Top Spine Surgeons Reap Royalties, Medicare Bounty

Norton Hospital in Louisville, Ky., may not be a household name nationally. But five senior spine surgeons have helped put it on the map in at least one category: From 2004 to 2008, Norton performed the third-most spinal fusions on Medicare patients in the country.

The five surgeons are also among the largest recipients nationwide of payments from medical-device giant Medtronic Inc. In the first nine months of this year alone, the surgeons—Steven Glassman, Mitchell Campbell, John Johnson, John Dimar and Rolando Puno—received more than $7 million from the Fridley, Minn., company.

Medtronic and the surgeons say the payments are mostly royalties they earned for helping the company design one of its best-selling spine products.

Corporate whistleblowers and congressional critics contend such arrangements—which are common in orthopedic surgery—amount to kickbacks to stoke sales of medical devices. They argue that the overuse of surgical hardware ranging from heart stents to artificial hips is a big factor behind the soaring costs of Medicare, the government medical-insurance system for the elderly and disabled.

Medtronic says it can't develop new medical products that improve patients' lives without the help of surgeons. It says the royalties it pays them are legitimate but it doesn't give detailed information about what intellectual property each recipient contributes. It says it doesn't pay its collaborating surgeons royalties on the devices they personally use in their patients, removing any financial incentive for them to do more surgeries than necessary.

Norton's Dr. Glassman cited this policy as a safeguard against any conflict of interest and said the royalties he and his colleagues receive are "legitimate." He added that they inform their patients of their financial ties with Medtronic. Norton Hospital said it has policies "to prevent direct conflicts of interest." The other Norton surgeons didn't respond to requests for comment put to them through Norton and Dr. Glassman.

Using a Medicare database that tracks hospitals' billing, The Wall Street Journal was able to ascertain that Norton is among the most aggressive practitioners of spinal fusion in the country.

Spinal fusion has become one of medicine's most controversial procedures. It involves fusing together two or more vertebrae to alleviate back pain, usually with the help of metal plates, rods and screws implanted in the patient's back. Tens of thousands of dollars of hardware can go into a single surgery.

Medtronic is the biggest maker of spinal implants. Last year, its spine business generated world-wide sales of $3.5 billion, accounting for half of the roughly $7 billion spinal-implant market.

Conservative spine surgeons argue that a spinal fusion is appropriate only for a small number of conditions, such as spinal instability, spinal fracture or a severe curvature of the spine known as scoliosis, and that financial incentives have caused the procedure to become overused. Others say it's a useful tool to treat patients who have debilitating back pain and have tried other options like physical therapy to no avail.

The Journal consulted several experts to determine which back conditions are commonly thought to require a fusion and which are subject to the most debate. The most hotly debated use of spinal fusion surgery centers on patients who merely suffer from aging disks, a condition known as degenerative disk disease.

One health insurer, the nonprofit Blue Cross and Blue Shield of North Carolina, announced in September that it would stop paying for spine fusions performed on such patients beginning on Jan. 1. The insurer said that the procedures are "considered not medically necessary."

The Journal mined hospitals' Medicare claims to see what proportion of fusions performed fall in this category. Due to a three-decade-old court ruling guarding the confidentiality of physician information, the paper is barred from disclosing what it found regarding the five Norton surgeons.

Critics of the court ruling and of the privacy policies of the federal Medicare program argue that making such information public would help taxpayers understand where their money is going, and potentially deter abusive or wasteful practices.

But the Journal is permitted to disclose its findings for Norton Hospital as a whole, where 27 surgeons performed one or more spine fusions in 2008.

At Norton, spinal fusions on patients who only suffered from aging disks accounted for 24% of the 2,475 fusions the hospital performed for Medicare between 2004 and 2008, compared with 17% nationally. This placed it 11th in percentage terms out of 60 hospitals that performed 1,000 or more spine fusions in those years, and fourth in raw count. Norton ranked third nationally in the overall numbers of spine-fusion surgeries.

In emailed responses to questions, Dr. Glassman said he and his four colleagues "do not overuse spine fusion procedures," and argued that the diagnostic codes the Journal based its analysis on "do not convey indication for spinal fusion with the specificity that you are attributing to this data."

Norton Hospital in Louisville, Ky., may not be a household name nationally. But five senior spine surgeons have helped put it on the map in at least one category: From 2004 to 2008, Norton performed the third-most spinal fusions on Medicare patients in the country.

The five surgeons are also among the largest recipients nationwide of payments from medical-device giant Medtronic Inc. In the first nine months of this year alone, the surgeons—Steven Glassman, Mitchell Campbell, John Johnson, John Dimar and Rolando Puno—received more than $7 million from the Fridley, Minn., company.

