LATEST HEADLINES Headline News and Press Releases Many OTC Medications Not Recommended for Cough Treatment New Research 2006 Research Summaries Online CE Spotlights ChiroCredit.com Releases New Online Courses Specialty Certifications Childhood Developmental Disorders Many OTC Medications Not Recommended for Cough Treatment In their January 2006 Press Release, the American College of Chest Physicians (ACCP)has stated that Many OTC Medications are Not Recommended for Cough Treatment. “Cough is the number one reason why patients seek medical attention. Although an occasional cough is normal, excessive coughing or coughing that produces blood, or thick, discolored mucus is abnormal,” said Chair of the guidelines Richard S. Irwin, MD, FCCP, University of Massachusetts Medical School, Worcester, MA “The new ACCP guidelines define how physicians should diagnose and manage cough associated with everything from the common cold to chronic lung conditions. The guidelines also are the most comprehensive evidence-based recommendations for treating cough in children.” “There is no clinical evidence that over-the-counter cough expectorants or suppressants actually relieve cough,” said Dr. Irwin. “There is considerable evidence that older type antihistamines help to reduce cough, so, unless there are contraindications to using these medicines, why not take something that has been proven to work?” To view the full press release, please Click here. If the link does not work, please cut and paste the following into your browser and click go: http://www.chestnet.org/about/press/releases/2006/010906a.php TOP 2006 Research Summaries A non-surgical approach to the management of lumbar spinal stenosis: a prospective observational cohort study BMC Musculoskelet Disord. 2006 Feb 23;7:16. Murphy DR, Hurwitz EL, Gregory AA, Clary R. Rhode Island Spine Center, Pawtucket, RI 02860, USA. rispine@aol.com BACKGROUND: While it is widely held that non-surgical management should be the first line of approach in patients with lumbar spinal stenosis (LSS), little is known about the efficacy of non-surgical treatments for this condition. Data are needed to determine the most efficacious and safe non-surgical treatment options for patients with LSS. The purpose of this paper is to describe the clinical outcomes of a novel approach to patients with LSS that focuses on distraction manipulation (DM) and neural mobilization (NM). METHODS: This is a prospective consecutive case series with long term follow up (FU) of fifty-seven consecutive patients who were diagnosed with LSS. Two were excluded because of absence of baseline data or failure to remain in treatment to FU. Disability was measured using the Roland Morris Disability Questionnaire (RM) and pain intensity was measured using the Three Level Numerical Rating Scale (NRS). Patients were also asked to rate their perceived percentage improvement. RESULTS: The mean patient-rated percentage improvement from baseline to the end to treatment was 65.1%. The mean improvement in disability from baseline to the end of treatment was 5.1 points. This was considered to be clinically meaningful. Clinically meaningful improvement in disability from baseline to the end of treatment was seen in 66.7% of patients. The mean improvement in "on average" pain intensity was 1.6 points. This did not reach the threshold for clinical meaningfulness. The mean improvement in "at worst" pain was 3.1 points. This was considered to be clinically meaningful. The mean duration of FU was 16.5 months. The mean patient-rated percentage improvement from baseline to long term FU was 75.6%. The mean improvement in disability was 5.2 points. This was considered to be clinically meaningful. Clinically meaningful improvement in disability was seen in 73.2% of patients. The mean improvement in "on average" pain intensity from baseline to long term FU was 3.0 points. This was considered to be clinically meaningful. The mean improvement in "at worst" pain was 4.2 points. This was considered to be clinically meaningful. Only two patients went on to require surgery. No major complications to treatment were noted. CONCLUSION: A treatment approach focusing on DM and NM may be useful in bringing about clinically meaningful improvement in disability in patients with LSS. --------------------------- Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations Spine J. 2006 Mar-Apr;6(2):131-7. Santilli V, Beghi E, Finucci S. Direttore Cattedra Medicina Fisica e Riabilitativa, Universita di Roma La Sapienza, P.le Aldo Moro 5, Roma, Rome, 00185, Italy. BACKGROUND CONTEXT: Acute back pain and sciatica are major sources of disability. Many medical interventions are available, including manipulations, with conflicting results. PURPOSE: To assess the short- and long-term effects of spinal manipulations on acute back pain and sciatica with disc protrusion. STUDY DESIGN/SETTING: Randomized double-blind trial comparing active and simulated manipulations in rehabilitation medical centers in Rome and suburbs. PATIENT SAMPLE: 102 ambulatory patients with at least moderate pain on a visual analog scale for local pain (VAS1) and/or radiating pain (VAS2). OUTCOME MEASURES: Pain-free patients at end of treatment; treatment failure (proportion of patients stopping the assigned treatment for lack of effect on pain); number of days with no, mild, moderate, or severe pain; quality of life; number of days on nonsteroidal anti-inflammatory drugs; number of drug prescriptions; VAS1 and VAS2 scores; quality of life and psychosocial