Perceived Distortion in Scoliosis Tied to Quality of Life

or adult patients with adolescent idiopathic scoliosis, there is an inverse association between perceived distortion and quality of life, according to a study published online Oct. 27 in Spine.

(HealthDay News) — For adult patients with adolescent idiopathic scoliosis, there is an inverse association between perceived distortion and quality of life (QOL), according to a study published online Oct. 27 in Spine.

Aina J. Danielsson, M.D., Ph.D., from Sahlgrenska University Hospital in Göteborg, Sweden, and colleagues examined the effects of subjective present body appearance on QOL in adult patients with idiopathic scoliosis. In 1995, patients with adolescent idiopathic scoliosis with moderate curve sizes were assigned to a brace or observation (non-braced). Sixteen years after maturity, 37 and 40, respectively, were followed up and completed the Scoliosis Research Society quality-of-life questionnaire (SRS-22) and the Short Form-36 (SF-36). The participants' opinions on body appearance were graded by pictorial evaluation using the Spinal Appearance Questionnaire. Curve sizes, scoliometer measurements for grading trunk asymmetry, and QOL measures were compared with these scores.

The investigators found that the groups had a similar age and curve size (mean age, 32 years; curve size, 35 degrees). There was an inverse association between distortion and the SRS-22 total score and satisfaction/dissatisfaction with management subscore, but no association with the SRS-22 function subscore. Trunk rotation was similar for non-braced and braced patients (mean, 10.7 and 10.8 degrees, respectively). Compared with braced patients, non-braced patients estimated their body appearance to be significantly less distorted.

"Patients who experienced less body asymmetry were more satisfied with treatment and had a better quality of life," the authors write.

Abstract
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About Dr Kevin Lau
Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau D.C. is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition from Clayton College of Natural Health in USA. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to: http://www.hiyh.info.

or adult patients with adolescent idiopathic scoliosis, there is an inverse association between perceived distortion and quality of life, according to a study published online Oct. 27 in Spine.

(HealthDay News) — For adult patients with adolescent idiopathic scoliosis, there is an inverse association between perceived distortion and quality of life (QOL), according to a study published online Oct. 27 in Spine.

Aina J. Danielsson, M.D., Ph.D., from Sahlgrenska University Hospital in Göteborg, Sweden, and colleagues examined the effects of subjective present body appearance on QOL in adult patients with idiopathic scoliosis. In 1995, patients with adolescent idiopathic scoliosis with moderate curve sizes were assigned to a brace or observation (non-braced). Sixteen years after maturity, 37 and 40, respectively, were followed up and completed the Scoliosis Research Society quality-of-life questionnaire (SRS-22) and the Short Form-36 (SF-36). The participants' opinions on body appearance were graded by pictorial evaluation using the Spinal Appearance Questionnaire. Curve sizes, scoliometer measurements for grading trunk asymmetry, and QOL measures were compared with these scores.

The investigators found that the groups had a similar age and curve size (mean age, 32 years; curve size, 35 degrees). There was an inverse association between distortion and the SRS-22 total score and satisfaction/dissatisfaction with management subscore, but no association with the SRS-22 function subscore. Trunk rotation was similar for non-braced and braced patients (mean, 10.7 and 10.8 degrees, respectively). Compared with braced patients, non-braced patients estimated their body appearance to be significantly less distorted.

"Patients who experienced less body asymmetry were more satisfied with treatment and had a better quality of life," the authors write.

Abstract
Full Text (subscription or payment may be required)

About Dr Kevin Lau
Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau D.C. is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition from Clayton College of Natural Health in USA. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to: http://www.hiyh.info.

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Does eating high cholesterol foods increase heart disease risk?

Back in 1913 a Russian scientist, Dr Anitschkov, thought he had found the answer to heart disease: he found that it was induced by feeding cholesterol to rabbits. What he failed to realise was that rabbits, being vegetarians, have no means for dealing with this animal fat. Since the fatty deposits in the arteries of people with heart disease have also been found to be high in cholesterol, it was soon thought that these deposits were the result of an excess of cholesterol.

Such a simple theory had its attractions and many doctors still advocate a low fat, low cholesterol diet as the answer to heart disease – despite a consistent lack of positive results. In truth, this prevailing myth has been fuelled by the existence of highly profitable statin drugs, sold for their cholesterol lowering ability, which are more easily marketed by making cholesterol the villain.

