tag:blogger.com,1999:blog-43294732416598983272024-03-08T14:55:11.260-08:00A Word of HealthNW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.comBlogger19125tag:blogger.com,1999:blog-4329473241659898327.post-44186980243789556092011-07-27T08:03:00.000-07:002011-07-27T08:04:10.320-07:00Statin Drugs can lead to Diabetes...JAMA. 2011 Jun 22;305(24):2556-64.<br />Risk of incident diabetes with intensive-dose compared with moderate-<br />dose statin therapy: a meta-analysis.<br /><br />CONTEXT:<br />A recent meta-analysis demonstrated that statin therapy is associated<br />with excess risk of developing diabetes mellitus.<br /><br />OBJECTIVE:<br />To investigate whether intensive-dose statin therapy is associated<br />with increased risk of new-onset diabetes compared with moderate-dose<br />statin therapy.<br /><br />DATA SOURCES:<br />We identified relevant trials in a literature search of MEDLINE,<br />EMBASE, and the Cochrane Central Register of Controlled Trials<br />(January 1, 1996, through March 31, 2011). Unpublished data were<br />obtained from investigators.<br /><br />STUDY SELECTION:<br />We included randomized controlled end-point trials that compared<br />intensive-dose statin therapy with moderate-dose statin therapy and<br />included more than 1000 participants who were followed up for more<br />than 1 year.<br /><br />DATA EXTRACTION:<br />Tabular data provided for each trial described baseline<br />characteristics and numbers of participants developing diabetes and<br />experiencing major cardiovascular events (cardiovascular death,<br />nonfatal myocardial infarction or stroke, coronary revascularization).<br />We calculated trial-specific odds ratios (ORs) for new-onset diabetes<br />and major cardiovascular events and combined these using random-<br />effects model meta-analysis. Between-study heterogeneity was assessed<br />using the I(2) statistic.<br /><br />RESULTS:<br />In 5 statin trials with 32,752 participants without diabetes at<br />baseline, 2749 developed diabetes (1449 assigned intensive-dose<br />therapy, 1300 assigned moderate-dose therapy, representing 2.0<br />additional cases in the intensive-dose group per 1000 patient-years)<br />and 6684 experienced cardiovascular events (3134 and 3550,<br />respectively, representing 6.5 fewer cases in the intensive-dose group<br />per 1000 patient-years) over a weighted mean (SD) follow-up of 4.9<br />(1.9) years. Odds ratios were 1.12 (95% confidence interval [CI],<br />1.04-1.22; I(2) = 0%) for new-onset diabetes and 0.84 (95% CI,<br />0.75-0.94; I(2) = 74%) for cardiovascular events for participants<br />receiving intensive therapy compared with moderate-dose therapy. As<br />compared with moderate-dose statin therapy, the number needed to harm<br />per year for intensive-dose statin therapy was 498 for new-onset<br />diabetes while the number needed to treat per year for intensive-dose<br />statin therapy was 155 for cardiovascular events.<br /><br />CONCLUSION:<br />In a pooled analysis of data from 5 statin trials, intensive-dose<br />statin therapy was associated with an increased risk of new-onset<br />diabetes compared with moderate-dose statin therapy.<br /><br />PMID: 21693744 [PubMed - indexed for MEDLINE]<br /><span style="color:#888888;"><br /></span>NW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.comtag:blogger.com,1999:blog-4329473241659898327.post-43379712817890984372011-06-29T08:57:00.001-07:002011-06-29T08:57:55.047-07:00High-dose statins raise risk of diabetes: study<p><span>By <a href="http://blogs.reuters.com/search/journalist.php?edition=us&n=julie.steenhuysen&" style="color: rgb(0, 0, 204);" target="_blank"><b><span style="color: rgb(0, 110, 151); text-decoration: none;">Julie Steenhuysen</span></b></a></span></p><p class="MsoNormal" style="margin: 0px;"><span><span style="font-size: 8.5pt; color: rgb(102, 102, 102);">CHICAGO</span></span><span style="font-size: 8.5pt; color: rgb(102, 102, 102);"> | <span>Tue Jun 21, 2011 4:06pm EDT</span></span></p><p class="MsoNormal" style="margin: 0px 0px 7.5pt;"><span><span style="font-size: 15pt;">CHICAGO</span></span><span style="font-size: 15pt;"> (Reuters) - Taking a high-dose statin to lower cholesterol may increase risk of developing diabetes by as much as 12 percent, but the heart benefits of statins still outweigh the risks, new research shows.</span></p><p><span>Statins such as Pfizer's Lipitor are the world's best-selling drugs. They work by lowering levels of low-density lipoprotein, or LDL, the so-called "bad" cholesterol.</span></p><p><span>Doctors say the new research made public on Tuesday should not prompt any patients to stop taking statins, but patients on high doses of statins should get screened regularly for diabetes.</span></p><p><span>The findings on two of the biggest-selling statins may lead doctors to choose Lipitor when high doses are needed versus the less expensive, generic version of Merck & Co's Zocor.</span></p><p><span>While both drugs raise the risk of diabetes, high-dose Lipitor worked far better than generic Zocor at cutting heart risks, the team said.</span></p><p><span>Study after study has shown that taking statins can lower the risk of heart attacks and strokes, but some studies have suggested that the drugs may raise the risk of diabetes.</span></p><p><span>To see if dose is a factor, researchers from St George's, University of London and the University of Glasgow analyzed data from five different studies involving 32,752 patients who were treated with high and moderate doses of statins.</span></p><p><span>Over a five-year period, 2,749 participants, or 8.4 percent, developed diabetes, and 6,684 participants, or 20 percent, had a major heart problem.</span></p><p><span>"Overall, we found that high doses were associated with a 12 percent increased risk of diabetes compared with standard doses," Professor Kausik Ray of St George's said in an e-mail.</span></p><p><span>He said for every 498 patients treated there was one extra case of diabetes. But use of high-dose statins reduced risk of heart attacks, strokes, and the need for artery-clearing angioplasty by 16 percent.</span></p><p><span>For every 155 people treated, one of these heart problems was prevented, the team reported in the Journal of the American Medical Association on Tuesday.</span></p><p><span>"Nobody should stop taking their prescribed statins because of the evidence shown in this research," Professor Peter Weissberg of the British Heart Foundation, who was not involved with the study, said in a statement.</span></p><p><span>"Statins play a vital role in protecting the hearts of many, many people and the benefits still far outweigh any risks associated with diabetes," he said.</span></p><p><span>LIPITOR BETTER THAN GENERIC ZOCOR?</span></p><p><span>"Patients who need high doses of statins are at very high risk of heart attacks and strokes. They should not come off these drugs, but simply be monitored more closely." Ray said.</span></p><p><span>The team also compared rates of heart problems in people who took high doses of Zocor, available widely as the generic simvastatin and less costly than brand-name Lipitor.</span></p><p><span>Lipitor, or atorvastatin, had global sales last year of nearly $11 billion and is expected to lose U.S. patent protection at the end of November.</span></p><p><span>The risk of developing diabetes proved to be the same with both drugs. But high-dose Lipitor cut the risk of heart attacks and strokes by 22 percent, compared with a 5 percent reduction in heart risk among those who took simvastatin, Ray said.</span></p><p><span>He said the study shows high-dose simvastatin is not the best option.</span></p><p><span>"The net benefit of simvastatin is clearly very low and patients on simvastatin 80 mg should be moved to atorvastatin 80 mg instead," Ray said. "I don't think we can wait for loss of (Lipitor's) patent to stop using simvastatin 80 mg," Ray said in an email.</span></p><p><span>Currently, the National Institute for Health and Clinical Excellence, Britain's health cost watchdog, recommends an 80 mg dose of simvastatin because it is the least costly option for patients with heart disease.</span></p><p><span>U.S. health regulators earlier this month recommended limiting the 80 mg dose of simvastatin because it increases the risk of muscle damage.</span></p><p><span>An estimated 2.1 million patients in the United States were prescribed a product containing 80 mg of simvastatin in 2010, according to the U.S. Food and Drug Administration.</span></p><p><span>(Editing by <a href="http://blogs.reuters.com/search/journalist.php?edition=us&n=michele.gershberg&" style="color: rgb(0, 0, 204);" target="_blank">Michele Gershberg</a> and <a href="http://blogs.reuters.com/search/journalist.php?edition=us&n=jackie.frank&" style="color: rgb(0, 0, 204);" target="_blank">Jackie Frank</a>)</span></p>NW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.comtag:blogger.com,1999:blog-4329473241659898327.post-20414692239511918572011-06-27T09:40:00.000-07:002011-06-27T09:48:29.300-07:00Diabetes Cases Double to 347 Million<p>The number of adults with diabetes has doubled world-wide over the last three decades to nearly 350 million and increased nearly threefold in the U.S., a sign that the epidemic will impose an ever-greater cost burden on health systems.</p> <p>The latest calculation, based on a study published in the British journal Lancet, found that the number of adult diabetics jumped to 347 million from 153 million in 1980.<br /></p><p>Many public-health experts consider the rise in diabetes to be more worrying than the rise in high blood pressure rates and cholesterol levels. While rates for those conditions have dropped in some parts of the world, type-2 diabetes is becoming more common almost everywhere, and is increasingly showing up in children.</p><p>In the U.S., the total cost of diagnosed diabetes was estimated at $174 billion in 2007, according to the American Diabetes Association.<br /></p><p>What's worse is that patients are looking to drugs to help manage their condition however, the underlying causes which are primarily lifestyle related, are not being addressed. Diabetes is one of the most avoidable diseases and with a little education, we can avoid this disease.</p><p>To learn more about what we can do to help you with this problem, please call us at (360) 433-9580.</p><p><br /></p><p><br /></p>NW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.comtag:blogger.com,1999:blog-4329473241659898327.post-44036593883879955712011-06-23T13:28:00.000-07:002011-06-23T21:00:03.600-07:00Resveratrol retards progression of diabetic nephropathy<div class="entry-meta"> <span class="meta-prep meta-prep-author">Posted on</span> <a href="http://www.stonehearthnewsletters.com/resveratrol-retards-progression-of-diabetic-nephropathy/diabetes/" title="9:04 AM" rel="bookmark"><span class="entry-date">June 23, 2011</span></a> <span class="meta-sep">by</span> <span class="author vcard"><a class="url fn n" href="http://www.stonehearthnewsletters.com/author/admin/" title="View all posts by Stone Hearth News">Stone Hearth News</a></span> </div> <p>Resveratrol retards progression of diabetic nephropathy through modulations of oxidative stress, proinflammatory cytokines, and AMP-activated protein kinase</p> <p>Chih-Chun Chang, Chieh-Yu Chang, Yang-Tzu Wu, Jiung-Pang Huang, Tzung-Hai Yen and Li-Man Hung</p> <p>Journal of Biomedical Science 2011, 18:47 doi:10.1186/1423-0127-18-47<br />Published: 23 June 2011</p> <p><strong>Abstract (provisional)</strong></p> <p><strong>Background</strong></p> <p>Diabetic nephropathy (DN) has been recognized as the leading cause of end-stage renal disease. Resveratrol (RSV), a polyphenolic compound, has been indicated to possess an insulin-like property in diabetes. In the present study, we aimed to investigate the renoprotective effects of RSV and delineate its underlying mechanism in early-stage DN.</p> <p><strong>Methods</strong></p> <p>The protective effects of RSV on DN were evaluated in streptozotocin (STZ)-induced diabetic rats.