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HEALTHBEAT SHOW NOTES .... Episode #27 - Recorded January 12, 2006

Hello and welcome to this week’s edition of HealthBeat, Chiropractic OnLine Today’s Health, News and informational Podcast.

In this week’s news:  We’ll Look At -

• OIG says CMS overpaid modifier 59 claims

• Smoking and Eye Problems

• Atrium acquires Douglas Labs

• Research paper shows benefit of flexion distraction

• NCCAM and Menopause

• Cholesterol and Hypertension

• CAM usage Most Popular at Midlife

• And finally, Computer Corner looks at Security Threats

For HealthBeat, This is Dr. Todd Eglow.

Welcome to HealthBeat Podcast #27, recorded January 12, 2006.  HealthBeat is Chiropractic OnLine Today’s radio program, providing current news and commentary about Chiropractic and Health.

This week’s Episode is sponsored by DaVinci Laboratories.  Please surf to our web site at ChiropracticRadio.com and click on the DaVinci link for your Health and Nutritional needs.

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And Now for some news ….  

OIG says CMS overpaid modifier 59 claims

The Centers for Medicare and Medicaid Services (CMS) may be scrutinizing the use of modifiers 59 and 25. According to a report issued by the Office of Inspector General (OIG), the watchdog of the Department of Health and Human Services (HHS) programs, 40 percent of code pairs billed with modifier 59 in fiscal year 2003 did not meet program requirements, resulting in an estimated $59 million in improper payments.

The report also found that 35 percent of claims for E/M (evaluation and management) services allowed by Medicare in 2002 did not meet program requirements, resulting in $538 million in improper payments.

The OIG report did not differentiate between medical and chiropractic payments.

Modifier 59 is used to indicate that a provider performed a distinct procedure or service for a beneficiary on the same day as another procedure or service. Modifier 59 should be attached to the secondary, additional, or lesser service in the code pair.

The report showed that in 15 percent of modifier 59 cases, the services coded were not distinct. And in 25 percent, the services were not adequately documented. The audit also found that 11 percent of code pairs billed with modifier 59 in fiscal year 2003 were paid when modifier 59 was billed with the incorrect code.

For more information, surf to our Show Notes for links to the CMS and for tips for correcting the problem - http://www.chiroeco.com/news/2005/December/OIG.php  

Smoking and Eye Problems

According to a study being reported in the British Journal of Ophthalmology Smoking greatly increases the risk of vision loss due to age-related macular degeneration, and that risk hits both smokers and people who live with them, a new study shows.

Macular degeneration is a progressive eye disease that is the leading cause of partial vision loss and blindness in the United States and many European countries.

People who regularly smoked a pack of cigarettes or more a day for 40 years had nearly triple the risk of age-related macular degeneration compared with non-smokers. Smoking increased the risk of both of the two main types of macular degeneration, the researches noted.

However, quitting smoking for 20 years or more reduced the risk to a level comparable with people who'd never smoked.

For more information, surf to our Show Notes for a link to this study - http://bjo.bmjjournals.com/cgi/content/abstract/90/1/75
 

Atrium acquires Douglas Labs

Douglas Laboratories, a high-profile nutritional supplement provider to the chiropractic market, has been purchased by Atrium Biotechnologies of Canada. The acquisition, announced Dec. 8, was for $92 million, approximately 6.4 times the adjusted EBITDA generated by Douglas .

According to an Atrium press release, Douglas’ executives will become shareholders of Atrium and will stay on to ensure the successful integration of Douglas as a subsidiary organization and to sustain its growth.

For more information, surf to -  www.atrium-bio.com  

Research paper shows benefit of flexion distraction

In an update to an earlier COT HealthBeat item concerning the effectiveness of Traction in the treatment of back pain, a research paper written by M. R. Gudavalli, DC, and associates shows that flexion-distraction therapy used by chiropractors reduces pain significantly more than the active trunk exercise protocol (ATEP) used by physical therapists. The paper was published online Dec. 8, 2005, in the European Spine Journal.

The research showed that overall, flexion-distraction provided more pain relief than active exercise. However, the results varied based on stratification of patients with and without radiculopathy and with and without recurrent symptoms.  The subgroup analysis provides a possible explanation for contrasting results among randomized clinical trials of chronic low back pain treatments and these results also provide guidance for future work in the treatment of chronic low back pain.

For more information, surf to our Show Notes for a link to this study’s Abstract - http://www.springerlink.com/(u35ta455msp4hfaitqrc4n55)/app/home/contribution.asp?referrer=parent&backto=searcharticlesresults,2,2

NCCAM and Menopause

The National Center for Complementary and Alternative Medicine has created a new backgrounder covering CAM therapies for menopausal symptoms. The backgrounder discusses CAM therapies based upon the scientific evidence for these therapies, and also provides tips for the consumer.

Menopause is a natural process for women as they age. Menopause can also occur as a result of certain medical treatments that affect a woman's ovaries.  Many women and their health care providers have become interested in complementary and alternative medicine ( CAM ) for menopausal symptoms. This fact sheet is based on findings from a 2005 National Institutes of Health (NIH) State-of-the-Science conference on the management of menopause-related symptoms. It answers some frequently asked questions and lists resources for more information.

For more information, surf to our Show Notes for a link to this Backgrounder information - http://nccam.nih.gov/health/menopauseandcam/

Cholesterol and Hypertension

A recent study found that there may be a link between dyslipidemia, a strong predictor of cardiovascular disease and hypertension.  Dyslipidemia is a condition marked by abnormal concentrations of lipids or lipoproteins in the blood.

Abnormal levels of total cholesterol, high density lipoprotein (HDL) cholesterol (the "good" cholesterol), non-HDL cholesterol and the ratio between total cholesterol and HDL cholesterol are independently associated with a subsequent increased risk of high blood pressure (hypertension) in men, results of a 14-year study suggest.