Putting cholesterol to the test

An average egg contains about 275mg of cholesterol and two thirds of its calories come from fat. So, eggs are the perfect candidate for testing the theory that eating cholesterol, or high fat, raises blood cholesterol. I've kept an eye on studies on eggs (and other high cholesterol foods such as shellfish) since the 70's and they all show the same thing. Eating cholesterol doesn't raise blood cholesterol.

Does eating high cholesterol foods increase heart disease risk?

Inuit people of North America (Eskimos) were always an enigma with regard to the cholesterol theory. Their traditional diet, high in seal meat, has among the highest cholesterol levels of any cultural diet, yet their rate of cardiovascular disease is among the lowest. However, we now know their diet of seal meat is exceptionally high in omega 3 fats, which confer protection. But what about people eating high cholesterol foods that aren't high in omega 3 fats?

It is now evident that there is no clear relationship between intake of dietary cholesterol and cardiovascular disease. This said, however, a lot of high cholesterol foods also happen to be high in saturated fat and often fried. While this might not significantly raise cholesterol you might get more oxidized cholesterol, which is bad news. It is therefore prudent not to go overboard on high cholesterol foods, while at the same time, there is no need for cholesterol phobia.

Cholesterol more a marker, than a cause

Foods that tend to reduce cardiovascular risk tend to lower cholesterol levels as well. So, your blood cholesterol statistics are not irrelevant, they are just not quite as important as we've been led to believe. If you or your doctor rely only on cholesterol to predict risk without assessing other critical risk factors such as triglycerides, homocysteine, glycosylated haemoglobin and lipoprotein(a), you may still be at high risk despite a normal cholesterol. You certainly don't want to put all your eggs in the cholesterol basket because you might miss other important indicators. If you do, however, have a high cholesterol level, avoiding cholesterol foods isn't going to make much difference. But there are other diet and lifestyle changes that will.

The reason for this is that the body needs cholesterol, it makes what it needs. It is only when you are eating, or living, in such a way that stops the normal cycle of cholesterol production and clearance by HDL that you start to get a change in cholesterol statis

About Dr Kevin Lau
Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau D.C. is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition from Clayton College of Natural Health in USA. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to: http://www.hiyh.info.

Back in 1913 a Russian scientist, Dr Anitschkov, thought he had found the answer to heart disease: he found that it was induced by feeding cholesterol to rabbits. What he failed to realise was that rabbits, being vegetarians, have no means for dealing with this animal fat. Since the fatty deposits in the arteries of people with heart disease have also been found to be high in cholesterol, it was soon thought that these deposits were the result of an excess of cholesterol.

Such a simple theory had its attractions and many doctors still advocate a low fat, low cholesterol diet as the answer to heart disease – despite a consistent lack of positive results. In truth, this prevailing myth has been fuelled by the existence of highly profitable statin drugs, sold for their cholesterol lowering ability, which are more easily marketed by making cholesterol the villain.

Putting cholesterol to the test

An average egg contains about 275mg of cholesterol and two thirds of its calories come from fat. So, eggs are the perfect candidate for testing the theory that eating cholesterol, or high fat, raises blood cholesterol. I've kept an eye on studies on eggs (and other high cholesterol foods such as shellfish) since the 70's and they all show the same thing. Eating cholesterol doesn't raise blood cholesterol.

Does eating high cholesterol foods increase heart disease risk?

Inuit people of North America (Eskimos) were always an enigma with regard to the cholesterol theory. Their traditional diet, high in seal meat, has among the highest cholesterol levels of any cultural diet, yet their rate of cardiovascular disease is among the lowest. However, we now know their diet of seal meat is exceptionally high in omega 3 fats, which confer protection. But what about people eating high cholesterol foods that aren't high in omega 3 fats?

It is now evident that there is no clear relationship between intake of dietary cholesterol and cardiovascular disease. This said, however, a lot of high cholesterol foods also happen to be high in saturated fat and often fried. While this might not significantly raise cholesterol you might get more oxidized cholesterol, which is bad news. It is therefore prudent not to go overboard on high cholesterol foods, while at the same time, there is no need for cholesterol phobia.

