It’s definitely not brain surgery!

Seemingly every day, science finds more evidence to prove that what we THINK is critical to how we FEEL, physically as well as emotionally. To a great degree, our thoughts can, and do, regulate our health. While intelligence is distributed throughout the entire body, the brain is the central processing location, the “Grand Central Station ” of the network of nerve impulses. We teach this to our patients when describing the benefits of chiropractic, acupuncture, or other neurologically based health care.

It would probably be a good idea, then, to make sure they have some basic information on how they can maintain and improve brain health at all stages of life.

John H. Byrne, Ph.D., professor and chairman of the Department of Neurobiology and Anatomy at the University of Texas Health Science Center (UTHealth) at Houston Medical School, studies the neuronal and molecular mechanisms underlying learning and memory. Here are three tips he offers for maintaining and improving brain health. Giving this list to your patients will be one more way you can help them live longer, healthier lives.

1) Exercise

“Everyone knows that exercise is good for the heart, but what they may not know is that exercise also appears to be good for the brain,” said Dr. Byrne, the June and Virgil Waggoner Chair. “There is a lot of recent evidence demonstrating that exercise itself promotes neurogenesis — the generation of new nerve cells in the brain. It had long been believed that once you lose nerve cells, they are gone for good and the brain cannot regenerate them, but exercise appears to inspire the brain’s ability to generate nerve cells.”

2) Diet

“There are certain ‘brain foods’ that seem to have a benefit on the brain,” Byrne said. “New research shows that Omega-3 fatty acids, such as those found in salmon and other fish, may build the brain’s gray matter. Foods and beverages that are rich in antioxidants may also help keep the brain sharp. For brain food, consider a glass of red wine, some salmon, blueberries, a little bit of chocolate or a cup of green tea. Foods, indeed, can play a role in brain health, but remember, everything in moderation. Research shows that those who are obese have a higher incidence of Alzheimer’s disease and other diseases that affect the brain. Staying slim appears to promote brain health, so exercise, watch your calories and eat the right types of food.”

Naturally, there are some “qualifications” to that advice. Taking the cue from Byrne’s counsel “everything in moderation,” a glass of red wine is good… a bottle isn’t. Dark or raw chocolate is good… milk chocolate isn’t. Salmon and selected other fish in small quantities is good… mercury-laden species or fried fish isn’t.

3) Brain activity

“You’ve heard the saying,’Use it or lose it.’ It’s true,” Byrne said. Those who are intellectually active have a lower incidence of Alzheimer’s. You must exercise your brain cells just as you exercise your muscles, so read a book or do a crossword puzzle. Those types of activities can protect your brain. There is also evidence that social activities help to promote brain health. Interacting with others stimulates the brain.”

SOURCE: University of Texas Health Science Center at Houston

40 percent of malpractice claims are for diagnostic errors

By Terry A. Rondberg, DC

Journal of the AMA - logoA commentary published in the July 28 issue of the Journal of the American Medical Association (JAMA) revealed that diagnostic errors are the single largest contributor to medical malpractice claims, accounting for about about 40% of all claims and costing approximately $300,000 per claim.

The authors — Mark Graber, MD, of Stony Brook University Medical Center; and Hardeep Singh, MD, MPH, of Baylor College of Medicine — pointed their fingers at everything BUT the practitioners themselves.

“The great majority of diagnostic errors have root causes that derive from the properties of the healthcare setting, organization and practice,” Dr. Graber said. “By working together, cognitive scientists, informaticians, clinicians, and human factors engineers have a unique opportunity to decrease the likelihood of diagnostic error to the extent that the five principles we outline in JAMA can be incorporated into every new medical home.”

The authors discussed a new model of primary care, called the patient-centered medical home, developed and endorsed by the American Academy of Family Physicians, the American Academy of Pediatrics, American College of Physicians, and the American Osteopathic Association.

The model facilitates partnerships between individual patients, their personal physician, and, when appropriate, the patient’s family. Care is assisted by physician “extenders,” nurse empowerment, information technology, and other means to assure that patients get care when and where they need and want it in a culturally and linguistically appropriate manner.

The medical home model places emphasis on team-based care, and primary care teams could include not only physicians but also nurses, allied health professionals and personnel, the authors explained.

In this model, the medical doctor would be the gatekeeper and decide what role the “allied” health professions would have. “The physician could take a leadership role, while the entire group collectively takes care of the patient,” explained Dr. Singh.

