First, I should say that my favorite quote from the commentary on this review was:
"Thus, it is important when reading this report to remember that absence of evidence of effectiveness is NOT the same as evidence of absence of effectiveness."
So what is not new is that chiropractic is found to be CLEARLY EFFECTIVE and worthy of trial for
low back pain, neck pain, migraine, cervicogenic headache or dizziness, and extremities.
So what is new is that chiropractic is found to be CLEARLY INEFFECTIVE for
asthma, menstrual cramps, stage 1 hypertension, and infantile colic.
And the jury is still out on everything else....
Anyway, what I offer in my office is a natural approach to total health. I don't work on symptoms, I work on PEOPLE. And what this study can't touch is the profound impact that chiropractic has on quality of life. I offer a chiropractic lifestyle that is far more powerful in improving the average person's quality of life than what they get from their MD. So I will stay here for you and I will offer you the truth at any cost. That said, here is the latest info: go to...
http://mvchiro.com/MissionChiroPages/Effectiveness.asp
Friday, February 26, 2010
Chiropractic First!
In Mission Viejo, it's Choropractic First!
http://www.squidoo.com/mvchirodotcom
from mvchiro.com
Monday, February 22, 2010
Living Well News
Mission Viejo Chiropractic's February 2010 edition of the "Living Well
News" has just been posted: http://tinyurl.com/ylk2x72
News" has just been posted: http://tinyurl.com/ylk2x72
from mvchiro.com
Wednesday, February 17, 2010
Nutrisweet by any other name.... is still crap
Dr. Harriott's Comment:
What can I say, just by naming it "Benevia" doesn't mean it isn't still toxic crud. Try the simple natural sweeteners, or better yet, try to use less sweetener altogether. Don't ever do saccahrin, nutra-sweet, or any other such "industrial edibles". Heck, people jump up and down over corn syrup, for heaven's sake. What do you think this neurotoxic crap will leave you with down the line? STAY AWAY!!!!
=====================================================================
DEERFIELD, Ill.--(BUSINESS WIRE)--Feb. 6, 1996--Leveraging its position as the world's leading marketer of sweeteners, NutraSweet Consumer Products, an operating unit of Monsanto Co., announced today that it will be expanding into other "better for you" product categories and is changing its name to Benevia. Benevia is derived from the Latin roots "bene" meaning good and "via" meaning way.
The unit's most recognized brands, Equal sweetener in North America; Canderel sweetener in Europe, Africa and the Middle East; and NutraSweet sweetener in Asia and Latin America, comprise its core franchise of consumer products. The company continues to strengthen its sweetener base around the world, and now plans to extend into other "better for you" consumer categories.
"Even in sweeteners, we're not just NutraSweet," said Nick E. Rosa, president of Benevia. "We've built a global portfolio of sweetener brands over the past decade, and we continue to expand in this arena with new products that reflect individual market tastes and preferences.
"In the past year, we've acquired leading sweetener franchises in Italy and Argentina, and we've begun testing new sweetener opportunities in India and China."
Mission: to market "better-for-you" products worldwide
"But, the company's new mission is to go beyond sweeteners," Rosa said. "We are exploring a variety of innovative products and services to help people enjoy healthy living in markets around the world. Our new name and company logo are a reflection of this broader scope in our core business, as well as our vision for growth beyond sweeteners."
Benevia was the right choice for a variety of reasons, said Rosa. Because its mission now extends beyond sweeteners, the company purposefully selected a name that was unassociated with its leading brands. The company also wanted a name that would have meaning in many languages to reflect its global status. Currently, the company's sweetener products are marketed in 100 countries.
"In virtually any language, Benevia's translation speaks to the healthy living consumer arenas the company plans to pursue," said Rosa.
New hummingbird symbol: nimble, farsighted and fast
In conjunction with the name change, the company is also introducing a new hummingbird logo as its symbol.
"Hummingbirds symbolize our corporate culture," said Rosa. "They are nimble, farsighted and fast. Like us, they'll fly over the horizon in search of the sweetest reward.
"We're a small organization, so we can act swiftly, but we also have the advantage of being able to access Monsanto's considerable global resources when we need them. It's an enviable position to be in," said Rosa.