</p> <p><strong>Results</strong></p> <p>The plasma glucose, creatinine, and blood urea nitrogen were significantly elevated in STZ-induced diabetic rats. RSV treatment markedly ameliorated hyperglycemia and renal dysfunction in STZ-induced diabetic rats. The diabetes-induced superoxide anion and protein carbonyl levels were also significantly attenuated in RSV-treated diabetic kidney. The AMPK protein phosphorylation and expression levels were remarkably reduced in diabetic renal tissues. In contrast, RSV treatment significantly rescued the AMPK protein expression and phosphorylation compared to non-treated diabetic group. Additionally, hyperglycemia markedly enhanced renal production of proinflammatory cytokine IL-1beta. RSV reduced IL-1beta but increased TNF-alpha and IL-6 levels in the diabetic kidneys.</p> <p><strong>Conclusions</strong></p> <p>Our findings suggest that RSV protects against oxidative stress, exhibits concurrent proinflammation and anti-inflammation, and up-regulates AMPK expression and activation, which may contribute to its beneficial effects on the early stage of DN. </p>NW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.comtag:blogger.com,1999:blog-4329473241659898327.post-34986944034698652292011-06-21T14:15:00.000-07:002011-06-23T21:02:07.262-07:00Introducing our Clinic DirectorDr. Werner Marksfeld has been serving Washington for the last 11 years. He is a 1999 graduate of Western States Chiropractic College and started his first practice in Everett, WA in 2000. While serving the Everett Community, Dr. Marksfeld held the title as the Official Chiropractor to "The Everett Silvertips" as well as the Indoor Arena Football Team "The Everett Hawks". Dr. Marksfeld has had the opportunity to adjust many celebrities over the years. He sold his Everett practice in early 2007 to spend time in Kenya working with a medical missions group serving Aids orphans. <p> In early 2009, Dr. Marksfeld returned back to the Southwest Washington area to help those suffering with severe neurological conditions utilizing a revolutionary non-invassive treatment protocol that offers immediate results for disc pain sufferers, spinal stenosis and peripheral neuropathies.</p> <p>Dr. Marksfeld is committed to being at the leading edge in the field of Healthcare and regularly attends workshops, seminars and courses that enable him to provide the best possible care for his patients. Dr. Marksfeld has established highly effective treatment parameters for difficult cases, including peripheral neuropathies, herniated or bulging discs, spinal stenosis, numbness as well as challenging conditions like Fibromyalgia, Chronic Pain Syndrome's, Parkinson's, Multiple Sclerosis, Reflex Sympathetic Dystrophy, Symptoms related to brain injuries and strokes. </p> When not providing care to patients, Dr. Marksfeld spends time with his family and enjoys traveling, skiing, golfing and mountain biking.NW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.comtag:blogger.com,1999:blog-4329473241659898327.post-48667436084787974642010-09-04T18:35:00.000-07:002011-06-23T21:03:44.680-07:00Videos posted to Youtube of Dr Werner Marksfeld"Dr Werner Marksfeld"<br /><br />http://www.youtube.com/watch?v=MEQlTIDwO3I<br /><br />http://www.youtube.com/watch?v=e3TizQYCtzI<br /><br />"Dr Werner Marksfeld, WA"NW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.comtag:blogger.com,1999:blog-4329473241659898327.post-46344742684671767582010-07-24T15:59:00.000-07:002011-06-23T21:04:44.913-07:00Do YOU Take Any of These 11 Dangerous Cholesterol Drugs?Watch This Very Educational Video To Understand Cholesterol And What The Real Healthy Levels Are As Well As The Effects Of Statin Drugs!<br /><br />http://articles.mercola.com/sites/articles/archive/2010/07/20/the-truth-about-statin-drugs-revealed.aspxNW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.comtag:blogger.com,1999:blog-4329473241659898327.post-8871013757720284352010-07-01T09:32:00.000-07:002011-06-23T21:05:10.283-07:00Neuropathic Low Back Pain: Where does it hurt?<p><b><span style="font-size:medium;"><span style="font-family:georgia,palatino;"><br /></span></span></b></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">Acute LBP vs Chronic LBP vs Neuropathic LBP </span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">Chiropractors can easily recognize the pain that arrives from biological components of the back, but as anyone who has practiced more than six months realizes, all pain has a psychological component as well.1 In contrast to the acute low back pain that we treat on a daily basis, patients with chronic pain may involve pathological processes affecting the nervous system which potentially can be a disease all its own. Because the processes involved are different, patients with acute and chronic pain should not be treated in the same way. Moreover, chronic pain is difficult to treat as the contribution from biological processes and psychosocial and environmental factors are often difficult to flesh out. Unfortunately in the chiropractic practice, the aim of treatment in chronic pain patients is to merely reduce suffering. These people then become chronic chiropractic patients. This may be because the NEUROPATHIC COMPONENT of the low back pain patient makes an accurate diagnosis and treatment difficult.</span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;"> </span></span></p> <p><b><span style="font-size:small;"><span style="font-family:georgia,palatino;">The Nature of Chronic Low Back Pain</span></span></b></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">Pain can be broadly described as nociceptive and neuropathic pain. These two types of pain are caused by different neurophysiological processes and may require different treatment modalities.2,3 For our typical chiropractic patients, nociceptive pain results from the activity in neural pathways caused by actual or potential </span></span><b><span style="font-size:small;"><span style="font-family:georgia,palatino;">tissue damaging</span></span></b><span style="font-size:small;"><span style="font-family:georgia,palatino;"> stimuli (e.g. chemical, thermal or mechanical) and is mediated by polymodal pain receptors (e.g. A-delta and C fibres) which are located in the skin, bone, connective tissue, discs, muscles and viscera.4</span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">Neuropathic pain, in contrast, is produced by damage to, or pathological changes in the peripheral and/or central nervous system. The Special Interest Group on Neuropathic Pain of the International Association for the Study of Pain (NeuPSIG) has recently redefined neuropathic pain as ‘pain arising as a direct consequence of a lesion or disease affecting the somatosensory system’.5</span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;"> Or to be more specific, the conventional definition of neuropathic pain is pain resulting from injury to or dysfunction of the nervous system in the absence of direct nociceptive input. The injury or dysfunction may involve peripheral or central nervous system structures.6</span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;"> </span></span></p> <p><b><span style="font-size:small;"><span style="font-family:georgia,palatino;">Nociceptive Pain Components of Back Pain </span></span></b></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">Doctors reading this article do not need a primer on structural components of low back pain associated with degeneration of bones, muscles, ligaments, joints and intravertebral discs. We clearly understand that the facet (zygapophyseal) joints have the ability to become nociceptive pain generators and our chiropractic care works appropriately for these mechanisms. Arthritis in these joints gives rise to mechanical pain or a local nociceptive pain resulting in chronic activation of C fibres. Also the annulus of a healthy vertebral disc is innervated by C fibres to a depth of about 3 mm. When the disc cracks or is damaged, a neo-innervation (or a sprouting of C fibres) can occur which may also result in chronic pain.4</span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;"> </span></span></p> <p><b><span style="font-size:small;"><span style="font-family:georgia,palatino;">Neuropathic Pain Components of Back Pain</span></span></b></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">The mechanisms involved in neuropathic pain are complex and involve both peripheral and central phenomenon but one underlying dysfunction involves deafferentation within the peripheral nervous system. That old disc injury may very well have injured the nerve root directly and following a peripheral nerve injury (eg. crush, stretch, or axotomy) sensitization occur which is characterized by spontaneous activity by the neuron, a lowered threshold for activation and increased response to a given stimulus. Also the connective tissue sheath around peripheral nerves is innervated by the nervi nervorum. Injury, compression, and inflammation of the sheath may also cause pain.7</span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">Neuropathic low back pain can also be caused by lesions of nociceptive sprouts within the degenerated disc (local neuropathic), mechanical compression of the nerve root (mechanical neuropathic root pain), or by action of inflammatory mediators (inflammatory neuropathic root pain) originating from the degenerative disc even without any mechanical compression. 8</span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">A local neuropathic low back pain can arise from the old disc injury as a result of direct damage to the nerve root by mechanical compression and/or through the action of inflammatory mediators, (9) long after our care has healed the disc.</span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">Looking across the pain syndromes that enter our office, there is also the “in-between” group of nociceptive and neuropathic pain. Chronic low back pain patients, for example, often have pain components from both the nociceptive (tissue) and neuropathic (nerve) processes. These complex patients have back pain from both pain-generating mechanisms can be described as “mixed pain syndromes”. The etiologies that can give rise to mixed pain syndromes of the lower back include: disc herniation, failed-back-surgery syndrome (due to scarring), foraminal stenosis, and osteoporotic fractures the vertebra.8</span></span></p> <p><b><span style="font-size:small;"><span style="font-family:georgia,palatino;">It’s a BIG Pain Problem</span></span></b></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">In research recently completely, approximately 4% of the general adult population experienced back pain with a neuropathic component. The neuropathic low back pain patient has a much higher severity of pain and costs. A person suffering neuropathic back pain had as much as 67% higher back pain related costs as an average patient with nociceptive back pain only.10</span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">Large epidemiological studies show that 20% to 35% of patients with back pain suffer from a neuropathic pain component. 8 Some studies demonstrated that 41% of the chronic low back pain patients had neuropathic pain while 59% had nociceptive pain. 11 Another problem with damage to nerves can occur if there is a loss of sensory input into the dorsal horn of the spinal cord, a process known as deafferentation.12 This is the case also with chiropractic patients that have diabetes or other un-recognized forms of peripheral nerve damage in the lower extremity. This often results in pain signals being transmitted to the spinal cord in a way that makes up for the lack of sensory input into the Dorsal Horn. In a sense the spinal cord second order neurons make up their own response to the lack of normal background information. 12 This can result in severe neuropathic pain, sometimes delayed for years after the injury, which arises suddenly without clear provocative incident. In fact, this type of neuropathic pain, which is particularly challenging to treat effectively, is found in 8% of patients affected by low back pain.13</span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;"> </span></span></p> <p><b><span style="font-size:small;"><span style="font-family:georgia,palatino;">Neuropathic Back Pain evaluation goes beyond how much it hurts.</span></span></b><span style="font-size:small;"><span style="font-family:georgia,palatino;"> </span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">Diagnosing the source of the structural spinal pathology alone is not enough. Neuropathic low back pain may be highly prevalent in our chiropractic offices but the diagnosis and management remains difficult for the most clinicians to pin down because there is no “gold standard”. Most doctor rely on clinical experience as current diagnostic tests used to identify the source of back pain and their usefulness in clinical practice and for guiding treatment selection is unclear. 