John Wiens DC

Danish researchers claim that antibiotics could cure 40% of chronic back pain patients

By John Wiens DC|May 7, 2013|News|

Up to 40% of patients with chronic back pain could be cured with a course of antibiotics rather than surgery, in a medical breakthrough that one spinal surgeon says is worthy of a Nobel prize. Surgeons in the UK and elsewhere are reviewing how they treat patients with chronic back pain after scientists discovered that many of the worst cases were due to bacterial infections.

The shock finding means that scores of patients with unrelenting lower back pain will no longer face major operations but can instead be cured with courses of antibiotics costing around £114. One of the UK’s most eminent spinal surgeons said the discovery was the greatest he had witnessed in his professional life, and that its impact on medicine was worthy of a Nobel prize.

“This is vast. We are talking about probably half of all spinal surgery for back pain being replaced by taking antibiotics,” said Peter Hamlyn, a consultant neurological and spinal surgeon at University College London hospital.

Specialists who deal with back pain have long known that infections are sometimes to blame, but these cases were thought to be exceptional. That thinking has been overturned by scientists at the University of Southern Denmark who found that 20% to 40% of chronic lower back pain was caused by bacterial infections.

“This will not help people with normal back pain, those with acute, or sub-acute pain – only those with chronic lower back pain,” Dr Hanne Albert, of the Danish research team, told the Guardian. “These are people who live a life on the edge because they are so handicapped with pain. We are returning them to a form of normality they would never have expected.”

The Danish team describe their work in two papers published in the European Spine Journal. In the first report, they explain how bacterial infections inside slipped discs can cause painful inflammation and tiny fractures in the surrounding vertebrae.

In the second paper, the scientists proved they could cure chronic back pain with a 100-day course of antibiotics. In a randomised trial, the drugs reduced pain in 80% of patients who had suffered for more than six months and had signs of damaged vertebra under MRI scans.

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McMaster chiropractic working group aims to further health research and interdisciplinary care

By John Wiens DC|April 24, 2013|Research|

Source The Vancouver Sun

by Dr Don Nixdorf

Research is key to developing better treatments and care protocols to eliminate disease and stay healthy. The chiropractic profession is fortunate to have twelve Canadian Chiropractic Research Foundation (CCRF) research chairs in major universities across the country, each of which conducts and contributes to world class research. But the more significant benefits to weaving these research chairs into the fabric of academia are the interdisciplinary connections and collaborations that result. There is no other time in history where we have seen so many different health professions coming together with one common goal: improving healthcare.

When many different health professionals work together, patients routinely experience better care and are on average better prepared to care for themselves. There are several examples of this in practice already. St. Michael’s Hospital in Toronto uses a multi-disciplinary approach to treat and manage back pain. Community health clinics with nurse practitioners, dentists, nutritionists and several other health care providers are peppered throughout Canada and experience tremendous success in the amount of patients they can treat and the quality of the care that is delivered. Let’s also not forget our amazing Canadian athletes who benefit from a team healthcare approach. It makes perfect sense that patients benefit from having multiple perspectives of expertise that work together to treat the whole person, not just the corner of their body with a problem.

In an effort to gain further momentum to this type of approach and increase collaboration in the academic community, several chiropractic doctors out of McMaster University came together to form the McMaster Chiropractic Working Group in 2009. Dr. Steven Passmore DC, PhD, a researcher from the University of Manitoba is one of the founding members of this group that aims to raise the profile of chiropractic in the university setting through credible research and collaborative efforts. With the exception of the CCRF researchers in universities, chiropractic education and advancement is primarily through chiropractic schools and funded almost entirely by chiropractic doctors. Even after earning his PhD from McMaster in 2012, Dr. Passmore continues to be a part of this initiative that is setting an example for others across the country. BC is already investigating the potential of a local working group based on the McMaster model. (more…)

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Macquarie backs off from chiropractic

By John Wiens DC|April 24, 2013|Chiropractic Education|

Source The Australian

Macquarie University has announced plans to offload its chiropractic teaching by 2015.

It said it would begin discussions with other “interested” higher education providers about taking over its chiropractic units and degrees, including academic staff and teaching facilities. Executive science dean Clive Baldock said his faculty wanted to concentrate on developing “recent major strategic investments” in research-intensive disciplines including biomedical science and engineering.

“Macquarie University has recently invested significantly in a postgraduate medical school and a state-of-the-art private hospital,” he said. “We naturally want to focus our efforts on supporting these initiatives with our teaching and research.” Professor Baldock issued a sales pitch to possible tenderers while acknowledging that the discipline didn’t meet Macquarie’s requirements “from a research-intensive perspective”.

“We believe our chiropractic degrees to be of the highest teaching quality, and they remain extremely popular with students,” he said.“We therefore believe the responsible thing to do is to begin discussions with other higher education providers who are keen to grow in this area.”

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Chiropractic: What does the future hold?

By John Wiens DC|March 22, 2013|Philosophy|

The Institute for Alternative Futures (IAF) is a leader in the creation of preferred futures. Since its founding in 1977 by Clement Bezold, Alvin Toffler and James Dator, IAF has helped organizations monitor trends, explore future possibilities and create the futures they prefer. IAF draws on a robust selection of futures methodologies, such as environmental scans, forecasts, scenarios, visioning and its own “aspirational futures” technique.