Headquartered in Deerfield, Ill., a suburb of Chicago, Benevia is a global consumer products business unit of Monsanto Co.
CONTACT: Lesnik Public Relations
Joel Feldstein, 312/755-3595
or after 2/8/96:
Benevia
Nancy Nevin, 847/405-6574
What can I say, just by naming it "Benevia" doesn't mean it isn't still toxic crud. Try the simple natural sweeteners, or better yet, try to use less sweetener altogether. Don't ever do saccahrin, nutra-sweet, or any other such "industrial edibles". Heck, people jump up and down over corn syrup, for heaven's sake. What do you think this neurotoxic crap will leave you with down the line? STAY AWAY!!!!
=====================================================================
DEERFIELD, Ill.--(BUSINESS WIRE)--Feb. 6, 1996--Leveraging its position as the world's leading marketer of sweeteners, NutraSweet Consumer Products, an operating unit of Monsanto Co., announced today that it will be expanding into other "better for you" product categories and is changing its name to Benevia. Benevia is derived from the Latin roots "bene" meaning good and "via" meaning way.
The unit's most recognized brands, Equal sweetener in North America; Canderel sweetener in Europe, Africa and the Middle East; and NutraSweet sweetener in Asia and Latin America, comprise its core franchise of consumer products. The company continues to strengthen its sweetener base around the world, and now plans to extend into other "better for you" consumer categories.
"Even in sweeteners, we're not just NutraSweet," said Nick E. Rosa, president of Benevia. "We've built a global portfolio of sweetener brands over the past decade, and we continue to expand in this arena with new products that reflect individual market tastes and preferences.
"In the past year, we've acquired leading sweetener franchises in Italy and Argentina, and we've begun testing new sweetener opportunities in India and China."
Mission: to market "better-for-you" products worldwide
"But, the company's new mission is to go beyond sweeteners," Rosa said. "We are exploring a variety of innovative products and services to help people enjoy healthy living in markets around the world. Our new name and company logo are a reflection of this broader scope in our core business, as well as our vision for growth beyond sweeteners."
Benevia was the right choice for a variety of reasons, said Rosa. Because its mission now extends beyond sweeteners, the company purposefully selected a name that was unassociated with its leading brands. The company also wanted a name that would have meaning in many languages to reflect its global status. Currently, the company's sweetener products are marketed in 100 countries.
"In virtually any language, Benevia's translation speaks to the healthy living consumer arenas the company plans to pursue," said Rosa.
New hummingbird symbol: nimble, farsighted and fast
In conjunction with the name change, the company is also introducing a new hummingbird logo as its symbol.
"Hummingbirds symbolize our corporate culture," said Rosa. "They are nimble, farsighted and fast. Like us, they'll fly over the horizon in search of the sweetest reward.
"We're a small organization, so we can act swiftly, but we also have the advantage of being able to access Monsanto's considerable global resources when we need them. It's an enviable position to be in," said Rosa.
Headquartered in Deerfield, Ill., a suburb of Chicago, Benevia is a global consumer products business unit of Monsanto Co.
CONTACT: Lesnik Public Relations
Joel Feldstein, 312/755-3595
or after 2/8/96:
Benevia
Nancy Nevin, 847/405-6574
Wednesday, February 10, 2010
Safe Treatment for Depression in Pregnancy!
Dr. Harriott's Comments:
Did you know we have a great acupuncturist on staff at Mission Viejo Chiropractic?
============================================
From Medscape Medical News
Acupuncture May Successfully Lift Depression in Pregnant Women
Nancy Fowler Larson
February 9, 2010 (Chicago, Illinois) — Acupuncture might be an effective method of treating depression in pregnant women, according to a study presented here at the Society for Maternal-Fetal Medicine (SMFM) 30th Annual Meeting: The Pregnancy Meeting.
Approximately 10% of women who are pregnant have clinical depression. Of those, 20% experience worsened symptoms during pregnancy. Although this rate of depression is similar to that of postpartum and nonpregnant women, concerns about using antidepressants leave pregnant women with few alternatives, lead investigator Rachel Manber, PhD, from the Department of Psychiatry & Behavioral Sciences at Stanford University School of Medicine in California, told Medscape Ob/Gyn and Women's Health.
