Lifecare Chiropractic
James Bogash, DC
Amy Strock, DC
1830 S. Alma School Rd
Bldg 7, Ste 135
Mesa, AZ 85210
(480) 839-CARE (2273)
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Research Updates 5-8-2005
***Iatrogenic events resulting in intensive care admission: Frequency, cause, and disclosure to patients and institutions***
Let's face it...physicians are human. Mistakes will always happen. However, when mistakes are made, we need to face up to it. A simple "I'm sorry" can go a long way with patients. In this study, 1.2% of patients in the ICU were there because of iatrogenic events (doctor-caused). 33% of these were because of their meds. In only 5% of the cases, where the patients were in the ICU because of their prior medical treatment, were the patients or patients caregiver informed of this. The sad case is that, if most clinicians were current on the medical literature, many of these conditions probably would've been managed differently with a much better outcome (lifestyle changes = less drugs = less likelihood for dangerous side effects).
***N-Acetylcysteine for the Prevention of Contrast-induced Nephropathy***
Remember that NAC exerts one of its main actions by increasing the amount of available glutathione, and that glutathione is one of the body's more potent antioxidant molecules as well as a major participant in detoxification. This was a review and meta-analysis of several studies, with the consensus being that NAC helps to predict the kidneys in the event of a bad reaction to dyes used in diagnostic imaging. The problem is that it needs to be administered 12 hours prior to the testing. It would be nice to see if oral dosages would be as effective as IV. In the meantime, probably a good idea to pop some NAC if you're having any imaging done that requires contrast medium.
***Metabolic risk factors in formerly obese women-effects of a pronounced weight loss by gastric band operation compared with weight loss by diet alone***
Some interesting observations here. First, while no one should be surprised, I am NOT a fan of any type of gastric bypass. Mother Nature put it there for a reason. I'm sure that, when all the long term data are in, we will see much greater risks of chronic diseases in these patients due to malabsorption of any number of vitamins, minerals and phytonutrients. That being said, the patients undergoing surgery lost more weight than those choosing the diet route, however, their insulin sensitivity was better than their dietary counterparts prior to surgery--suggesting that they may not have been as metabolically "bad off" as the diet group. What I find VERY interesting was that, after surgery, this group of patients had elevated levels of TNF-apha, a marker of inflammation that begins a cascade of further inflammation in the body. Not a good sign, at all. Even more interestingly, this data were mentioned in the conclusion but no importance was given to this finding.
***Meta-Analysis: Pharmacologic Treatment of Obesity***
Speaking of less-than-preferred methods of losing weight...There is much debate about whether these drugs are actually even better than placebo, but lets say they are. Taking sibutrimine alone, the additional weight lost in a year over placebo was just shy of 10 pounds. The cost? Probably close to $1000. That's about $100/per pound. Not to mention any costs associated with physician visits and costs associated with any interventions needed to deal with any serious adverse effects that occur. 10 pounds in a year. On a strickly calories in/calories out model of weight loss, that could be achieved by cutting caloric intake by 57 calories per day. That's like one less Snickers bar per WEEK. Why anyone would even consider these drugs is beyond me. They have side effects that, in some cases have been lethal, the cost ain't exactly cheap, and they don't teach anything about fixing the real problem which is lifestyle. Also, not surprisingly, any studies of these pharmaceutical approaches to weight loss focus on WEIGHT--not body composition. I would put some money on the fact that a large chunk of weight loss is coming out of the muscle mass.
***Effect of orlistat on cardiovascular disease risk in obese adults***
Just so you know--it wasn't me that designated April/May as "beat up the pharmaceuticals for obesity" months. This study found improvements in several metabolic risk factors for CVD, but not enough to lower 10-year risk assessment. Interestingly, although the patients on orlistat had lower total cholesterol, none reduced their cholesterol lowering meds. I can practically guarantee that lifestyle changes geared towards a healthy body composition will definately lower a patient's need for cholesterol lowering drugs.
***Relationship between follicle size at insemination and pregnancy success***
I continue to have a problem with fertility "specialists" that force a woman to ovulate when her body is not ready. Given that our number one absolute priority as a species is to procreate, if a woman's body is NOT ovualating, there is a damn good reason. The imbalance in physiology that is occurring is what needs to get fixed and rarely is recognized by the "specialist." This article, while relating to cows, would strongly support the idea that forced ovulation is not good. Basically, if the egg is released at gunpoint (artificially with a compound like Clomid) it will be smaller and is much less healthy and more likely to produce a miscarriage. However, in a spontaneously released egg size does not matter and is not related to the likelihood of a successful pregnancy.
***Is a change in vaginal flora associated with an increased risk of preterm birth?***
While clinicians are slow to recognize it, inflammation in the vaginal vault during pregnancy is not a good thing and increases the risk of miscarriage or preterm birth. So, chalk up another negative with our culture's overuse of antibiotics. I still contend that the development of antibiotic resistant bacteria is the small problem--destruction of normal flora and the resultant negative health effects far outweigh the restistance issue. Regardless, the use of probiotic douche would be a good idea to put in protective flora and reduce the risk of inflammation occurring in the vaginal vault from infection.
***Dairy products do not lead to alterations in body weight or fat mass in young women in a 1-y intervention***
Most physicians that stay current with the medical literature are not big fans of dairy for a variety of reasons. The recent barrage of "drink you milk and fit into your bikini by summer" ad campaigns must be a boon for the radio and TV networks, but are based on one study that showed a very modest weight reduction with dairy intake (I believe it was worth about 3 lbs over 6 months). The advertising that has gone into making the American public believe that dairy is an absolutely essential part of a healthy lifestyle is truly one for the textbooks. There is scant evidence to support the claims of the dairy industry, and much research to the contrary.
***Low dietary potassium intakes and high dietary estimates of net endogenous acid production are associated with low bone mineral density in premenopausal women and increased markers of bone resorption in postmenopausal women***
So, if dairy is not the answer, you query...than where does osteoporosis come from? It is a disease of lifestyle. This article is a wonderful reminder of how deficiencies in the Western diet can really wreak long term havoc on our health. Potassium helps to buffer the acids that we take in while eating a highly refined, animal based diet. Without adequate potassium the body can use calcium to buffer these acids, resulting in net loss of bone.
***Ratio of n–6 to n–3 fatty acids and bone mineral density in older adults***
Wow..will you look at that? Yet another study that has absolutely nothing to do with dairy and yet shows a protective effect on bone. I'm really not making this stuff up. This article once again supports lifestyle as a factor in bone health, with higher omega-6 fatty acids when compared to omega-3 showing lower bone density.
***Effect of Different Antilipidemic Agents and Diets on Mortality***
Not that it should be a surprise that omega-3 fatty acids outperformed statins, but it's nice to see it in black and white anyway. Surprisingly, the dietary interventions did not show a very strong effect. This may be more of a factor of the type of diet used. The AHA step 1 diet is not all that great and I would never recommend this type of diet to a patient wanting to lower their lipid levels.
James Bogash, DC and Amy Strock, DC
1830 S. Alma School Rd, Bldg 7, Ste 135, Mesa, AZ 85210
(Alma School Road, just south of the Superstition Freeway/Highway 60)
Chiropractic Health Care Chandler, Mesa, Gilbert & Tempe, Arizona
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