Recently the institute released Chiropractic 2025: Divergent Futures (pdf) which was made possible by funding from the NCMIC Foundation.

Therein, 4 scenarios are presented:

Scenario 1: Marginal Gains, Marginalized Field

As health care reorganizes, the historical isolation of chiropractors hinders most DCs in joining integrated care provider organizations. The majority remains in solo and small group practices and face major challenges in building or maintaining an adequate patient base. Research to develop and demonstrate evidence-informed practice grows. This gets DCs more favorable attention, yet networks often use the data to limit fees and the number of visits. Five states assign broader practice rights to DCs. Focused-scope oriented colleges join leading academic medical centers in exploring quantum biology to explain healing and subluxation. However, four chiropractic colleges close. Low starting income for chiropractors in many settings, and limited career prospects for most DCs coupled with high student debt, hamper the growth of the profession over the decade leading to 2025.

Scenario 2: Hard Times & Civil War
(more…)

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New data concerning the effectiveness of the influenza vaccine

By John Wiens DC|February 22, 2013|Vaccination|

Source Huffington Post

Flu vaccine is not as effective as public health messaging traditionally has claimed, says a new report that suggests overselling of flu shots is getting in the way of developing more effective and longer lasting vaccines.

The project that led to the report was called the CIDRAP Comprehensive Influenza Vaccine Initiative, and it involved mining more than 12,000 documents, articles and meeting transcripts as well as more than 5,700 peer-reviewed vaccine studies published from 1936 through April 2012. The full report can be found here.

In recent years studies by a variety of research groups have shown that the long-quoted claims that flu shots offered 70 to 90 per cent protection against influenza have been off the mark.

Somewhere in the order of 50 to 60 per cent, in healthy adults, is more accurate, the newer studies suggest. Efficacy rates are lower in the elderly or people in poor health. Vaccine effectiveness in those 65 and older against both influenza A and B was 27% (95% CI, -31% to 59%), and against H3N2 it was 9% (95% CI, -84% to 55%), but both numbers are statistically not significant.

The report suggests that the higher numbers came from old studies done on vaccines that were not formulated the way current shots are. It also suggests that the belief that universal vaccination for flu would be useful and desirable, rather than solid scientific evidence, was what drove decisions to recommend flu shots for all in the U.S. (The study did not look at decisions made in Canada or elsewhere.)

Even the vaccine used in the U.S. during the 2009 pandemic — where there was a perfect match between the virus in the vaccine and the strain infecting people — didn’t offer better protection. Studies cited in the report pegged the U.S. vaccine’s effectiveness at 56 per cent.

A key argument of the report is the fact that the current vaccine that offers moderate protection is actually getting in the way of developing long-lasting flu vaccines that offer more effective protection — vaccines, for example, that might require a shot every five or 10 years. Currently flu shots are reformulated every year to try to keep up with the evolution of flu viruses.

Even though a flu shot is a relatively inexpensive vaccine, manufacturers sell hundreds of millions of doses of them a year. In fact, the report notes that the global market for flu vaccine is estimated at US$2.8 billion — a decent chunk of the estimated US$20 billion annual market for all vaccines combined.

For an interesting article of influenza and the protectiveness of Vitamin D please read On the epidemiology of influenza

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Is sunlight good for our heart?

By John Wiens DC|February 18, 2013|Research|

Source European Heart Journal

Humans evolved being exposed for about half of the day to the light of the sun. Nowadays, exposure to sunlight is actively discouraged for fear of skin cancer, and contemporary lifestyles are associated with long hours spent under artificial light indoors. Besides an increasing appreciation for the adverse effects of these life-style-related behavioural changes on our chronobiology, the balance between the beneficial and harmful effects of sunlight on human health is the subject of considerable debate, in both the scientific and popular press, and the latter is of major public health significance. While there is incontrovertible evidence that ultraviolet radiation (UVR) in the form of sunlight is a significant predisposing factor for non-melanoma and melanoma skin cancers in pale skinned people, a growing body of data suggest general health benefits brought about by sunlight.

The researchers propose that many of the beneficial effects of sunlight, particularly those related to cardiovascular health, are mediated by mechanisms that are independent of melatonin, vitamin D, and exposure to UVB alone. Specifically, they suggest that the skin is a significant store of nitric oxide (NO)-related species that can be mobilized by sunlight and delivered to the systemic circulation to exert coronary vasodilator and cardioprotective as well as antihypertensive effects. They further hypothesize that this dermal NO reservoir is a product of local production and dietary supply with nitrate-rich foods.

The full article (pdf) is available on the European Heart Journal website.

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About John Wiens DC

Danish researchers claim that antibiotics could cure 40% of chronic back pain patients

McMaster chiropractic working group aims to further health research and interdisciplinary care

Macquarie backs off from chiropractic

Macquarie University has announced plans to offload its chiropractic teaching by 2015.

Chiropractic: What does the future hold?

New data concerning the effectiveness of the influenza vaccine

Flu vaccine is not as effective as public health messaging traditionally has claimed, says a new report that suggests overselling of flu shots is getting in the way of developing more effective and longer lasting vaccines.

Is sunlight good for our heart?