Medtronic and the surgeons say the payments are mostly royalties they earned for helping the company design one of its best-selling spine products.

Corporate whistleblowers and congressional critics contend such arrangements—which are common in orthopedic surgery—amount to kickbacks to stoke sales of medical devices. They argue that the overuse of surgical hardware ranging from heart stents to artificial hips is a big factor behind the soaring costs of Medicare, the government medical-insurance system for the elderly and disabled.

Medtronic says it can't develop new medical products that improve patients' lives without the help of surgeons. It says the royalties it pays them are legitimate but it doesn't give detailed information about what intellectual property each recipient contributes. It says it doesn't pay its collaborating surgeons royalties on the devices they personally use in their patients, removing any financial incentive for them to do more surgeries than necessary.

Norton's Dr. Glassman cited this policy as a safeguard against any conflict of interest and said the royalties he and his colleagues receive are "legitimate." He added that they inform their patients of their financial ties with Medtronic. Norton Hospital said it has policies "to prevent direct conflicts of interest." The other Norton surgeons didn't respond to requests for comment put to them through Norton and Dr. Glassman.

Using a Medicare database that tracks hospitals' billing, The Wall Street Journal was able to ascertain that Norton is among the most aggressive practitioners of spinal fusion in the country.

Spinal fusion has become one of medicine's most controversial procedures. It involves fusing together two or more vertebrae to alleviate back pain, usually with the help of metal plates, rods and screws implanted in the patient's back. Tens of thousands of dollars of hardware can go into a single surgery.

Medtronic is the biggest maker of spinal implants. Last year, its spine business generated world-wide sales of $3.5 billion, accounting for half of the roughly $7 billion spinal-implant market.

Conservative spine surgeons argue that a spinal fusion is appropriate only for a small number of conditions, such as spinal instability, spinal fracture or a severe curvature of the spine known as scoliosis, and that financial incentives have caused the procedure to become overused. Others say it's a useful tool to treat patients who have debilitating back pain and have tried other options like physical therapy to no avail.

The Journal consulted several experts to determine which back conditions are commonly thought to require a fusion and which are subject to the most debate. The most hotly debated use of spinal fusion surgery centers on patients who merely suffer from aging disks, a condition known as degenerative disk disease.

One health insurer, the nonprofit Blue Cross and Blue Shield of North Carolina, announced in September that it would stop paying for spine fusions performed on such patients beginning on Jan. 1. The insurer said that the procedures are "considered not medically necessary."

The Journal mined hospitals' Medicare claims to see what proportion of fusions performed fall in this category. Due to a three-decade-old court ruling guarding the confidentiality of physician information, the paper is barred from disclosing what it found regarding the five Norton surgeons.

Critics of the court ruling and of the privacy policies of the federal Medicare program argue that making such information public would help taxpayers understand where their money is going, and potentially deter abusive or wasteful practices.

But the Journal is permitted to disclose its findings for Norton Hospital as a whole, where 27 surgeons performed one or more spine fusions in 2008.

At Norton, spinal fusions on patients who only suffered from aging disks accounted for 24% of the 2,475 fusions the hospital performed for Medicare between 2004 and 2008, compared with 17% nationally. This placed it 11th in percentage terms out of 60 hospitals that performed 1,000 or more spine fusions in those years, and fourth in raw count. Norton ranked third nationally in the overall numbers of spine-fusion surgeries.

In emailed responses to questions, Dr. Glassman said he and his four colleagues "do not overuse spine fusion procedures," and argued that the diagnostic codes the Journal based its analysis on "do not convey indication for spinal fusion with the specificity that you are attributing to this data."

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When to Consider Orthotics: Research-Based Recommendations

Sometimes a patient's need for custom-made foot orthotics becomes apparent only after an inadequate response to chiropractic care. Some patients, however, reveal an obvious need, and orthotics should be provided early in their care.

This will allow a good response to adjustments and prevent frustration all around. What follows are some commonly seen patient characteristics that indicate the need for foot orthotics.

History

Back problems worse with standing, walking, running. When a patient reports a link between locomotor activities and their spinal symptoms, this clearly calls for orthotics to minimize the stress being transmitted from the lower extremities to the spine.1

Recurrent ankle sprains. A history of previous sprain injuries to one or both ankles indicates biomechanical instability and probable permanent ligament damage. Custom-made stabilizing orthotics provide the support needed to help prevent re-injury.2-3

Family history of foot problems or surgery. A patient who has family members with foot problems and/or surgery has a much higher probability of the same. Fitting for orthotics may prevent these problems from developing and could help the patient avoid surgery.

