Support Chiropractic Research!
Facebook

Frank M. Painter

About Frank M. Painter

I was introduced to Chiro.Org in early 1996, where my friend Joe Garolis helped me learn HTML, the "mark-up language" for websites. We have been fortunate that journals like JMPT have given us permission to reproduce some early important articles in Full-Text format. Maintaining the Org website has been, and remains, my favorite hobby.
FacebookXEmail

More Bad News For Low Back Pain Sufferers: Drug-induced Meningitis

By |October 4, 2012|Iatrogenic Injury, Low Back Pain, Steroids|

More Bad News For Low Back Pain Sufferers: Drug-induced Meningitis

The Chiro.Org Blog

SOURCE:   Associated Press ~ Oct 4, 2012

By MIKE STOBBE

Medication Linked to Meningitis Deaths May Have Reached 23 States

The potential scope of the meningitis outbreak that has killed at least five people widened dramatically Thursday as health officials warned that hundreds, perhaps thousands, of patients who got steroid back injections in 23 states could be at risk.

UPDATE: October 09, 2012: The number of identified cases has reached 119, with 11 deaths in 10 different states.

UPDATE: October 11, 2012: The number of identified cases has reached 170, with 14 deaths in 11 different states.

UPDATE: October 12, 2012: from MedScape The number of people exposed to potentially contaminated methylprednisolone acetate produced by the New England Compounding Center (NECC) in Framingham, Massachusetts, is closer to 14,000 — not 13,000 — as originally reported on October 8, federal health officials said today.

“These 14,000 patients received the medication as a steroid injection either into the spinal area or into a joint space such as a knee, shoulder or ankle,” said J. Todd Weber, MD, incident manager of the multistate meningitis outbreak at the Centers for Disease Control and Prevention (CDC). More than 12,000 of these people have been contacted to date, he said.

As of today, the CDC said a total of 170 cases (including the 14 deaths) have been reported across 11 states: Florida (7 cases, 2 deaths), Idaho (1 case), Indiana (21 cases, 1 death), Maryland (13 cases, 1 death), Michigan (39 cases, 3 deaths), Minnesota (3 cases), New Jersey (2 cases), North Carolina (2 cases), Ohio (3 cases), Tennessee (49 cases, 6 deaths), and Virginia (30 cases, 1 death).

UPDATE: October 25, 2012: from MedScape There are currently 328 reported cases of fungal infection, with 24 deaths now reported in 18 states. This includes 5 peripheral joint infections.

UPDATE: November 27, 2012: from Fox News There are currently 510 reported cases of fungal infection, with 36 deaths now reported in 19 states, and another 14 cases of peripheral joint infection reported.

NEW YORK (AP) — The potential scope of the meningitis outbreak that has killed at least five people widened dramatically Thursday as health officials warned that hundreds, perhaps thousands, of patients who got steroid back injections in 23 states could be at risk.

 

Clinics and medical centers rushed to contact patients who may have received the apparently fungus-contaminated shots. And the Food and Drug Administration urged doctors not to use any products at all from the Massachusetts pharmacy that supplied the suspect steroid solution.

It is not clear how many patients received tainted injections, or even whether everyone who got one will get sick.

So far, 35 people in six states — Tennessee, Virginia, Maryland, Florida, North Carolina and Indiana — have contracted fungal meningitis, and five of them have died, according to the Centers for Disease Control and Prevention. All had received steroid shots for back pain, a highly common treatment.

This is especially disturbing, because

Steroid Injections Offer Minimal Relief for Lower Back Pain

(more…)

Read More
 5

The Subluxation – Historical Perspectives Part II

By |September 30, 2012|Chiropractic Care, Subluxation|

The Subluxation – Historical Perspectives Part II

The Chiro.Org Blog

SOURCE:   Chiropractic Journal of Australia 2009 (Dec); 39 (4): 143–150

Rolf E. Peters, DC, MCSc, FICC, FACC, FPAC
Editor, Chiropractic Journal of Australia

Thanks to Dr. Rolf Peters, editor of the Chiropractic Journal of Australia for permission to republish this Full Text article, exclusively at Chiro.Org!

Subluxation is a term that has been used by the chiropractic profession since its early days. The term, meaning less than a luxation, has been used for millennia, similarly so has manipulation been the preferred intervention to overcome this problem.

This paper reviews some of the early uses of subluxation and manipulation identifying highlights, to help the reader appreciate that subluxation and manipulation, both spinal and general, are as old as civilisation itself.

INDEX TERMS: (MeSH) CHIROPRACTIC; MANIPULATION, CHIROPRACTIC; HISTORY OF MEDICINE; HISTORICAL ARTICLE. (Other): SUBLUXATION.

 

Introduction

D.D. Palmer stated that he manipulated the spine of Harvey Lillard on 18 September 1895 and restored his hearing after 17 years of deafness, and shortly thereafter gave immediate relief in a case of heart trouble. [1] With the advice of a patient, the Reverend Samuel Weed, they coined the word Chiropractic from the Greek words chiro and praxis, meaning done by hand on 14 January 1896. [2]

In 1905 D.D., with reference to himself in the third person, stated that

…he does not, nor ever has claimed that vertebrae may be displaced and replaced. He, however, is the first to draw the attention of the public to the difference between a complete luxation known to the medical world as such, and a subluxation as known to the chiropractor as a displacement of the articular processes.