8</span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">It is clear that we need to improve our understanding of factors that practicing chiropractors can employ in order that we can structure our services to better diagnose and treat the neuropathic low back patient and perhaps stop its development in our chronic patients.</span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">Since sensory symptoms likely translate into pain-generating mechanisms, (14) enrichment of our clinical exam and diagnostic skills that we employ to detect sensory losses in our patients peripheral nervous system may show us potential treatments based on sensory profiles. Clearly the task of treating chronic neuropathic low back pain is extremely complex and challenging. What we offer at Concentro Laboratories, are methods to diagnose and treat the neuropathic component of our patients’ pain, opening an avenue to us as clinicians to better understand and identify these patients. The ability to identify neuropathic pain mechanisms can lead us to innovative and individualized treatments resulting in improved pain control in our patients with chronic and neuropathic low back pain. </span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;"> 1. Manchikanti L, Fellows B, Pampati V, et al. Comparison of psychological status of chronic pain patients and the general population. Pain Physician 2002; 5: 40-8. </span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">2. Finnerup NB, Otto M, McQuay HJ, et al. Algorithm for neuropathic pain treatment: an evidence based proposal. Pain 2005; 118: 289-305. </span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">3. Robert D. Helme. Drug treatment of neuropathic pain. Aust Prescr 2006; 29: 72-5. </span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">4. Adams MA, Roughley PJ. What is intervertebral disc degeneration, and what causes it? Spine 2006; 31: 2151-61. </span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">5. <a href="http://www.neupsig.org/" target="_blank">www.neupsig.org/</a> (Accessed July 2009) </span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">6. Wolfe GI, Barohn RJ. Curr Treat Options Neurol Painful Peripheral Neuropathy. 2002; May;4(3):177-188. </span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">7. Asbury AK, Fields HL. Pain due to peripheral nerve damage; an hypothesis. Neurology 1984; 34:1587-1590 </span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">8. Freynhagen R, Baron R. The evaluation of neuropathic components in low back pain. Curr Pain Headache Rep. 2009 Jun;13(3):185-90. </span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">9. Mullemann D, et al. Pathophysiology of disk-related sciatica. Evidence supporting a chemical component. Joint Bone Spine 2006; 73: 151-8. </span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">10. Schmidt CO, Schweikert B, Wenig CM, et al. Modelling the prevalence and cost of back pain with neuropathic components in the general population. Eur J Pain. 2009 Feb 5. [Epub ahead of print] </span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">11. Hassan AE, Saleh HA, Baroudy YM, et al. Prevalence of neuropathic pain among patients suffering from chronic low back pain in Saudi Arabia. Saudi Med J. 2004 Dec;25(12):1986-90. </span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">12. Fields HL, Hill RG. The near and far horizon, In Neuropathic Pain: Pathophysiology and Treatment, Seattle, 2001, IASP press, p 258-261. </span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">13. Torrance N, Smith BH, Bennett MI, et al. The epidemiology of chronic pain of predominantly neuropathic origin. Results from a general population survey. J Pain (2006) 7:281–9. </span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;">14. Baron R, Tölle TR, Gockel U, et al. A cross-sectional cohort survey in 2100 patients with painful diabetic neuropathy and postherpetic neuralgia: Differences in demographic data and sensory symptoms. Pain. 2009 Jul 8. [Epub ahead of print]</span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;"> </span></span></p> <p><span style="font-family:georgia,palatino;"><span style="font-size:small;"></span></span></p> <p><span style="font-size:small;"><span style="font-family:georgia,palatino;"> </span></span></p> <p><span style="font-family:georgia,palatino;"><span style="font-size:small;"></span></span></p> <span style="font-size:small;"><img align="left" height="145" width="200" src="" /><span style="font-family:georgia,palatino;"></span></span>NW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.comtag:blogger.com,1999:blog-4329473241659898327.post-37877511049223037942010-06-29T13:24:00.000-07:002011-06-23T21:05:33.877-07:00Statin Study<span style="color: rgb(147, 0, 0); font-weight: bold;"></span> <div id="content" class="article"> <div> </div> <div class="story"> <h1>New articles highlight rift over statins</h1> <h2>Two studies and a review of previous studies address the widely prescribed cholesterol drugs. One questions their use as a preventive measure; another suggests they help prostate cancer patients.</h2> <div id="story-body" class="articlebody "> <div style="float: left; clear: both;"> <div class="articlerail"> <div class="googleAd"> <iframe src="http://www.latimes.com/hive/common/includes/google-adsense-content-la.html?client=ca-tribune_news3_html&google_ad_channel=null_story_pos1&type=wide&page_url=http://www.latimes.com/news/science/la-sci-statins-20100629,0,3460932,print.story" marginwidth="0" marginheight="0" frameborder="0" height="0" scrolling="no" width="234"></iframe> </div> </div> </div> <span class="toolSet" style="width: 345px;"> <div class="byline"> <span class="byline">By Melissa Healy, Los Angeles Times</span> <p class="date"><span class="dateString">June 29, 2010</span></p> </div> <div class="tools"> <ul><li id="articletools-email"><a href="http://www.latimes.com/news/science/la-sci-statins-20100629,0,3793176,email.story" target="win_54637170" onclick="if (window.windoid) windoid('','win_54637170',650,550,'resizable=1,scrollbars=1')"><img src="http://www.latimes.com/hive/images/icons/email_icon.png" alt="Email" class="icon" />E-mail</a></li><li id="articletools-print"><a href="http://www.latimes.com/news/science/la-sci-statins-20100629,0,3460932,print.story" rel="nofollow"><img src="http://www.latimes.com/hive/images/icons/print_icon.png" alt="print" class="icon" />Print</a></li><li id="articletools-share"> <div id="sb_sharethis" class="social"> <script type="text/javascript" src="http://w.sharethis.com/button/sharethis.js#tabs=web%2Cpost%2Cemail&charset=utf-8&services=digg%2Ctwitter%2Cfacebook%2Cstumbleupon%2Clinkedin%2Creddit%2Cfriendfeed%2Cdelicious%2Ctechnorati&style=default&publisher=4b7449a5-38e2-462a-a6cd-97326133f123&headerbg=%23ff0000&inactivebg=%23ff0000&inactivefg=%23ff0000&linkfg=%23ff0000&buttonText=Share&embeds=true&onmouseover=false"></script><span id="sharethis_0"><a st_page="home" href="javascript:void(0)" title="ShareThis via email, AIM, social bookmarking and networking sites, etc." class="stbutton stico_default"><span st_page="home" class="stbuttontext">Share</span></a></span> </div> </li><li id="articletools-fontsize" class="font-size"> <a class="arrow" href="http://www.latimes.com/news/science/la-sci-statins-20100629,0,7388273.story#" rel="nofollow" onclick="textSize('increase'); return false;"> <img src="http://www.latimes.com/hive/images/icons/atools-uparrow.gif" alt="increase text size" class="arrow-img" /> </a> <a class="arrow" href="http://www.latimes.com/news/science/la-sci-statins-20100629,0,7388273.story#" rel="nofollow" onclick="textSize('decrease'); return false;"> <img src="http://www.latimes.com/hive/images/icons/atools-downarrow.gif" alt="decrease text size" class="arrow-img" /> </a> <span class="text">Text Size</span> </li></ul> </div> <div id="facebook-like"> <iframe src="http://www.facebook.com/plugins/like.php?href=http://www.latimes.com/news/science/la-sci-statins-20100629,0,7388273.story&layout=standard&show_faces=false&width=350&action=like&colorscheme=light&height=36" allowtransparency="true" frameborder="0" scrolling="no"></iframe> </div> </span> <div id="tugsRating" class="clearfix"> <span id="rateMarket">la-sci-statins-20100629</span> <div class="rating" id="rating_1" style="height: 20px; display: block;"><img id="star_1_1" class="on" src="http://www.latimes.com/hive/images/ratings/rating_on.jpg" /><img id="star_1_2" src="http://www.latimes.com/hive/images/ratings/rating_off.jpg" class="off" /><img id="star_1_3" src="http://www.latimes.com/hive/images/ratings/rating_off.jpg" class="off" /><img id="star_1_4" src="http://www.latimes.com/hive/images/ratings/rating_off.jpg" class="off" /><img id="star_1_5" src="http://www.latimes.com/hive/images/ratings/rating_off.jpg" class="off" /></div> </div> <script type="text/javascript"> TUGS.setInitCount('{"rate_summary":{"total_score":20,"average":20,"total_count":1}}'); TUGS.tugsURL = "http://discussions.latimes.com/"; TUGS.init_starRating(); </script> <br /> <div id="story-body-text"> <!-- sphereit start --> <p>A simmering scientific dispute over statins, the cholesterol-lowering prescription drugs that rake in some $26 billion a year for their makers, heated up Monday with an exchange of published volleys that drove back the reputation of the widely prescribed medications in one area even as it advanced their stature in another.</p><p>A meta-analysis — a review of previous studies — <a href="http://archinte.ama-assn.org/cgi/content/short/170/12/1024">published in the Archives of Internal Medicine</a> found that statins do not lower death rates among patients with risk factors but no evidence of established cardiovascular disease who take them as a preventive measure. The new study would seem to be a blow both to the drugs' makers and to three-quarters of statin users — that is, those who take the drug in hopes of averting a first heart attack or stroke.</p><p>At the same time, a study in the journal Cancer suggests that for men who have undergone surgery for prostate cancer, statin use appears to reduce the chance that the disease will return.</p><p>Against the backdrop of such research, a third study released Monday characterized as "flawed" a widely hailed 2008 study that appeared to establish the benefit of the statin rosuvastatin (commercially marketed as Crestor) in the prevention of heart attack and stroke.</p> <div id="article-promo" class="left"> <hr class="hr-promo"> <a href="http://www.latimes.com/extras/events/lp/AUD/10AUD236/register.html" target="" id="articlePromoLink">Get important science news and discoveries delivered to your inbox with our Science & Environment newsletter. Sign up »</a> <hr class="hr-promo"> </div> <br /> <p>The third article, <a href="http://archinte.ama-assn.org/cgi/content/short/170/12/1032">also published in the Archives of Internal Medicine</a>, raised questions about the financial and professional motives of the medical researchers who conducted the highly influential study, known as the JUPITER trial. Nine clinical trials published in the last six years have found no benefit to the use of statins in the prevention of heart disease, but "the results [of the JUPITER trial] have undoubtedly propelled many healthy persons without elevated cholesterol levels onto long-term statin treatment," wrote the authors of the critique.</p><p>The belief that statins lower the risk of a heart attack or stroke has helped make them the second-most-commonly prescribed class of drugs in the United States, behind antipsychotic medications. </p><p>Both studies published in the Archives suggest that statins' effectiveness in this area has been limited, at best, to preventing nonfatal attacks, while failing to budge the rates of fatal ones. The first, an analysis of 11 clinical trials that included a total of 65,229 patients, found that among patients who were considered at high risk of heart attack or stroke but who had not had one, statin therapy did not lower the risk of death.</p><p>Reaction to those studies underscored the rift that statins' widening use has prompted among physicians and researchers. Dr. Beatrice Golomb, a researcher at UC San Diego who is tallying reports of statins' side effects, said the thrust of the studies "supports what we should already have known — that for patients without established heart disease, statins are more risky than helpful."