GO AUSSIES
as always, more research is needed, but I loved this one...


A Single Mechanical Impulse to the Neck: Does It Influence Autonomic Regulation of Cardiovascular Function?



N. Watanabe; B. Polus.

Chiropractic Journal of Australia.

Vol 37 No. 2

June 2007



Abstract:



Objective: This study aims to examine the effects of a simulated cervical manipulation in the absence of any head movement on automomic regulation of cardiovascular funciton in young healthy adults.



Design: A Pre- post-test study design



Setting: An acute laboratory-based study that examined the effect of application of a brief mechanical stimulus (simulating a chiropractic adjustment using an Activator® instrument) to the neck on cardiac automomic nervous and cardiovascular function.



Participants: Eleven young healthy adults completed this study.



Intervention: A single mechanical impulse (“sham” or “authentic” manipulation procedure) was applied to the neck.



Main Outcome Measures: Heart rate (HR), heart rate variability (HRV), and non-invasive beat-to-beat blood pressure (BP) were measured.



Results: There were significant reductions in BP after application of the mechanical stimulus in the supine posture (p>.05). Particularly the reductions peaked at 20 sec post-stimulation. Changes in HR and most HRV parameters, however, were not significant in either supine or sitting posture (p>.05). Also there were no significatnt differences in responses between authentic and sham manipulation procedures.


Conclusions: Our results showed that a mechanical stimulus applied to the upper cervical region is capable of acutely influencing cardiovascular function in young adults. The sham spinal manipulative procedure chosen for this study appeared to be contaminated with unspecified factors that had interventional effects, or the response might be due to an arousal reaction. This issue is being addressed in fruther investigations. (Chiropr J Aust 2007; 37:42-48)


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Fat is good, especially for kids:

http://news.bbc.co.uk/1/hi/health/6948204.stm

Fat 'crucial' in children's diet


Cucumber is simply not enough, the research warns
While parents may be increasingly worrying about childhood obesity, they must ensure their offspring eat enough fat, research from the US urges.
Concerns about their child becoming overweight means some parents put them on low-fat diets, but the Nutrition Journal study said this was misguided.
Researchers found children burned substantially more fat than adults relative to their calorie intake.
Youngsters needed that fat to grow and thrive, they argued.
Over a third of a child's energy intake should be made up of fat, the researchers at Pennsylvania State University said, a recommendation in line with UK requirements.
"Despite this, many parents and children restrict fat for health reasons," they said. "Sufficient fat must be included in the diet for children to support normal growth and development."
'Absolutely right'

All of the participants - 10 children and 10 adults - were put on the same diet, adjusted to estimated calorie requirements of each one.

Young children need more fat and energy for the whole purpose of growing and living - to give them low-fat and sugar-free products is a bad idea


During testing, none of the group led an active lifestyle. They spent their time watching films, reading, and taking occasional slow walks.

While the children did not use up more fat than adults in total, they burned up substantially more relative to the amount of energy they used, despite all participants' sedentary lifestyle.

UK nutritionists stressed fat, as much as possible, should come from "healthy" sources such as oily fish, while chips and crisps should be cooked in olive or sunflower oil.

"Too much saturated fat in the diet, e.g. from cakes, biscuits, pastries and fatty meats, should be avoided," said Claire Williamson of the British Nutrition Foundation.

The National Obesity Forum welcomed the study.

"I think this research is absolutely right," said board member Tam Fry. "Young children need more fat and energy for the whole purpose of growing and living.

"To give them low-fat and sugar-free products is a bad idea."

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Years ago, the head of the Sydney Children's Hospital here said cough meds do not even work...
thats probably why the...


FDA Warns Parents Not to Give Cold, Cough Medicine to Children Under 2

Thursday , August 16, 2007

The U.S. government is warning parents not to give cough and cold medicines to children under 2 without a doctor's order, part of an overall review of the products' safety and effectiveness for youngsters.

Amid questions about benefits and risks, the Food and Drug Administration said Wednesday its Nonprescription Drugs Advisory Committee will meet Oct. 18-19 to discuss the use of cough and cold drugs by children.

The FDA issued a public health advisory that cited serious adverse effects linked to children — particularly those 2 and younger — who have received too great a dose of over-the-counter medications for coughs and colds.

Parents should carefully follow directions for use that come with a medication, the FDA said. Other recommendations in the advisory included:

—Do not use cough and cold products in children under 2 unless given specific directions to do so by a health care provider.

—Do not give children medicine that is packaged and made for adults. Use only products marked for use in babies, infants or children, sometimes called "pediatric" use.

