CEO Newsletter 2008 - Number 8

Contents
1. How Common is Back Pain in Women With Gastrointestinal Problems?

2. Poor Postural Control May Signal Autonomic Imbalance: A Cross-Sectional Pilot Study.

3. Hormones Produced By Heart Eliminated Human Cancers

1. How Common is Back Pain in Women With Gastrointestinal Problems?
Objective: This study examined the relationship between back pain and gastrointestinal (GI) symptoms in a large scale population study with consideration of possible confounding factors.
Methods: Cross-sectional analysis of survey data from the Australian Longitudinal Study on Women's Health was conducted using multinomial logistic regression to model 4 frequencies of back pain in relation to number of GI symptoms (including constipation, hemorrhoids, and other bowel problems). A total of 38,050 women from 3 age cohorts were included in analysis.
Results: After adjustment for confounding factors, the number of GI symptoms was significantly associated with back pain among all age cohorts. Odds ratios for experiencing back pain "rarely," "sometimes," and "often" increased with the number of GI symptoms. Young, mid-age, and older women who experience 2 or 3 GI symptoms had adjusted odds ratios of 3.3 (2.5 to 4.4), 3.0 (2.5 to 3.7) and 2.8 (2.3 to 3.4), respectively, for "often" having back pain.
Discussion: This study has identified a strong association between back pain and GI symptoms in women. Possible factors that may account for this relationship include referred pain through viscerosomatic convergence, altered pain perception, increased spinal loading when straining during defecation, or reduced support of the abdominal contents and spine secondary to changes in function of the abdominal muscles.
Smith MD, et al. The Clinical Journal of Pain. March/April 2008; Vol. 24, Iss. 3, pp. 199-203.

I was reading through this and I thought that this clearly defined the link between all these symptoms. I look at how often a chiropractic participant presents to me with back pain and GIT dysfunction. I see these as symptoms of a system under strain, stressed out! It would be interesting to see how many of these people once under a chiropractic care routine, changed in back pain and GIT problems.
Just for your thoughts and information. Travis Mitchell, DC

Editor’s notes: Thank you, Dr. Mitchell! Just women, I wonder???? We have to stop and go back to dealing with the cause - what a concept – OK, the back pain challenge comes from GI problems and where does the GI problem come from?? Here are your questions of the month – what effect does the fight/flight response have on the digestive tract??? Is this a mechanical problem or a neurological problem? What role does “Stress” play in GI challenges? What does chiropractic have to do with flight/fight responses?
Dr. Mitchell is a CEO member and practices in Dubai.

2. Poor Postural Control May Signal Autonomic Imbalance: A Cross-Sectional Pilot Study. Kristan Giggey, DC, and Rodger Tepe, PhD

Body sway is an indicator used in sacro occipital technique to differentiate between pelvic torsion associated with reduced sacral nutation (category one) and pelvic torsion associated with sacroiliac joint instability (category two). "In this study autonomic balance was assessed using heart rate variability (HRV). Autonomic imbalance (low HRV state) is associated with multiple pathological conditions but has not been examined in relation to postural control. "Postural control is the body's ability to reflexively sway within normal sway limits. Slower sway is thought to indicate greater stability, whereas faster sway suggests instability. This study seeks to determine if a relationship exists between autonomic balance and postural control. The results of the study found that the high-HRV group exhibited greater postural control than the low-HRV group. A postural exam may serve as a screening test to identify persons with autonomic imbalance, an indicator for manipulative therapy."
The Journal of Chiropractic Education. 2008; 22(1):87.

Editor’s Note: This article was sent in by another CEO member – Dr. Andrew Paul, DC practicing in Australia. An interesting note here is that Rodger Tepe is head of the research department for Logan College. We met with the research department about 2 years ago and arranged to have them receive an InVision unit for some research projects. Dr. John Zhang, a member of the Logan research team, has been using the unit and we are waiting for some publication from him.
While a postural examination is an important examination procedure, bilateral or quad scales are even better for sway patterns. I suggest that they be done pre and post every adjustment and of course the result added to your s.o.a.ps.