</p><p>Cleveland Clinic cardiologist Dr. Steven Nissen defended the use of statins in the prevention of heart attack and stroke for some patients. He also decried what he called an "ad hominem attack" on the reputations of the JUPITER trial's lead researchers — scientists he described as "eminent," "legendary" and "above reproach."</p><p>"We know that in the right patients, with the right reasons, statins can reduce a first heart attack," Nissen said. "Should they be put in water? Absolutely not. But there was definitely a reduction and it was definitely sizeable in the right people."</p><p>Editorializing in the Archives, Dr. Lee A. Green of the University of Michigan acknowledged that physicians faced with advising their still-healthy patients on the use of statin medications "really must admit that we do not know" what their best course should be. But the research that will inform those consultations in the future, Green wrote, "must be free of incentives to find any desired answer."</p><p><a href="mailto:melissa.healy@latimes.com">melissa.healy@latimes.com</a></p> <script type="text/javascript"> var afterLoginLocation = ''; var defaultLocation = $('articlePromoLink').href; var wasClicked = false; if (!!window.carnival) { new memberNav( '#articlePromoLink', function() { //user is logged in if(!!afterLoginLocation && afterLoginLocation != '' && afterLoginLocation != 'default'){ $('articlePromoLink').onclick = function(){ carnival.utils.listener.fire('_carnival_'+afterLoginLocation); wasClicked = true; return false; } } }, function(){ //user is not logged in if(!!afterLoginLocation && afterLoginLocation != ''){ $('articlePromoLink').onclick = function(){ carnival.utils.popUp(carnival.configuration('hostname')+ carnival.configuration('userPath')+ '/popupsignon.html?callbackUrl='+ carnival.utils.cleanLocation()); wasClicked = true; return false; } } } ).writeNav(); carnival.user.afterLogin( function(){ if(!!afterLoginLocation && afterLoginLocation != '' && afterLoginLocation != 'default'){ carnival.utils.listener.fire('_carnival_'+afterLoginLocation); } else if(wasClicked){ window.location = defaultLocation; } } ); } </script> <!-- sphereit end --> </div> <script type="text/javascript">textSize()</script> </div> <p class="copyright">Copyright © 2010, <a href="http://www.latimes.com/" target="_blank">The Los Angeles Times</a></p> <img src="http://mv.trb.com/clear.gif?dname=www.latimes.com&uri=/news/science/la-sci-statins-20100629,0,7388273.story&tag=/news/science&citype=story&title=New%20articles%20highlight%20rift%20over%20statins&hkey=297854f6a0a39cf24ab74b4a56164648" alt="" height="10" width="10" /> <div class="google-ad-story-bottom"> <iframe src="http://www.latimes.com/hive/common/includes/google-adsense-content-la.html?client=ca-tribune_news3_html&google_ad_channel=null_story_pos2&page_url=http://www.latimes.com/news/science/la-sci-statins-20100629,0,3460932,print.story" marginwidth="0" marginheight="0" frameborder="0" height="84" scrolling="no" width="600"></iframe> </div> <div class="sphereTools"> <div class="sphereContainer" id="sphereContainer"><div id="sphereRelated"><h3 id="sphereMainTitle" class="headerSphereRelated">Related stories<a id="surphaceRelatedLink" style="float: right;" href="http://www.surphace.com/" target="_new"><img style="margin-left: 2px;" src="http://cdn11.surphace.com/images/poweredby/poweredbysurphace-inline.png" align="absmiddle" border="0" /></a></h3><div id="sphere_fromsite" class="sphereContent"><h3 class="headerSphereRelated" id="header_fromsite">From the L.A. 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Typical of these are:<br />a) Gallium Aluminum Arsenide at around 820nm (0.82 microns) which is maximally penetrative. This modality is the most important one for treatment of pain but is also effective in healing, reaching well into connective tissue corium. Absorbed by cell wall chromophores.<br />b) Visible Red at 633nm (0.633 microns) Helium Neon or 660nm (0.66 microns) Diode. These wavelengths have a propensity for healing particularly epithelial tissue and for laser acupuncture. Absorbed by mitochondrial cytochromes.<br />2) Dosimetry is all important in determining effect and in reporting a treatment episode. It is necessary to specify:</p> <p>a) Wavelength e.g.820nm</p> <p>b) Incident Power of Probe e.g.200mw (a good all around value)</p> <p>c) Energy Per Point e.g. 10-20 joules for myofascial pain or 2-4 joules for healing of an intractable ulcer. A 60 milliwatt probe generates 4 joules in one minute for example.</p> <p>d) Energy Density (”radiant exposure” or “fluence rate”) this can be calculated easily by knowing the area of the beam spot and multiplying this as a fraction of a square centimeter by the energy per point e.g. energy per point of 4 joules with the spot which is an eight of a square centimeter will result in an energy density of 4X8=32 joules per square centimeter. It should be emphasized that this is a convention which does not exactly represent the way in which photic energy is scattered in tissue as revealed by CCD camera.</p> <p>A formula for more formal calculation of energy density is:<br />Energy density (J/CM2)= Power (w)X time (s) area(cm2)of spot</p> <p>- Where the power of the probe is in milliwatts divide by 1000 to convert to watts in the formula.</p> <p>e) Power Density (or “irradiance” or “fluence”)</p> <p>A formula for calculation of power density (w/cm2) =Power(w)</p> <p>area (cm2) of spot</p> <p>This can be converted to milliwatts per square centimeter by multiplying by 1000.</p> <p>f) Pulsing Characteristics and Duty Cycle Declare whether constant wave or pulsed.</p> <p>g) Time of Treatment This is helpful to determine rate of energy application.</p> <p>3) Mechanisms of Action may be summarized as:</p> <p>a) Energization of Depleted Enzymes Enzymes may be denatured or depleted in areas of inflammation by hypoxia and acidosis. Important examples are:<br />1) Sodium Potassium ATPASE: Vital for nerve polarisation in transmission of an action potential. Low energies (less than around 4 joules per sq.cm. at the site) tend to increase concentrations and are logical for use in nerve regeneration e.g. in facial paralysis. High energies (more than around 4 joules per sq.cm. at site) tend to decrease concentrations being indicated for pain where the object is stabilization of sensitized pain fibres-nonmyelinated C fibres for slow dull pain and lightly myelinated A delta fibres for rapid sharp pain. This is the so-called Arndt Schultz response where low energies stimulate and high energies suppress.<br />2) Superoxide Dysmutase (SOD). This enzyme breaks down free radicals which are a cause of pain in trigger areas in muscle in myofascial pain.<br />3) Transforming Growth Factor Beta Fractions. Energization will help repair and heal. There are several fractions.</p> <p>b) Vascular Effects</p> <p>There is no doubt that laser energy is capable of initiating new vessel formation (angiogenesis) which is an important factor in healing e.g. with soft tissue flaps. It is often suggested that LILT causes an immediate augmentation of blood flow but there is no objective evidence of this unless energies are above normal therapeutic values sufficient to cause local healing (more than 150 joules per sq.cm).</p> <p>c) Immune Augmentation<br />It seems likely that LILT can augment local and systemic immune mechanisms particularly if these are below par. Experience with irradiation of the blood has revealed a balancing effect where low rheology values are raised and high ones brought to normal values suggesting an important role for light in homeostasis.</p> <p>d) Cellular Energization<br />Most cells after LILT demonstrate accumulation of energy molecules in the form of ATP.<br />e) Overall Effect Overall, the laser energy shortens the inflammatory phase after tissue injury hastening repair and remodeling.</p> <p>4) Models of Usage</p> <p>a) Local application to Nociceptive Foci. e.g. trigger points in muscle. Usually constant wave, adequate power rating for penetration and positive pressure to milk out excessive tissue fluid aiding penetration.</p> <p>b) Entrainment of Bioresonances LILT in pulsed mode may be geared to correspond with central bioresonances. Various frequencies are suggested (Sisken & Walker) e.g.<br />2Hz Nerve regeneration, neurite outgrowth<br />7Hz Bone growth<br />10Hz Ligamentous healing<br />15, 20, 72, Hz Decreased skin necrosis, stimulation of capillary formation and fibroblast proliferation.<br />c) Ligamentous Healing Low energy<br />d) Nerve Regeneration<br />e) Laser Acupuncture Over acupuncture points or known nerve outflows. These points are highly reactive responding to low energies.</p> <p>f) Component of Multi-Modality Treatment Regimens When treating pain the use of several methods each working through a different substantiated mechanism are more likely to be successful then single methods (Melzak & Wall). e.g.</p> <p>1) May be combined with medication such as anticonvulsant and antidepressants in chronic pain thereby reducing dosage. Cortisone steroid however may negate LILT’s immune enhancement.<br />2) May be used with other forms of energy medicine e.g<br />Ultrasound<br />Short Wave Diathermy<br />Interferential Treatment<br />Acupuncture<br />Action Molecules (homeopathy)</p> <p>g) Energization of Photodynamic Agents e.g. Toluidene Blue for bacterial reduction. This is an innovative which is in the experimental stage at the moment but which is likely to be increasingly important in the future in view of increasing resistance of bacteria to antibiotics.</p> <p>TEXTBOOKS<br />Therapeutic Lasers Theory & Practice<br />G. David Baxter Churchill Livingstone 1994<br />SBN-0-443-04393-0</p> <p>Energy Medicine The Scientific Basis<br />James L. Oschman. Churchhill Livingstone 2000<br />ISBN 0-443-06261-7</p> <p>Low Level Laser Therapy as a Medical Treatment Entity<br />Pekka Pontinen Art Urpo Ltd 1992<br />ISBN 951-96632-0-7.</p> <p>Lasers in Medicine and Dentistry: Low Intensity Laser Therapy<br />Editor: Z Simunovic. Vitagraf 2000<br />ISBN 953-6059-30-4</p> <p>Low Level Laser Therapy Clinical Practice & Scientific Background<br />Jan Tuner & Lars Hode<br />Prima Books 1999. ISBN 91-630-7616-0</p> <p>Teaching Module Abstract presented at the 3rd Annual Meeting of the North American Association for Laser Therapy (NAALT), Uniformed Services University for the Health Sciences, Bethesda, MD, April 4, 2003. www.naalt.org</p> <p>Paul F. Bradley, M.D., D.D.S, M.S. Professor and Chairman, Oral Diagnostic Sciences. Director Head and Neck Pain, Nova Southeastern University, College of Dental Medicine. Health Professions Division 3200 South University Drive, Fort Lauderdale, FL 33328-2018</p> <table border="0" cellpadding="3" cellspacing="0" width="100%"><tbody><tr> <td align="left">LANCET: Efficacy of low-level laser therapy in the management of neck pain</td> </tr> <tr> <td align="left" valign="top"><span>Written by Vaman J N [Stream:Ayurveda]</span></td> </tr> <tr> <td align="left" valign="top">Thursday, 11th March 2010</td> </tr> <tr> <td align="left">Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials <p>Original Text</p> <p>Dr Roberta T Chow MBBS a Corresponding AuthorEmail Address, Prof Mark I Johnson PhD b, Prof Rodrigo AB Lopes-Martins PhD c, Prof Jan M Bjordal PT d e<br />Summary<br />Background<br />Neck pain is a common and costly condition for which pharmacological management has limited evidence of efficacy and side-effects. Low-level laser therapy (LLLT) is a relatively uncommon, non-invasive treatment for neck pain, in which non-thermal laser irradiation is applied to sites of pain. We did a systematic review and meta-analysis of randomised controlled trials to assess the efficacy of LLLT in neck pain.</p> <p>Methods<br />We searched computerised databases comparing efficacy of LLLT using any wavelength with placebo or with active control in acute or chronic neck pain. Effect size for the primary outcome, pain intensity, was defined as a pooled estimate of mean difference in change in mm on 100 mm visual analogue scale.