Strenuous athletic activities. Those who engage in upright, weight-bearing sports need both shock absorption and foot/ankle stability. Orthotic support can increase performance and prevent injuries in many individual and team sports.4

History of lower extremity stress fractures, recurring shin splints, hamstring strains. Whenever an athlete, whether recreational or competitive, reports symptoms of overuse injury (microtrauma) in the lower extremities, orthotics should be provided. These conditions are closely correlated with biomechanical asymmetries, and require better support and shock absorption.5-6

Chronic knee pain, patellofemoral arthralgia, ACL injury. The knee joint is a sensitive indicator of abnormal biomechanical stress, and these conditions have all been shown to indicate the need for orthotics. Controlling pronation decreases the rotational forces, improving patellar tracking and protecting the anterior cruciate ligament.7

Exam Findings

Postural imbalances (e.g., pelvic tilt, scoliosis, forward head). When a standing structural evaluation discloses any pelvic tilt, a lower extremity asymmetry requiring orthotics for proper correction is likely. Both functional and idiopathic types of spinal curvatures can benefit from the foot stabilization and neurological stimulus provided by orthotics.8 Many postural complexes (forward head is one of the most common) are secondary to poor standing balance and proprioception from the feet.

Gait asymmetry (e.g., calcaneal eversion, excessive pronation, foot flare). Looking for indicators of biomechanical asymmetry while a patient walks will often demonstrate the need for orthotics.9 If the foot and ankle complex is not functioning correctly during the stance phase of gait, this stress is transmitted to the pelvis and spine with every step.

Foot calluses, bunions, hallux valgus. Heavy callousing, bunion development and abnormal alignment all reveal evidence of abnormal or poorly tolerated forces during walking and indicate the need for improved biomechanics and orthotics.10

Lack of an arch (especially unilateral). This is seen during the weight-bearing portion of the exam, when a foot collapses under the weight of the body. A foot without an arch will not function properly and thus requires support.11

Knee instability, high Q-angle, poor patellar tracking. When the knee does not align properly or track correctly, degenerative wear-and-tear and other chronic symptoms will follow. Orthotic alignment is required to reduce the abnormal forces on this complex joint, which must be able to sustain frequent high forces during walking and running.12-13

X-Ray Findings

Scoliosis (functional or idiopathic), widespread disc degeneration. The spine will demonstrate poor support from one of the lower extremities by developing a lateral curvature. Gait disturbances may be one of the causative factors for idiopathic scoliosis. Significant intervertebral disc degeneration is proof of poor spinal shock absorption, and orthotics with viscoelastic properties often reduce symptoms dramatically.9

Unlevel sacral base, sacroiliac joint degeneration. The pelvis shows evidence of inadequate support by the appearance of a tilted sacral base when standing. This is often due to a functional short leg requiring orthotic support.14 Sacroiliac degeneration is unusual; when found, it indicates significant abnormal stresses.

Low femur head, coxafemoral DJD. These conditions are due to either an anatomical or a functional short leg. Degenerative changes in the hip joint have been correlated with the stress of a longer leg. Both will benefit from the improved balance and support provided by orthotics.14

Heel spur, DJD in knees, metatarsals. X-rays of the feet and knees may reveal evidence of long-standing regional stress, such as degenerative changes in weight-bearing joints and connective tissue calcification. Calcium deposited in the calcaneal attachment of the plantar fascia specifically indicates the need for support of the arches of the foot to help reduce shock and symptoms in degenerated joints, and provide arch stabilization.11

Treatment Response

Recurrent subluxations. Making the same adjustment to a patient's spine again and again suggests poor structural support for the region. Orthotics have been used for decades by chiropractors who don't want to continue adjusting the same area and who want to see the adjustment "hold" better.

Unresolving muscle strain, myalgia. Myofascial symptoms not responding to treatment often are a clue to an underlying biomechanical imbalance. Many chronic muscle spasms and strains can be corrected by providing orthotics to support and stabilize.15

Flare-ups, exacerbations. A patient who is feeling better, returns to daily activities, and then suffers a return of symptoms probably needs orthotics. Without proper biomechanical support, these patients find that every attempt to establish normal routines causes a recurrence of their symptoms.

Foot symptoms are only one of the many reasons for supplying orthotics. In fact, the feet are seldom painful in most of the conditions that are clear indicators of an need for orthotic support. All chiropractors must be alert for signs of lower extremity involvement in spinal conditions. The good news is that these conditions can all be helped. Investigation and correction of foot biomechanics can help most patients, especially the recreationally active and the elderly.