"Women who are depressed during pregnancy need more options that don't involve medication," said Dr. Manber.
A total of 150 women who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for major depressive disorder participated in the study. They were randomized into 3 groups:
52 women received acupuncture for the specific purpose of relieving depression (SPEC group)
49 women received acupuncture without a stated purpose and served as a control group (CTRL group)
49 women received massage therapy and served as a second control group (MSSG group).
All women underwent 12 sessions of their particular therapy during an 8-week period. During the acupuncture sessions, junior acupuncturists who were masked to treatment needled the participants at points determined earlier by senior practitioners. Patients who received massage and their masseuses were not blinded.
The primary measurement of outcome was the Hamilton Rating Scale for Depression, administered by blinded raters at baseline, after 4 weeks, and again at 8 weeks. The results were as follows:
The severity of depression in the SPEC group was significantly lower (P < .05) than that in the CTRL group (P < .05; Cohen′s d = 0.46; 95% confidence interval [CI], −1.24 to 2.31) and in both control groups combined (Cohen′s d = 0.39; 95% CI, −1.31 to 1.65).
Those in the SPEC group also had a higher rate of response (63.0%) than those in the CTRL group (37.5%; P < .05; number needed to treat [NNT], 3.9; 95% CI, 2.2 to 19.8) and those in both control groups combined (44.3%; P < .05; NNT, 5.3; 95% CI, 2.8 to 75.0).
Between control groups, reduction of symptoms and response rates did not vary greatly (37.5% for CTRL and 50.0% for MSSG groups).
Of the 150 participants, 43 reported mild and temporary adverse effects (4 in MSSG, 19 in CTRL, 20 in SPEC). A much smaller number of the MSSG women reported adverse effects than in the other 2 groups (P < .01). Acupuncture adverse effects included discomfort at the acupuncture sites in some subjects and slight bleeding in 1 participant.
No placebo effect is indicated by the findings. "There was no difference whether the subjects believed in acupuncture or not," according to Dr. Manber. She and her colleagues concluded that acupuncture could be a viable choice for pregnant women who do not wish to take medication.
Dr. Manber noted 1 limitation of the study — that the practitioner who evaluated the subjects for acupuncture was not the same one who administered the procedure, a situation that differs from that of an actual acupuncture session.
George Macones, MD, MSCE, chair of the Ob/Gyn department at Washington University in St. Louis, Missouri, and program chair of the SMFM conference who reviewed the study abstract for the American Journal of Obstetrics and Gynecology, said the findings are too premature to advise any patient to discontinue medication during pregnancy. But, in an interview with Medscape Ob/Gyn and Women's Health, Dr. Macones said he would offer acupuncture as an option to women with unmedicated depression.
"If a patient said, 'I'm really reluctant to start a medication, is there anything else you could offer to me?' I probably would be willing to discuss acupuncture with someone in that group," Dr. Macones said.
The Agency for Healthcare Research and Quality supported the study. Dr. Manber and Dr. Macones have disclosed no relevant financial relationships.
Society for Maternal-Fetal Medicine (SMFM) 30th Annual Meeting: The Pregnancy Meeting: Abstract 8. Presented February 4, 2010.
Authors and Disclosures
Journalist
Nancy Fowler Larson
Nancy Fowler Larson is a freelance writer for Medscape.
Medscape Medical News © 2010 Medscape, LLC
Send press releases and comments to news@medscape.net.
www.medscape.com
Society for Maternal-Fetal Medicine (SMFM) 30th Annual Meeting: The Pregnancy Meeting
This coverage is not sanctioned by, nor a part o
Did you know we have a great acupuncturist on staff at Mission Viejo Chiropractic?
============================================
From Medscape Medical News
Acupuncture May Successfully Lift Depression in Pregnant Women
Nancy Fowler Larson
February 9, 2010 (Chicago, Illinois) — Acupuncture might be an effective method of treating depression in pregnant women, according to a study presented here at the Society for Maternal-Fetal Medicine (SMFM) 30th Annual Meeting: The Pregnancy Meeting.
