August 3, 2000 Research Update

Paucity of Evidence Supporting Lumbar Belts and Braces

Too many people rely on these lumbar belts to protect them. They should be used as a reminder to always use good lifting techniques and posture.

Joint Letter 6(5):50, 2000 Enthusiasts recommend lumbar belts and back braces for both the prevention and treatment of back pain. However, two recent reviews suggest there is little high-quality evidence to support either intervention. There is no definitive evidence from scientific studies that lumbar supports can effectively prevent back pain. Mireille van Poppel, PhD, et al. performed a systematic review employing Cochrane Collaboration methodology and a qualitative meta-analysis to determine if the evidence of effectiveness (or lack thereof) is strong, moderate, limited, or conflicting.

Measles Presence in Some Patients With IBD, Autistic Enterocolitis

There has been much controversy about whether the MMR vaccine can lead to autism in suseptable persons. This is another study that begins to add weight to this theory.

Dig Dis Sci 2000;45:723-729 Japanese and UK-based scientists have detected measles virus sequences in peripheral blood mononuclear cells (PBMCs) from patients with Crohn's disease, ulcerative colitis and autistic enterocolitis — the recently described syndrome purportedly associated with measles-mumps-rubella vaccination. Dr. Hisashi Kawashima from Tokyo Medical University and colleagues there and in London explain that previous studies have suggested that measles virus may be present in the intestine of Crohn's disease patients. They also allude to the reported association between measles-mumps-rubella (MMR) vaccination and some cases of autistic enterocolitis, a syndrome of gastrointestinal symptoms and developmental regression in children leading to autism (See Reuters Health report, February 27, 1998). Numerous other reports, however, have discounted that association.

Early Measles Infection Linked to Inflammatory Bowel Disease

More information on the link between measles and other diseases than don't show up until much later in life. Although the researchers were hesitant to suggest a link with the measles vaccine, the link does seem to come up again and again in research circles.

Am J Gastroenterol 2000;95:1480-1485 Early measles infection may increase the risk of developing Crohn's disease and ulcerative colitis, according to researchers from the Mayo Clinic. In the study, they identified individuals who had been diagnosed with measles before the age of 5 years from 1950 to 1966 through the Mayo Clinic and the Rochester Epidemiology Project. Of this initial group of 1,164 eligible cases, 662 completed a questionnaire to determine if the patient had subsequently developed Crohn's disease or ulcerative colitis, or symptoms of undiagnosed disease. Overall, the researchers found six cases of Crohn's disease and six cases of ulcerative colitis that could be confirmed by the patients' physicians. Based on the incidence of cases in Olmsted County, Minnesota, they would have expected significantly fewer cases: 1.9 for Crohn's disease and 2.0 for ulcerative colitis. Seventy-five percent of the cases had measles before the age of 2 years, the authors note, but this did not reach statistical significance. The investigators also emphasized that their study did not consider the effect of measles vaccination, and "unless more compelling data become available to implicate measles vaccine as a risk factor for inflammatory bowel disease, we fully support the current recommendation for universal vaccination against measles."

GI response to non-harmful bacteria very primitive

The body does not respond to harmful and non-harmful bacteria in the same way. This researcher suggests that the method the GI tract uses to deal with these bacteria is very primitive; suggesting that this relationship between us and our bacteria has been around for a long, long time.

Science 2000;288:2222-2226 The immunoglobulin IgA produced in gut mucosa to keep intestinal flora in check is produced by a "primitive" T cell-independent mechanism. "The immune system in the intestine sees and responds to the enormous load of nonpathogenic bacteria (greater than 500 thousand billion) in an apparently primitive way," Dr. Macpherson told Reuters Health. "The bacteria do not seem to penetrate the body much, and the IgA response by the intestine that we have discovered is important in keeping them out." According to Dr. Macpherson, the findings may have implications for research into disorders like Crohn's disease and ulcerative colitis, which involve an inflammatory response to commensal intestinal bacteria. "It is pretty reasonable to suppose that failure to dampen down the inflammatory reactions to them is the key, but we don't know the relative importance of the pathway that we have described in this," he said.

Cocoa inhibits platelet activation and function

Cocoa contains polyphenols--those beneficial chemicals also found in green tea that are believed to account for its benefits. This may be a safer way to prevent heart attacks instead of "an aspirin a day." Now, don't confuse this with chocolate, which contains stearic acid and has definate bad effects on human health.

AJCN -- Abstracts: Rein et al. 72 (1): 30 http://www.ajcn.org/cgi/content/abstract/72/1/30

Doctors' strike in Israel may be good for health

This article really has some incredible implications. This is not the first time that a strike by physicians has led to a decrease in the death rate. Hopefully, one day we can realize that many, many pharmaceutical drugs have side effects that can be more dangerous than the disease originally intended to treat.

bmj.com Siegel-Itzkovich 320 (7249): 1561 http://www.bmj.com/cgi/content/full/320/7249/1561