He was the first to write lengthy articles, setting forth that 90 to 95 per cent of all diseases were caused by subluxation of vertebrae, and today no other person has placed such statements in the hands of the public unless copied from those written by D.D. Palmer

He was the first person to adjust, replace vertebrae by the unique method known as Chiropractic, using the spinous and transverse processes as handles.[3] (Emphasis added)

But, what are the facts?

This is just one of many articles @:

The Chiropractic Subluxation Page

(more…)

Read More
 0

The Subluxation – Historical Perspectives

By |September 28, 2012|Chiropractic Education, Subluxation|

The Subluxation – Historical Perspectives

The Chiro.Org Blog

SOURCE:   Chiropractic J of Australia 2009 (Dec); 39 (4): 151–164

Meridel I. Gatterman, MA, DC, MEd

Chiropractic Consultant,
Florissant, Colorado

Thanks to Dr. Rolf Peters, editor of the Chiropractic Journal of Australia for permission to republish this Full Text article, exclusively at Chiro.Org!

Subluxation is a term that continues to generate controversy into the 21st Century. This paper describes the controversy surrounding terminology arrived at through consensus in the latter part of the 20th century in addition to ongoing issues surrounding the use of the term subluxation.

Introduction

A word is not a crystal, transparent and unchanged; it is the skin of a living thought and may vary greatly in color and content according to the circumstances and time in which it is used.

— Oliver Wendell Holmes, Jr.

Historically subluxation has been central to the philosophy, science, and practice of chiropractic as the primary articular lesion treated by chiropractors. A number of issues have surrounded the use of the term subluxation including: terminology, the nature of the lesion (aberrant motion versus misalignment), and clinical, economic and political issues. The complexity of these issues precludes discrete discussion, classifying them as such, however, gives focus to much of the controversy.

Aberrant Motion versus Misalignment

The controversial nature of the chiropractic subluxation began as early as 1906 with the Palmers emphasizing vertebral displacement (misalignment) [1] at the same time that Smith Langworthy and Paxson emphasized aberrant motion as the primary characteristic of subluxation [2] They stated that:

“A simple subluxed vertebra differs from a normal vertebra only in its field of motion and the center of its field of motion.” [2]

The aberrant motion concept subsequently became more popular in Europe, However in North America, Budden [3] was using the term “fixation” when referring to a subluxation at Western States Chiropractic College by 1930.

His definition described the vertebral fixation as:

“The fixation of a joint in a position of motion, usually at the extreme of motion.” [3]

This is just one of many articles @:

The Chiropractic Subluxation Page

(more…)

Read More
 0

The Placebo, the Sensory Trick and Chiropractic

By |September 27, 2012|Chiropractic Care, Placebo, Spinal Manipulation|

The Placebo, the Sensory Trick and Chiropractic

The Chiro.Org Blog

SOURCE:   Chiropractic J. Australia 2004 (Jun); 34 (2): 58–62

Brian S. Budgell, DC, MSc

School of Health Sciences,
Faculty of Medicine,
Kyoto University, Kyoto, Japan

Thanks to Dr. Brian S. Budgell and Dr. Rolf Peters, editor of the Chiropractic Journal of Australia for permission to republish this Full Text article, exclusively at Chiro.Org!

Background:   As standards for randomised, controlled, clinical trials in medicine evolve, there is debate about whether the RCT model of investigation is appropriate for chiropractic and other forms of so-called “complementary and alternative medicine.” There may be some question as to whether the use of placebo interventions can be justified ethically and scientifically given that experimental treatments must eventually compete in a marketplace where there is often already a clinical alternative which is more effective than placebo. Beyond these concerns, design of an appropriate placebo for chiropractic trials is particularly problematic since the therapeutic component of overall chiropractic treatment may be difficult to isolate.

Objective:   To compare placebo interventions in current use in chiropractic clinical research with simple somatic stimuli that produce significant physiological effects in a selected group of patients (those suffering from dystonia).

Methods:   A literature search was made using MEDLINE, with the key words dystonia, sensory trick and geste antagoniste. Articles were reviewed for descriptions of these stimuli. The stimuli were compared, in terms of site and modality, with placebo interventions used in recent chiropractic clinical trials.

Results:   Stimuli used as placebo procedures in recent chiropractic clinical trials are quite similar, in terms of site and modality, to the “sensory tricks” that either cause substantial temporary relief, or, alternatively, provocation of symptoms in dystonic patients.

Conclusions:   Caution should be used in assuming that control (placebo) procedures used in chiropractic clinical trials—procedures that involve physical contact or positioning of patients—lack specific effects on neuromusculoskeletal symptomatology.