findings; and reduction of disc protrusion on magnetic resonance imaging. METHODS: Manipulations or simulated manipulations were done 5 days per week by experienced chiropractors, with a number of sessions which depended on pain relief or up to a maximum of 20, using a rapid thrust technique. Patients were assessed at admission and at 15, 30, 45, 90, and 180 days. At each visit, all indicators of pain relief were used. RESULTS: A total of 64 men and 38 women aged 19-63 years were randomized to manipulations (53) or simulated manipulations (49). Manipulations appeared more effective on the basis of the percentage of pain-free cases (local pain 28 vs. 6%; p<.005; radiating pain 55 vs. 20%; p<.0001), number of days with pain (23.6 vs. 27.4; p<.005), and number of days with moderate or severe pain (13.9 vs. 17.9; p<.05). Patients receiving manipulations had lower mean VAS1 (p<.0001) and VAS2 scores (p<.001). A significant interaction was found between therapeutic arm and time. There were no significant differences in quality of life and psychosocial scores. There were only two treatment failures (manipulation 1; simulated manipulation 1) and no adverse events. CONCLUSIONS: Active manipulations have more effect than simulated manipulations on pain relief for acute back pain and sciatica with disc protrusion. TOP ChiroCredit.com Releases New Online Courses Pediatrics 111 Laura Hanson, DC 1 Hour of Credit A Great Course Offered by a Footleveler Instructor Educational Objectives: Define developmental pediatric chiropractic care Associate the neurological connection of the reflexive response to the vestibular apparatus, sympathetics and postural faults Identify significant landmarks in the pregnancy and birth history Examine the pediatric patient neurologically Define persisted reflexes Soft Tissue Injuries 101 Linda Simon, DC 2 Hours of Credit Soft Tissue Injury: The Neglected Cause of Musculoskeletal Disorders< Educational Objectives: Explain the anatomy and functionality of healthy soft tissue components Explain the effects of injury on soft tissue Define effects of injured soft tissue on functionality of the spine and extremities Discuss patterns of musculoskeletal relationships of recruiting other structures after injury and their effects on functionality Describe various methods of treatment for dysfunctional soft tissue Explain relationship of injured tissue to its surrounding structures, its effects and treatment Explain compensation and recruitment of healthy tissue to the broader scope of complications and the effective treatment of primary and now secondary effects of injury Describe rehabilitation exercises in relation to proprioception Pediatrics 111 Robin Mayfield, DC 4 Hours of Credit Intro to Hormones, with special emphasis on Adrenal Fatigue, Insulin Resistance, Metabolic Syndrome and Menopause Educational Objectives: Name the major glands of the endocrine system Name the primary hormones produced by each gland with its function Name the 3 phases of Selye’s General Adaptation Syndrome List at least 4 symptoms of adrenal dysfunction List 3 ways to overcome adrenal exhaustion Understand the etiology of Insulin Resistance and Type II Diabetes List the normal days of the female cycle for ovulation and regular menses Define Estrogen Dominance and its etiology List 3 signs and symptoms of menopause and premenopause List 3 signs and symptoms of hypothyroidism List 3 signs and symptoms of low testosterone levels in men List 3 lifestyle strategies to support a healthy endocrine system Many more...Almost 500 hours of Courses to select from. Click here to go to ChiroCredit.com and take these Courses NOW TOP Specialty Certification: Childhood Development Disorders In the past two decades, we have witnessed an explosion in the diagnosis of neurobehavioral disorders, including ADHD, Dyslexia and Autism. This four course series emphasizes hands on training in the use of specific assessment tools and treatment protocols. After completing these programs, you will feel confident to use these tools. None of the assessment or treatment protocols will involve the use of any specialized equipment of any kind. Many of the treatments and exercises can be either taught to patients for home use or can be done in the office under supervision. These courses will be taught by Robert Melillo, DC, DABCN, the author of the acclaimed textbook Neurobehavioral Disorders of Childhood - An Evolutionary perspective. Dr. Melillo has over two decades of clinical experience in the treatment of Childhood Disorders. Please Click here to view a brochure with more details and registration information. If the link does not work, please cut and paste the following into your browser and click go: http://www.chirowire.com/adhd.pdf DATE COURSE LOCATION 4/21 - 4/23/2006 ADHD I: 930 Dallas, TX 5/5 - 5/7/2006 ADHD I: 930 Los Angeles, CA 5/12 - 5/14/2006 ADHD I: 930 Hartford, CT 6/2 - 6/4/2006 ADHD II: 931 Hartford, CT 6/16 - 6/18/2006 ADHD II: 931 Dallas, TX 6/23 - 6/26/2006 ADHD I: 930 Orlando, FL 7/14 -7/16/2006 Dyxlexia 981 Atlanta, GA 7/21 - 7/23/2006 ADHD II Los Angeles, CA 8/11 - 8/13/2006 ADHD II: 931 Orlando, FL 8/18 - 8/20/2006 Dyslexia 981 Atlanta, GA 9/15 - 9/17/2006 ADHD I: 930 Milan, Italy 9/29 - 10/1/2006 Autism 980 San Francisco, CA 10/20 - 10/22/2006 Dyslexia 981 San Francisco, CA 10/27 - 10/29/2006 Autism 980 Minneapolis, MN 11/17 - 11/19/2006 ADHD II: 931 Milan, Italy 12/8 - 12/10/2006 Dyslexia 981 Minneapolis, MN TOP SUBSCRIBE NOW! SUBSCRIBE NOW! 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