Frank M. Painter

Recognizing Subdural Hemorrhage in Older Adults

By Frank M. Painter|March 20, 2011|Education|

Recognizing Subdural Hemorrhage in Older Adults

SOURCE: Topics in Integrative Health Care 2010; 1 (2)

By: Mark T. Pfefer, RN, MS, DC and Richard Strunk MS, DC

A subdural hematoma, also known as a subdural hemorrhage (SDH) is caused by a post-traumatic accumulation of blood within the potential space between the dura mater and the arachnoid layer covering the brain. Chronic SDH is much more common in the elderly. Patients can have a good outcome with neurosurgical management if the conditions is promptly recognized. All health care providers, as well as nursing home staff, should be aware of this condition because older patients presenting with headache and/or other neurologic complaints need careful assessment to identify SDH.

Keywords: subdural hematoma; subdural hemorrhage; chronic subdural hemorrhage; headache

Definition and Etiology

A subdural hematoma, also known as a subdural hemorrhage (SDH) is caused by a post-traumatic accumulation of blood within the potential space between the dura mater and the arachnoid layer covering the brain. All health care providers, especially those who frequently treat patients with musculoskeletal complaints, as well as nursing home staff, should be aware of this condition because older patients presenting with headache and/or other neurologic complaints need careful assessment. SDH should be considered in the differential assessment of any older patient presenting for care following trauma as it has been associated with minor head injury or falls, even those not involving direct trauma to the head. [1] In fact, absence of direct trauma to the head is associated with up to half of all cases of SDH, and a case has been reported in an adult following a roller coaster ride. [2] Based upon this it should be assumed that motor vehicle collisions could generate forces sufficient to cause SDH in older patients. (more…)

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Got An Opinion on Tort Reform?

By Frank M. Painter|March 18, 2011|News, Tort Reform|

Got An Opinion on Tort Reform?

The Chiro.Org Blog

SOURCE: MedScape

NOTE: Registration is free on MedScape

Medscape’s new headline trumpets: “Tort Reform Bill Would Reduce Deficit by $40 Billion”. Sounds pretty intoxicating doesn’t it. Aren’t we all just dying to see the deficit shrivel down to where it was when Bill Clinton was in office? I sure am.

However, after reading several paragraphs, I am horrified to see the unreasonable limits they want to set on noneconomic damages. I have heard too many stories of amputations of the wrong limb to think that a pittance is a reasonable payout for sloppy workmanship. Read on:

Tort Reform Bill Would Reduce Deficit by $40 Billion

By: Robert Lowe

March 11, 2011 — A House bill that caps noneconomic damages in malpractice cases at $250,000 and enacts other reforms to curb frivolous lawsuits against clinicians would reduce the federal deficit by $40 billion from 2011 to 2021, according to the Congressional Budget Office (CBO).

The bill, called the Help Efficient, Accessible, Low-Cost Timely Healthcare (HEALTH) Act of 2011, would lower premiums for malpractice insurance and reduce the number of “defensive medicine” services ordered by clinicians to avoid getting sued, the CBO stated in an analysis released yesterday. As a result of these lower costs, direct federal spending on healthcare would decrease by $34 billion over 10 years.

In addition, lower costs on the provider side would cause premiums for private health insurance to fall, which would allow employers to increase taxable wages for employees. That, in turn, would boost federal tax revenue by roughly $6 billion. (more…)

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New LBP Study Reveals Chiropractic Is Superior to PT and MD Care

By Frank M. Painter|March 17, 2011|Low Back Pain, Physical Therapy, Research|

New LBP Study Reveals Chiropractic Is Superior to PT and MD Care

The Chiro.Org Blog

SOURCE: J Occupational and Enviro Medicine 2011 (Mar 14)

Cifuentes M, Willetts J, Wasiak R.

The Center for Disability Research at the Liberty Mutual Research Institute for Safety

This study is unique in that it was conducted by the Center for Disability Research at the Liberty Mutual Research Institute for Safety and the University of Massachusetts Lowell, Hopkinton, Mass; and the Center for Health Economics & Science Policy at United BioSource Corporation, London, United Kingdom.

Their objective was to compare the occurrences of repeated disability episodes between types of health care providers, who treat claimants with new episodes of work-related low back pain (LBP). They followed 894 patients over 1-year, using workers’ compensation claims data.

By controlling for demographics and severity, they determined the hazard ratio (HR) for disability recurrence between 3 types of providers:
Physical Therapists (PT),
Physicians (MD), and
Chiropractors (DC).