INDEX TERMS: (MeSH)   PLACEBO, SENSORY TRICK, GESTE ANTAGONISTE, CHIROPRACTIC

You may also want to refer to our:

The Problem with Placebos/Shams Page

 

 

INTRODUCTION:

In common parlance, the placebo may be thought of as a sham treatment given to placate the gullible or troublesome patient. In medical practice, it is more often thought of as medication, most often a pill, which has no specific action against the complaint for which it is prescribed. More recently, standards for design of clinical research have demanded more rigorous definition of what has been called “the imaginary term in medicine’s algebraic formula.” [1]

For purposes of pharmacological research, it is possible to select placebo substances that appear, with a very high level of probability, to be physiologically inert in humans, or at least to have no specific action against a disorder that is the target of investigation. Nonetheless, various studies have indicated that such supposedly inert substances may be associated with impressive levels of therapeutic effects, sometimes rivalling the medications, which are known to have specific pharmacological effects. [2]

(more…)

Read More
 0

How Deliciously Unscientific! Modern Medicine Embraces Intuition

By |September 26, 2012|News|

How Deliciously Unscientific!
Modern Medicine Embraces Intuition

The Chiro.Org Blog

SOURCE: MedPage Today ~ Sept. 25, 2012

By Nancy Walsh, Staff Writer

Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston

 

 

 

     ‘Gut Feelings’ Matter in Diagnosis of Kids’ Infections

This new MedPage review advises medical doctors that:   Physicians should pay attention to their “gut feeling” that something may be seriously wrong when assessing a child with an infectious disease — even if the clinical appearance is reassuring. [1]

Among 3,369 children whose primary care evaluation did not suggest a serious illness, six (0.2%) ultimately were admitted to the hospital with a severe infection, according to Ann Van den Bruel, MD, PhD, of the Radcliffe Observatory Quarter in Oxford, England, and colleagues.

The clinician’s gut feeling that the child was seriously ill considerably increased the chance that a severe infection was present, with a likelihood ratio of 25.5 (95% CI 7.9 to 82), and heeding the feeling might have prevented two cases from being overlooked (33%, 95% CI 0.95 to 1.75), the researchers reported online in BMJ.

Considerable research has focused on developing tools for clinical prediction in acutely ill children, including symptoms, vital signs, and laboratory tests, but primary care physicians often see children before the full clinical picture has developed — and sometimes report relying on intuition that a potentially serious problem exists even though they’re unsure why.

Moreover, a systematic review recently determined that such a gut feeling had considerable diagnostic significance. [1]

The most remarkable findings in this study were: (more…)

Read More
 0

A Replication of the Ernst Study“Adverse Effects of Spinal Manipulation: A Systematic Review”

By |September 24, 2012|Iatrogenic Injury, Spinal Manipulation|

A Replication of the Ernst Study
“Adverse Effects of Spinal Manipulation: A Systematic Review”

The Chiro.Org Blog

SOURCE:   Chiropractic & Manual Therapies 2012 (Sep 21)

Peter J. Tuchin, GradDipChiro, DipOHS, PhD

Macquarie University, Bld E5A Rm 355,
Waterloo Rd, North Ryde,
Sydney, NSW 2109, Australia

Objective   To assess the significance of adverse events after spinal manipulation therapy (SMT) by replicating and critically reviewing a paper commonly cited when reviewing adverse events of SMT as reported by Ernst. (J R Soc Med. 2007 (Jul); 100 (7): 330-338).

Method   Replication of a 2007 Ernest paper to compare the details recorded in this paper to the original source material. Specific items that were assessed included the time lapse between treatment and the adverse event, and the recording of other significant risk factors such as diabetes, hyperhomocysteinemia, use of oral contraceptive pill, any history of hypertension, atherosclerosis and migraine.

Results   The review of the 32 papers discussed by Ernst found numerous errors or inconsistencies from the original case reports and case series. These errors included alteration of the age or sex of the patient, and omission or misrepresentation of the long term response of the patient to the adverse event. Other errors included incorrectly assigning spinal manipulation therapy (SMT) as chiropractic treatment when it had been reported in the original paper as delivered by a non-chiropractic provider (e.g. Physician).

The original case reports often omitted to record the time lapse between treatment and the adverse event, and other significant clinical or risk factors. The country of origin of the original paper was also overlooked, which is significant as chiropractic is not legislated in many countries. In 21 of the cases reported by Ernest to be chiropractic treatment, 11 were from countries where chiropractic is not legislated.

Conclusion   The number of errors or omissions in the 2007 Ernest paper, reduce the validity of the study and the reported conclusions. The omissions of potential risk factors and the timeline between the adverse event and SMT could be significant confounding factors. Greater care is also needed to distinguish between chiropractors and other health practitioners when reviewing the application of SMT and related adverse effects.

 

The Full-Text Article:

Introduction

The use of a treatment by health care providers requires examination of the evidence of effectiveness and assessment of the evidence for risks or adverse events (AE) caused by the treatment [1]. Spinal manipulation therapy (SMT) has strong evidence for treatment of low back pain, neck pain, headache and migraine [2-6]. This is supported by numerous systematic reviews of a large number of randomized controlled trials [7-10] (more…)

Read More
 1
Copyright 1995 - Chiropractic Resource Organization | All Rights Reserved | Powered by Chirowebs.net | Disclaimer
Facebook