J-shaped curve for the dose-response effects of intense physical activity.

Research involving stable chronic heart disease (CHD) patients found daily strenuous exercise to be associated with a more than twofold increased risk for cardiovascular mortality compared with moderate (two- to four-times a week) exercise, and high-intensity physical activity early in adulthood, but not in middle-age, was found to be associated with an increased risk for atrial fibrillation later in life in a Swedish trial. The study is one of several linking regular strenuous exercise early in life to increased afib risk.

"The literature over the last 50 years overwhelmingly point toward moderate exercise being extremely beneficial from a cardiovascular standpoint, but it is also increasingly clear that extremes on both ends of the exercise spectrum might be detrimental,"

Read more...
 
Humira No Help for Arthritic Hands
Written by Editor   
Friday, May 16, 2014 03:08 PM

Treatment with adalimumab (Humira) was unsuccessful in providing pain relief for hand osteoarthritis (OA), a randomized multicenter trial found.

Among patients with hand OA who had not previously responded to analgesics and nonsteroidal anti-inflammatory drugs, 35.1% of those given adalimumab experienced a 50% improvement in pain at week six, as did 27.3% of those given placebo, according to Xavier Chevalier, MD, of Henri Mondor Hospital in Creteil, France, and colleagues.

Read more...
 
Asthma Risk Increases with Early Antibiotics
Written by Editor   
Friday, May 16, 2014 03:04 PM

Kids treated with antibiotics before their first birthday have increased risk of asthma, researchers reported.

And the risk increases the more often antibiotics are prescribed, according to Kenneth Mandl, MD, of Harvard Medical School, and colleagues.

Read more...
 
Thyroid or Hypothalamic Dysfunction?
Written by Editor   
Friday, May 16, 2014 02:57 PM

Obese patients who continue to have "thyroid symptoms" even when their levels are normalized may have a hypothalamic dysfunction, researchers reported here.

In a single-center study of 50 patients referred for evaluation of thyroid symptoms, 68% had at least four symptoms that were characteristic of hypothalamic obesity disorder.  Those include fatigue, temperature dysregulation, weight change, changes in sleeping patterns, pain, and mood disorders, the researchers said.

"Patients who insist they have thyroid disease causing their weight problems are frequent," the researchers said. "Some try thyroid medications, yet they feel worse and don't lose weight. These patients would only benefit from therapy for their hypothalamic dysfunction."

Read more...
 
Want More Physiotherapy Evidence? Check PEDro
Written by Editor   
Friday, May 16, 2014 02:51 PM

PEDro is the Physiotherapy Evidence Database. PEDro is a free database of over 27,000 randomised trials, systematic reviews and clinical practice guidelines in physiotherapy. For each trial, review or guideline, PEDro provides the citation details, the abstract and a link to the full text, where possible. All trials on PEDro are independently assessed for quality. These quality ratings are used to quickly guide users to trials that are more likely to be valid and to contain sufficient information to guide clinical practice.

Read more...
 
Obese Patients Need Counseling for Heart Health
Written by Editor   
Tuesday, May 13, 2014 12:48 PM

Obese and overweight adults with at least one other cardiovascular risk factor should receive intensive behavioral counseling to promote healthy diet and physical activity for heart disease prevention, according to a U.S. Preventive Services Task Force (USPSTF) preliminary recommendation.

The draft of the grade B recommendation expands on previous guidance from the task force by including a physical activity component and calling for more at-risk adults to receive behavioral interventions.

This draft will be available for public comment on the USPSTF Web site until June 9.

Read more...
 
Bone Changes in Spine Disease Worse With Inflammation
Written by Editor   
Tuesday, May 13, 2014 12:21 PM

Whether inflammation and disease activity correlate with the radiographic damage caused by new spinal bone formation in AS has been a matter of debate, with two main hypotheses emerging. Some have argued that the bone effects are independent of inflammation and others claim that inflammation underlies osteoblast stimulation.

"The first hypothesis states that inflammation, including the upregulation of TNF, triggers local damage and subsequently repair leading to new bone formation and ankylosis. The second hypothesis states that a common trigger is responsible for both inflammation and new bone formation, but that both phenomena further develop in a largely molecularly independent way,"

Read more...
 
Fasting May Change Brain's Hunger Response
Written by Editor   
Tuesday, May 13, 2014 12:08 PM

Intermittent fasting is an alternative to calorie restriction used primarily in lab experiments. It usually involves placing animals on a 24-hour on, 24-hour off feeding cycle, and usually results in weight loss.  Several studies have suggested that it promotes a number of significant improvements in health.  "We concluded that improvements in cardiovascular risk factors and cardiovascular and neuroendocrine stress adaptation occur in response to [intermittent fasting]," one study reported.  Intermittent fasting caused changes in the hypothalamus of rats that may explain the low feeding efficiency, reduced body mass, and overeating seen in these animals, researchers reported.

Though most of the research on the benefits of intermittent fasting has been done in lab animals, research is starting to be done in humans, and the results are similar to those seen in animals.

Read more...
 
Lack of Exercise Tops Women's CV Risk
Written by Editor   
Tuesday, May 13, 2014 11:16 AM

Physical inactivity had the greatest impact on a woman's lifetime risk for heart disease after age 30, according to an Australian study.

Looking at four cardiovascular disease risk factors -- smoking, high body mass index (BMI), high blood pressure (BP), and physical inactivity -- among 32,154 Australian women, researchers found that, from age 30 until the late 80s, low physical activity was responsible for higher levels of population risk than any of the other risk factors.

Read more...
 
Chronic Pain : The Importance of a Multidisciplinary Approach
Written by Editor   
Tuesday, May 13, 2014 11:10 AM

A white paper reports that health recovery after a traumatic injury or the acute onset of disease symptoms is a complex process. In many cases, there is no straight line from injury to full recovery. Indeed, it is all too often the case that complications intervene to frustrate the normal recovery process, thereby contributing to the development of serious chronic pain presentations. Return to function, including a return to a “new normal”, in such cases often becomes the best measure of a successful outcome.

Facilitating positive outcomes for those who are aected by debilitating injury or illness and who are at risk of developing chronic pain requires atargeted and comprehensive multidisciplinary approach to clinically assessing the status of aected individuals when managing files.

Read more...
 
<< first < Prev 11 12 Next > last >>

Page 11 of 12