3. Hormones Produced By Heart Eliminated Human Cancers In Most Mice Treated
http://www.sciencedaily.com/releases...0226104403.htm

A new study shows that hormones produced by the heart eliminated human pancreatic cancer in more than three-quarters of mice treated with the hormones and eliminated human breast cancer in two-thirds of the mice.
Hormones produced by the heart eliminated human pancreatic cancer in more than three-quarters of the mice treated with the hormones and eliminated human breast cancer in two-thirds of the mice, according to researcher David Vesely, a doctor at the James A. Haley Veterans Hospital in Tampa and a professor at the University of South Florida (USF).The treatment has not yet been tried in humans, but a private biotechnology company is raising money in the hope of beginning human trials. Vesely is the hospital’s chief of endocrinology, diabetes and metabolism and is also professor of medicine, molecular pharmacology and physiology at USF.The discovery of cardiac hormonesFor more than 350 years, scientists and physicians thought the heart was a pump, delivering blood and oxygen to the body. But that view changed dramatically in 1981 when Adolfo deBold discovered that the heart produces atrial natriuretic factor (ANF), so-named because it is produced in the atrium of the heart and stimulates the production of urine and the excretion of sodium.Vesely later discovered three more hormones that are produced from the same gene as ANF. He called them:* Long acting natriuretic peptide, which also stimulates urine production and sodium excretion.* Vessel dilator which opens the blood vessels and lowers blood pressure* Kaliuretic peptide which increases potassium excretionThe hormones, called peptide hormones because they are composed of amino acids, help regulate blood volume and blood pressure. Most hormones, including such well-known hormones as insulin, are peptide hormones.Started with congestive heart failure researchVesely began his research on cardiac hormones by looking at the role they can play in diagnosing and treating congestive heart failure. Following his wife’s death from breast cancer in 2002 -- and as it became clear that the hormones controlled cell growth -- he decided to place the hormones into cancer cell cultures.Using colon, ovarian, breast, prostate and pancreatic cancer cells, among others, Vesely found that the hormones kill up to 97% of all cancers in cell cultures within 24 hours. He then turned to trials with mice, injecting some with pancreatic cancer cells and others with breast cancer cells. Once the mice developed tumors, he treated them with the hormones.At the end of one month, the treatment had eliminated cancer in 80% of the mice injected with human pancreatic cancer and in 66% of the mice injected with breast cancer. The results with pancreatic cancer were particularly exciting because it is a fast-moving cancer with poor prognosis.No side effects in miceThe pancreatic cancers that were not cured were reduced to less than 10% of their original size. Treatment with vessel dilator gave the best results: reducing the tumor to 2% of its largest size. None of the mice died of cancer – all died of old age – and none suffered any side effects.None of the mice received any other course of treatment such as surgery, chemotherapy or radiation and they did not suffer any side effects. After the mice died at the end of a normal life span, the researchers found that the cancer had not spread. If the hormones act the same way in humans, cancer could become a chronic condition treatable with these hormones, Vesely said.A private biotechnology company is raising money to begin human trials, Vesely said. The Haley hospital and University of South Florida hold the patents on the discoveries.Vesely will present his research at a symposium April 9 at the Experimental Biology 2008 conference in San Diego. The American Federation for Medical Research sponsors the session, which takes place during the annual meeting of The American Physiological Society.

Editor’s notes: OK, OK, OK. Nice to know but how about we look at this information in the other direction. If the heart hormones prevent or cure cancer then wouldn’t you say that there is a strong possibility that an improperly functioning heart and therefore a lack or reduction of these hormones would allow the development of these cancers?? Perhaps I’m missing something, or I’m just reading where they are going with this that forces me to respond this way. It seems to me that the missing lines here are….. so now we need to build some drugs to do the job.
Call me dumb, but it makes more sense to me to render care that either resets normal heart function and thus proper hormone production or better yet care that keeps the heart function correct from the start. So how can we tell if the heart is functioning correctly? Well, without penetrating the cell wall protective barrier (The Skin) and doing blood hormone tests, I think the Stress Response Evaluation is a great place to start. Heart rate, respiration rate, and HRV readings tell us a lot about heart function when resting, under stress and during recovery. So how many of these critical health factors are you missing with your patients?
Ad Summum Nitamur!

CEO Newsletter 2008 Number 7

Contents
1. Blooming Kids Letter
2. A Bad Relationship Can Cause Heart Attack
3. The Organisation of the Stress Response, and its relevance to chiropractors: a commentary

1. Blooming Kids Letter
Hi Richard,Just checking you got the email: article in our local paper after the first network meeting for the children's services 'Blooming Kids' that Belinda co-ordinated. It was a great success with over 20 local practitioners attending, with a future meeting scheduled in 6 weeks time! We had practitioners ringing us, asking if they could be included once the word got out. Look what happens when your intent is right! This has created a great network of practitioners for the children of the Southern Highlands NSW Australia. Come on other CEO guys, you can do this too!!!!!love and regards Toni

Editor’s notes: Belinda Hawkins started this project and the response has been great. While many of the other non chiropractic professional in the group don’t understand the Chiropractic role, they now have the opportunity to hear Chiropractic presented in modern terms with supporting data. This program is much more than just inching our way into changing the public’s concepts of Chiropractic - it is a quantum leap and once again the Hats Off Award goes to the Office of D. Steve and Belinda Hawkins, and of course their super CA Toni.