Sometimes a patient's need for custom-made foot orthotics becomes apparent only after an inadequate response to chiropractic care. Some patients, however, reveal an obvious need, and orthotics should be provided early in their care.

This will allow a good response to adjustments and prevent frustration all around. What follows are some commonly seen patient characteristics that indicate the need for foot orthotics.

History

Back problems worse with standing, walking, running. When a patient reports a link between locomotor activities and their spinal symptoms, this clearly calls for orthotics to minimize the stress being transmitted from the lower extremities to the spine.1

Recurrent ankle sprains. A history of previous sprain injuries to one or both ankles indicates biomechanical instability and probable permanent ligament damage. Custom-made stabilizing orthotics provide the support needed to help prevent re-injury.2-3

Family history of foot problems or surgery. A patient who has family members with foot problems and/or surgery has a much higher probability of the same. Fitting for orthotics may prevent these problems from developing and could help the patient avoid surgery.

Strenuous athletic activities. Those who engage in upright, weight-bearing sports need both shock absorption and foot/ankle stability. Orthotic support can increase performance and prevent injuries in many individual and team sports.4

History of lower extremity stress fractures, recurring shin splints, hamstring strains. Whenever an athlete, whether recreational or competitive, reports symptoms of overuse injury (microtrauma) in the lower extremities, orthotics should be provided. These conditions are closely correlated with biomechanical asymmetries, and require better support and shock absorption.5-6

Chronic knee pain, patellofemoral arthralgia, ACL injury. The knee joint is a sensitive indicator of abnormal biomechanical stress, and these conditions have all been shown to indicate the need for orthotics. Controlling pronation decreases the rotational forces, improving patellar tracking and protecting the anterior cruciate ligament.7

Exam Findings

Postural imbalances (e.g., pelvic tilt, scoliosis, forward head). When a standing structural evaluation discloses any pelvic tilt, a lower extremity asymmetry requiring orthotics for proper correction is likely. Both functional and idiopathic types of spinal curvatures can benefit from the foot stabilization and neurological stimulus provided by orthotics.8 Many postural complexes (forward head is one of the most common) are secondary to poor standing balance and proprioception from the feet.

Gait asymmetry (e.g., calcaneal eversion, excessive pronation, foot flare). Looking for indicators of biomechanical asymmetry while a patient walks will often demonstrate the need for orthotics.9 If the foot and ankle complex is not functioning correctly during the stance phase of gait, this stress is transmitted to the pelvis and spine with every step.

Foot calluses, bunions, hallux valgus. Heavy callousing, bunion development and abnormal alignment all reveal evidence of abnormal or poorly tolerated forces during walking and indicate the need for improved biomechanics and orthotics.10

Lack of an arch (especially unilateral). This is seen during the weight-bearing portion of the exam, when a foot collapses under the weight of the body. A foot without an arch will not function properly and thus requires support.11

Knee instability, high Q-angle, poor patellar tracking. When the knee does not align properly or track correctly, degenerative wear-and-tear and other chronic symptoms will follow. Orthotic alignment is required to reduce the abnormal forces on this complex joint, which must be able to sustain frequent high forces during walking and running.12-13

X-Ray Findings

Scoliosis (functional or idiopathic), widespread disc degeneration. The spine will demonstrate poor support from one of the lower extremities by developing a lateral curvature. Gait disturbances may be one of the causative factors for idiopathic scoliosis. Significant intervertebral disc degeneration is proof of poor spinal shock absorption, and orthotics with viscoelastic properties often reduce symptoms dramatically.9

Unlevel sacral base, sacroiliac joint degeneration. The pelvis shows evidence of inadequate support by the appearance of a tilted sacral base when standing. This is often due to a functional short leg requiring orthotic support.14 Sacroiliac degeneration is unusual; when found, it indicates significant abnormal stresses.

Low femur head, coxafemoral DJD. These conditions are due to either an anatomical or a functional short leg. Degenerative changes in the hip joint have been correlated with the stress of a longer leg. Both will benefit from the improved balance and support provided by orthotics.14

Heel spur, DJD in knees, metatarsals. X-rays of the feet and knees may reveal evidence of long-standing regional stress, such as degenerative changes in weight-bearing joints and connective tissue calcification. Calcium deposited in the calcaneal attachment of the plantar fascia specifically indicates the need for support of the arches of the foot to help reduce shock and symptoms in degenerated joints, and provide arch stabilization.11

Treatment Response

Recurrent subluxations. Making the same adjustment to a patient's spine again and again suggests poor structural support for the region. Orthotics have been used for decades by chiropractors who don't want to continue adjusting the same area and who want to see the adjustment "hold" better.