—Cough and cold medicines come in different strengths. If unsure about the right product for a child, ask a health care provider.

—If other medicines, whether over-the-counter or prescription, are being given to a child, the child's health care provider should review and approve their combined use.

—Read all of the information in the "Drug Facts" box on the package label to know the active ingredients and the warnings.

—For liquid products, parents should use the measuring device that is packaged with each medicine formulation and is marked to deliver the recommended dose. A kitchen teaspoon or tablespoon is not an appropriate measuring device.


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The debate with EBM and gut instinct continues....

Gut Feelings May Trump Evidence-Based Medicine When Choosing PCI to Treat Stable CAD

News Author: Shelley Wood

August 20, 2007 — Gut instincts may sometimes trump evidence-based medicine when it comes to performing percutaneous coronary intervention (PCI) in patients with stable coronary artery disease (CAD), a new study suggests. [1] Cardiologists asked hypothetically about their motives for choosing PCI even in patients who might do just as well or better with medical therapy acknowledged that PCI instinctively seemed a better choice, or that past experiences or anticipated regret sometimes guided their decision.

"The apparent gulf between evidence and practice appears to be motivated primarily by emotional and psychological factors," Dr Grace A Lin (University of California-San Francisco [USCF]) and colleagues write in the August 13/27, 2007 issue of Archives of Internal Medicine.

To heartwire, senior author on the study Dr Rita F Redberg (UCSF) emphasized that physicians in the focus groups defended their choices, despite agreeing on a lack of evidence to support them. "We did try to point out during the focus sessions that PCI was an invasive therapy and there could be complications secondary to invasive therapy. And people still told us that they would feel much worse about a heart attack or sudden death that could have been prevented than a complication of a PCI, and even though there is no data that they actually would be preventing a heart attack or sudden death by doing PCI."

Emotional Decision-Making

Lin and colleagues conducted three focus groups with a total of 20 interventional and noninterventional cardiologists who were asked to discuss three hypothetical case scenarios and describe what course of action they would take. One case involved a 45-year-old asymptomatic man with a history of myocardial infarction (MI) and a high calcium score; the second hypothetical case was a 55-year-old female smoker with sharp pain in the chest occurring primarily in the evenings and not associated with exercise; the third, a 60-year-old man with no chest pain or shortness of breath who tires early.

Despite reviewing evidence that showed that an invasive approach was not warranted in any of the hypothetical cases, the focus groups generally agreed in all cases that they would send the patient for PCI. Some cardiologists justified their decision by saying that an open artery is always preferable and that they wanted to deliver the best possible therapy, which in their minds is PCI. Others told anecdotes of past patients who had not gotten PCI who went on to have MIs or die suddenly and said that this influenced their subsequent decision-making. Assuaging patient anxiety, particularly if the patient self-referred after obtaining a coronary calcium score, was another driving factor, as was the occulostenotic reflex.

"Once a lesion considered significant was identified, the consensus about current practice was to proceed, in most situations, with PCI at the same time," the authors note. Additional explanations for choosing PCI included medicolegal concerns and technological advancements such as electron-beam computed tomography (EBCT) and computed tomographic (CT) angiography that persuaded cardiologists to refer for or perform angiography and PCI.

The study authors conducted their study before the results of COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation) came out in March. According to Redberg, there is a heightened awareness about the lack of benefit of PCI in stable CAD patients in the wake of the COURAGE trial, "but even before COURAGE came out, people really knew that there never had been a study that found a benefit of PCI over medical therapy, and we do report that data in our paper.... But COURAGE got a lot of publicity and certainly may have changed the way people think about medical therapy vs PCI for stable CAD."

But Redberg also thinks physicians fail to recognize when they themselves are not basing decisions on evidence, preferring to think that it is others who are acting inappropriately. "I think we have to have some sort of understanding or recognition that there is more than evidence that drives practice. I think most people feel that they practice according to the best evidence, but even when we tried to be quite clear that there is just no evidence to support what people are telling us they would do, I don't think anyone changed their minds. They still felt doing an intervention would still be better than not doing one."

Selective Evidence-Based Medicine

An accompanying editorial by Dr Mauro Moscucci (University of Michigan, Ann Arbor) points out that PCI is not without its risks: "Inappropriate procedures will put patients who are unlikely to benefit from the procedure at substantial risk of fatal and nonfatal complications," he writes. As such, Lin et al's work is a "sobering first documentation that the practice of medicine pertaining to PCI might be far from evidence based."

Moscucci's views are echoed by Dr William Boden (Buffalo General Hospital, NY), co-primary investigator for the COURAGE trial, who commented on Lin et al's paper for heartwire.

