Drinking Alcohol in Moderation Protects Against Heart Disease, Meta-Analysis Finds

Individuals who drink alcohol in moderation (about one drink a day or less) are 14-25% less likely to develop heart disease compared to those who drink no alcohol at all, finds research led by Professor William Ghali from the University of Calgary, published online in the British Medical Journal.

The first paper, led by Paul Ronksley from the University of Calgary, emphasises that a balance needs to be found between the public health message that consuming large amounts of alcohol is bad for you, and the one that drinking in moderation can have health benefits.

An accompanying paper led by Dr Susan Brien, also from the University of Calgary, finds that moderate consumption of alcohol (up to one drink or 15 g alcohol per day for women and up to two drinks or 30 g alcohol per day for men) is good for health. They say moderate amounts of alcohol significantly increase the levels of 'good' cholesterol circulating in the body and this has a protective effect against heart disease.

Brien and colleagues argue that their study strengthens the case that there is a causal link between alcohol consumption and reduced heart disease.

The authors of both papers acknowledge that a number of previous studies have concluded that moderate alcohol consumption has been associated with a decrease in heart disease. However, they say that the research was out-of-date and there was a need for new material. Professor Ghali says his team's research is the most comprehensive to date.

Ghali and colleagues reviewed 84 studies of alcohol consumption and heart disease. They compared alcohol drinkers with non-drinkers and their outcomes in relation to heart disease, death from heart disease, incidences of stroke and death from having a stroke.

In the companion study, Brien and colleagues reviewed 63 studies and investigated alcohol consumption with known physical markers for heart disease such as cholesterol, levels of inflammation, fat cells and the condition of blood vessels. They also assessed the impact of the type of alcohol consumed (wine, beer and spirits).

Interestingly, Brien's research concludes that it is the alcohol content that provides the health benefits not the type of alcoholic beverage (wine, beer or spirits) that is drunk.

Professor Ghali concludes that the debate between the impact of alcohol on heart disease should now centre "on how to integrate this evidence into clinical practice and public health messages."

He adds "with respect to public health messages there may now be an impetus to better communicate to the public that alcohol, in moderation, may have overall health benefits that outweigh the risks in selected subsets of patients … any such strategy would need to be accompanied by rigorous study and oversight of impacts."

Individuals who drink alcohol in moderation (about one drink a day or less) are 14-25% less likely to develop heart disease compared to those who drink no alcohol at all, finds research led by Professor William Ghali from the University of Calgary, published online in the British Medical Journal.

The first paper, led by Paul Ronksley from the University of Calgary, emphasises that a balance needs to be found between the public health message that consuming large amounts of alcohol is bad for you, and the one that drinking in moderation can have health benefits.

An accompanying paper led by Dr Susan Brien, also from the University of Calgary, finds that moderate consumption of alcohol (up to one drink or 15 g alcohol per day for women and up to two drinks or 30 g alcohol per day for men) is good for health. They say moderate amounts of alcohol significantly increase the levels of 'good' cholesterol circulating in the body and this has a protective effect against heart disease.

Brien and colleagues argue that their study strengthens the case that there is a causal link between alcohol consumption and reduced heart disease.

The authors of both papers acknowledge that a number of previous studies have concluded that moderate alcohol consumption has been associated with a decrease in heart disease. However, they say that the research was out-of-date and there was a need for new material. Professor Ghali says his team's research is the most comprehensive to date.

Ghali and colleagues reviewed 84 studies of alcohol consumption and heart disease. They compared alcohol drinkers with non-drinkers and their outcomes in relation to heart disease, death from heart disease, incidences of stroke and death from having a stroke.

In the companion study, Brien and colleagues reviewed 63 studies and investigated alcohol consumption with known physical markers for heart disease such as cholesterol, levels of inflammation, fat cells and the condition of blood vessels. They also assessed the impact of the type of alcohol consumed (wine, beer and spirits).

Interestingly, Brien's research concludes that it is the alcohol content that provides the health benefits not the type of alcoholic beverage (wine, beer or spirits) that is drunk.

Professor Ghali concludes that the debate between the impact of alcohol on heart disease should now centre "on how to integrate this evidence into clinical practice and public health messages."

