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Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
September, 2002, Vol. 02, Issue 09
Bye-Bye Hormone Replacement Therapy, Hello Alternative Medicine
By James P. Meschino, DC, MS
On July 9, 2002, researchers announced they were stopping the American Women's Health Initiative (WHI) trial of 16,000 women taking hormone replacement therapy (HRT). The reason was that after a little over five years of the study, there was a 26 percent increased risk of breast cancer in women taking HRT, compared with those receiving the placebo.Women taking HRT also showed a 41 percent increased risk of stroke, and a 29 percent increased risk of myocardial infarction.
Prior to this, the Nurses' Health Study indicated that for each year a woman remained on HRT her risk of breast cancer increases by 2.3 percent. Thus, after 10 years she had a 23 percent increased risk of breast cancer, and after 20 years, a 46 percent increased risk of breast cancer compared to postmenopausal women who did not use HRT.
Adding to the alarming results of the WHI trial is the study published in the Journal of the American Medical Association (July 17, 2000 issue). This follow-up study of 44,241 former participants in the Breast Cancer Detection Demonstration Project showed that women taking estrogen replacement therapy (with no progesterone, known as unopposed estrogen) had an increased risk of ovarian cancer. For women who had used estrogen replacement for 10 to 19 years the relative risk was 1.8, which increased to 3.2 for women who used estrogen replacement therapy for 20 or more years.
These latest findings are changing the way the medical profession views the use of HRT and estrogen replacement (ERT). Doctors are now encouraged to use HRT only in cases where there is an absolute need, and ERT, which was commonly prescribed for women who had undergone hysterectomy, is no longer the treatment of choice. As the results of these findings begin to emerge in the popular media, patients themselves are voluntarily terminating their use of HRT and ERT in large numbers, and this movement is anticipated to continue at a predictable pace.
The question on the minds of consumers and practitioners is if there are natural alternatives to the use of HRT and ERT that are safe and effective in the management of menopausal symptoms. There are three clinically proven natural supplements that all practitioners should be aware of: black cohosh extract, gamma-oryzanol, and soy isoflavones.
In head-to-head studies against HRT, diazepam, and placebo, black cohosh extract (containing 2.5 percent triterpene glycoside content), has been shown to reduce hot flashes, insomnia, nervousness, anxiety, and a host of other emotional and physical menopausal symptoms. The triterpene constituents have been shown to act like the body's weakest estrogen (estriol), and serves as a precursor from which the female body can synthesize progesterone. Black cohosh extract has been widely researched and is a medically approved intervention in many European countries as a treatment for menopausal symptoms. In Germany, it has been in use for over 40 years, with no evidence of serious side effects, contraindications, or harmful interactions with other drugs.
Gamma-oryzanol is a substance derived from rice bran oil, which is a prescription drug in Japan and is used to reduce hot flashes associated with menopause, and to reduce high cholesterol and triglyceride levels in the blood stream. As heart disease is the number one killer of postmenopausal women, it is convenient that gamma-oryzanol can reduce bothersome symptoms of menopause, and help to lower risk of heart disease by reducing cholesterol and triglycerides by 12-15 percent. Recall that when people with high cholesterol lower their blood cholesterol level by one percent, there is a corresponding reduction in risk of heart disease of two to three percent. Thus, a 12 percent reduction in blood cholesterol translates into at least a 24 percent reduction in risk of heart attack and related cardiovascular events. The dosage of gamma-oryzanol required to contain menopausal symptoms and lower blood lipids is 150 mg, twice daily. Soy isoflavones have also been shown to reduce hot flashes and other menopausal symptoms, and lower cholesterol by 9-12 percent in hypercholesterolemic patients.
Soy isoflavones are also associated with a reduction in risk of breast cancer and have recently been shown, along with black cohosh triterpenes, to help support bone mineral density in postmenopausal women.
These are all attractive features for the postmenopausal woman, who is prone to heart disease, breast cancer, and osteoporosis. For this reason I recommend to postmenopausal female patients (who have no prior history of breast cancer) that they use a combination supplement product that contains all three herbal and accessory nutrients reviewed in this update, in one capsule, at the following doses:
The dangers of HRT and ERT will likely prompt a flurry of questions about the use of safe, and natural alternatives to these drugs. Health care practitioners will be called upon to help postmenopausal patients make informed decisions about the management of menopause, anti-aging and disease prevention strategies, based upon the existing scientific evidence. It is vital that patients be made aware of the evidence-based research in this area, which should help to avoid their reliance upon less effective or ineffective dietary supplements in the management of their menopausal years.
Black Cohosh References
Estrogen Replacement Therapy and Breast Cancer References
Click here for previous articles by James P. Meschino, DC, MS.
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