Approximately 10% of women who are pregnant have clinical depression. Of those, 20% experience worsened symptoms during pregnancy. Although this rate of depression is similar to that of postpartum and nonpregnant women, concerns about using antidepressants leave pregnant women with few alternatives, lead investigator Rachel Manber, PhD, from the Department of Psychiatry & Behavioral Sciences at Stanford University School of Medicine in California, told Medscape Ob/Gyn and Women's Health.
"Women who are depressed during pregnancy need more options that don't involve medication," said Dr. Manber.
A total of 150 women who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for major depressive disorder participated in the study. They were randomized into 3 groups:
52 women received acupuncture for the specific purpose of relieving depression (SPEC group)
49 women received acupuncture without a stated purpose and served as a control group (CTRL group)
49 women received massage therapy and served as a second control group (MSSG group).
All women underwent 12 sessions of their particular therapy during an 8-week period. During the acupuncture sessions, junior acupuncturists who were masked to treatment needled the participants at points determined earlier by senior practitioners. Patients who received massage and their masseuses were not blinded.
The primary measurement of outcome was the Hamilton Rating Scale for Depression, administered by blinded raters at baseline, after 4 weeks, and again at 8 weeks. The results were as follows:
The severity of depression in the SPEC group was significantly lower (P < .05) than that in the CTRL group (P < .05; Cohen′s d = 0.46; 95% confidence interval [CI], −1.24 to 2.31) and in both control groups combined (Cohen′s d = 0.39; 95% CI, −1.31 to 1.65).
Those in the SPEC group also had a higher rate of response (63.0%) than those in the CTRL group (37.5%; P < .05; number needed to treat [NNT], 3.9; 95% CI, 2.2 to 19.8) and those in both control groups combined (44.3%; P < .05; NNT, 5.3; 95% CI, 2.8 to 75.0).
Between control groups, reduction of symptoms and response rates did not vary greatly (37.5% for CTRL and 50.0% for MSSG groups).
Of the 150 participants, 43 reported mild and temporary adverse effects (4 in MSSG, 19 in CTRL, 20 in SPEC). A much smaller number of the MSSG women reported adverse effects than in the other 2 groups (P < .01). Acupuncture adverse effects included discomfort at the acupuncture sites in some subjects and slight bleeding in 1 participant.
No placebo effect is indicated by the findings. "There was no difference whether the subjects believed in acupuncture or not," according to Dr. Manber. She and her colleagues concluded that acupuncture could be a viable choice for pregnant women who do not wish to take medication.
Dr. Manber noted 1 limitation of the study — that the practitioner who evaluated the subjects for acupuncture was not the same one who administered the procedure, a situation that differs from that of an actual acupuncture session.
George Macones, MD, MSCE, chair of the Ob/Gyn department at Washington University in St. Louis, Missouri, and program chair of the SMFM conference who reviewed the study abstract for the American Journal of Obstetrics and Gynecology, said the findings are too premature to advise any patient to discontinue medication during pregnancy. But, in an interview with Medscape Ob/Gyn and Women's Health, Dr. Macones said he would offer acupuncture as an option to women with unmedicated depression.
"If a patient said, 'I'm really reluctant to start a medication, is there anything else you could offer to me?' I probably would be willing to discuss acupuncture with someone in that group," Dr. Macones said.
The Agency for Healthcare Research and Quality supported the study. Dr. Manber and Dr. Macones have disclosed no relevant financial relationships.
Society for Maternal-Fetal Medicine (SMFM) 30th Annual Meeting: The Pregnancy Meeting: Abstract 8. Presented February 4, 2010.
Authors and Disclosures
Journalist
Nancy Fowler Larson
Nancy Fowler Larson is a freelance writer for Medscape.
Medscape Medical News © 2010 Medscape, LLC
Send press releases and comments to news@medscape.net.
www.medscape.com
Society for Maternal-Fetal Medicine (SMFM) 30th Annual Meeting: The Pregnancy Meeting
This coverage is not sanctioned by, nor a part o
Tuesday, February 9, 2010
Soft Drinks and Pancreatic Cancer
Dr. Harriott's Comments:
This study suggests that insulin spikes may be the culprit behind increased risk of pancreatic cancer in regular soda drinkers. But who cares, really? We already know that the phosphoric acid is bad and contributes to osteopoenia (thinning, weak bones). Artificial sweeteners are toxic and those drinking these actually GAIN weight instead of lose weight. And a big bolus of sugar now and then eventually leads to adult-onset diabetes.