</p> <p>Findings<br />We identified 16 randomised controlled trials including a total of 820 patients. In acute neck pain, results of two trials showed a relative risk (RR) of 1·69 (95% CI 1·22—2·33) for pain improvement of LLLT versus placebo. Five trials of chronic neck pain reporting categorical data showed an RR for pain improvement of 4·05 (2·74—5·98) of LLLT. Patients in 11 trials reporting changes in visual analogue scale had pain intensity reduced by 19·86 mm (10·04—29·68). Seven trials provided follow-up data for 1—22 weeks after completion of treatment, with short-term pain relief persisting in the medium term with a reduction of 22·07 mm (17·42—26·72). Side-effects from LLLT were mild and not different from those of placebo.</p> <p>Interpretation<br />We show that LLLT reduces pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain.</p> <p>________________________________</p> <p>a Nerve Research Foundation, Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia<br />b Faculty of Health, Leeds Metropolitan University, Leeds, UK<br />c Institute of Biomedical Sciences, Pharmacology Department, University of São Paulo, São Paulo, Brazil<br />d Faculty of Health and Social Science, Institute of Physiotherapy, Bergen University College, Bergen, Norway<br />e Section of Physiotherapy Science, Institute of Public Health and Primary Health Care, University of Bergen, Bergen, Norway<br />Corresponding Author Information Correspondence to: Dr Roberta T Chow, Honorary Research Associate, Nerve Research Foundation, Brain and Mind Research Institute, University of Sydney, 100 Mallett Street, Sydney, NSW 2050, Australia</p> <p>http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2961522-1/fulltext</p></td></tr></tbody></table>NW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.comtag:blogger.com,1999:blog-4329473241659898327.post-87625129152944872532010-06-23T23:44:00.000-07:002010-06-23T23:45:28.015-07:00U.S. Health Care Ranks Low Among Developed Nations: Report<h3 class="entry-header"><br /></h3> <o:smarttagtype name="country-region" namespaceuri="urn:schemas-microsoft-com:office:smarttags"></o:smarttagtype><o:smarttagtype name="City" namespaceuri="urn:schemas-microsoft-com:office:smarttags"></o:smarttagtype><o:smarttagtype name="PlaceType" namespaceuri="urn:schemas-microsoft-com:office:smarttags"></o:smarttagtype><o:smarttagtype name="PlaceName" namespaceuri="urn:schemas-microsoft-com:office:smarttags"></o:smarttagtype><o:smarttagtype name="place" namespaceuri="urn:schemas-microsoft-com:office:smarttags"></o:smarttagtype><o:smarttagtype name="PersonName" namespaceuri="urn:schemas-microsoft-com:office:smarttags"></o:smarttagtype><br /><o:p></o:p> <h2>Despite high cost, it delivers too little to patients, Commonwealth Fund says<o:p></o:p></h2> <p class="byline"><strong>By Steven Reinberg</strong><br /><em>HealthDay Reporter</em><o:p></o:p></p> <p>WEDNESDAY, June 23 (HealthDay News) -- Compared with six other industrialized nations, the United States ranks last when it comes to many measures of quality health care, a new report concludes.<o:p></o:p></p> <p>Despite having the costliest health care system in the world, the <st1:country-region st="on"><st1:place st="on">United States</st1:place></st1:country-region> is last or next-to-last in quality, efficiency, access to care, equity and the ability of its citizens to lead long, healthy, productive lives, according to a new report from the Commonwealth Fund, a Washington, D.C.-based private foundation focused on improving health care.<o:p></o:p></p> <p>"On many measures of health system performance, the <st1:country-region st="on"><st1:place st="on">U.S.</st1:place></st1:country-region> has a long way to go to perform as well as other countries that spend far less than we do on healthcare, yet cover everyone," the Commonwealth Fund's president, Karen Davis, said during a Tuesday morning teleconference.<o:p></o:p></p> <p>"It is disappointing, but not surprising, that despite our significant investment in health care, the <st1:country-region st="on"><st1:place st="on">U.S.</st1:place></st1:country-region> continues to lag behind other countries," she added.<o:p></o:p></p> <p>However, <st1:city st="on"><st1:place st="on">Davis</st1:place></st1:city> believes new health care reform legislation -- when fully enacted in 2014 -- will go a long way to improving the current system. "Our hope and expectation is that when the law is fully enacted, we will match and even exceed the performance of other countries," she said. <o:p></o:p></p> <p>The report compares the performance of the American health care system with those of <st1:country-region st="on">Australia</st1:country-region>, <st1:country-region st="on">Canada</st1:country-region>, <st1:country-region st="on">Germany</st1:country-region>, the <st1:country-region st="on">Netherlands</st1:country-region>, <st1:country-region st="on">New Zealand</st1:country-region> and the <st1:country-region st="on"><st1:place st="on">United Kingdom</st1:place></st1:country-region>.<o:p></o:p></p> <p>According to 2007 data included in the report, the <st1:country-region st="on"><st1:place st="on">U.S.</st1:place></st1:country-region> spends the most on health care, at $7,290 per capita per year. That's almost twice the amount spent in <st1:country-region st="on">Canada</st1:country-region> and nearly three times the rate of <st1:country-region st="on"><st1:place st="on">New Zealand</st1:place></st1:country-region>, which spends the least.<o:p></o:p></p> <p>The <st1:country-region st="on"><st1:place st="on">Netherlands</st1:place></st1:country-region>, which has the highest-ranked health care system on the Commonwealth Fund list, spends only $3,837 per capita.<o:p></o:p></p> <p>Despite higher spending, the <st1:country-region st="on">U.S.</st1:country-region> ranks last or next to last in all categories, <st1:city st="on"><st1:place st="on">Davis</st1:place></st1:city> said, and scored "particularly poorly on measures of access, efficiency, equity and long, healthy and productive lives." <o:p></o:p></p> <p>The <st1:country-region st="on"><st1:place st="on">U.S.</st1:place></st1:country-region> ranks in the middle of the pack in measures of effective and patient-centered care, she added.<o:p></o:p></p> <p>Overall, the <st1:country-region st="on">Netherlands</st1:country-region> came in first on the list, followed by the <st1:country-region st="on">United Kingdom</st1:country-region> and <st1:country-region st="on"><st1:place st="on">Australia</st1:place></st1:country-region>. <st1:country-region st="on">Canada</st1:country-region> and the <st1:country-region st="on">United States</st1:country-region> ranked sixth and seventh, <st1:city st="on"><st1:place st="on">Davis</st1:place></st1:city> noted. <o:p></o:p></p> <p>Speaking at the teleconference, Cathy Schoen, senior vice president at the Commonwealth Fund, pointed out that in 2008, 14 percent of <st1:country-region st="on"><st1:place st="on">U.S.</st1:place></st1:country-region> patients with chronic conditions had been given the wrong medication or the wrong dose. That's twice the error rate observed in <st1:country-region st="on">Germany</st1:country-region> and the <st1:country-region st="on"><st1:place st="on">Netherlands</st1:place></st1:country-region>, she noted.<o:p></o:p></p> <p>"Adults in the <st1:country-region st="on"><st1:place st="on">United States</st1:place></st1:country-region> [also] reported delays in being notified about abnormal test results or given the wrong results at relatively high rates," Schoen said. "Indeed, the rates were three times higher than in <st1:country-region st="on">Germany</st1:country-region> and the <st1:country-region st="on"><st1:place st="on">Netherlands</st1:place></st1:country-region>."<o:p></o:p></p> <p>"As a result we rank last in safety and do poorly on several dimensions of quality," Schoen said.<o:p></o:p></p> <p>In addition, many Americans are still going without medical care because of cost, she said. "We also do surprisingly poorly on access to primary care and access to after hours care given our overall resources and spending," Schoen said.<o:p></o:p></p> <p>In fact, 54 percent of people with chronic conditions reported going without needed care in 2008, compared with 13 percent in <st1:country-region st="on">Great Britain</st1:country-region> and 7 percent in the <st1:country-region st="on"><st1:place st="on">Netherlands</st1:place></st1:country-region>, she said.<o:p></o:p></p> <p>The <st1:country-region st="on"><st1:place st="on">United States</st1:place></st1:country-region> also ranked last in efficiency, Schoen said. There are too many duplicate tests, too much paperwork, high administrative costs and too many patients using emergency rooms as doctor's offices. In addition, poverty appears to be a big factor in whether Americans have access to care, the report found.<o:p></o:p></p> <p>The <st1:country-region st="on"><st1:place st="on">United States</st1:place></st1:country-region> also performed worst in terms of the number of people who die early, in levels of infant mortality, and for healthy life expectancy among older adults, Schoen said.<o:p></o:p></p> <p>Dr. David Katz, director of the <st1:placename st="on">Prevention</st1:placename> <st1:placename st="on">Research</st1:placename> <st1:placetype st="on">Center</st1:placetype> at Yale University School of Medicine, commented that "as a physician and public health practitioner, I have routinely spoken out in favor of health care reform in the <st1:country-region st="on"><st1:place st="on">U.S.</st1:place></st1:country-region> The responses evoked have not always been kind. Prominent among the counterarguments has been: 'You should see what health care is like in other countries.'"<o:p></o:p></p> <p>"This report utterly belies the notion that the former status quo for health care delivery in the <st1:country-region st="on"><st1:place st="on">U.S.</st1:place></st1:country-region> was as good as it gets. Others have been doing better and we can, and should, too," he said. <o:p></o:p></p> <p>However, at least one expert doesn't believe that health care reform, as it now stands, will solve these problems.<o:p></o:p></p> <p>Dr. Steffie Woolhandler, a professor of medicine at <st1:placename st="on">Harvard</st1:placename> <st1:placename st="on">Medical</st1:placename> <st1:placetype st="on">School</st1:placetype> and co-founder of Physicians for a National Health Program, said that "the <st1:country-region st="on"><st1:place st="on">U.S.</st1:place></st1:country-region> has the worst health care system among the seven countries studied, and arguably the worst in the developed world." <o:p></o:p></p> <p>"Unfortunately, the U.S. will almost certainly continue in last place, since the recently passed health reform will leave 23 million Americans without coverage while enlarging the role of the private insurance industry, which obstructs care and drives up costs," she said.</p>NW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.comtag:blogger.com,1999:blog-4329473241659898327.post-47680757416146658622010-06-21T23:32:00.000-07:002010-06-21T23:36:28.950-07:00The Amazing Non Invassive Way of Treating Herniated Discs<span style="font-weight: bold; color: rgb(51, 51, 255);">Herniated Disc</span> <div id="contentText3"><h3>Anatomy of the spine</h3><img src="http://www.americanspinal.com/images/stories/content/herniated_disc/001.jpg" alt="Image" title="Image" border="0" height="309" hspace="6" width="166" /><p>The intervertebral discs are located between each vertebrae in the spinal column. Of the vertebrae, there are 7 cervical (neck), 12 thoracic (mid-back) and 5 lumbar (low back) discs. The discs make up approximately 1/3 of the spinal column. They have three main functions: (1) "Absorb shock" from everyday wear and tear. (2) Allow movement of our spinal column. (3) Separate the vertebrae.</p><p>The intervertebral disc is actually a type of cartilaginous joint. Discs consist of an outer layer, annulus fibrosis, and an inner nucleus pulposus, which is a soft, jelly-like, substance. The disc is made up of proteins called collagen and proteoglycans that attract water. Normally, discs compress when pressure is put on them and decompress when the pressure is relieved. These discs do not have a blood supply; therefore, they exchange nutrients by a process called "imbibition". Imagine a sponge filled with water; when that sponge is compressed, the water is forced out of the sponge. When the compressive force is removed, the water is "sucked" back into the sponge. This is precisely how discs stay healthy and functional. Diseased discs can lead to degenerative disc disease that can then lead to: arthritis, herniated discs, bulging discs, facet syndromes, sciatica and spinal stenosis.