Science In Brief

Chiropractic Litterature Review

sidebar2

Occasionally, I stumble across something I should have written about long ago. This is one of those articles, particularly relevant to chiropractors, that I don't recall reading anything about when it was published over a year ago. So...pardon my tardiness. It's not exactly cutting edge news, but definitely worth knowing. I hope you find it informative.

                                                                              Mark R Payne DC

                                                              Author/Editor Science In Brief

This study from Lancet Neurology (Jan 2013)looked 1141 patients who suffered confirmed ischemic stroke in an effort to determine the relationship between transient early neurological symptoms and subsequent stroke events. The authors classified brainstem symptoms such vertigo, isolated double vision, feelings of generalized weakness, and disturbances of binocular vision as TNA's (Transient Neurological Attacks) in the area of the brain supplied by the vertebrobasilar circulation. Limb shaking, transient loss of vision (atypical amaurosis fugax) were classified as TNA's in the region of the brain affected by the carotid circulation while slurred speech, migraine headache, transient confusion and hemisensory tingling were considered as TNAs in "uncertain territory".

Of 1034 stroke patients where the affected vascular territory could be confirmed, 275 suffered vertebrobasilar stroke and 759 suffered carotid stroke. Isolated TNAs were found to have been more frequent in 16.3% (45/275) of the vertebrobasilar stroke victims particularly in the two days prior to the actual stroke event. Conversely, in carotid stroke cases, only 10 out of out of 759 experienced increased TNA symptoms. It's important to note that only 8% of all patients exhibiting TNAs were actually severe enough to meet the established criteria for classification as TIAs (Transient Ischemic Attacks). Of those patients who did experience TNA symptoms, only 10 (22%) actually sought medical attention prior to their stroke. Of those who sought medical attention, a vascular cause was suspected in only a single case.

Transient neurological brainstem symptoms are fairly common in patients who will subsequently suffer vertebrobasilar stroke events. Most of these events will not be so profound as to be classified as true TIA events. Given the current medico-legal environment in which chiropractors may well get blamed for vertebrobasilar strokes occurring while the patient is under their care, DC's should be very aware of those TNA symptoms of vertigo, isolated double vision, feelings of generalized weakness, and disturbances of binocular vision associated with the vertebrobasilar circulation. TNA symptoms may well be the only early warning that your patient may be about to suffer a full blown ischemic stroke event.

Author: Mark R Payne DC

Link to Full Text: http://www.thelancet.com/journals/laneur/article/PIIS1474-4422(12)70299-5/fulltext

Write comment (0 Comments)

In November we covered a new study looking at the use of probiotics in treating depression. Today I ran across another article which shows significant benefits for IBS patients as well. This newest study is a randomized, double blind, placebo-controlled trial which looked at the use of a multispecies probiotic supplement in patients with irritable bowel symptoms. A total of 49 patients were divided into two treatment groups. (25 received probiotics and 24 received only a placebo). Patients were surveyed on their symptoms and in addition, fecal microflora were analyzed in 34 patients (17 from each group) to determine if changes in intestinal flora were actually taking place following supplementation.

The authors conclude that "Multispecies probiotics are effective in IBS patients and induce the alterations in the composition of intestinal microbiota." At the end of 4 weeks, 68% of the treatment group was reporting substantial relief in terms of pain/discomfort, bloating, stool frequency/consistency... nearly twice the percentage of the placebo group.

The study is small but appears to be promising. Questions remain regarding which species of intestinal microflora may be most effective, but one thing seems increasingly clear. The notion of probiotic supplementation as an effective therapeutic measure seems here to stay. The challenge for professionals continues to be separating facts from hype as manufacturers rush to hawk the "unique" benefits of their own products.

Author: Mark R Payne DC

Link to Abstract: http://www.ncbi.nlm.nih.gov/pubmed/23829297

Write comment (0 Comments)

Here's a new article making headlines from this month's Journal of the American Heart Association. We've known for some time that consumption of fish, a food high in natural Omega-3 polyunsaturated fatty acids (PUFAs) appears to be associated with reduced risk of stroke and heart disease. This study gives new information that increased intake of PUFAs may also be associated with reduced risk of subclinical brain infarcts and brain atrophy as well.