"This just reinforces that there is an apparent disconnect between clinical knowledge and the belief about the benefits of PCI," Boden said. "The benefits of angioplasty in STEMI patients have created a belief that because the procedure is identical to that which is undertaken electively in stable patients, the benefit that accrues in the acute patients will likewise accrue in the chronic patients, and that has become the conventional wisdom."

Boden worries that a study like Lin et al's will "fly below the radar" of most cardiologists, who should, in fact, use this kind of qualitative research to pause and rethink their own decision-making. "Belief systems trump evidence," he said. "We continue to see example after example of how we really don't practice evidence-based medicine in this country. I like to refer to this as either selective evidence-based medicine or feel-good evidence-based medicine. We love studies that reinforce our preconceived belief systems and we go out of our way to tout their virtues. By contrast, when studies like OAT (Occluded Artery Study), ICTUS (Invasive vs Conservative Treatment in Unstable Coronary Syndromes), or COURAGE come out, everybody is quick to criticize them and is very reluctant to incorporate them into their clinical practice approaches."

Boden continued: "We have this peculiar brand of evidence-based medicine in the US, which is that we embrace studies that reinforce our belief systems and disdain, denigrate, go out of our way to bad-mouth studies that collide with our existing belief systems."

Sources

Lin GA, Dudley RA, Redberg RF. Cardiologists' use of percutaneous coronary interventions for stable coronary artery disease. Arch Intern Med 2007;167:1604-1609.
Moscucci M. Behavioral factors, bias, and practice guidelines in the decision to use percutaneous coronary interventions for stable coronary artery disease. Arch Intern Med 2007;167:1573-1575.
The complete contents of Heartwire, a professional news service of WebMD, can be found at www.theheart.org, a Web site for cardiovascular healthcare professionals.

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The Sustainability of Chiropractic

Is Greg Stanley a doom-sayer or properly prophetic?
Read for yaself...
http://www.chiroweb.com/archives/25/19/19.html
joe

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anyone interested in a paper entitled:

Death by Medicine

by

Gary Null, PhD ~ Carolyn Dean, MD, ND
Martin Feldman, MD ~ Debora Rasio, MD
Dorothy Smith, PhD

Yes?...click the link if you are

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while we are on the topic of experimental rubbish (like upper cervical---sarcasm---) masquerading as EBM, here's another wake up call for them...


Use of complementary and alternative medicine in pediatric otolaryngology patients attending a tertiary hospital in the UK.

Shakeel M, Little SA, Bruce J, Ah-See KW.

Department of Otolaryngology, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, Scotland, UK.

OBJECTIVE: Little data is available on complementary and alternative medicine (CAM) use in children attending otolaryngology services. We investigated the prevalence and pattern of CAM use among children attending the pediatric otolaryngology department in a tertiary pediatric teaching hospital in Scotland. 

DESIGN: A cross-sectional survey conducted by administering an anonymous questionnaire to the parents accompanying patients attending the pediatric otolaryngology department. Elective admissions and clinic attendees were included over a 3-month period in 2005/2006. 

SETTING: Academic tertiary care referral centre in North-East Scotland. 
PATIENTS: Five hundred and fifty-four consecutive patients aged less than 16 years were eligible. The response rate was 59% (n=327). 

MAIN OUTCOME MEASURES: Prevalence of CAM use in children. Secondary measures include types of CAM used, indications for use and communication with family physicians. 

RESULTS: Based on 327 responses, 93 patients (29%) had ever used CAM, 20% within the last year. Commonly used CAM preparations were cod-liver oil, echinacea, aloe vera, cranberry, primrose oil and herbal vitamin supplements. The popular non-herbal CAM included homeopathy, massage, aromatherapy, chiropractic, yoga and reiki. Nineteen percent used CAM for their admission illness. Sixty-one percent of parents thought that CAM was effective and 65% would recommend it to others. Fifty-one percent of parents stated that the family physician was unaware of CAM use by the child. 

CONCLUSIONS: Despite concerns regarding the efficacy, safety and cost effectiveness of complementary and alternative medicine, its use among the pediatric otolaryngology population is more common than many providers may realize. This has implications for all healthcare workers involved in their care.

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Waist to Hip Ratio Calculator

http://www.healthcalculators.org/calculators/waist_hip.asp

good measure of health?

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Perfect quote to support chiro?

someone asked me for the perfect quote in support of chiropractic for musculoskeletal conditions

years ago, I already created an ad (never used) for it which you can view at my site www.ierano.com
or click here to get the pdf file

not a bad one from a prominent medical specialist
joe