It’s always heartening to see the medical profession recognize and admit the problems inherent in the current disease-oriented system, such as misdiagnoses, prescription errors, unnecessary surgeries, etc.

Still, I’ll continue to work toward the time when we supplant the old paradigm of labeling and treating conditions and symptoms with the new holistic view of the human body as a complex system of energy patterns that responds to non-invasive care such as chiropractic and other “energy medicine” approaches. And I especially look forward to the time when we don’t label all wellness and healing modalities as “medicine!”

Follow the money

By Terry A. Rondberg

Follow the Money - Terry A. Rondberg, DCA new study published by JAMA shows that among patients age 65 years and older, rosiglitazone (a medication for treating Type 2 diabetes) is associated with an increased risk of stroke, heart failure, and all-cause mortality (death) when compared with pioglitazone (another medication for diabetes).

In their conclusion, the authors wrote: “…in a population of more than 227,000 patients 65 years or older who initiated treatment with a thiazolidinedione, we found that, compared with pioglitazone, rosiglitazone was associated with an increased risk of stroke, heart failure, and death and the composite of AMI (heart attack), stroke, heart failure or death.” (JAMA.doi:10.1001/jama.2010.954)

Despite trying to put rosiglitazone in the most “favorable” light possible, researchers had to admit that “analysis showed no differences in the risk for heart attack between rosiglitazone and pioglitazone,” even though the study found that rosiglitazone was associated with a 1.25-fold increase in risk of heart failure compared with pioglitazone.

Obviously, BOTH medications have serious negative side effects, but the report’s wording seems somewhat biased to me so I delved a little deeper. Within the past five years, the study’s head researcher, Steven E. Nissen, MD, has received research support from numerous drug companies, including AstraZeneca, Atherogenics, Novartis, Pfizer, Resverlogix, Daiichi-Sankyo, Sanofi-Aventis and — most importantly — Eli Lilly and Takeda.

The drug that fared better in this study (branded name Actos) is manufactured by Eli Lilly and Takeda. Avandia, the branded version of rosiglitazone, is made by GlaxoSmithKline, a name curiously absent from the list of Nissen’s financial benefactors.

Probably just a coincidence, right? Yet, only this month, the BMJ (which used to be called British Medical Journal) published a report that explored a possible link between authors’ financial conflicts of interest and their position on the association of rosiglitazone with increased risk of myocardial infarction in patients with diabetes.

The research abstract noted: “Of the 202 included articles, 108 (53%) had a conflict of interest statement. Ninety authors (45%) had financial conflicts of interest. Authors who had a favourable view of the risk of myocardial infarction with rosiglitazone were more likely to have financial conflicts of interest with manufacturers of antihyperglycaemic agents in general, and with rosiglitazone manufacturers in particular, than authors who had an unfavourable view (rate ratio 3.38, 95% CI 2.26 to 5.06 and 4.29, 2.63 to 7.02, respectively). There was likewise a strong association between favourable recommendations on the use of rosiglitazone and financial conflicts of interest (3.36, 1.94 to 5.83)” (BMJ 2010;340:c1344)

In another, even more chilling report (also published in BMJ), the author writes: “Casually following the fortunes of the blockbuster diabetes drug rosiglitazone (Avandia), you can’t help but imagine a Hollywood thriller. There is the scene where a leading scientist secretly records a meeting with drug company executives, a high powered congressional investigation, and a bitter legal battle waiting in the wings. Yet when you look more closely, the facts are even stranger than fiction. An expensive new drug shown to raise the risk of heart failure and suspected of increasing the chance of heart attacks has been taken by millions of people around the world and is being kept on the market by an industry funded regulatory system, despite calls from senior safety experts to withdraw it.” (BMJ 2010;340:c1848)

I took a look at one other factor as well: pricing. The most common price I could find for Avandia — the drug touted as “safer” by the research paper — was $3.32 per pill (for 30 pills of 8mg, which is considered the normal dose). For Actos, the price was $1.34 per pill (for 30 pills of 30mg, again, considered the normal dose).

When it comes to this type of medical drug research, the saying “follow the money” seems to apply. Perhaps it’s also time to follow the advice of “X-Files” character Fox Mulder: TRUST NO ONE.

