October 23, 2000 Research Update

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

Time to stop misuse of antibiotics

This is a nice editorial written by a professor of otolaryngology reflecting on the decades of evidence stating that antibiotics are not effective for ear infections. bmj.com Thornett et al. 321 (7263): 765 http://bmj.com/cgi/content/full/321/7263/765#resp1

Infectious diseases may play a role in heart disease

The potential role of infection on heart disease keeps popping up in the medical literature. Usually when something like that happens there is strong validity to it. Western medicine is having a hard time grasping this concept, and I think the main reason is that it has always look for one cause for each disease. Many of today's chronic diseases are actually caused by many individual factors, and heart disease is no exception. Either way, if infection is a causative factor, this is yet another reason to maintain optimal health and a strong immune system.

(article) Several studies presented at the American Society of Microbiology meeting in Toronto link heart problems to infections with Epstein-Barr virus (EBV), cytomegalovirus (CMV), and Chlamydia pneumoniae bacteria, report the media on September 19, 2000. In a new theory, Dr Martin Lerner (William Beaumont Hospital, Royal Oak, MI) suggests "it's an infectious disease" that primarily attacks the heart, the Journal reports. "Dr. Lerner said daylong cardiac monitoring found that 95% of chronic-fatigue patients he and his research team tested in two separate small studies had abnormal electrocardiograms indicative of heart damage. Dr. Lerner said he suspects the heart damage is caused by Epstein-Barr virus and cytomegalovirus, both long implicated in the condition. The damage to the heart occurred, he believes, when the viruses were held in partial check by the patients' immune systems. Though the immune systems appear to have kept the viruses from reproducing, Dr. Lerner said partial bits of the viruses that were being produced appear to be causing heart damage," the paper reports.

Olive Oil Has Protective Effect on Colorectal Cancer

The Mediterranean diet, in which olive oil is the principle contributor to dietary fat (about 30%) has been shown to reduce the risks of heart disease, diabetes and certain types of cancer. This further supports this dietary pattern as being one of the healthiest on the planet. What is interesting in this study was that fish increased the risk of colon cancer. It would be interesting to compare types of fish to risks, as many types of fish have become contaminated with heavy metals.

J Epidemiol Community Health 2000;54:756-760 Olive oil, perhaps through its influence on secondary bile acid patterns in the colon, appears to protect against the development of colorectal cancer, according to research from Oxford University, in the UK. Meat and fish consumption, on the other hand, are positively associated with bowel cancer. "The model of meat, fish and olive oil accounted for 76% of the variation in colorectal cancer incidence between countries," the investigators write. Vegetable consumption lost significance in the model once olive oil was included. The authors suggest that meat increases deoxycholic acid in the colon and rectum, inhibiting diamine oxidase, which is thought to have a role in colonic mucosal proliferation. Olive oil may reduce deoxycholic acid, increasing the availability of diamine oxidase and protecting against "mucosal turnover, polyp formation, and the adenoma/carcinoma sequence."

Anti-Inflammatory Treatment of Soft-Tissue Sports Injuries

This article is a review of standard pharmaceutical approaches to chronic and acute sports injuries. As many of us in the manual medicine side of things have known forever, this author suggests that the benefits of anti-inflammatories is very limited and maybe even harmful.

(article) Treatment with anti-inflammatory medication is a popular choice of athletes and healthcare professionals. The effects of NSAIDs on the inflammatory reaction following an acute soft-tissue injury are small and do not appear to change the natural history of these injuries to any great extent. Derived from the hormone cortisol, corticosteroids are associated with much more pronounced and lasting anti-inflammatory effects compared with NSAIDs. Numerous studies have shown that they, in fact, can halt the healing process by virtually eliminating the inflammatory response. Inferior healing of ligament sprains and muscle strains has been observed in several animal models. For this reason, most healthcare professionals believe that corticosteroids have no role in the treatment of acute soft-tissue injuries.