Can we all just agree that regular consumption of soft drinks is not part of a healthy lifestyle or an enjoyable life as we age?
Nuff Said :)
==========================================
Soft Drinks Linked to Pancreatic Cancer Risk
By Chris Emery, Contributing Writer, MedPage Today
February 08, 2010
MedPage Today Action Points
Explain to interested patients that this study showed a potential association between soft drink consumption and an increased risk of pancreatic cancer in Singapore.
Note that the study found no link between fruit juice and pancreatic cancer.
Review
Regular consumers of sugary soft drinks are at higher risk for pancreatic cancer than fruit juice drinkers or the general population, a new Singaporean study has found.
Chinese men and women living in Singapore who drank two or more soft drinks per week were 87% more likely to contract pancreatic cancer after the researchers adjusted for factors such as smoking (95% CI 1.10 to 3.15), according to the report published Feb. 8 in Cancer Epidemiology, Biomarkers & Prevention.
"In this large prospective cohort of Chinese men and women in Singapore, those who reported regular soft drink consumption were at increased risk of pancreatic cancer when compared with those who largely abstained," Mark Pereira, PhD, of the School of Public Health at the University of Minnesota, and colleagues wrote. "There was no association between consumption of juice and risk of pancreatic cancer."
While pancreatic cancer is relatively rare, it is one of the most deadly cancers, with less than 5% of patients surviving five years after diagnosis. Although rates have generally plateaued in the U.S., they continue to climb in some Asian countries, including Singapore.
"This increase may reflect demographic and socioeconomic shifts as well as a transition towards a more westernized lifestyle and diet," the authors wrote.
Research has shown that insulin promotes pancreatic cancer cell growth, and some researchers think sugary foods could result in blood sugar and insulin fluctuations that expose the pancreas to high concentrations of insulin.
While fruit juices contain sugar, soft drinks are the major sources of added sugar in the U.S. diet and major contributors to hyperglycemia and hyperinsulinemia.
Pereira and colleagues followed 60,524 men and women who enrolled in the Singapore Chinese Health Study between April 1993 and December 1998 and were followed for 14 years.
At enrollment, the participants completed a 146-question food frequency questionnaire, which contained three items related to soft drinks and juice. The questions asked the participants how much, if any, they drank of soft drinks such as Coca-Cola and 7-Up, orange juice, and other fruit and vegetable juices.
The dietary data was later cross-referenced with records from the Singapore Cancer Registry and the Singapore Registry of Births and Deaths, to determine which of the participants had died of pancreatic cancer and whether it might be related to their soft drink or juice consumption.
Overall, researchers found that 140 participants had contracted pancreatic cancer.
The results were largely consistent with three of four previous U.S. studies on the links between pancreatic cancer and soft drinks. Three of the U.S. studies found an association between soft drinks and cancer.
The author acknowledged that soft drink consumers are more likely than abstainers to participate in other unhealthy behaviors, including smoking and overeating, which makes it difficult to determine that soft drink consumption is an independent risk factor for pancreatic cancer.
For instance, smokers in their study were at higher risk for pancreatic cancer. "We could not rule out the possibility of residual confounding by factors associated with the habit of drinking soft drinks or other unascertained factors such as waist circumference," they wrote.
They also noted that the study was limited in statistical power because pancreatic cancer is rare, which limited the sample size of cancer cases. "Also, because we were unable to collect repeated dietary measurements in this study, we were unable to account for changes in consumption of soft drinks and juices," they wrote, "especially when the diagnosis of diabetes occurred after the baseline interview."
The study was funded by the National Cancer Institute.
The authors reported no financial conflicts of interest.
Primary source: Cancer Epidemiology, Biomarkers & Prevention
Source reference:
Pereira M, et al "Soft drink and juice consumption and risk of pancreatic cancer: The Singapore Chinese Health Study" Cancer Epidemiol Biomarkers Prev 2010; 19: 447–55.
