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HEALTHBEAT SHOW NOTES .... Episode #92 - Recorded April 13, 2007

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 –  

• Atlas vertebra realignment and Hypertension

• Cervical Radiculopathy and Diagnostic Accuracy of Provocative Tests

• Alf Nachemson

• Nature Magazine Prints Discouraging Article about Homeopathy

• And Finally, Health Corner presents a Discussion on Hormonal Therapy

For HealthBeat, This is Dr. Todd Eglow.

Welcome to HealthBeat Podcast #92, recorded April 13, 2007.  HealthBeat is Chiropractic OnLine Today’s radio program, providing current news and commentary about Chiropractic and Health.

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And Now for some news ….

Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients

A study in the March issue of the Journal of Human Hypertension confirmed that anatomical abnormalities of the cervical spine at the level of the Atlas vertebra are associated with relative ischemia of the brainstem circulation and increased blood pressure.

Manual correction of this mal-alignment has been associated with reduced arterial pressure. This goal of the current study tests the hypothesis that correcting mal-alignment of the Atlas vertebra reduces and maintains a lower BP.

Patients received no antihypertensive meds during the 8-week study duration. The primary end point was changed in systolic and diastolic BP comparing baseline and week 8.  No adverse effects were recorded.

The authors of the study conclude that restoration of Atlas alignment is associated with marked and sustained reductions in BP similar to the use of two-drug combination therapy.

As always, COT’s HealthBeat recommends discussing all low back and neck pain and discomfort with your Doctor of Chiropractic.  It is important to see if you are a candidate for Chiropractic Therapy, including Cervical manipulation.

Surf to our Show Notes for a link to this study - http://www.nature.com/jhh/journal/vaop/ncurrent/abs/1002133a.html

Diagnostic Accuracy of Provocative Tests of the Neck for Diagnosing Cervical Radiculopathy

Clinical provocative tests of the neck are used to position the neck and arm in order to aggravate or relieve arm symptoms.  These tests are commonly used in clinical practice in patients with a suspected cervical radiculopathy. Their diagnostic accuracy, however, has never been examined in a systematic review.

A study in the April 2007 edition of the European Spine Journal, conducted a comprehensive search in order to identify all possible studies fulfilling the inclusion criteria.

A study was included if any of the following criteria were met:

1. any provocative test of the neck for diagnosing cervical radiculopathy was identified;

2. any reference standard was used;

3. sensitivity and specificity were reported or could be
   (re-)calculated; and,

4. the publication was a full report.

In general, Spurling’s test demonstrated low to moderate sensitivity and high specificity, as did traction/neck distraction, and Valsalva’s maneuver.

The upper limb tension test (ULTT) demonstrated high sensitivity and low specificity, while the shoulder abduction test demonstrated low to moderate sensitivity and moderate to high specificity.

This review suggests that, when consistent with the history and other physical findings, a positive Spurling’s, traction/neck distraction, and Valsalva’s might be indicative of a cervical radiculopathy, while a negative ULTT might be used to rule it out. However, the lack of evidence precludes any firm conclusions regarding their diagnostic value, especially when used in primary care. More high quality studies are necessary in order to resolve this issue.

Surf to our Show Notes for a link to this study - http://dx.doi.org/10.1007/s00586-006-0225-6

Alf Nachemson

It is with sadness that COTs HealthBeat reports on the passing of a legend in Musculoskeletal research field.  Alf Nachemson, M.D., Ph.D., an orthopedic surgeon and the well-known "conscience" of the spine community, passed away in December 2006, at the age of 75.

For more information, surf to our Show Notes - http://www.springerlink.com/content/9726661q48411807/

Nature Magazine Prints Discouraging Article about Homeopathy

COTs HealthBeat, in our efforts to present both sides of the Alternative Medicine story, reports on a controversial story recently published.

According to the story, a subject that many researchers see as a pseudoscience is achieving scientific status within the British education system, says a news report in the science journal Nature.

Over the past decade, several British universities have started offering bachelor of science (BSc) degrees in alternative medicine, including six that offer BSc degrees in homeopathy. Some scientists are increasingly concerned that such courses give homeopathy and homeopaths undeserved scientific credibility, and they are campaigning to get the label removed.

But homeopaths involved in the university courses — those that were willing to speak to Nature, at least — argue that they teach students scientific principles, including the critical analysis of evidence.

Surf to our Show Notes to read the full article along with the related commentary - http://www.nature.com/news/2007/070319/full/446352a.html

Health Corner – In this edition of HealthBeat’s Health Corner, we present a discussion from the PBS show NewsHour with Jim Leher.  The report focuses on current research into the usage of female hormonal therapy.

As always, please surf to our Podcast Show Notes at ChiropractiRadio.com for a full listing of web references mentioned in today’s show.

And remember - COT’s Healthbeat always recommends discussing any nutritional or exercise lifestyle modifications with a qualified healthcare professional.

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Finally, I leave you with the following quote:

"Remember that as a teenager you are at the last stage of your life when you will be happy to hear that the phone is for you."
– Fran Lebowitz

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

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