About Terry A. Rondberg, DC
Terry A. Rondberg is founder and CEO of the World Chiropractic Alliance. He is an ardent advocate for drug-free chiropractic care not just for back pain, but total body wellness. He has spoken globally on the issue of alternative care and the abuses of our current “health care” system.

How to get FDA approval for anything!

Buying the FDA - By Terry A. RondbergWhile pharmaceutical companies have boasted for decades that their pills and potions are “approved by the FDA,” does that really mean anything? Apparently, very little, if the story of how one drug — Multaq (dronedarone) — “earned” its approval is any indication.

Drug maker Sanofi-Aventis touts Multaq on its website as “a prescription medicine used to lower the chance you would need to go into the hospital for heart problems.” The FDA’s decision to approve the drug was based primarily on a study conducted last year by Richard Page, chairman of the department of medicine at the University of Wisconsin School of Medicine and Public Health. The paper was published in The New England Journal of Medicine.

However, it turns out that Page was pretty much “bought and paid for” by Sanofi-Aventis. The drug company PAID for the research, collected data, and performed the analysis without an external audit. Page put his name on the paper, never having seen the raw data. He simply trusted the company to be honest and ignored the fact that the major financial experts, including Morgan Stanley, estimated the drug could reach nearly $3 billion in revenues.

In addition, Page and four co-authors were Sanofi-Aventis paid consultants and/or speakers, and two co-authors worked directly for Sanofi-Aventis, and owned stock in the company.

Despite all that, Page shrugged it off with a glib, “There is a sense of trust that they won’t falsify data.” Either he’s incredibly naïve, or he thinks the rest of us are.

To add injury to insult, the Multaq branded pill was selling for 47 times as much as its generic equivalent — in Britain Sanofi was selling the drug for £2.25 pounds per day, compared to 5 pence a day for a generic competitor, amiodarone. That equates to $3.30 compared to 7¢!

But wait … it gets better. Another research study (this one, by researchers at the Cedars-Sinai Heart Institute — Journal of the American College of Cardiology, 2010; 55: 1569-76) has concluded that the branded drug is far less effective than the current standard drug, Cordarone (amiodarone) for atrial fibrillation, and has no safety benefits.

That’s pretty much what was known back in 2003, when a drug trial was actually stopped because patients receiving Multaq were dying in greater numbers than those getting a placebo.

Still, the drug was “approved” by the FDA. You have to ask yourself — what would it take for a drug to be rejected?

Researchers discover additional benefit of Vitamin A

By Terry A. Rondberg, DC

For years, chiropractors and other non-medical wellness professionals have advocated taking nutritional supplements to make up for the deficiencies in our modern diets. Vitamin A has always been among the most recommended, since it’s critical to maternal health and child survival.

Terry A. Rondberg, DC - Vitamin A BenefitsRecently, researchers at The Johns Hopkins Bloomberg School of Public Health have found a link between a newborn’s lung function and the vitamin A supplementation the mother has taken. The results were published in the May 13, 2010, issue of the New England Journal of Medicine.

“Children of mothers who received vitamin A supplementation before, during and after pregnancy had significantly improved lung function when compared to those whose mothers received beta-carotene supplementation or placebo,” said lead author of the study, William Checkley, MD, PhD, assistant professor in the Division of Pulmonary and Critical Care of the Johns Hopkins School of Medicine with a joint appointment in the Bloomberg School’s Department of International Health. “Lung function of offspring in mothers who received maternal vitamin A supplementation improved by about 40 ml versus those whose mothers received a placebo. This represents an approximately 3 percent increase in lung function. Furthermore, the magnitude of effect observed in this study is slightly greater than that associated with preventing exposure to parental smoking in school-age children.”

Vitamin A deficiency isn’t as widespread in the US as it is in some developing countries, where nearly 190 million pre-school age children worldwide don’t get enough vitamin A — the underlying cause of night blindness among children, as well as 650,000 early childhood deaths annually. But since the main sources of natural vitamin A are raw vegetables like carrots, sweet potatoes, winter squash, spinach, and cantaloupe, many people in America and Europe are not getting enough A either.

The new study emphasizes the need to eat nutritional, wholesome meals including plenty of vegetables, or to take supplementation as a safeguard. Since medical doctors receive little or no training in nutrition, this is where chiropractors and other wellness professionals can really make a difference. By educating patients and even providing access to nutritional supplements, we can make profound differences in the lives of all the people we serve.