Well-child doctor visits linked to increased risk of flu

February 19, 2014 by · Leave a Comment
Filed under: Research, Spinewave Bulletin 

well child GP visit fluNew research shows that well-child doctor appointments for annual exams and vaccinations are associated with an increased risk of flu-like illnesses in children and family members within two weeks of the visit.

This risk translates to more than 700,000 potentially avoidable illnesses each year, costing more than $490 million annually.

The study was published in the March issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.

“Well child visits are critically important. However, our results demonstrate that healthcare professionals should devote more attention to reducing the risk of spreading infections in waiting rooms and clinics. Infection control guidelines currently exist. To increase patient safety in outpatient settings, more attention should be paid to these guidelines by healthcare professionals, patients, and their families,” said Phil Polgreen, MD, MPH, lead author of the study. Read more

New blood pressure guidelines 2014

February 13, 2014 by · Leave a Comment
Filed under: Research, Spinewave Bulletin 

chiropractic high blood pressurePeople over 60 can now have a blood pressure of 150/90 before starting treatment. The goal had long been 140/90.

For people younger than 60 with high blood pressure, there is insufficient evidence for a systolic goal because the panel who put the new guidelines together could not find rigorous studies that established systolic blood pressure goals for younger people.

Therefore normal for people under 60 remains 140/90. “The mantra of blood pressure experts in the past has been that lower is better,” Dr. Oparil said. “Recent studies don’t seem to support that.”

Until now, people were told to strive for blood pressures below 140/90, with some taking multiple drugs to achieve that goal. But the guidelines committee, which spent five years reviewing evidence, concluded that the goal for people over 60 should be a systolic pressure of less than 150. And the diastolic goal should remain less than 90.

Systolic blood pressure, the top number, indicates the pressure on blood vessels when the heart contracts. Diastolic, the bottom number, refers to pressure on blood vessels when the heart relaxes between beats.

high blood pressure guidelinesThe committee, composed of 17 academics, determined that there was not strong evidence for the blood pressure targets that had been guiding treatment, and that there were risks associated with the medications used to bring pressures down.

The committee was tasked with updating guidelines last re-examined a decade ago. Their report was published in the Journal of the American Medical Association.

Hypertension experts said they did not have a precise figure on how many people would be affected by the new guidelines. But Dr. William B. White, the president of the American Society of Hypertension, said it was “a huge number for sure.” He estimated that millions of people over 60 had blood pressures between 140 and 150. Dr. Paul A. James, the chairman of the department of family medicine at the University of Iowa and co-chairman of the guidelines committee, said, “If you get patients’ blood pressure below 150, I believe you are doing as well as can be done based on scientific evidence.”

“We have this notion that if we can get blood pressure to normal, we will have the most health benefits,” Dr. James said. “That’s not necessarily true.”

For more, read the high blood pressure special chiropractic report.

Reference: JAMA doi:10.1001/jama.2013.284427

The mystery of chronic pain

February 11, 2014 by · Leave a Comment
Filed under: Research, Spinewave Bulletin 

ted-chronic-pain-chiropracticThe spine and nervous system is not a Lego set.

Chronic pain is clinically defined as pain that persists for more than 3 months, or beyond expected healing periods. 3 months is not a long time. Have pain for more than 3 months and one is already behind the 8-ball.

Many people who look to start treating their pain have been in pain much longer than this – most often years – and have misguided expectations around the biology of healing. This is because the pain is no longer just the symptom.

Chronic pain is completely different to acute pain. Changes occur to the nervous system. If the nervous system is continuously bombarded with pain signals for months or years, the nervous system will start to modify more permanently. This makes the job of correcting the problem even greater. Changes occur at the level of the spinal cord, brain and nerve endings (receptors).

The following TED talk illustrates pictorially how different cells start to change under the influence of chronic pain and why a multifaceted approach to dealing with the problem is imperative. Click here for more concepts in chronic pain.

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