</p><img src="http://www.americanspinal.com/images/stories/content/herniated_disc/002.jpg" alt="Image" title="Image" border="0" height="274" hspace="6" width="166" /><p>A herniation describes an abnormal condition of an intervertebral disc. Some refer to this condition as a "slipped", "ruptured", or "blown" disc. Most of the time it is not known what caused the disc to herniate, but it is thought to occur from repetitive stress due to occupation, poor spinal posture, and/or natural processes of aging and/or trauma.</p><p>A herniation begins when the inner nucleus pulposus bulges through the annulus fibrosis, causing a bulging or protruding disc. This bulge may push on a spinal nerve. This interferes with the natural blood supply to the nerve roots and sets up a condition known as intraneural edema. Basically, the nerve root microcirculation is compressed and can progress to the point where the nucleus begins to leak out of the disc. At this point the body begins to fight back by launching an autoimmune response to the disc material (nucleus pulposus). The reaction of this defense mechanism causes severe inflammation and progressive deterioration of the nerve root. If the herniation is located in the cervical spine (neck), the symptoms can range from neck pain, with or without arm pain, to numbness and tingling. Muscle weakness can be common as well. If the herniated disc is located in the lumbar spine (low back), the symptoms can range from low back pain, with or without leg pain, to numbness and tingling. Muscle weakness is also common. This type of pain and/or numbness in the legs or arms is referred to as a "radiculopathy". This happens because the nerves that exit your spinal cord innervate ("attach to") the skin in your arms and legs. They are responsible for sensation and for movement of the muscles in your arms and legs. They are also responsible for the reflexive movements as well. This is the reason some individuals with these conditions experience extremity (leg/arm) pain / numbness / tingling and/or weakness when they have a herniated or bulging disc. Be aware that, some individuals with herniated discs may report arm or leg pain only, with minimal neck or low back pain.</p><table id="data-tabl1" align="center" border="0" cellpadding="4" cellspacing="0"><tbody><tr><td id="table-header">LEG PAIN/SCIATICA</td><td id="table-spacer"> </td><td id="table-header">PARASTHESIAS</td></tr><tr><td>This pain is most commonly experienced at the outside of the thigh, the lower leg and/or the foot. Shooting pain that radiates down the leg is a common experience with herniated discs. Patients commonly report an electric shock type of symptom. </td><td id="table-spacer"> </td><td>This is the medical word for abnormal sensations such as tingling, numbness, weakness or “pins and needles”. These symptoms may be the result of a herniated disc and may be experienced in the same regions as painful sensations.</td></tr><tr><td id="table-header">MUSCLE WEAKNESS</td><td id="table-spacer"> </td><td id="table-header">BOWEL OR BLADDER PROBLEMS</td></tr><tr><td>Signals from the brain may be interrupted due to nerve irritation. This can cause muscle weakness, usually of the ankle. Nerve irritation can be tested by examining the reflexes of the knee and ankle.</td><td id="table-spacer"> </td><td>These symptoms are important because they may be a sign of Cauda Equina syndrome. This condition is possibly caused by a herniated disc. This is a medical emergency! You must see a medical doctor immediately if you have problems urinating, having bowel movements, or if you have numbness around your genitals. All of these symptoms are likely caused by irritation to one of the nerves as a result from a herniated disc.</td></tr></tbody></table><h3>DIAGNOSIS</h3><img src="http://www.americanspinal.com/images/stories/content/herniated_disc/003.jpg" alt="Image" title="Image" border="0" height="67" hspace="6" width="86" /> <p>Diagnosis of a herniated disc (either neck or low back) can be made from a thorough physical examination including a detailed history, orthopedic and/or neurological evaluation. Some disc patients will present with an antalgic gait (lean away from the side of the disc lesion), extremity pain/numbness/tingling (abnormal sensation) in addition to neck or low back pain. Muscle weakness may be present in the more chronic cases as well as areflexia ("loss of reflex"). X-rays can be helpful in identifying degenerative changes of the vertebra, but MRI’s are the "gold standard" to identify the exact nature of the lesion. When the disc is herniated in the lumbar spine (low back), and it is compressing the spinal nerve roots causing pain and numbness down the buttocks, thigh and leg, it is often referred to as sciatica.</p><p> </p><h3>TRADITIONAL TREATMENTS</h3><img src="http://www.americanspinal.com/images/stories/content/herniated_disc/004.jpg" alt="Image" title="Image" border="0" height="67" hspace="6" width="84" /><p>Traditional treatments for herniated disc includes physical/chiropractic therapy, epidural Injections, surgery and pain killers such as non-steroid anti-inflammatory medication (NSAID's).</p><p>Please keep in mind that NSAID's have an inherent risk of gastrointestinal (GI) ("stomach" and "intestinal") disorders such as: perforation, ulceration and hemorrhages. The New England Journal of Medicine reported that it has been conservatively estimated that 16,500 NSAID-related deaths occur every year in the United States, and conservative calculations estimate that approximately 107,000 Americans are hospitalized every year due to NSAID related GI complications. The number of deaths reported in the same study due to AIDS was 16,685. In addition to gastrointestinal disorders, drugs such as VIOXX have been known to cause serious cardiovascular (CV) events such as: heart attacks, strokes and heart failure. There have been similar complaints from other NSAID's such as: Bextra and Celebrex.</p><h3>NON-SURGICAL SPINAL DECOMPRESSION</h3><img src="http://www.americanspinal.com/images/stories/content/herniated_disc/005.jpg" alt="Image" title="Image" border="0" height="68" hspace="6" width="86" /><p>Non-Surgical Spinal Decompression offers to treat the root cause of the diseased or pathological disc based on the anatomical and physiological principles of Non-Surgical Spinal Decompression.</p><p>Non-Surgical Spinal Decompression relieves pressure from the disc, which, in turn, relieves pressure from the nerve.</p><p>Research has shown that Non-Surgical Spinal Decompression can create a negative pressure within the disc causing a "vacuum effect". This vacuum effect can "suck" the disc material back inside, thus relieving the pressure from the nerve.</p><p>According to the FDA 510k papers, the definition of decompression is “unloading due to distraction and positioning”, and additionally, “unweighting due to distraction and positioning”. This is important because the “unloading” of the injured area creates positive changes in the microcirculation of the disc and nerve roots.</p><p>Therefore, Non-Surgical Spinal Decompression for herniated discs is based on the following principles.</p><ul><li>Decompression of the involved disc creates a negative intradiscal ("within the disc") pressure which, in turn, creates</li><li>a vacuum effect which reduces ("sucks in") the size of the herniation, and which then takes pressure off the involved nerve root</li><li>Reduction or elimination of extremity (leg/arm) pain and/or numbness, while at the same time </li><li>The pumping motions, due to Non-Surgical Spinal Decompression, called, "imbibition", allows nutrients to be exchanged at the level of the disc and inflammation around the nerve root to be dispersed resulting in reduction or elimination of low back pain. </li></ul><h3>EPIDURAL INJECTION</h3><p>Epidural injections ("injection within the epidural space of the spinal cord") with corticosteroids, lidocaine or opioids have no proven benefit in treating neck or upper back symptoms. In the instances that people find improvement, the effects are often temporary and require repeat injections, and several per year are not uncommon. There is also an increase in risk in contracting a spinal infection that can lead to meningitis. In fact, the results of a randomized, double-blind trial, published in the June 2003 issue of the Annals of Rheumatic Diseases indicated that an epidural steroid injection was no better than an epidural saline ("salt water") Injection (i.e. placebo) for sciatica. These findings are consistent with those of another definitive trial presented at the last American College of Rheumatology meeting.</p><p>Given that there have been advances in spinal surgery, the outcomes can still be very unpredictable. In failed back surgery, post-operative pain syndrome is a very disabling and troubling reality of surgical intervention. According to the 2002 Johns Hopkins White Paper on “Low Back Pain and Osteoporosis “* by John P. Kostulk, M.D. and Simeon Margolis, M.D., PhD., surgery "is not the treatment of choice for most people with back pain." The report goes on to say “fewer than 5% of people with back pain are good candidates for surgery”. "Surgery ought to be used when all other measures have been explored, and only if it appears that there is a strong probability that it will improve the condition." An article in Spine reviewed the outcomes and complication rates for surgical intervention in degenerative disc disease. Complication rates were as high as 55% and included: hematoma, neurologic adjacent segment degeneration, infection and hardware/instrument-related issues. Another study determined the effects of single-level (2 vertebrae) and 2-level (3-4 vertebrae) spinal fusion success rates reported 53% with "good" and "fair" results with single- level fusion and no "good" results with 2-level fusions.</p><p>Having read about the possible side effects relating to these “traditional” treatments, you might want to consider the drugless, non-surgical approach that Non-Surgical Spinal Decompression has to offer.</p><ul><li>Wolfe, Michael MD et al. Gastrointestinal Toxicity of Non-Steroidal Anti-inflammatory Drugs. N Engl J Med. 1999 June 17; 340(24): 1888-1899. </li><li>Singh, G. Recent considerations in nonsteroidal anti-inflammatory drug gastropathy. Am J Med. 1998 Jul 27; 105(1B):31S-38S. </li><li>Soloman SD, McMurray JJ et. all. Cardiovascular risk associated with celecoxib in a clinical trial for colorectal adenoma prevention. N Engl J Med. 2005 Mar 17;352(17): 1071-80. </li><li>Kostulk, John P. M.D., Margolis, Simeon M.D., PhD Johns HopkinsWhite Paper on Low Back Pain and Osteoporosis 2002. </li><li>Glass, Lee MD. Occupational Medicine Practice Guidelines: American College of Occupational & Environmental Medicine. 2nd ed., OEM press. </li><li>Bono, Christopher MD, Lee, Casey MD. The Influence of Subdiagnosis on Radiographic and Clinical Outcomes After Lumbar Fusion for Degenerative Disc Disorders: An Analysis of the Literature From Two Decades. Spine. 30(2):227-234, 2005. </li><li>Knox BD, Chapman TM. Anterior Lumbar Interbody Fusion for Discogram Concordant Pain. J Spinal Disord 1993;6:242-244. </li></ul></div>NW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.comtag:blogger.com,1999:blog-4329473241659898327.post-10844220599748705472009-06-08T10:44:00.000-07:002009-06-08T11:25:38.961-07:00The Easy Fast Diet<a href="http://1.bp.blogspot.com/_3iDi3yNnApk/Si1WXDjV0LI/AAAAAAAAAEc/C93jyDDeWY8/s1600-h/Fastandeasy.jpg"><img style="TEXT-ALIGN: center; MARGIN: 0px auto 10px; WIDTH: 240px; DISPLAY: block; HEIGHT: 320px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5345023286849163442" border="0" alt="" src="http://1.bp.blogspot.com/_3iDi3yNnApk/Si1WXDjV0LI/AAAAAAAAAEc/C93jyDDeWY8/s320/Fastandeasy.jpg" /></a><br /><div><br />Week 1 FAST on Sunday<br />Week 2 FAST Sunday and Monday<br />Week 3 FAST Sunday through Tuesday<br />Week 4 FAST Sunday through Wednesday<br /><br /><br />I created this with the sick and extremely healthy in mind. I experienced fasting regimens while I lived in the Republic of China and experienced the benefits of eating clean food and fasting first hand. Do this as little or as many times as you like throughout the year. At a minimum I would schedule this event quarterly. You’ve likely heard of the Master Cleanse. It has become quite popular and for good reason. IT WORKS! It helps the body burn fat, rid toxins and develop the body's neurological awareness against toxins in foods and the environment. The EASY FAST is a 5 week version a powerful cleanse combined with the detoxification diet regimen. It allows the body to gradually become accustomed to a fasting environment building a gradual will power and offers a high potential for successful completion.