Unresolving muscle strain, myalgia. Myofascial symptoms not responding to treatment often are a clue to an underlying biomechanical imbalance. Many chronic muscle spasms and strains can be corrected by providing orthotics to support and stabilize.15

Flare-ups, exacerbations. A patient who is feeling better, returns to daily activities, and then suffers a return of symptoms probably needs orthotics. Without proper biomechanical support, these patients find that every attempt to establish normal routines causes a recurrence of their symptoms.

Foot symptoms are only one of the many reasons for supplying orthotics. In fact, the feet are seldom painful in most of the conditions that are clear indicators of an need for orthotic support. All chiropractors must be alert for signs of lower extremity involvement in spinal conditions. The good news is that these conditions can all be helped. Investigation and correction of foot biomechanics can help most patients, especially the recreationally active and the elderly.

Read More

Connect with Winn!

Winn's goal is to help "Every Cat, Every Day" and we can only do this with your assistance. Stay in touch with our activities and learn how you can become involved in the future of feline health.

Join over 3,000 other cat lovers on our Facebook page.

Follow us on Twitter and help spread the word!

Subscribe to our email newsletter - we promise, no spam :-)
  

Virtual Memorials for special cats loved by special owners

Winn's goal is to help "Every Cat, Every Day" and we can only do this with your assistance. Stay in touch with our activities and learn how you can become involved in the future of feline health.

Join over 3,000 other cat lovers on our Facebook page.

Follow us on Twitter and help spread the word!

Subscribe to our email newsletter - we promise, no spam :-)
  

Virtual Memorials for special cats loved by special owners

Read More

Feline Panleukopenia

Kruse BD, Unterer S, Horlacher K, et al. Prognostic factors in cats with feline panleukopenia. J Vet Intern Med 2010;24:1271-1276.

Feline panleukopenia is a highly contagious and frequently lethal disease affecting all members of the cat family. Clinical disease can range from subclinical infection to a peracute form with sudden death. The more typical signs include fever, lethargy, and loss of appetite. Cats may present with vomiting and develop watery to bloody diarrhea. Patients die from complications that arise from secondary bacterial infections, sepsis, dehydration, and disseminated intravascular coagulation. The cats most affected and at risk of death are kittens up to the age of 12 months. This study looked at potential prognostic factors for survival of cats with panleukopenia. The medical records of 244 cats were evaluated retrospectively. In this study, indoor cats were more commonly affected than outdoor cats, and 14.5% had no contact with other cats indicating that indirect transmission is an important mode of transmission. Transmission can occur by means of contaminated clothing, cages, and insect vectors. The survival rate amongst this group of cats was 51.1%. Age, living conditions, and clinical signs were not associated with illness severity and outcome. It was noted that leukocyte and thrombocyte counts as well as serum albumin and potassium concentrations did represent prognostic factors in feline panleukopenia. Also, vaccination protocols that do not include vaccination of kittens beyond 12 weeks of age may not be adequate to prevent panleukopenia.  [VT]

Related articles:
Truyen U, Addie D, Belak S, et al. Feline panleukopenia ABCD guidelines on prevention and management. J Feline Med Surg 2009;11:538-546.

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

Kruse BD, Unterer S, Horlacher K, et al. Prognostic factors in cats with feline panleukopenia. J Vet Intern Med 2010;24:1271-1276.

Feline panleukopenia is a highly contagious and frequently lethal disease affecting all members of the cat family. Clinical disease can range from subclinical infection to a peracute form with sudden death. The more typical signs include fever, lethargy, and loss of appetite. Cats may present with vomiting and develop watery to bloody diarrhea. Patients die from complications that arise from secondary bacterial infections, sepsis, dehydration, and disseminated intravascular coagulation. The cats most affected and at risk of death are kittens up to the age of 12 months. This study looked at potential prognostic factors for survival of cats with panleukopenia. The medical records of 244 cats were evaluated retrospectively. In this study, indoor cats were more commonly affected than outdoor cats, and 14.5% had no contact with other cats indicating that indirect transmission is an important mode of transmission. Transmission can occur by means of contaminated clothing, cages, and insect vectors. The survival rate amongst this group of cats was 51.1%. Age, living conditions, and clinical signs were not associated with illness severity and outcome. It was noted that leukocyte and thrombocyte counts as well as serum albumin and potassium concentrations did represent prognostic factors in feline panleukopenia. Also, vaccination protocols that do not include vaccination of kittens beyond 12 weeks of age may not be adequate to prevent panleukopenia.  [VT]

Related articles:
Truyen U, Addie D, Belak S, et al. Feline panleukopenia ABCD guidelines on prevention and management. J Feline Med Surg 2009;11:538-546.