Disclaimer
The information presented in this activity is that of the authors and does not necessarily represent the views of the University of Pennsylvania School of Medicine, MedPage Today, and the commercial supporter. Specific medicines discussed in this activity may not yet be approved by the FDA for the use as indicated by the writer or reviewer. Before prescribing any medication, we advise you to review the complete prescribing information, including indications, contraindications, warnings, precautions, and adverse effects. Specific patient care decisions are the responsibility of the healthcare professional caring for the patient. Please review our Terms of Use.
© 2004-2010 MedPage Today, LLC. All Rights Reserved.
This study suggests that insulin spikes may be the culprit behind increased risk of pancreatic cancer in regular soda drinkers. But who cares, really? We already know that the phosphoric acid is bad and contributes to osteopoenia (thinning, weak bones). Artificial sweeteners are toxic and those drinking these actually GAIN weight instead of lose weight. And a big bolus of sugar now and then eventually leads to adult-onset diabetes.
Can we all just agree that regular consumption of soft drinks is not part of a healthy lifestyle or an enjoyable life as we age?
Nuff Said :)
==========================================
Soft Drinks Linked to Pancreatic Cancer Risk
By Chris Emery, Contributing Writer, MedPage Today
February 08, 2010
MedPage Today Action Points
Explain to interested patients that this study showed a potential association between soft drink consumption and an increased risk of pancreatic cancer in Singapore.
Note that the study found no link between fruit juice and pancreatic cancer.
Review
Regular consumers of sugary soft drinks are at higher risk for pancreatic cancer than fruit juice drinkers or the general population, a new Singaporean study has found.
Chinese men and women living in Singapore who drank two or more soft drinks per week were 87% more likely to contract pancreatic cancer after the researchers adjusted for factors such as smoking (95% CI 1.10 to 3.15), according to the report published Feb. 8 in Cancer Epidemiology, Biomarkers & Prevention.
"In this large prospective cohort of Chinese men and women in Singapore, those who reported regular soft drink consumption were at increased risk of pancreatic cancer when compared with those who largely abstained," Mark Pereira, PhD, of the School of Public Health at the University of Minnesota, and colleagues wrote. "There was no association between consumption of juice and risk of pancreatic cancer."
While pancreatic cancer is relatively rare, it is one of the most deadly cancers, with less than 5% of patients surviving five years after diagnosis. Although rates have generally plateaued in the U.S., they continue to climb in some Asian countries, including Singapore.
"This increase may reflect demographic and socioeconomic shifts as well as a transition towards a more westernized lifestyle and diet," the authors wrote.
Research has shown that insulin promotes pancreatic cancer cell growth, and some researchers think sugary foods could result in blood sugar and insulin fluctuations that expose the pancreas to high concentrations of insulin.
While fruit juices contain sugar, soft drinks are the major sources of added sugar in the U.S. diet and major contributors to hyperglycemia and hyperinsulinemia.
Pereira and colleagues followed 60,524 men and women who enrolled in the Singapore Chinese Health Study between April 1993 and December 1998 and were followed for 14 years.
At enrollment, the participants completed a 146-question food frequency questionnaire, which contained three items related to soft drinks and juice. The questions asked the participants how much, if any, they drank of soft drinks such as Coca-Cola and 7-Up, orange juice, and other fruit and vegetable juices.
The dietary data was later cross-referenced with records from the Singapore Cancer Registry and the Singapore Registry of Births and Deaths, to determine which of the participants had died of pancreatic cancer and whether it might be related to their soft drink or juice consumption.
Overall, researchers found that 140 participants had contracted pancreatic cancer.
The results were largely consistent with three of four previous U.S. studies on the links between pancreatic cancer and soft drinks. Three of the U.S. studies found an association between soft drinks and cancer.
The author acknowledged that soft drink consumers are more likely than abstainers to participate in other unhealthy behaviors, including smoking and overeating, which makes it difficult to determine that soft drink consumption is an independent risk factor for pancreatic cancer.
For instance, smokers in their study were at higher risk for pancreatic cancer. "We could not rule out the possibility of residual confounding by factors associated with the habit of drinking soft drinks or other unascertained factors such as waist circumference," they wrote.
They also noted that the study was limited in statistical power because pancreatic cancer is rare, which limited the sample size of cancer cases. "Also, because we were unable to collect repeated dietary measurements in this study, we were unable to account for changes in consumption of soft drinks and juices," they wrote, "especially when the diagnosis of diabetes occurred after the baseline interview."
