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November 21, 2002 Research Update |
James Bogash, D.C. Mesa, AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com
Adrenocortical, Autonomic, Inflammatory Causes of Metabolic Syndrome
This article supports a link between chronic stress and Syndrome X. This is not at all surprising when you consider the fact that cortisol (the body's stress hormone) will increase abdominal adiposity and interfere with insulin action, resulting in hyperinsulinemia. Remember that the human body is a complex web, with each system interacting in such complexity that we may never truly understand it. We can only try to back up and try to heal it using the tools Mother Nature gave us.
Circulation -- Abstracts: Brunner et al. 106 (21): 2659
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Long-Term ERT Worsens Behavioral, Neuropathological Consequences of Chronic Brain Inflammation
In english, this animal study shows that, contrary to what the pharmaceutical ants are trying to prove to find a use for the multi-billion dollar HRT industry, HRT may actually worsen inflammation of the brain that could lead to Alzheimers. Keep in mind that Mother Nature does things for a reason. Menopause included. The downregulation of hormone production in our later years may be a protective effect designed to guard us from decades of chemical and lifestyle abuses.
Behavioral Neuroscience, August 2002 Abstracts
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Clostridium difficile, atopy and wheeze during the first year of life
More and more evidence is supporting the idea that a healthy bacterial population is essential for normal development of an infant's immune system. Here we see that C. difficile may increase risk of allergies. Well, it is well known that C. difficile can be a result of antibiotic use. Not only this, but antibiotics will kill off the bacteria that is supposed to be there in the first place. When it comes to antibiotic use, physicians need to view each case with the potential long term consequences. I think the idea that antibiotics are benign is still highly prevalent, and a change in the current thinking is needed.
Synergy Abstract
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Comparison of CRP and LDL in Prediction of First Cardiovascular Events
I find it amazing, with today's technology, that this article is no longer news!! I'm sure everyone has heard about this article already. What does amaze me, is that discussion in the medical literature still does not think that CRP levels should be checked routinely. My gosh...do we have to stamp "CRP" on a bat and whomp these doctors upside the head so they see it everytime they look in the mirror?? Personally, I've been telling people for years that CRP levels are important for assessing CVD risk (along with homocysteine, Lipoprotein A, ApoE4, fibrinogen...). However, I did have a gentleman in a class I was teaching today say that his cardiologist did not feel a need to check CRP levels because it was already known that he had CVD. HUH? Maybe the cardiologist did not order it because he/she would not know how to lower it if it was elevated? What if this patient's CRP levels are elevated and interventions such as avoiding refined carbs and fish oil can bring it down? I guess we'll never know.
NEJM -- Abstracts: Ridker et al. 347 (20): 1557
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Bezafibrate in men with lower extremity arterial disease
This is just such a wonderful example of putting blinders on when we look at disease. Here we see a cholesterol lowering medication in action. Sure, it lowers cholesterol. But does it actually lower deaths from heart attacks and strokes? NOPE. It's almost laughable if it wasn't so serious. The approach to CVD prevention here in the US is to check cholesterol levels and medicate if needed (with the guidelines for who needs medication constantly widening...). OOPS. This study may blow a hole in conventional wisdom and treatment. Anyone surprised that this article is not getting the press that CRP levels are?
bmj.com Abstracts: Meade et al. 325 (7373): 1139
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Flaxseed effects on prostatic carcinoma in transgenic mice
Although this is an animal study, many other benefits of flax has been identified. Keep in mind that the best source of flax is freshly ground seeds which will contain the lignans, oils, fiber and vitamins that are associated with health benefits.
ScienceDirect - Urology: Effect of flaxseed supplementation on prostatic carcinoma in transgenic mice
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Effects of Ethyl-Eicosapentaenoate in Patients w/ Ongoing Depression Despite Apparently Adequate Treatment With Standard Drugs
1 gram/day of EPA shows a dramatic improvement in depressive ratings for patients in this small study with no side effects. This is not the first trial to show a benefit for essential fatty acids and psychological health.
A Dose-Ranging Study of the Effects of Ethyl-Eicosapentaenoate in Patients With Ongoing Depression Despite Apparently Adequat..