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

Read More

Natto – The Wonder Food For Scoliosis

By Dr Kevin Lau

Many, many years ago, when the Samurai roamed feudal Japan, they got many things wrong. A warlike and brutal enemy, the Samurai would often kill and pillage hundreds in their professional lifetime. 

They still had to maintain the lifestyle though, and without the processed foods that are available today, manage a daily routine that often involved a lot of trekking and probable combat. They also had to maintain the horses that were so valuable to them to. These horses, warrior steeds that they were, were actually fed something close to a modern health snack by their Samurai owners. Natto is gaining massive acceptance in these modern times as a great dietary component for people who not only want to look after their inner organs, but also their bones too.

The first thing you need to think about when you approach natto as something you may like to try for a food item is the smell. It is often compared to a strong cheese, so strong is the aroma that it emits. If you can get over the smell, then you have a chance at trying one of the true powerhouse foods available today.

Natto is packed with nutrients. It offers more vitamin and mineral content than most things you can buy in a supermarket. The substance s made up of steamed soybeans, and presents as a paste that soon becomes an item with a stringy texture.

Natto has been something that the Japanese have been committed to as a food source for a number of years. Thousands of years, in fact. As stated previously, the Samurai used it on their horses to make them stringer and faster. The famous warrior Minamoto was the man responsible for bringing natto to Japan, and at one point it was even used by pregnant women to build strength.

Bacillus natto is added to soya beans to create the natto substance that is used as food stuff. The Bacillus natto acts upon the soya beans to produce the natto kinase enzyme. The food presents as pretty valuable even compared to meat, bringing the eater more fibre and iron than beef, for example.

So how does this work for scoliosis sufferers? Well, natto offers a great amount of support for bones and joints. Essentially, it boosts the calcium levels in bones, adding much more than other substances that are readily available on the market. However, it also adds something extra that makes it a real boost for sufferers of the condition.[K1] 

Vitamin K is present in natto to a high degree, and this benefit is passed into the eater almost immediately. Natto has a large part to play in the healthy development in bones, including massive benefits to cartilage health.

There have been many supporters of natto as a food stuff that can help sufferers of scoliosis. For example, Dr Kevin Lau has been a high profile believer in the benefits of using natto in the diet of anyone who needs help as regards the growth of their bones. In recent times, especially with the scoliosis problem developing in youngsters who need high level and intense support in a short space of time, natto is becoming a viable choice.

---

 [K1]More info about vitamin K and the benefits for cartilage and bone and hense the spine. Reference is also needed in this article.  Example: http://healthmatters.rgmultimedia.info/2010/08/06/vitamin-k2-and-vitamin-d-put-calcium-where-it-belongs/

By Dr Kevin Lau

Many, many years ago, when the Samurai roamed feudal Japan, they got many things wrong. A warlike and brutal enemy, the Samurai would often kill and pillage hundreds in their professional lifetime. 

They still had to maintain the lifestyle though, and without the processed foods that are available today, manage a daily routine that often involved a lot of trekking and probable combat. They also had to maintain the horses that were so valuable to them to. These horses, warrior steeds that they were, were actually fed something close to a modern health snack by their Samurai owners. Natto is gaining massive acceptance in these modern times as a great dietary component for people who not only want to look after their inner organs, but also their bones too.

The first thing you need to think about when you approach natto as something you may like to try for a food item is the smell. It is often compared to a strong cheese, so strong is the aroma that it emits. If you can get over the smell, then you have a chance at trying one of the true powerhouse foods available today.

Natto is packed with nutrients. It offers more vitamin and mineral content than most things you can buy in a supermarket. The substance s made up of steamed soybeans, and presents as a paste that soon becomes an item with a stringy texture.

Natto has been something that the Japanese have been committed to as a food source for a number of years. Thousands of years, in fact. As stated previously, the Samurai used it on their horses to make them stringer and faster. The famous warrior Minamoto was the man responsible for bringing natto to Japan, and at one point it was even used by pregnant women to build strength.

Bacillus natto is added to soya beans to create the natto substance that is used as food stuff. The Bacillus natto acts upon the soya beans to produce the natto kinase enzyme. The food presents as pretty valuable even compared to meat, bringing the eater more fibre and iron than beef, for example.