The study was funded by the National Cancer Institute.
The authors reported no financial conflicts of interest.
Primary source: Cancer Epidemiology, Biomarkers & Prevention
Source reference:
Pereira M, et al "Soft drink and juice consumption and risk of pancreatic cancer: The Singapore Chinese Health Study" Cancer Epidemiol Biomarkers Prev 2010; 19: 447–55.
Disclaimer
The information presented in this activity is that of the authors and does not necessarily represent the views of the University of Pennsylvania School of Medicine, MedPage Today, and the commercial supporter. Specific medicines discussed in this activity may not yet be approved by the FDA for the use as indicated by the writer or reviewer. Before prescribing any medication, we advise you to review the complete prescribing information, including indications, contraindications, warnings, precautions, and adverse effects. Specific patient care decisions are the responsibility of the healthcare professional caring for the patient. Please review our Terms of Use.
© 2004-2010 MedPage Today, LLC. All Rights Reserved.
Thursday, February 4, 2010
Family Physicians Recommend Surgery More Than Surgeons Do!!
Dr. Harriott's Comments:
Do MD's really expect or recommend that every patient referred to a surgeon should ultimately get surgery? Do they assume that I would consider every referral a good candidate for chiropractic manipulation? While every person would benefit from a chiropractic lifestyle I absolutely do not recommend manual spinal manipulation for every patient. My care plans are customized to the needs of the patient and most are but some are not candidates for manipulation. On the other hand, without the years of experience that I have as a chiropractor, MD's are the not the best persons to decide whether chiropractic care is appropriate for a given case. But then again, MD's typically think that unless you need their "cure", then you don't have a problem. At least there is one profession (Chiropractic) that understands where the need for "cure" comes from and is prepared to do something about it before that need manifests.
So, I think this article is misleading at best. If this were asked of me, I'd only be able to indicate my basis for recommendation for surgical consultation. I am not the professional best suited to recommend surgery, and neither is the family physician. The the article's premise makes it pretty worthless.
===================================
Surgeons are less likely than family physicians to recommend lumbar spine surgery
1st on the web (February 1, 2010)
Surgeons are less likely than family physicians to recommend surgery as the preferred treatment option for patients with lumbar spine problems; and patients, surgeons and family physicians have different factors affecting their decision-making regarding surgery, according to the results of a study appearing in Spine.
S. Samuel Bederman, MD, PhD, FRCSC, and colleagues hope that their research will help better align the opinions of doctors and patients and improve the shared decision-making process.
“This can directly result in a significant improvement in patient satisfaction with the health care process and even overall health status following treatment,” Bederman stated in a press release.
The investigators surveyed orthopedic surgeons, neurosurgeons and family physicians, to determine the factors influencing their recommendations for lumbar spinal surgery. They also surveyed patients regarding their preferences for surgery and the factors influencing their decisions.
The investigators presented the participants with hypothetical scenarios involving the following key factors:
walking ability;
duration of pain;
severity of pain;
location of pain;
neurological symptoms; and
factors inducing pain.
The groups ranked their recommendations and preferences for surgery regarding each scenario, and the investigators noted the factors impacting the participants’ choices.
Among the three groups, the investigators discovered that family physicians would recommend surgery most often, while orthopedic and neurosurgeons would recommend surgical treatment the least. The study also revealed that the most important factor regarding decision-making for surgeons was the location of pain, and that most preferred surgery for patients with leg pain compared to back pain.
For family physicians, neurologic symptoms were the most important factor regarding their recommendations for surgery followed by patients’ walking ability and severity of pain, according to the study.
In addition, the investigators found that pain severity, walking ability and pain duration were the most important factors regarding patients’ preferences.
“All of these symptoms are highly related to quality of life and have little direct bearing on outcomes following surgery,” Bederman stated in the release.
Orthopedics Today Editorial Board Section Editor Scott D. Boden, MD, said that the results of the study match his experience with the different groups that were surveyed.
“Family practitioners do not have the detailed experience to sort out which patients actually need surgery, but can identify patients that may benefit from surgery,” Boden told OrthoSuperSite.com. “Thus, many patients referred to surgeons either do not need surgery or decide not to choose surgery once they learn more details and are seen by more of a specialist.” He noted that many different lumbar spine problems often present with a similar or overlapping set of symptoms. However, only a specific set of lumbar problems best treated with surgery.