<br />THE DAY BEFORE: The day before the fast you eat a normal detoxifying regimen diet but without any meat for dinner. Have just veggies and legumes for dinner.<br />FASTING DAYS: On fasting days one starts the day with a Greens complex mixed in water. For the duration of the day one drinks room temperature, or above, lemon water and Green Tea. The calculation for water is half your body weight in ounces. For example a 200lb person would drink 100 ounces of water. The calculation for green tea is half that of water. For example a 200lb person would drink 50 ounces of green tea. These values are a MINIMUM. You can drink as much water and green tea as you like.<br />The last drink of the day one would add 1 teaspoon of Kosher Salt to a glass of water and drink it.<br /><br /><br />EXERCISE:<br />This is important. Walking, Running and Cycling are recommended. The tempo of the exercise is critical. This program uses High Intensity Interval Training. The Swedish call this “Fartlek” it makes getting the heart pumping fun and easy.<br />It involves adding random “intervals” of all out speed during a walk, jog or while cycling. The number of intervals during a workout are gradually increased over time. It is used by the worlds top athletes to create MASSIVE action in the body’s physiology. It allows us to do more for our bodies in less time. What a concept!<br /><br />Sample Diet Menu ( non fasting days)<br />A B<br />Breakfast Greens+Protein+H20 Hard boiled or poached egg<br />Grapefruit half and Green Tea Greens+Protein+H20<br />Hard boiled or Poached egg Grapefruit half & Green Tea<br /><br />Snack 10 Almonds,Apple w/Cinnamon 10 Almonds,Veggie Mix<br />& Green Tea & Green Tea<br /><br />Lunch Spinach Salad w/ ACV Balsamic Dressing Spinach Salad with Hummus<br />with Broiled Oregano Chicken Breast Vinegar & Veggies & Tuna<br />and Black Beans Lentil or Bean Soup<br /><br />Snack 1/2 cup Blue Berries Apple with Cinnamon<br />Carrot Stick + Hummus (Handful) Green Tea<br />Green Tea Pistaccios (15) or<br />5Kalamata Olives<br /><br />Dinner Ahi Tuna Steak Grilled<br />with Garlic and Basil with Veggies Oregano/Basil Grilled<br />Marinated in Lemon Juice<br />with Veggies<br /><br />Snack Pineapple (1/2 cup) Blueberris/Pomagranate (1/2 cup)<br /><br />SUPPLEMENTATION: On Fasting Days only the Greens Complex and Body Lean is taken unless otherwise specified by the Doctor.<br /><br />And as always consult with your physician before starting this program if you have any health conditions. Pick a date on the calendar to begin, go shopping and prepare to experience a whole new feeling of health and vitality!<br /><br />The Ultimate Detox Diet<br />Use this diet to take a load off of your pancreas, kidneys, liver and gastrointestinal tract.<br />Here is what you should avoid:<br />Processed foods<br />Any food that contains genetically modified ingredients, artificial sweeteners, artificial flavors or anything you cannot pronounce.<br />Starches and grains<br />Pasta, Potatoes, Breads, Cereals and anything with gluten content.<br />Juices and soft drinks<br />Water and teas are the only acceptable beverage, juice is a waste of energy they usually contain processed sugars and artificial sweeteners.<br />Here is what you should upload into your life:<br />Vegetables<br />Fiber and Alkalinity are some of the greatest benefits of veggies. Order organic to your doorstep if you can it's cheap and it forces you to take advantage of some amazing variety. Go green! Green leafy veggies have so much nutrition like calcium and iron as well as tons of antioxidant power. I like Swiss chard, kale, collard greens, green beans, peppers and spinach. A great substitute for lettuce in salads is baby spinach. Remember that POTATOES ARE NOT VEGGIES. OK, maybe by definition but a nutritional breakdown suggests that they fit much better with pasta, white bread and white rice so leave them alone! Uploading veggies as part of every meal and snack plus substituting with a "Greens" nutritional supplement mix will allow the body to maintain an alkaline environment which will allow the body's cells to repair and regenerate.<br />Legumes<br />A great source of fiber and protein. This list includes<br />• Adzuki Beans<br />• Black Beans<br />• Black-eyed peas<br />• Broad Beans (Fava Beans)<br />• Butter Beans<br />• Calico Beans<br />• Cannellini Beans<br />• Chickpeas (Garbanzo Beans)<br />• Edamame<br />• Great Northern Beans<br />• Italian Beans<br />The Ultimate Detox Diet Cont…<br />• Kidney Beans<br />• Lentils<br />• Lima Beans<br />• Mung Beans<br />• Navy Beans<br />• Pinto Beans<br />• Soy Beans including black soy beans<br />• Split Peas<br />Wow! Look at all this variety. In Eastern and European countries these are staples and those countries have a dramatically lower incidence of disease.<br />Nuts<br />Yes you can be nuts over nuts! Raw nuts be them almonds, pasticcios, cashews, peanuts, walnuts, pecans and all the rest. Almonds are my favorite and contain the most nutrient-bang for you buck with the most protein, calcium (yes calcium!), B vitamins, magnesium, phosphorus, and potassium to name a few. So have raw nuts handy as a snack in between meals and for dessert.<br />Poultry and Fish<br />If you look at most healthy countries' dinner plates, meat is a garnish. It is prepared with utmost care and flavour to savour but it doesn't make up the bulk of the plate. So eat and savour meat just don't load up on it. Cook your meats with healthy oils like olive, canola and coconut oils and flavor them with light kosher salt, pepper and spices like paprika, cayenne, turmeric and herbs like fresh oregano, basil and rosemary.<br />Fruits<br />I am tired of hearing diabetic patients say they can't eat fruits because of sugar while they throw artificial sweeteners and processed foods down the hatch. Real organic fruit is full of fiber, antioxidants and nutrition that is excellent for the body while not raising blood sugar levels through the roof. Stick to powerful and easy fruits that aren't too acidic like apples, blue berries, bananas and pomegranates.<br /><br /><br /><br />THE SHOPPING LIST: Go to a natural health food store and shop for your week.<br />1. Case of Mineral Water<br />2. Lemons<br />3. Green Tea - there are lots of versions, get PLAIN tea<br />4. Herbs and flavor - Fresh Basil, Oregano, Cinnamon and Garlic, ACV and Balsamic Vinegar (Kalamata Olives optional)<br />5. Fruit- Blueberries, Grapefruit, Apples, Pineapple, (No Strawberries) and the list<br />6. Veggies - Refer to The Ultimate Detoxification Diet for examples<br />7. Legumes - Black Beans (Canned or Dry), Refer to The Ultimate Detoxification Diet for others. Buy some cans of Lentil and Bean Soup for easy meals as well as Hummus to spread on salad and dip for veggies.<br />8. Nuts - Refer to The Ultimate Detoxification Diet<br />9. Poultry and Fish and Eggs - Chicken Breast, Salmon (Wild), Ahi Tuna Steak, Free Range Eggs. Refer to The Ultimate Detoxification Diet for preparation instructions </div>NW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.comtag:blogger.com,1999:blog-4329473241659898327.post-3072366650602853832009-06-07T18:45:00.001-07:002009-06-07T18:47:21.681-07:00Healthy Receipes That Taste Amazing! Part 2<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://4.bp.blogspot.com/_3iDi3yNnApk/SixtlVxg2nI/AAAAAAAAAEM/Qlf1a_a0fgc/s1600-h/Mango+Ginger+Sauce.png"><img style="cursor: pointer; width: 320px; height: 113px;" src="http://4.bp.blogspot.com/_3iDi3yNnApk/SixtlVxg2nI/AAAAAAAAAEM/Qlf1a_a0fgc/s320/Mango+Ginger+Sauce.png" alt="" id="BLOGGER_PHOTO_ID_5344767346049342066" border="0" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://4.bp.blogspot.com/_3iDi3yNnApk/SixtlJp5-QI/AAAAAAAAAEE/c1_mIM_2boY/s1600-h/White+Bean+Tuna+Salad.png"><img style="cursor: pointer; width: 320px; height: 163px;" src="http://4.bp.blogspot.com/_3iDi3yNnApk/SixtlJp5-QI/AAAAAAAAAEE/c1_mIM_2boY/s320/White+Bean+Tuna+Salad.png" alt="" id="BLOGGER_PHOTO_ID_5344767342796208386" border="0" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://4.bp.blogspot.com/_3iDi3yNnApk/SixtkkpLlYI/AAAAAAAAAD8/fqtVa4u8mCg/s1600-h/Lemon+Garlic+Chicken.png"><img style="cursor: pointer; width: 320px; height: 162px;" src="http://4.bp.blogspot.com/_3iDi3yNnApk/SixtkkpLlYI/AAAAAAAAAD8/fqtVa4u8mCg/s320/Lemon+Garlic+Chicken.png" alt="" id="BLOGGER_PHOTO_ID_5344767332861056386" border="0" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://3.bp.blogspot.com/_3iDi3yNnApk/SixtkeYDpEI/AAAAAAAAAD0/_L_kvUE1yCg/s1600-h/Turkey+Burger.png"><img style="cursor: pointer; width: 320px; height: 154px;" src="http://3.bp.blogspot.com/_3iDi3yNnApk/SixtkeYDpEI/AAAAAAAAAD0/_L_kvUE1yCg/s320/Turkey+Burger.png" alt="" id="BLOGGER_PHOTO_ID_5344767331178619970" border="0" /></a>NW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.comtag:blogger.com,1999:blog-4329473241659898327.post-60633394210873393562009-06-07T18:31:00.000-07:002009-06-07T18:45:00.194-07:00Healthy Receipes That Taste Amazing! Part 1<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://1.bp.blogspot.com/_3iDi3yNnApk/Sixs7nMAYhI/AAAAAAAAADs/lALJlnDI4S8/s1600-h/Chicken+Salad.png"><img style="cursor: pointer; width: 320px; height: 152px;" src="http://1.bp.blogspot.com/_3iDi3yNnApk/Sixs7nMAYhI/AAAAAAAAADs/lALJlnDI4S8/s320/Chicken+Salad.png" alt="" id="BLOGGER_PHOTO_ID_5344766629169357330" border="0" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://4.bp.blogspot.com/_3iDi3yNnApk/Sixs7agYexI/AAAAAAAAADk/qIN-w9g86mA/s1600-h/Tuna+Salad.png"><img style="cursor: pointer; width: 320px; height: 140px;" src="http://4.bp.blogspot.com/_3iDi3yNnApk/Sixs7agYexI/AAAAAAAAADk/qIN-w9g86mA/s320/Tuna+Salad.png" alt="" id="BLOGGER_PHOTO_ID_5344766625765161746" border="0" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://1.bp.blogspot.com/_3iDi3yNnApk/Sixs67gPvMI/AAAAAAAAADc/0pmThJ8yPkA/s1600-h/Vegetable+Soup.png"><img style="cursor: pointer; width: 320px; height: 159px;" src="http://1.bp.blogspot.com/_3iDi3yNnApk/Sixs67gPvMI/AAAAAAAAADc/0pmThJ8yPkA/s320/Vegetable+Soup.png" alt="" id="BLOGGER_PHOTO_ID_5344766617443089602" border="0" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://1.bp.blogspot.com/_3iDi3yNnApk/Sixs6rbQ_HI/AAAAAAAAADU/36pAcQfnj5A/s1600-h/Gazpacho.png"><img style="cursor: pointer; width: 320px; height: 192px;" src="http://1.bp.blogspot.com/_3iDi3yNnApk/Sixs6rbQ_HI/AAAAAAAAADU/36pAcQfnj5A/s320/Gazpacho.png" alt="" id="BLOGGER_PHOTO_ID_5344766613127232626" border="0" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://2.bp.blogspot.com/_3iDi3yNnApk/Sixs6Konn-I/AAAAAAAAADM/bDDG12kjH2c/s1600-h/Chilled+Cucumber+Soup.png"><img style="cursor: pointer; width: 320px; height: 122px;" src="http://2.bp.blogspot.com/_3iDi3yNnApk/Sixs6Konn-I/AAAAAAAAADM/bDDG12kjH2c/s320/Chilled+Cucumber+Soup.png" alt="" id="BLOGGER_PHOTO_ID_5344766604324872162" border="0" /></a>NW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.comtag:blogger.com,1999:blog-4329473241659898327.post-90930309923329555982009-06-07T18:23:00.000-07:002009-06-07T18:30:31.172-07:00Health Benefits of Fasting<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://3.bp.blogspot.com/_3iDi3yNnApk/Sixpr7hpPOI/AAAAAAAAADE/PENjxsAr-Ik/s1600-h/fasting.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 320px; height: 213px;" src="http://3.bp.blogspot.com/_3iDi3yNnApk/Sixpr7hpPOI/AAAAAAAAADE/PENjxsAr-Ik/s320/fasting.jpg" alt="" id="BLOGGER_PHOTO_ID_5344763061216034018" border="0" /></a><br /><br />The online encyclopedia Wikipedia defines fasting as, "the act of willingly abstaining from some or all food and/or drink, for a period of time...Medical fasting can be a way to promote detoxification." Fasting is actually one of the oldest known medical practices used to treat all types of ailments. Even Hippocrates, the father of Western medicine, acknowledged the power of fasting. He believed the practice allowed the body to heal itself. In almost every known religion, fasting is used as a way to medically and spiritually heals one's self. Since fasting is such a widespread practice, you may wonder how such a practice that denies the body of food can be good for it. Here's how.