Cholesterol more a marker, than a cause

Foods that tend to reduce cardiovascular risk tend to lower cholesterol levels as well. So, your blood cholesterol statistics are not irrelevant, they are just not quite as important as we've been led to believe. If you or your doctor rely only on cholesterol to predict risk without assessing other critical risk factors such as triglycerides, homocysteine, glycosylated haemoglobin and lipoprotein(a), you may still be at high risk despite a normal cholesterol. You certainly don't want to put all your eggs in the cholesterol basket because you might miss other important indicators. If you do, however, have a high cholesterol level, avoiding cholesterol foods isn't going to make much difference. But there are other diet and lifestyle changes that will.

The reason for this is that the body needs cholesterol, it makes what it needs. It is only when you are eating, or living, in such a way that stops the normal cycle of cholesterol production and clearance by HDL that you start to get a change in cholesterol statis

About Dr Kevin Lau
Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau D.C. is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition from Clayton College of Natural Health in USA. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to: http://www.hiyh.info.

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Feline Injection-Site Sarcomas

Phelps HA, Kuntz CA, Milner RJ et al: Radical excision with five-centimeter margins for treatment of feline injection-site sarcomas: 91 cases (1998–2002), J Am Vet Med Assoc 239:97, 2011.

This study is a retrospective case series of 91 cats with injection-site sarcomas (ISS). The authors evaluated the outcomes of radical excision of the ISS by local recurrence and metastasis rates, survival times, and complications associated with surgery. Rates reported in the literature for local recurrence of feline ISS after treatment range from 26% to 59%. There are no current studies evaluating the outcome of consistently performed radical excision without adjuvant treatment for feline ISS. For this study, radical excision was defined as tumor resection including 5-cm margins surrounding the palpable tumor edge and two fascial planes or bone deep to the tumor. The overall median survival time was 901 days. Fourteen percent of the cats had local tumor recurrence; 18% had evidence of metastasis after surgery. Metastasis significantly affected overall survival with pulmonary metastasis as the most common form. The study reported a major complication rate of 11%, with wound dehiscence being the most commonly encountered problem; none of the complications were fatal. The recurrence rate for this study appeared to be substantially less than rates reported with less aggressive surgeries, suggesting that radical excision may be valuable as a means to achieving an improved outcome in the treatment of ISS in cats. [VT]

Related articles:
Shaw SC, Kent MS, Gordon IK et al: Temporal changes in characteristics of injection-site sarcomas in cats: 392 cases (1990-2006), J Am Vet Med Assoc 234:376, 2009.

More on cat health: Winn Feline Foundation Library
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Phelps HA, Kuntz CA, Milner RJ et al: Radical excision with five-centimeter margins for treatment of feline injection-site sarcomas: 91 cases (1998–2002), J Am Vet Med Assoc 239:97, 2011.

This study is a retrospective case series of 91 cats with injection-site sarcomas (ISS). The authors evaluated the outcomes of radical excision of the ISS by local recurrence and metastasis rates, survival times, and complications associated with surgery. Rates reported in the literature for local recurrence of feline ISS after treatment range from 26% to 59%. There are no current studies evaluating the outcome of consistently performed radical excision without adjuvant treatment for feline ISS. For this study, radical excision was defined as tumor resection including 5-cm margins surrounding the palpable tumor edge and two fascial planes or bone deep to the tumor. The overall median survival time was 901 days. Fourteen percent of the cats had local tumor recurrence; 18% had evidence of metastasis after surgery. Metastasis significantly affected overall survival with pulmonary metastasis as the most common form. The study reported a major complication rate of 11%, with wound dehiscence being the most commonly encountered problem; none of the complications were fatal. The recurrence rate for this study appeared to be substantially less than rates reported with less aggressive surgeries, suggesting that radical excision may be valuable as a means to achieving an improved outcome in the treatment of ISS in cats. [VT]

Related articles:
Shaw SC, Kent MS, Gordon IK et al: Temporal changes in characteristics of injection-site sarcomas in cats: 392 cases (1990-2006), J Am Vet Med Assoc 234:376, 2009.

More on cat health: Winn Feline Foundation Library
Join us on Facebook
Follow us on Twitter

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Is decreased bone mineral density associated with development of scoliosis?A bipedal osteopenic rat model

An association between adolescent idiopathic scoliosis and osteopenia has been proposed to exist. It is still not clear whether there is such an association and if so, whether osteopenia is a causative factor or a consequence.