Further, Reuters Health recently reported a study by Dr. Howard D. Sesso and colleagues at Harvard Medical School in Boston showing that high cholesterol is linked to the development of hypertension in women.

The study included 3,110 male physicians between the ages of 40 and 84 with previous cholesterol measurements and no history of cerebrovascular or cardiovascular disease, including hypertension, and who had not been treated for high cholesterol.

Those with the highest levels of cholesterol components, excluding HDL, had a 39 percent increased risk compared with men with the lowest levels.

Furthermore, men with the highest ratio of total cholesterol to HDL cholesterol were 54 percent more likely to develop hypertension.

Elevated cholesterol levels seem to precede the onset of hypertension, according to Dr. Sesso's group notes. They suggest that the relationship may be associated with cholesterol abnormalities and that hypertension may be a sign of atherosclerosis, also known as "hardening of the arteries."

The authors conclude that "By identifying potential risk factors amenable to intervention, there may be a way to eventually reduce the burden of hypertension and subsequent cardiovascular disease."

For more information, surf to the January 2006 issue of the journal Hypertension.

http://heart.healthcentersonline.com/newsstories/highcholesterolmayleadhighbloodpressure.cfm

http://hyper.ahajournals.org/cgi/content/abstract/47/1/45

CAM usage Most Popular at Midlife

According to a study published in the October 2005 issue of the Journal of Aging and Health, middle-age people are more likely than younger or older adults to use complementary and alternative medicine ( CAM ).

According to the study’s authors, Midlife adults entered adulthood at a time of more widespread use of complementary and alternative medicine ( CAM ) in the population and when public-health policy was shifting attention toward individual responsibility for health and health promotion.

Types of CAM used for prevention include acupuncture, homeopathy, naturopathy, chelation therapy, folk medicine, herb use, special diets or megavitamins. Massage therapy and other body-based methods, such as chiropractic, were found to be used primarily to treat existing conditions, according to a press release for this study’s results.

This study provides the first estimates of notable age-related differences in whether CAM is used to treat an existing health condition or for illness prevention and health promotion.

For more information, surf to www.massagemag.com - http://www.massagemag.com/News/2005/December/CAM.php

COT’s HealthBeat also recommends that you discuss the role that Chiropractic and other CAM therapies can play as Preventive measures.

Computer Corner - In this edition of HealthBeat’s Computer corner, we look at some recent security threats that can affect your home or office.

In HealthBeat Episode #6, Computer Corner provided some basic concepts of how to safeguard computer data and information.  In this edition of Computer Corner, we will further explore these security issues.

With the rising popularity of Internet Broadband services, such as Cable modems and DSL connections, many homes and offices have established internet connections that allow for easy intrusions and attacks.

Part of the problem is the fact that at the time the Personal Computer was becoming popularized in the early 1990’s, little thought was being given to having an open door into the computer via these internet connections.

One of the best suggestions to not become “infected” with some sort of computer bug or virus or other attack, is to never open up an Email attachment unless you are 100% sure of the source of the email…. And even then, you still may need to be concerned if the person you trust is not that computer savvy.

But even taking all the security measures necessary to safeguard your home or office computers may not be enough. 

WMF Vulnerability

In November, 2005, a new Flaw in Windows machines was discovered.  Referred to as the Windows Metafile/Zero-Day bug, the Windows Metafile format, also known by the acronym WMF, is a reference to an imaging format for the Windows PC platform that will display Microsoft Windows graphics drawing library.

With this latest “bug” which was discovered at towards the end of 2005, All versions of Windows from Windows 98 through ME, NT, 2000, XP, and 2003 are known to be vulnerable, and a large and rapidly growing number of malicious exploits are already circulating in the wild. As of this warning, at least 57 exploits had been discovered.  The fear is, that the exploits are being actively used to install malware and Trojans into user's machines. Viruses and worms are expected to appear shortly.

As of Thursday January 5^th, Microsoft released their official Patch to fix this hole in the Windows Operating System.

It is strongly recommend that you go to the Window Update site to run the official patch – http://windowsupdate.microsoft.com

Another recommendation is to make sure that all Anti-Virus programs are kept up-to-date with their current database updates.

Prior to Microsoft releasing their official patch for this bug, a 3^rd Party fix from Russia became very popular.  If you had previously run the 3^rd Party patch, simply go into the Control Panel and choose the Add/Remove icon and uninstall the 3^rd party Fix.  It’s listed alphabetically under the Windows section.

For more information, surf to our Show Notes for a link to Steve Gibson’s Security Now page.  And while Microsoft has been slow in releasing a patch on their own, it would be suggested to consistently run Windows Update on a regular basis.

3^rd Party Fix

While some of the large corporations (http://www.informationweek.com/software/showArticle.jhtml?articleID=175801150) have voiced some concerns over the current solution, others, such as Steve Gibson’s Security Now Podcast (http://www.grc.com, have urged all Windows XP and 2000 users to install a 3^rd Party fix:

WMF Patch - Download Ilfak's WMF patch utility from GRC

WMF Vulnerability Test - Download Ilfak's WMF Vulnerability test from GRC

Thank you for listening…. As always, We Want to hear from you.  Please send us emails…. Simply surf to our Web Site at ChiropracticRadio.com and click on the Email link.

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If you have an idea for a future Health Segment, please feel free to contact me directly via email …. The address is: healthbeat@chiropracticradio.com

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Finally, I leave you with the following quote:

"No trumpets sound when the important decisions of our life are made. Destiny is made known silently." 
– Agnes de Mille

For Chiropractic OnLine Today’s HealthBeat, This is Dr. Todd Eglow.

Music – One by Chris Spheeris

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