The results are quite interesting: (more…)

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ICPA Launches “Chiropractic Care and Wellness” Research Project

By Frank M. Painter|March 17, 2011|Announcement, Pediatrics, Research|

ICPA Launches “Chiropractic Care and Wellness” Research Project

The Chiro.Org Blog

The ICPA is pleased to announce that its Practice Based Research Network (PBRN) has achieved recognition by and affiliation with the Agency for Health Care Research and Quality, under the US Department of Health and Human Services.

The ICPA/ PBRN is the first chiropractic PBRN to have achieved this status. We would like to thank all of our participants so far for their contributions of data, making this possible.

A Practiced Based Research Network (PBRN) is our best opportunity to determine the parameters of care we provide by submitting data from our practices. The ICPA has formed the largest PBRN in chiropractic and the only one addressing family wellness care. This is your voice in evidenced based chiropractic care. We need your participation now! (more…)

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Chiropractic Cost-Effectiveness

By Frank M. Painter|March 16, 2011|Cost-Effectiveness, News|

Chiropractic Cost-Effectiveness

The Chiro.Org Blog

SOURCE: Health Insights Today

By Daniel Redwood, DC

“Doctors of chiropractic are a vital part of our nation’s health care system. Your services have been proven both effective and cost-effective and every day you help countless Americans with a variety of health conditions.”

~ Kathleen Sebelius,
Secretary of Health and Human Services
2011 National Chiropractic Legislative Conference

Health care costs in the United States continue to rise and now account for 17.6% of the economy. In the public sector, Medicare and Medicaid budgets are under continual strain, while accelerating private sector insurance premium increases are pricing millions of American families out of the market each year.

Aside from outlawing pre-existing condition exclusions and providing premium subsidies for those who need them most, the Patient Protection and Affordable Care Act of 2010 (PPACA) empowers the Department of Health and Human Services to take a variety of steps toward controlling costs. But attempts to utilize these powers will trigger strong opposition from groups facing adverse impact to their bottom lines. Further complicating matters, the future of PPACA remains uncertain as opponents seek to vilify, defund and repeal it. (more…)

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8 drugs doctors wouldn’t take: If your physician would skip these, maybe you should, too

By Frank M. Painter|March 15, 2011|Education|

8 drugs doctors wouldn’t take
If your physician would skip these, maybe you should, too

The Chiro.Org Blog

SOURCE: Men’s Health ~ 6-22-2008

By Morgan Lord

With 3,480 pages of fine print, the Physicians’ Desk Reference (a.k.a. PDR) is not a quick read. That’s because it contains every iota of information on more than 4,000 prescription medications. Heck, the PDR is medication — a humongous sleeping pill.

Doctors count on this compendium to help them make smart prescribing decisions — in other words, to choose drugs that will solve their patients’ medical problems without creating new ones. Unfortunately, it seems some doctors rarely pull the PDR off the shelf. Or if they do crack it open, they don’t stay versed on emerging research that may suddenly make a once-trusted treatment one to avoid. Worst case: You swallow something that has no business being inside your body.

Of course, plenty of M.D.’s do know which prescription and over-the-counter drugs are duds, dangers, or both. So we asked them, “Which medications would you skip?” Their list is your second opinion. If you’re on any of these meds, talk to your doctor. Maybe he or she will finally open that big red book with all the dust on it.

Advair

It’s asthma medicine … that could make your asthma deadly. Advair contains the long-acting beta-agonist (LABA) salmeterol. A 2006 analysis of 19 trials, published in the Annals of Internal Medicine, found that regular use of LABAs can increase the severity of an asthma attack. Because salmeterol is more widely prescribed than other LABAs, the danger is greater — the researchers estimate that salmeterol may contribute to as many as 5,000 asthma-related deaths in the United States each year. In 2006, similarly disturbing findings from an earlier salmeterol study prompted the FDA to tag Advair with a “black box” warning — the agency’s highest caution level. (more…)

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About Frank M. Painter

Recognizing Subdural Hemorrhage in Older Adults

Recognizing Subdural Hemorrhage in Older Adults

Got An Opinion on Tort Reform?

Got An Opinion on Tort Reform?

New LBP Study Reveals Chiropractic Is Superior to PT and MD Care

New LBP Study Reveals Chiropractic Is Superior to PT and MD Care

ICPA Launches “Chiropractic Care and Wellness” Research Project

ICPA Launches “Chiropractic Care and Wellness” Research Project

Chiropractic Cost-Effectiveness

Chiropractic Cost-Effectiveness

8 drugs doctors wouldn’t take: If your physician would skip these, maybe you should, too

8 drugs doctors wouldn’t take If your physician would skip these, maybe you should, too

8 drugs doctors wouldn’t take
If your physician would skip these, maybe you should, too