So how does this work for scoliosis sufferers? Well, natto offers a great amount of support for bones and joints. Essentially, it boosts the calcium levels in bones, adding much more than other substances that are readily available on the market. However, it also adds something extra that makes it a real boost for sufferers of the condition.[K1] 

Vitamin K is present in natto to a high degree, and this benefit is passed into the eater almost immediately. Natto has a large part to play in the healthy development in bones, including massive benefits to cartilage health.

There have been many supporters of natto as a food stuff that can help sufferers of scoliosis. For example, Dr Kevin Lau has been a high profile believer in the benefits of using natto in the diet of anyone who needs help as regards the growth of their bones. In recent times, especially with the scoliosis problem developing in youngsters who need high level and intense support in a short space of time, natto is becoming a viable choice.

---

 [K1]More info about vitamin K and the benefits for cartilage and bone and hense the spine. Reference is also needed in this article.  Example: http://healthmatters.rgmultimedia.info/2010/08/06/vitamin-k2-and-vitamin-d-put-calcium-where-it-belongs/

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Do your kids prefer junk food? Blame yourself

Be it junk or healthy food -- what you eat during pregnancy affects your child's food preferences as it helps to form their sense of smell, so says a new study.

This makes the mother's diet more attractive to the child when they are older, reports the Daily Mail.

Study author Josephine Todrank, now at the University of Haifa in Israel, said: "If the mother drinks alcohol, her child may be more attracted to alcohol because the developing foetus 'expects' that whatever comes from the mother must be safe."
"If she eats healthy food, the child will prefer healthy food," added Todrank, according to the journal Proceedings of the Royal Society B.

Researchers studying mice found that the pups' sense of smell was changed by what their mothers ate, teaching them to like the flavours in her diet.

At the same time, they found significant changes in the structure of the brain's olfactory glomeruli, which processes smells, because odours in the amniotic fluid affect how this system develops.

Study sponsor Diego Restrepo, said: "This is the first study to address the changes in the brain that occur upon steady exposure to flavours in utero and early in postnatal life

Be it junk or healthy food -- what you eat during pregnancy affects your child's food preferences as it helps to form their sense of smell, so says a new study.

This makes the mother's diet more attractive to the child when they are older, reports the Daily Mail.

Study author Josephine Todrank, now at the University of Haifa in Israel, said: "If the mother drinks alcohol, her child may be more attracted to alcohol because the developing foetus 'expects' that whatever comes from the mother must be safe."
"If she eats healthy food, the child will prefer healthy food," added Todrank, according to the journal Proceedings of the Royal Society B.

Researchers studying mice found that the pups' sense of smell was changed by what their mothers ate, teaching them to like the flavours in her diet.

At the same time, they found significant changes in the structure of the brain's olfactory glomeruli, which processes smells, because odours in the amniotic fluid affect how this system develops.

Study sponsor Diego Restrepo, said: "This is the first study to address the changes in the brain that occur upon steady exposure to flavours in utero and early in postnatal life

Read More

Aspirin Helps in Reducing Cancer Deaths, a Study Finds

Many Americans take aspirin to lower their risk of heart disease, but a new study suggests a remarkable added benefit, reporting that patients who took aspirin regularly for a period of several years were 21 percent less likely decades later to die of solid tumor cancers, including cancers of the stomach, esophagus and lung.

As part of the new study, published online Monday in the journal Lancet, researchers examined the cancer death rates of 25,570 patients who had participated in eight different randomized controlled trials of aspirin that ended up to 20 years earlier.

Participants who had been assigned to the aspirin arms of the studies were 20 percent less likely after 20 years to have died of solid tumor cancers than those who had been in the comparison group taking dummy pills during the clinical trials, and their risk of gastrointestinal cancer death was 35 percent lower. The risk of lung cancer death was 30 percent lower, the risk of colorectal cancer death was 40 percent lower and the risk of esophageal cancer death was 60 percent lower, the study reported.

The specific dose of aspirin taken did not seem to matter — most trials gave out low doses of 75 to 100 milligrams — but the participants in the longest lasting trials had the most drastic reductions in cancer death years later.

“This is important as a proof of principle that a single simple compound like aspirin can reduce the risk of cancer substantially,” said the study’s lead author, Dr. Peter M. Rothwell, professor of neurology at the University of Oxford. “There’s been a lot of work over the years showing that certain compounds can increase the risk of cancer, but it’s not been shown before that we can reduce the risk with something as simple as aspirin.”

But even as some experts hailed the new study as a breakthrough, others urged caution, warning people not to start a regimen of aspirin without first consulting a doctor about the potential risks, including gastrointestinal bleeding and bleeding in the brain (hemorrhagic strokes).