Our previous pilot studies have suggested the presence of osteopenia in scoliotic animals. The aim of this study was to investigate the development of scoliosis in an unpinealectomized bipedal osteopenic rat model, implementing osteoporosis as a causative factor. 

Methods: Fifty Sprague-Dawley rats were rendered bipedal at the 3rd postnatal week and separated into control (25 rats) and heparin (25 rats receiving 1 IU/gr body weight/day) groups.

DEXA scans after 4 weeks of heparin administration showed low bone mass in the heparin group. Anteroposterior and lateral x-rays of the surviving 42 animals (19 in heparin and 23 in control groups) were taken under anesthesia at the 40th week to evaluate for spinal deformity.

Additional histomorphometric analysis was done on spine specimens to confirm the low bone mass in heparin receiving animals. Results of the DEXA scans, histomorphometric analysis and radiological data were compared between the groups. 

Results: Bone mineral densities of rats in the heparin group were significantly lower than the control group as evidenced by both the DEXA scans and histomorphometric analyses.

However, the incidence of scoliosis (82% in heparin and 65% in control; p>0.05) as well as the curve magnitudes (12.13.8 in heparin versus 10.14.3 degrees in control; p>0.05) were not significantly different. Osteopenic rats were significantly less kyphotic compared to control specimens (p=0.001). 

Conclusions: This study has revealed two important findings.

One is that bipedality (in the absence of pinealectomy) by itself may be a cause of scoliosis in this animal model. Further studies on animal models need to consider bipedality as an independent factor.

Secondly, relative hypokyphosis in osteopenic animals may have important implications. The absence of sagittal plane analyses in previous studies makes comparison impossible, but nonetheless these findings suggest that osteopenia may be important in the development of 3D deformity in adolescent idiopathic scoliosis.

Author: Ozgur DedeIbrahim AkelGokhan DemirkiranNadir YalcinRalph MarcucioEmre Acaroglu
Credits/Source: Scoliosis 2011, 6:24

About Dr Kevin Lau
Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau D.C. is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition from Clayton College of Natural Health in USA. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to: http://www.hiyh.info.

An association between adolescent idiopathic scoliosis and osteopenia has been proposed to exist. It is still not clear whether there is such an association and if so, whether osteopenia is a causative factor or a consequence.

Our previous pilot studies have suggested the presence of osteopenia in scoliotic animals. The aim of this study was to investigate the development of scoliosis in an unpinealectomized bipedal osteopenic rat model, implementing osteoporosis as a causative factor. 

Methods: Fifty Sprague-Dawley rats were rendered bipedal at the 3rd postnatal week and separated into control (25 rats) and heparin (25 rats receiving 1 IU/gr body weight/day) groups.

DEXA scans after 4 weeks of heparin administration showed low bone mass in the heparin group. Anteroposterior and lateral x-rays of the surviving 42 animals (19 in heparin and 23 in control groups) were taken under anesthesia at the 40th week to evaluate for spinal deformity.

Additional histomorphometric analysis was done on spine specimens to confirm the low bone mass in heparin receiving animals. Results of the DEXA scans, histomorphometric analysis and radiological data were compared between the groups. 

Results: Bone mineral densities of rats in the heparin group were significantly lower than the control group as evidenced by both the DEXA scans and histomorphometric analyses.

However, the incidence of scoliosis (82% in heparin and 65% in control; p>0.05) as well as the curve magnitudes (12.13.8 in heparin versus 10.14.3 degrees in control; p>0.05) were not significantly different. Osteopenic rats were significantly less kyphotic compared to control specimens (p=0.001). 

Conclusions: This study has revealed two important findings.

One is that bipedality (in the absence of pinealectomy) by itself may be a cause of scoliosis in this animal model. Further studies on animal models need to consider bipedality as an independent factor.

Secondly, relative hypokyphosis in osteopenic animals may have important implications. The absence of sagittal plane analyses in previous studies makes comparison impossible, but nonetheless these findings suggest that osteopenia may be important in the development of 3D deformity in adolescent idiopathic scoliosis.

Author: Ozgur DedeIbrahim AkelGokhan DemirkiranNadir YalcinRalph MarcucioEmre Acaroglu
Credits/Source: Scoliosis 2011, 6:24

About Dr Kevin Lau
Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau D.C. is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition from Clayton College of Natural Health in USA. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to: http://www.hiyh.info.

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