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What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
January, 2006, Vol. 06, Issue 01
Whooping Cough: A Re-Emerging Disease
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
Happy New Year! I, and I'm sure everyone else at Massage Today, hope that 2006 is full of joy, accomplishment and satisfaction for all of us. One way to achieve those goals is to keep healthy.On that note, let us turn to today's topic of discussion: whooping cough.
For most people born after 1950, whooping cough might sound like the stuff of 19th-century fiction - the kind of disease you'd find in Little Women or Huckleberry Finn. Indeed, whooping cough was at one time a common childhood infection with the potential to be deadly. The development of an effective vaccine in the late 1940s has largely eradicated the sense of threat this condition once carried.
Several decades later, however, whooping cough is viewed as an emerging disease that carries some significant threats. The reasons for this are twofold. First, the childhood vaccines many of us had do not (as was once thought) impart lifelong immunity; in fact, they probably begin to wear off after about five years. Second, as the threat of childhood death from infections like mumps, rubella and scarlet fever has declined, the sense of importance of childhood vaccinations also has declined. Consequently, many children are not fully immunized.
Note: This is not the place to debate the efficacy, appropriateness or legitimacy of vaccines in general. Vaccinations are not a black-and-white issue. Some vaccines have higher efficacy and lower rates of complications than others (and vice-versa). Anyone who would like to debate this point will have to find another platform. That discussion is not my intention.
Whooping Cough: What Is it?
Whooping cough, also called pertussis, is a bacterial infection of the respiratory tract caused by a pathogen called bordetella pertussis. (Dog owners might recognize this name because a related bacterium causes "kennel cough," or bordetella.) About 10,000 people are diagnosed with whooping cough each year in this country (although some studies indicated it might largely be under-reported), and it causes about 10 deaths per year. The people most vulnerable to dangerously extreme infections are young children.
How Does it Work?
Whooping cough is highly communicable through airborne respiratory secretions, so a person with a bad cough easily can spread it to others. This bacterium invades the respiratory tract, killing ciliated cells and releasing toxins that stimulate a systemic immune reaction. The coughing that ensues has a characteristic presentation: the infected person expels so much breath that air rushes into the lungs with a "whoop" sound.
After a 7-10 day incubation period, whooping cough develops in three stages. The first stage is called the "catarrhal phase." At this point, it is indistinguishable from a common cold, and it lasts for several days. Instead of resolving, however, it proceeds to stage two: characteristic paroxysmal coughing, which occurs for up to 50 episodes a day and lasts 2-4 weeks. Coughing episodes are exhausting, and can be so taxing that they induce vomiting. The third stage is convalescence, which typically involves 3-4 weeks of recovery. A full course of whooping cough can cause even a fundamentally healthy person to lose 6-8 weeks of productivity and good health. Its effects on young children can be much worse.
The coughing pertussis causes is so severe that it can lead to bruised or broken ribs, abdominal or inguinal hernias, and vomiting. In young children, additional complications include under-nutrition (it's hard to eat when you're coughing so much it makes you throw up), pneumonia, anoxia, convulsions and even brain damage or death from lack of oxygen. Young children have the highest risk for the worst complications of pertussis; the rest of the population might experience severe infection, but are unlikely to have life-threatening complications.
Treatment options for whooping cough present an interesting quandary. In its early stages, pertussis is indistinguishable from the common cold, and it's slow and expensive to culture. Any pediatrician might make a reasonable assumption that coughing, sneezing and mild fever are due to viral infection, and therefore not responsive to antibiotics. By the time a child has entered the severe coughing phase, antibiotics might no longer serve to shorten the duration or reduce the communicability of the infection. In short, the most efficient way to reduce the risks of pertussis in young children is to prevent the infection from developing, i.e., to be vaccinated.
Whooping Cough and Massage
Unless massage therapists work with young children, they are unlikely to see a client with the worst possible case of whooping cough. However, adolescents and young adults whose vaccinations have worn off are at risk for the infection, as are other people who come in contact with them. A client who has been diagnosed with this infection (or who has a family member with it) should wait until it has run its course before coming in close contact with other people. If a client has recovered from a pertussis infection, massage is, of course, safe and appropriate.
For Next Time
The floor is open. It will be early spring; crocuses will be poking up from a crust of snow. What disorders or diseases would you like to read about? One condition that's been generating a lot of attention lately is celiac disease, also called celiac sprue. While once considered rare, this gluten-sensitivity disorder is now considered by some researchers to be present in a low-grade form in about one out of every 33 people. Unless I hear otherwise, that's what I will pursue for March. If you have something else you'd like to discuss, let me know: what's on your table?
Until then, many thanks and many blessings.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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