May 29, 2003 Research Update

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

Spinal manipulative therapy is an independent risk factor for vertebral artery dissection

Had to comment on this one. With the risks that some researchers have stated, patients would be dropping dead left and right in my office alone. Other, more favorable researchers doing very large studies (this one had 171) have estimated that 1 chiro in 40 will experience a cerebral-vascular incident in THEIR LIFETIME OF PRACTICE. When we talk deaths, there are literally less than 100 on record over the past 50 years or so. Compare this to NSAIDs, a common therapy for neck pain. Conservatively, 16,000 deaths PER YEAR. And a quick search on PubMed did not produce ANY articles showing benefit of NSAIDs in neck pain. And yet these researchers have started a cascade of controversy that states that risks of spinal manipulation outweighs benefits. Talk about double standards!! Neurology -- Abstracts: Smith et al. 60 (9): 1424

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Peppermint oil reduces gastric spasm during upper endoscopy

Peppermint has been used for centuries to calm GI spasms. For patients with irritable bowel syndrome, many have found relief with peppermint oil. Here we see it replacing a commonly used antispasmodic during endoscopy. Gastrointestinal Endoscopy Online

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Risk of CVD–Related, All-Cause Death & Serum Enterolactone

There is much evidence suggesting a protective effect of plant lignans (found in whole grains, flaxseed, soy...) on many diseases including CVD and breast and endometrial cancer. However, many of these studies are not raising a fundamental question. Lignans are converted by intestinal bacterial to enterolactone. What impact does the widespread destruction of normal flora with antibiotics have on this conversion rate? Arch Intern Med -- Abstracts: Vanharanta et al. 163 (9): 1099

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Intermittent fasting effects on glucose metabolism, neuronal resistance to injury from calorie intake

One of the only well founded true "anti-aging" approaches out there is calorie restriction w/o nutrient restriction. Well, unfortunately, this approach is just not fun. Well, we may have an easier alternative. Alternate day fasting in mice appears to produce the same favorable changes in insulin sensitivity, serum glucose and ability to protect neurons from injury. PNAS -- Abstracts: Anson et al. 100 (10): 6216

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Seasonal Prevalence of Intestinal Parasites in US During 2000

Most people are blissfully unaware of the high prevalence of parasites here in the US and believe infection with parasites is limited to those outside of the US. Welcome to reality. A study of 5,792 samples showed a prevalence as high as 43% in the summer of several types of parasites. Think that course of diarrhea last week was the flu???... Thanks to DSD newsletter for bringing this to my attention. American Journal of Tropical Medicine and Hygiene, June 2002 Abstracts

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Inertia on folic acid has caused unnecessary deaths

I commend this author on her heroism in stating that some 350,000 deaths due to cardiovascular disease could have been prevented in the past decade if physicians would've started recommending and industry fortifying with folic acid. Of course, this number would need to be extraplated back an additional 3 decades because first hints that folic acid could prevent neural tube defects begin in the late 50's. The morale?? While waiting on the sidelines to recommend a potentially beneficial vitamin like folic acid, which, incidently, has never been linked to one single death at 400 mcg, millions were dying. How many nutrients are in the same situation now that folic acid was in 40+ yrs ago? bmj.com Ellis 326 (7398): 1054-c

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Mitochondrial dysfunction in elderly: possible role in insulin resistance

This is an intersting concept and would lead to some additional intervention for lower insulin resistance in an elderly population. Mitochondrial support with supplements such as coenzyme Q10, carnitine and malic acid may be warranted in this situation. This would, of course, be on top of lifestyle changes, resistance training, chromium and essential fatty acids to affect the insulin resistance. Entrez-PubMed

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Adverse renal effects of anti-inflammatory agents: evaluation of selective and nonselective cyclooxygenase inhibitors

With the sharp increase in COX-2 use such as Celebrex and Vioxx (most of this use being inappropriate for its indications), we really need to evaluate the selective COX-2 inhibitors against other known damages from NSAIDs. Here we see that the COX-2 inhibitors are just as dangerous to the kidneys as traditional NSAIDs. And much more expensive. Hey--just use the cheaper NSAIDs and save the extra money for that kidney transplant!!

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Evaluation of cyclooxygenase 2 inhibitor use in patients admitted to a large teaching hospital

For those of you that thought I was just babbling about the overuse of COX-2 inhibitors...

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Up regulation of TNF-alpha, interferon gamma in ankylosing spondylitis during treatment with etanercept

This article really raises some concern with me (beyond my previous level of concern over this class of drugs). Recall that TNF-alpha is a cytokine that controls many other aspects of the immune system and is generally thought of as an up-regulator of the immune system. However, we do know that this class of molecule is also important in fighting cancer cells. Elevated TNF-alpha levels are associated with autoimmune diseases such as rheumatoid arthritis, ankylosing spondylitis and Crohns and a new class of drugs "binds up" these TNF-alpha molecules floating around in an attempt to lower clinical aspects of these conditions. However, in this article we see that etanercept (a TNF-alpha blocker) surely does binds up TNF-alpha, but the T-cells of the body respond by producing even more. While this may be okay while on the therapy, what happens with the patient terminates medication usage? Will this "super" elevated TNF-alpha level result in even worse degree of disease than prior to medication usage? We just don't know yet. Ann Rheum Dis -- Abstracts: Zou et al. 62 (6): 561

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