Treatment of chronic problems is traditionally through relative rest, physical therapy, and NSAIDs. Again, NSAID use can result in pain relief but does not appear to promote healing of these conditions. Several randomized studies have failed to show a significant advantage over other analgesics or even placebo. Other treatment modalities may be more important to stimulate healing in these conditions. Corticosteroids also remain a popular choice in the treatment of chronic soft-tissue injuries. Often they are used in a parenteral form and injected directly on and around the affected tendon. A corticosteroid injection can result in quick and dramatic relief of the pain symptoms associated with tendinopathy. The exact mechanism through which this is accomplished remains unclear, as inflammatory features are often absent in these lesions. Problems associated with corticosteroid use include weakening of the tendon and the possibility of tendon rupture. Although the exact rupture risk has not been determined, many healthcare professionals avoid using corticosteroids in weight-bearing tendons such as the Achilles tendon. In the upper extremity, corticosteroids are more frequently used. In addition, the pain relief obtained from a corticosteroid injection can be temporary. Recurrence of the pain after several weeks is not uncommon.

Thimerosal-Free Vaccines

I still find it strange that, although the experts state that there is no harm in using mercury containing preservatives in vaccines, they are being phased out. First of all, with the sheer volume of vaccines that a infant receives by the age of 4, a substantial amount of mercury is actually delivered to the developing child. Is it any wonder that some parents opt not to have their child vaccinated?? Second, this change away from thimerosal is not a cheap process...there is NO way the pharmaceuticals would undertake such a drastic change without good reason...

Clinician Reviews 10(8):95-96, 2000 How much mercury will our infants continue to absorb from vaccines that contain the mercury-containing preservative thimerosal? A recent joint statement from an alliance of four major health organizations reports the progress drug manufacturers have made in eliminating or reducing thimerosal content in the vaccination regimen. Findings from research to determine infant blood levels of mercury from vaccines that contain thimerosal have been contradictory. Preliminary data from one collaborative investigation involving the National Institutes of Health, the University of Rochester in New York, and the Bethesda Naval Hospital in Maryland indicated that "a very small number of term infants who had received thimerosal-containing vaccines had mercury blood levels less than 2.0 µg/L. Yet another recent study published in the Journal of Pediatrics revealed mercury levels exceeding 2.9 µg/L in nine of 15 premature, very low—birth weight infants who were immunized against hepatitis B before age 1 week.

Otitis Media Guidelines May Not Be Affecting US Physician Habits

For the past 20 years, research has indicated that antibiotics should not be used for childhood ear infections, and the past 5 or 6 years the recommendations have been strong to avoid antibiotics. And yet the doctors are not getting the message. Does this suggest that they are not getting the info? That is sort of scary...part of being a physician is staying on top of recent developments to improve the efficacy and safety of your practice.

(article) Federal guidelines for treating otitis media with effusion in children may not be making their way into US physicians' practices, according to survey results released here at the annual meeting of the American Academy of Otolaryngology—Head and Neck Surgery Foundation. The guidelines were published by the Agency for Health Care Quality and research, now known as the Agency for Healthcare research and Quality (AHRQ), in 1994, to what survey author Dr. Michael G. Stewart called a "warm reception" among pediatricians and otolaryngologists. But the survey of nearly 600 such physicians shows that many are either unaware of the guidelines or unwilling to use them. "It's very clear that it's not enough to produce a guideline and just put it out there. Many studies show this with many guidelines, that if you can't implement them with a concerted educational effort at the clinical level that they will have no effect." AHRQ now has an initiative called Translating research into Practice, designed to find ways to increase the effectiveness of guidelines.

Water fluoridation

I'm not going to get on a soapbox about the fluoride issue...let it be suffice to say that myself, as well as every researcher and biochemist I would call a mentor, is strongly against the idea of fluoridating public water. It's crazy that this is even a consideration as you start delving deeper and deeper into the research. This is a commentary done by a frequent contributor to the British Medical Journal. bmj.com Carnall 321 (7265): 904a http://www.bmj.com/cgi/content/full/321/7265/904/a