<br /><br />It is believed that many of the health benefits of fasting come from giving your digestive system a break from its work of breaking down foods. Through the practice of fasting, the digestive system also gets a break from combating the toxins that enter the body in the form of the highly processed foods that made up the majority of our modern diets. Since the body is not expending energy in the digestive process, this energy can be used for other purposes such as allowing the body to heal itself. Also, since the body's immune system is not busy fighting of bacteria and other toxins that enter the body through the foods we eat, the immune system can concentrate on healing what diseases and sicknesses in the body.<br /><br />One of the most obvious health benefits of fasting is the detoxification this practice brings. Some believe fasting can not only allow cells to rid themselves of harmful toxins, and dead or diseased tissue, but can also rejuvenate the internal organs, allowing them to work more efficiently. Some doctors also claim fasting can help cure diseases such as cancer, lupus, arthritis, asthma, high blood pressure and allergies.<br /><br />In addition to the detoxification benefits of fasting, this practice can also be used as a way to lose weight quickly. While it may seem fasting would be an ideal way to lose weight, be careful because the body had defense mechanisms which can cause this form of dieting to backfire. The first couple of days of your fast you will lose as much as 2 pounds per day, with most of the weight being water. After the initial fast weight loss, however, you will stop losing as quickly and your weight loss will slow to about ½ pound each day. The reason for this slowing down of the weight losing process is that after a few days of having no food, the body thinks there may be a chance it is starving. In an attempt for self preservation, the body will automatically readjust its metabolic rate to conserve energy and stored fats.<br /><br />This is why staying on a fast too long just so you can lose weight is not a good idea. If you want to use fasting for weight loss it's best to follow a staggered plan of 1 or 2 days of fasting followed by 3 days of healthy eating.<br /><br />Recorded since the beginning of time, fasting is a practice that has many benefits for the body. Not only does it give the body a chance to heal itself, it also cleans all the toxins and poisons from the body. The health benefits of fasting can leave you feeling more energized and more physically fit that ever before.NW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.comtag:blogger.com,1999:blog-4329473241659898327.post-3499477555311786232009-06-07T13:05:00.000-07:002010-06-24T20:31:28.584-07:00Benefits of Water<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://4.bp.blogspot.com/_3iDi3yNnApk/SiweXHBVBnI/AAAAAAAAACk/4Vg7aVRKqtA/s1600-h/pouring-water.jpg"><img style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer; width: 240px; height: 320px;" src="http://4.bp.blogspot.com/_3iDi3yNnApk/SiweXHBVBnI/AAAAAAAAACk/4Vg7aVRKqtA/s320/pouring-water.jpg" alt="" id="BLOGGER_PHOTO_ID_5344680240152381042" border="0" /></a><br /><h2 style="color: rgb(0, 102, 0);">Easy Energy and Weight Control: The Benefits of Water</h2>Like the famous hip hop star Jay Z says in one of his songs, “H to the O!” (I’m sure that’s not what he meant but it works for the purpose of this article). Everyday in our clinic the importance of water has become a mantra. We hear so much about how our body is made primarily of water and that we need to drink lots. What is lots? Some say 8 cups a day, others say 64 ounces a day, some say just keep drinking until your urine is clear. Well I’d have to agree the closest with the latter, but how do you get there without inspecting your urine constantly? <p>Here is the simple formula to follow in relation to water:</p> <p><strong>Drink 1/2 Your body weight in ounces every day. Therefore if you weigh 100 lbs, you should drink 50 ounces of water.</strong></p> <p>In addition to that for any beverage you drink that isn’t water you need to drink that much more water. For example, if you have a 20 ounce cup of coffee in the morning you must add 20 more ounces of water to your daily quota. THIS GOES FOR ANY BEVERAGE THAT ISN’T WATER.</p> <p><strong>Tips:</strong></p> <ul><li>Be sure to get at least half that quota down before noon so that you’re not up all night.</li><li>Carry a water bottle with you and calculate how many fill-ups you need to meet each day. Never say "I should drink more water" or "I will drink more water". What is more? Define exactly how much your body needs and do it!</li><li>Add a lemon or lime to your bottle for flavour.</li><li>Try to drink out of a bottle that is made of glass or a SIGG water bottle</li><li>Drink only mineral or sparkling water, distilled water is useless for your body.</li></ul> <p><strong>Benefits:</strong></p> <ul><li>Aids your body by promoting alkalinity (refer to <a href="http://awordofhealth.blogspot.com/2009/06/alkalinity.html">Alkalinity The Power of Going Green</a> for more information on the benefits of alkalinity)</li><li>Helps quench hunger cravings, most hunger cravings are really signs of dehydration.</li><li>Promotes elasticity and turgor (fullness) of the skin keeping you wrinkle free!</li><li>Rids your body of toxins</li><li>Increases Energy Levels (Your cell’s energy and growth is dependent on the electrons it gets from water)</li><li>Increases Physical and Mental Performance</li></ul> <p>So get up and out of your seat, calculate your daily quota and fill up! The more consistent you make this healthy habit the more your body will thank you. You’ll find that your nervous system learns how to use the water more efficiently as the weeks go by.</p><p><br /></p>NW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.comtag:blogger.com,1999:blog-4329473241659898327.post-37394618538360918782009-06-07T12:33:00.000-07:002011-06-23T21:06:26.178-07:00Alkalinity<a href="http://3.bp.blogspot.com/_3iDi3yNnApk/SiwWhffbjoI/AAAAAAAAACc/ATPmP1k3nhU/s1600-h/fresh-vegetables.jpg" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img style="margin: 0pt 0pt 10px 10px; float: right; cursor: pointer; width: 275px; height: 182px;" src="http://3.bp.blogspot.com/_3iDi3yNnApk/SiwWhffbjoI/AAAAAAAAACc/ATPmP1k3nhU/s320/fresh-vegetables.jpg" alt="" id="BLOGGER_PHOTO_ID_5344671622426758786" border="0" /></a><br /><h2 style="color: rgb(0, 153, 0);">Alkalinity: The Power of Going Green</h2>If you listen to one thing I write about. If you take one piece of advice, it’s this! The power of creating an alkaline environment in your body can be the difference between poor health and amazing vitality!<br /><br />The pH of the blood should be 7.63. An alkaline environment is where cells thrive and have the best potential to regenerate and complete their cycle. Acid environments, are those created by diets loaded with protein (Atkins, American), highly refined carbohydrates, sugar and processed foods.<br /><br />So it’s simple acid kills cells and the opposite, alkalinity lets cells grow and do their thing.<br /><br />The more acid we have in our bodies also promotes fat tissue to stick around because it buffers acid. Acid in the body is also associated with osteoporosis and kidney stones. If the body is acidic it will excrete calcium from the bones to create it’s own version of TUMS. The problem is that other than depleting your bodies bone density free calcium gets stuck in the sinuses of your kidneys and now you have a calcium oxolate stone, the most common kind of kidney stone.<br /><br />Do you want the secret to alkalinity? Ok it’s easy.<br /><br />Drink loads of pure undistilled water. Half your body weight in ounces per day. For every ounce of coffee, juice or tea you drink, you must drink that much more water. ½ body weight in ounces eg. 100lb girl would drink 50 ounces of water<br />Eat loads of fresh organic fruits and vegetables. I try to convince all my patients to go organic and join a coop or door to door organic delivery (every cool city has one) where the money you spend stays in the community with supporting local farmers.<br />Go Green! Take a greens supplement every morning on an empty stomach and periodically throughout the day. I have my patients take Greens from Chiropractors Blend. It is the best one I could find it contains: loads of fiber; the green power of spirulina, barley juice, wheat grass; the digestive powers of bromelain, papain, amylase and probiotics; the detoxifying powers of beet juice, milk thistle, green tea and loads more.<br />Stay away from processed sugars, excessive meats, aspartame and other harsh chemicals, and refined grains. (This means put the soda can down, in fact throw it far away!)<br />If you follow these simple steps you can protect your body from aging, cancer, sickness and disease. Don’t wait till you start having symptoms, start the GREEN REVOLUTION today!<br /><br />Yours in Health,<br /><br />- Dr. MalikNW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.comtag:blogger.com,1999:blog-4329473241659898327.post-13056547048791308722009-06-07T12:09:00.000-07:002009-06-07T19:27:35.923-07:00<span style="color: rgb(0, 153, 0);font-size:180%;" ><span style="color: rgb(51, 255, 51);">Dr. M's Top 5 Metabolic Enhancers- Jumpstart your Metabolism</span></span><br />June 7, 2009 - Dr. Malik<br />Green Tea- Contains ECGC a potent thermodynamic enhancer helping melt off pounds while packing a super anti-oxidant punch helping keep Cancer and other diseases from presenting. Be sure to steep your tea for 5 minutes to get all the goodstuff into the cup and it's not a bad idea to use 2 tea bags to be sure. Flavour with a lemon if you like but try not to add sugar. Drink at least 2 big cups a day and more if you want more metabolic kick. Cheers!<br />Lecithin- This potent fat burner is found in Oatmeal and Eggs. It can also be purchased as a supplement. It has the added benefits of being a great anti-oxidant and helping support healthy brain function. Add an egg (the whole thing!) and a cup of steel cut oats to your morning routine to give you a great boost and energetic start for your day.<br />Sea Kelp- Supports the Thyroid Gland with a great source of Iodine. The Thryoid gland takes sugar from the body and converts it to heat keeping the body at 98.6 degrees. Iodine helps fuel this metabolic machine. It seems that every third women who comes into my office is on or has been told they need to take a synthetic version of Thryoid Hormone and that is a life sentence. Get your kelp early in life and avoid the pressure of popping pills.<br />Water- I mention water and it's huge contribution to phenomenal health everyday. Drinking AT LEAST 1/2 your body weight in ounces will propel your metabolism and help your body normalize it's fat within months. (Read my article on water....) Up your dose past the minimum quota and watch your energy and motivation sore and your love handles slowly disappear. It takes about six months of consistent water intake to see the dramatic results but in just a few short weeks you should start to feel awesome!<br />Superfoods- Superfoods contain potent antioxidants and alkaline boosters to help the body rid it's toxins from fats and help cells function optimally. Eat these foods and watch fat blast away and healthy vitality explode bringing out a youthful glow in that baby soft skin of yours. Here are some superfoods you should incorporate weekly if not daily into your diet. Wheatgrass, Spirulina, Blueberries, Acai Fruit, Gogi Berries, Noni Juice and Grapefruits. Hit your natural healthfood supermarket or CO-OP and pick some of these up today and start living vital.<br />What to Avoid- Genetically Modified foods, Trans Fats in the form of hydrogenated oils and subsequent products, refined carbohydrates like potatoes, white bread and white sugar. All of these dumb down your nervous system and slow metabolism.<br /><br />There you have my FAB 5 for Fat Loss! Make them part of your everyday.<br /><br />Yours in Health and Reaching your maximum potential,<br /><br />Dr. MalikNW Pain Institutehttp://www.blogger.com/profile/12338041301905421959noreply@blogger.com