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CVD, diabetes mortality determined by nutrition during parents' and grandparents' slow growth period
Hold onto your socks for this one. This study evaluated times of feast and famine and whether this would have an impact on the risk for cardiovascular disease and diabetes along the male's line of CHILDREN AND GRANDCHILDREN. This answer? Definately so. Low food availability = low risk. High food availability = high risk. The implications of this go beyond what most clinicians and people are willing to accept. With this in mind, what do you think will happen to the grandkids of today's obese children? Not to sound like a pessimist, at this time of the greatest knowledge of impacts on human health, our health is poorer than it ever has been. This will lead to a reduction in the life expectancy here in the US. If we keep at the same rate as we are now, medicating rather than addressing the true root of most chronic diseases, there is no way we can continue to life longer and longer lives.
Cardiovascular and diabetes mortality determined by nutrition during parents' and grandparents' slow growth period
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Homocysteine and CVD: evidence on causality from a meta-analysis
Forty years of cummulative evidence, and we finally have a mainstream medical journal unquestionably recommending certain vitamins to lower risk of stroke and cardiovascular disease. This was all in the same month that CRP gained notoriety. What a ground shaking month for cardiologists and clinicians that have not cracked a medical journal in years. Add to this several studies showing no or little benefit from cholesterol lowering medication (especially when compared with CRP and homocysteine!!) and they have to be feeling like a stockbroker two years ago...
bmj.com Abstracts: Wald et al. 325 (7374): 1202
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Steroid Injections Result in Only Limited Short-Term Benefits for Sciatica
Considering that I see sciatica on a daily basis in my office, this study does not surprise me. What does surprise me is how people still does consider chiropractic when considering options for sciatic pain. I'm proud to say that I have not had a single patient that stuck with me for sciatic pain due to a disc herniation go to surgery. Some of the case were tough, but all resolved without surgery. Also, I have occasionally sent patients for epidurals, but not as the only therapy. That may have been the problem with this study. As one tool to lower the level of inflammation, it can allow other therapies to be more effective. The same goes for shoulders. In now way, shape or form do drugs or injections fix whatever was wrong with the problem.
ACR 66th annual meeting: Abstract 530. Presented Oct. 26, 2002.
In patients with sciatica, epidural injections of corticosteroids appear to produce only limited relief and no sustained benefit, according to findings from the largest randomized controlled trial of its kind.Nigel K. Arden, MD, a senior lecturer in rheumatology at the University of Southampton, U.K., and colleagues presented their research here Saturday at the American College of Rheumatology (ACR) 66th Annual Scientific Meeting. According to Dr. Arden, the procedure is fairly common. "In the U.K., for every million population that comes into the hospital, we are doing 800 epidurals," he said. To evaluate the efficacy of corticosteroid epidurals, the researchers recruited 228 patients with clinical evidence of unilateral sciatica from four hospitals. At baseline, patients from two of the hospitals underwent magnetic resonance imaging (MRI) of the lumbar spine. Patients were stratified based on whether they had acute or chronic sciatica and were then randomized to receive either three weekly lumbar epidural injections of triamcinolone acetonide 80 mg and bupivacaine or three injections of saline into the interspinous ligament.Patients were assessed at 0, 3, and 12 weeks. Both groups improved at 3 weeks, but the active group had a slightly greater but nonsignificant improvement compared with the placebo group (Oswestry score, 33.5 vs. 38.9; P=.053). At three weeks, 60.8% of the participants in the active group and 39.8% of those in the placebo group reported that their sciatica had improved (P=.03). But at 6 weeks and 12 weeks, the differences were no longer significant (P=0.5 and 0.7, respectively). In addition, the researchers also performed several a priori subgroup analyses to explore predictors of response, such as duration and severity of sciatica at study entry, presence of a significant MRI lesion, and the presence of neurological dysfunction; however, none of these predicted a response."This study was meant to be the definitive study," Dr. Arden said. "We used the highest dose and most potent steroid possible," he said. "We even powered it so that we could pick up a nonclinically significant effect," he added."There is no quick fix or magic injection," says Dr. Arden. According to Dr. Arden, the answer may be to combine pain relief with physiotherapy. "Only a small amount of this condition is physical, so if the patient is also depressed, they should also see a psychologist," he added. Dr. Arden pointed out that pain consultants tend to think these injections work whereas "rheumatologists tend to think they do not work."Sidney Block, MD, the session moderator and a rheumatologist in private practice in Bangor, Maine, agreed. "I think it has to do with the perspective of the physician," he said. "Orthopedists, who are not anxious to operate on a patient's back, will frequently turn to this as a method of pain relief hoping that it will delay the need for surgery." "Rheumatologists may also turn to this before surgery, but this study raises the question as to whether this therapy is effective," he said.