“Many people may wonder if they should start taking daily aspirin, but it would be premature to recommend people starting taking aspirin specifically to prevent cancer,” said Eric J. Jacobs, an epidemiologist with the American Cancer Society.

While Dr. Jacobs said the study design was valid, relatively few women were included in the trials, making it difficult to generalize the results to women.

“It’s hard to assess effects on mortality from just one study,” he said.

The findings do not come entirely as a surprise, Dr. Rothwell said, because aspirin has been found to slow or prevent the growth of tumor cell lines in the laboratory. Observational studies have reported that people who took aspirin were at lower risk for colorectal cancer recurrences, while other studies have pointed to similar reductions in cancers of the lung, stomach and esophagus.

“There have been hints of this before, but the quality of this study is the gold standard because it is based on randomized clinical trials,” said Dr. Alan A. Arslan, an assistant professor of obstetrics and gynecology and environmental medicine at New York University School of Medicine, who did an observational study several years ago reporting that women who had taken aspirin regularly had a lower risk of ovarian cancer. “Randomized controlled trials carry more weight.”

The strong results “add to the accumulating evidence that aspirin may be protective against various cancers,” Dr. Arslan said.

There are several ways in which aspirin may work to slow the development of cancers, experts say. Inflammation may play a role in cancer, and aspirin blocks the synthesis of prostaglandins, which are mediators of inflammation, and may affect early tumor promotion.

Aspirin may also induce the death of early cancer cells before they become aggressive, Dr. Arslan suggested.

Many Americans take aspirin to lower their risk of heart disease, but a new study suggests a remarkable added benefit, reporting that patients who took aspirin regularly for a period of several years were 21 percent less likely decades later to die of solid tumor cancers, including cancers of the stomach, esophagus and lung.

As part of the new study, published online Monday in the journal Lancet, researchers examined the cancer death rates of 25,570 patients who had participated in eight different randomized controlled trials of aspirin that ended up to 20 years earlier.

Participants who had been assigned to the aspirin arms of the studies were 20 percent less likely after 20 years to have died of solid tumor cancers than those who had been in the comparison group taking dummy pills during the clinical trials, and their risk of gastrointestinal cancer death was 35 percent lower. The risk of lung cancer death was 30 percent lower, the risk of colorectal cancer death was 40 percent lower and the risk of esophageal cancer death was 60 percent lower, the study reported.

The specific dose of aspirin taken did not seem to matter — most trials gave out low doses of 75 to 100 milligrams — but the participants in the longest lasting trials had the most drastic reductions in cancer death years later.

“This is important as a proof of principle that a single simple compound like aspirin can reduce the risk of cancer substantially,” said the study’s lead author, Dr. Peter M. Rothwell, professor of neurology at the University of Oxford. “There’s been a lot of work over the years showing that certain compounds can increase the risk of cancer, but it’s not been shown before that we can reduce the risk with something as simple as aspirin.”

But even as some experts hailed the new study as a breakthrough, others urged caution, warning people not to start a regimen of aspirin without first consulting a doctor about the potential risks, including gastrointestinal bleeding and bleeding in the brain (hemorrhagic strokes).

“Many people may wonder if they should start taking daily aspirin, but it would be premature to recommend people starting taking aspirin specifically to prevent cancer,” said Eric J. Jacobs, an epidemiologist with the American Cancer Society.

While Dr. Jacobs said the study design was valid, relatively few women were included in the trials, making it difficult to generalize the results to women.

“It’s hard to assess effects on mortality from just one study,” he said.

The findings do not come entirely as a surprise, Dr. Rothwell said, because aspirin has been found to slow or prevent the growth of tumor cell lines in the laboratory. Observational studies have reported that people who took aspirin were at lower risk for colorectal cancer recurrences, while other studies have pointed to similar reductions in cancers of the lung, stomach and esophagus.

“There have been hints of this before, but the quality of this study is the gold standard because it is based on randomized clinical trials,” said Dr. Alan A. Arslan, an assistant professor of obstetrics and gynecology and environmental medicine at New York University School of Medicine, who did an observational study several years ago reporting that women who had taken aspirin regularly had a lower risk of ovarian cancer. “Randomized controlled trials carry more weight.”

The strong results “add to the accumulating evidence that aspirin may be protective against various cancers,” Dr. Arslan said.

There are several ways in which aspirin may work to slow the development of cancers, experts say. Inflammation may play a role in cancer, and aspirin blocks the synthesis of prostaglandins, which are mediators of inflammation, and may affect early tumor promotion.

Aspirin may also induce the death of early cancer cells before they become aggressive, Dr. Arslan suggested.

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