The authors followed over 3600 senior adults for a period of five years using before and after MRIs to assess brain health. Patients with any prior TIAs or stroke were excluded from the study. Additionally they measured plasma levels of circulating PUFAs. After adjusting for other variables, they found that patients with higher PUFA levels in the blood were significantly less likely to have experienced subclinical brain infarcts or brain atrophy during the five year follow up period. Patients with higher PUFA levels also tended to show better grades of white matter as well.

It appears, at least among older adults, that increased consumption of food high in Omega-3s is associated with reduced risk of brain injury from subclinical infarction as well as white matter degradation over time. Eat more fish!

Author: Mark R Payne DC

Link to Abstract:

http://www.ncbi.nlm.nih.gov/pubmed/24113325

Write comment (0 Comments)

    Even though they've been around for years, it looks like "probiotics" are now the next new thing. Every time I pick up a journal or attend a seminar I'm bombarded with ads, literature, and sales reps hawking their particular brands. The newest buzz is around probiotics and depression. As usual, hype and hyperbole abound, but there is actually some growing evidence of an interrelationship between the gut and behavior. (Check out our most recent issue of ScienceInBrief.com) Here's some news that may give a bit of perspective.

      Enter "psychobiotics", a new term defined as "a live organism that, when ingested in adequate amounts, produces a health benefit in patients suffering from psychiatric illness." Timothy Dinan, lead author of Psychobiotics: a novel class of psychotropic, published in November's issue of Biological Psychiatry, states these bacteria are capable of delivering neuroactive substances (i.e. serotonin or GABA) which can affect mental health via the brain-gut axis. The authors cite evidence that certain types of intestinal flora may play a role in alleviating symptoms of depression and even chronic fatigue.

     Exactly how the body develops imbalances of the intestinal flora isn't precisely known, but various theories such as early childhood stress and antibiotic therapies have been widely discussed to date. The one thing which seems likely at this point is that all "probiotics" will not be equal in terms of psychotropic effect. Dinan has been quoted as saying "What is clear at this point is that, of the large number of putative probiotics, only a small percentage have an impact on behavior and may qualify as psychobiotics."

     For now...stay alert and don't believe everything the supplement reps are telling you! More data is definitely needed, but this is a hot topic and additional studies will almost certainly be coming down the pipe. This is a subject of considerable interest to chiropractors so we'll try to stay on top of it as things develop.

Author: Mark R Payne DC

Link to Abstract:

 http://www.ncbi.nlm.nih.gov/pubmed/23759244

Write comment (0 Comments)

In the News- August 13, 2013

An article from PLOS Genetics (June 2013) has recently been getting more attention in the popular press. NY Times author Gretchen Reynolds recently commented on this interesting article regarding the impact of exercise on genetic expression. And although genetics is a bit far afield from the daily practice of chiropractic, this paper is noteworthy because so many DCs advise patients on lifestyle choices such as exercise and nutrition. Until fairly recently, it was thought that our genetic code was basically set in stone and that nothing could alter our genetic destiny. Turns out, that isn't quite the whole story.

Enter "Epigenetics" As it turns out, individual genes can be influenced to turn on or off by attachment of methyl groups to the outside of the gene. The attachment of these methyl hydrocarbons can make it either easier or more difficult for various genes " to receive and respond to messages from the body." So, even though the underlying genetic code isn't actually changed, the functional expression of the genes is altered. Even more interesting, the pattern of methylation of various genes can actually be passed on to your children!

New research is showing that epigenetic patterns "may occur in response to environmental, behavioural, psychological and pathological stimuli." This new study from Lund University in Sweden indicates we can now add exercise to that list.. Researchers were able to document changes in methylation patterns throughout the genome following institution of strenuous exercise programs. They particularly noted altered methylation patterns of the genetic material contained in muscle and fat cells. Genes which seemed to be particularly affected were those thought to be involved in the development of diabetes and obesity.

It is not yet known whether or not these specific methylation patterns can be passed on to offspring, but it would appear that the potential may well be there. According to lead author Charlotte Ling, these new findings "are additional proof of the robust effect exercise can have on the human body, even at the level of our DNA."

Author: Mark R Payne DC

Link to Full Text Article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3694844/

Write comment (0 Comments)

Sign up/Logon for Free Subscription

Follow Us

       

Need help or more information?

Contact Us

Search

Subscribe today

subscribe-sticker

Science In Brief 

Copyright © 2013. All Rights Reserved.