He added, “It is my hope that well-educated surgeons and patients that go through a true shared-decision making process will together make the most appropriate decisions about surgery on a case-by-case basis.”
Reference:
Bederman SS, Mahomed NN, Kreder HJ, et al. In the eye of the beholder: preferences of patients, family physicians, and surgeons for lumbar spinal surgery. Spine. 2010.1;35(1):108-115.
Do MD's really expect or recommend that every patient referred to a surgeon should ultimately get surgery? Do they assume that I would consider every referral a good candidate for chiropractic manipulation? While every person would benefit from a chiropractic lifestyle I absolutely do not recommend manual spinal manipulation for every patient. My care plans are customized to the needs of the patient and most are but some are not candidates for manipulation. On the other hand, without the years of experience that I have as a chiropractor, MD's are the not the best persons to decide whether chiropractic care is appropriate for a given case. But then again, MD's typically think that unless you need their "cure", then you don't have a problem. At least there is one profession (Chiropractic) that understands where the need for "cure" comes from and is prepared to do something about it before that need manifests.
So, I think this article is misleading at best. If this were asked of me, I'd only be able to indicate my basis for recommendation for surgical consultation. I am not the professional best suited to recommend surgery, and neither is the family physician. The the article's premise makes it pretty worthless.
===================================
Surgeons are less likely than family physicians to recommend lumbar spine surgery
1st on the web (February 1, 2010)
Surgeons are less likely than family physicians to recommend surgery as the preferred treatment option for patients with lumbar spine problems; and patients, surgeons and family physicians have different factors affecting their decision-making regarding surgery, according to the results of a study appearing in Spine.
S. Samuel Bederman, MD, PhD, FRCSC, and colleagues hope that their research will help better align the opinions of doctors and patients and improve the shared decision-making process.
“This can directly result in a significant improvement in patient satisfaction with the health care process and even overall health status following treatment,” Bederman stated in a press release.
The investigators surveyed orthopedic surgeons, neurosurgeons and family physicians, to determine the factors influencing their recommendations for lumbar spinal surgery. They also surveyed patients regarding their preferences for surgery and the factors influencing their decisions.
The investigators presented the participants with hypothetical scenarios involving the following key factors:
walking ability;
duration of pain;
severity of pain;
location of pain;
neurological symptoms; and
factors inducing pain.
The groups ranked their recommendations and preferences for surgery regarding each scenario, and the investigators noted the factors impacting the participants’ choices.
Among the three groups, the investigators discovered that family physicians would recommend surgery most often, while orthopedic and neurosurgeons would recommend surgical treatment the least. The study also revealed that the most important factor regarding decision-making for surgeons was the location of pain, and that most preferred surgery for patients with leg pain compared to back pain.
For family physicians, neurologic symptoms were the most important factor regarding their recommendations for surgery followed by patients’ walking ability and severity of pain, according to the study.
In addition, the investigators found that pain severity, walking ability and pain duration were the most important factors regarding patients’ preferences.
“All of these symptoms are highly related to quality of life and have little direct bearing on outcomes following surgery,” Bederman stated in the release.
Orthopedics Today Editorial Board Section Editor Scott D. Boden, MD, said that the results of the study match his experience with the different groups that were surveyed.
“Family practitioners do not have the detailed experience to sort out which patients actually need surgery, but can identify patients that may benefit from surgery,” Boden told OrthoSuperSite.com. “Thus, many patients referred to surgeons either do not need surgery or decide not to choose surgery once they learn more details and are seen by more of a specialist.” He noted that many different lumbar spine problems often present with a similar or overlapping set of symptoms. However, only a specific set of lumbar problems best treated with surgery.
He added, “It is my hope that well-educated surgeons and patients that go through a true shared-decision making process will together make the most appropriate decisions about surgery on a case-by-case basis.”
Reference:
Bederman SS, Mahomed NN, Kreder HJ, et al. In the eye of the beholder: preferences of patients, family physicians, and surgeons for lumbar spinal surgery. Spine. 2010.1;35(1):108-115.
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