2. A Bad Relationship Can Cause Heart Attack: Study Stress, Anxiety in Hostile Relationships Increase Heart Risk.
It has been the stuff of great romantic novels and blockbuster films. Doctors have long suspected it. A study of 9,000 British civil servants has at last established it is possible to die of a 'broken heart'. The study, reported in the Archives of Internal Medicine, found the stress and anxiety of hostile, angry relationships can boost the risk of developing heart disease. Chances of a heart attack or chest pain rose by 34 percent compared to people on good terms with a spouse or partner."A person's heart condition seems to be influenced by negative intimate relationships," researchers wrote. "We showed that the negative aspects of close relationships...are associated with coronary heart disease."Other research has shown more social connections can mean a healthier life -- the "protective effect" -- but few studies have looked at how close friendships or marriages affect health, said Roberto De Vogli, an epidemiologist at University College London, who led the study.The researchers studied civil servants who completed questionnaires about negative aspects of their relationships -- which included a spouse or close friend -- between 1989 and 1990 or between 1985 and 1988.Bad Experiences 'Replayed' The questions asked whether people had emotional support, a chance to talk with someone about problems or whether they could count on a partner or close friend for something as simple as a ride to the grocery store, De Vogli said.The team followed up over a 12-year period and found that people who reported that arguments, criticism and other types of conflict were common had a 34 percent greater risk of heart attacks or chest pain.When the researchers stripped out risk factors such as obesity, smoking, drinking and family history, the chance of a heart attack was still 23 percent higher, De Vogli said."If you have good people around it is good for your health," he said in a telephone interview. "If you have negative people around it is much worse for your health." The study did not look at whether a bad relationship played a role in the severity of a heart attack."It seems clear from this analysis that no matter if positive aspects of social relationships are having a significant protective effect, the negative impact seems far stronger," De Vogli said."People continually replay negative experiences."

Editor’s Note: Once again the picture of Stress and Stress Response Patterns comes into play. While the nervous system controls the heart, the heart also feeds information back into the Central Nervous System. In the next newsletter we will present some information about the heart’s hormones and reduction of pancreatic cancer. New research continues to reveal the incredibly delicate balance within the systems of the body and the effect on health when they become unbalanced.

3. The organisation of the stress response, and its relevance to
chiropractors: a commentary - Katie Hardy1 and Henry Pollard*1,2

Abstract
The stress response is a natural reaction by the body, against potentially harmful stimuli to enhance the chance for survival. Persistent activation of the stress response can cause changes to homeostatic mechanisms.

The study of stress neurophysiology, in the evaluation of the manifestation of disease in the body, suggests that these chronic changes have detrimental effects on sub cortical structures. Furthermore, there is much scientific support for the notion that chronic activation of supraspinal systems will lead to maladaptation of homeostatic mechanisms, causing the impairment of processes within the body, and ultimately leading to visceral disorders.

The chiropractic profession for many years has alluded to chronic change of neurophysiological pathways as a potential explanation of visceral disorders, but the profession has typically described these in terms of somatovisceral or viscerosomatic reflex activity. Change in supraspinal neurophysiological efferent activity is increasingly being used to explain "stress" related disease.

The chiropractic profession should consider investigating such stress responses by conducting spinal manipulative therapy trials that evaluate supraspinal effects of manipulation. Such research may help elucidate key mechanisms associated with the change of visceral disorders noted by some
chiropractors following manipulative therapy.

Conclusion
Sufficient evidence exists to consider stress and its mechanism, in the generation of diseases often seen by chiropractors. To date little investigation of this potential mechanism of disease and treatment has been conducted by the chiropractic profession.
In a time when peak chiropractic organizations are calling for a mind-body
approach to the management of chronic musculoskeletal and non – musculoskeletal disease [165], due consideration of the body of neurobiological evidence that supports the broadening of the operating paradigm within chiropractic seems warranted.

Despite the call for a broadening of approaches and the embrace of such approaches by groups within chiropractic, it appears the threat to the
dominant paradigm appears too great for most to adapt.

The profession should consider more closely the emerging areas of study such as psychoneuroimmunology and how the development of that literature actually supports a broadening of the dominant mechanistic paradigm to
reflect recent advances in science.

Editor’s notes: I published this earlier but feel these comments are so important that you need to revisit them again. The profession needs to regain the understanding that 1. We deal with the nervous system first and foremost. 2. How our nervous systems respond and recover to the stressors in our lives is critical and 3. We can now demonstrate the effectiveness of our care in improving the stress response and recovery. How does it get any better than this!!!

Ad Summum Nitamur!