March 22, 2004 Research Update

James Bogash, D.C. Mesa, AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com

Gastric Bypass Surgery for Morbid Obesity Leads to an Increase in Bone Turnover and a Decrease in Bone Mass

I'm sure if I thought about it there may actually be a good reason to perform a gastric bypass, I would guess the majority of these surgies done would not fall into my category.

Who ever developed this surgery?? Hey--let's bypass an essential component of human health so a patient can lose some weight!!!

JCEM -- Abstracts: Coates et al. 89 (3): 1061

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Blood pressure and cognitive functioning among independent elderly

Just thought I'd throw a little wrench in the works for the idea that the lower the BP the better. I can tell you that from experiences in my office, not all patients feel better when their BP drops to "normal" of 120/80. It is not unusual for these patients to feel disoriented and unsteady at this BP.

ScienceDirect - American Journal of Hypertension : Blood pressure and cognitive functioning among independent elderly

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Federal funding for comparative drug studies not in US budget

Isn't that interesting? We have seen several editorials comparing the added cost of newer, more expensive drugs that are no more effective or safer than drugs currently in use. The recent ALLHAT study stunned many by showing that the old approach of diuretics for high blood pressure where just as effective as the much more expensive calcium channel blockers and ACE inhibitors. So, at the drug companies' "urging," the government has decided they don't have the money to compare the cost and efficacy of newer drugs to older ones. If it wasn't our money feeding into the Medicare drug mess it would almost be entertaining...

bmj.com Marwick 328 (7440): 603

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Developing countries could derail global anti-obesity plan

This is definately the "tribute to big money" issue of the Updates. Basically, the US, under pressure from the junk food industry, does not think the World Health Organization's plan to address diet, physical activity and lifestyle to fix obesity is a good idea. If these organizations can have this much of an effect outside the US, think of the effect while they serve on the committees to decide the AHA and ADA dietary plans. Your health has very little impact on the recommendations of these committees.

bmj.com Fleck 328 (7440): 604

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Induction of Protective IgA by Intestinal Dendritic Cells Carrying Commensal Bacteria

Sorry for the long title, but the basic idea is that normal flora interacts with the immune cells of the GI tract at a local level only. The presence of normal flora such as lactobacillus or acidopholus does not elicit a systemic immune response as would be expected by the presence of a pathogen such as salmonella, candida or clostridium. Do we need any more evidence than this that these bacteria are supposed to be there and that destroying them with antibiotics without thought to replacing them is poor medicine?

Science -- Abstracts: Macpherson and Uhr 303 (5664): 1662

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Caloric Restriction and Incidence of Breast Cancer

Knowing that caloric restriction without nutrient restriction is the only "anti-aging" approach that consistently extends life span in mammals, the results of this study should not surprise anyone. However, I will not exactly advocate anorexia followed by pregnancy to lower your risk of breast cancer (which is what this study evaluated), but a whopping 76% reduction is breast cancer risk is incredible. Most likely the lowered risk is tied in with insulin signaling somewhere.

JAMA -- Abstracts: Michels and Ekbom 291 (10): 1226

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Actual Causes of Death in the United States, 2000

Two leading contributors to death in the US in 2000. Tobacco related deaths #1, poor dietary and physical inactivity #2. All this money focused on findings a cure (to date relatively disappointing results as far as cancer and AIDS are concerned despite BILLIONS spent...) and the leading two causes of death are lifestyle related. Prevention. Period.

JAMA -- Abstracts: Mokdad et al. 291 (10): 1238

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Percutaneous Coronary Angioplasty Compared With Exercise Training in Patients With Stable Coronary Artery Disease. A Randomized Trial

I have had many patients who were immediately given heart catheterization at a suspect cardiac event. Two patients in the past year were negative. Not a lot of fun from what they said. Well, basically, exercise gave a better outcome for cheaper than the invasive procedure. The cost thing, however, surprises me...$3429 for one year of exercise training. That's $285/month. We could all have personal trainers coming to our house for that kind of money. So basically, this was a hyped-up exercise program and was really unfair to do a cost comparison. Of course, a real cost comparison of walking around the neighborhood for one year versus invasive cardiac procedures would be ridiculous.

Hambrecht et al., 10.1161/01.CIR.0000121360.31954.1F

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Stress-induced structural remodeling in hippocampus: Prevention by lithium treatment

I thought this article was very interesting considering how much our approach to psychiatric disorders have shifted away from the simple approaches to a much more complicated, drug ridden approach. Lithium was used for decades as a treatment for bipolar disorder but has now fallen out of favor and replaced with new drugs that affect the central nervous system. Interestingly, lithium was also used for many years as a treatment for diabetes because of its insulin sensitizing properties. Might this protection to the hippocampal region be mediated through its effects on insulin? Incidently, many of the side effects associated with lithium treatment come from using the carbonate form, which is less bioavailable than other forms of lithium.

PNAS -- Abstracts: Wood et al. 101 (11): 3973

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Inactivated Intranasal Flu Vaccine and Risk of Bell's Palsy

For those of you unfamiliar with Bell's Palsy, it is paralysis of the facial nerve which results in one half of the face drooping. This damage can be permanent in some instances. Usually takes several months to resolve. Here we have a vaccine for the flu--which, unless you are immunocomprimised in some way I cannot see the rationale for getting--gives you a 19 times greater risk of developing Bell's Palsy. For those of you really interested, I have included a piece done prior to release of the vaccine, when the manufacturer was aware of an increased risk of Bell's Palsy but downplayed the risk to the FDA. Some much for government agencies protecting the public...

NEJM -- Use of the Inactivated Intranasal Influenza Vaccine and the Risk of Bell's Palsy in Switzerland

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SAFETY EVALUATION OF TOXIN ADJUVANTS DELIVERED INTRANASALLY, Meeting Information, Division of Microbiology and Infectious Dis..

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