He adds "with respect to public health messages there may now be an impetus to better communicate to the public that alcohol, in moderation, may have overall health benefits that outweigh the risks in selected subsets of patients … any such strategy would need to be accompanied by rigorous study and oversight of impacts."

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10 Unsettling Facts about Diet Soda

We've all heard that if you're going to drink sodas, choose diet. This may seem like the best option for diabetics and people who are watching their weight, but there is more to consider when drinking diet sodas than just calories. We may not know exactly what these carbonated colas are doing to our bodies, but there is plenty of research that suggests they aren't doing much good. Here are 10 unsettling facts about diet soda:

1. Causes Diabetic Complications: Diet sodas are often recommended to diabetics, who have to reduce their sugar intake. However, research suggests that the artificial sweetener, aspartame, may actually cause negative side effects for diabetics. Aspartame may cause diabetic complications or worsen them, such as retinopathy, cataracts and metabolic disorders. The artificial sweetener can also make it harder for diabetics to properly control their insulin levels, in addition to affecting appetite or causing weight gain.
2. Dissolves Tooth Enamel: Even though diet sodas do not directly cause cavities like the sugar in regular sodas, the acid in diet sodas may contribute to enamel breakdown, which makes you more susceptible to tooth decay when sugar is consumed. Diet sodas are very acidic. For example, Diet Coke, Diet Dr. Pepper and Diet 7-Up have pH values ranging from 3.39 to 3.67. Acid starts to dissolve tooth enamel at pH value of 5.5 or less.
3. Contains a High Caffeine Amount: One 12oz can of diet soda contains anywhere from 23 to 54 mg of caffeine. The amount of caffeine varies by diet soda brands, but most diets sodas contain more caffeine than regular sodas. If you're caffeine intake exceeds 500 to 600 mg a day, your health could be in risk. High caffeine consumption may cause headaches, restlessness, anxiety and other potential health problems.
4. Leaches Calcium from Bones: Diet sodas leach calcium from your bones in several ways. The phosphoric acid in diet sodas can increase calcium excretion in urine, therefore promoting calcium loss. Caffeine can also zap calcium from bones and weaken them if the body is not replaced with enough calcium. Getting an adequate amount of calcium and vitamin D every day, as well as limiting caffeine intake to 300 mg or less a day, will help diet soda drinkers maintain strong and healthy bones.
5. Increases Stroke Risk: Recent medical studies have determined a link between diet soda consumption and an increased risk of stroke and heart attack. The study used 2,500 participants to analyze the health effects of daily diet soda consumption. It found that 61 percent of people who drank a diet soda daily had an increased risk of heart problems compared to non-soda drinkers. It also accounted for smoking, exercise, alcohol consumption and calories consumed per day.
6. Causes Weight Gain: Diet sodas have been linked to causing weight because sugar substitutes, such as saccharin, sucralose, aspartame, neotame and acesulfame-K, may actually increase people's cravings for more food to feel satisfied. Research shows that artificial sweeteners are hundreds of times sweeter than real sugar and can be addictive. This may increase cravings and consumption of larger and sweeter desserts to get your sweets fix, which may result in weight gain.
7. Causes Dehydration: Diet soda is a diuretic, which increases the flow of urine and calcium excretion. Depending on how many diet sodas you drink and how much water you consume, this process can cause dehydration. Excessive diet soda consumption can also cause a laxative effect and shed some water weight, but it's very important to be aware of the signs of dehydration and stay replenished with water.
8. Increases Risk of Developing Metabolic Syndrome: Research suggests that drinking diet soda may increase one's chances of developing metabolic syndrome. Metabolic syndrome is characterized by a group of risk factors that could lead to heart disease, stroke and type 2diabetes. Abdominal obesity, high blood pressure, insulin resistance or glucose intolerance and high cholesterol are some of the known risk factors. Daily diet soda drinkers, who don't exercise and eat unhealthy foods, are increasing their chances of developing metabolic syndrome at a faster rate than those who don't drink sodas but eat the same way.
9. Inceases Risk of Cell Damage: A preservative found in diet sodas, called sodium benzoate, has been linked to an increase in cell damage. Sodium benzoate is added to sodas to prevent mold. When mixed with the additive vitamin C, it produces a carcinogenic substance called benzene. Studies also show that sodium benzoate may damage the mitochondria, a very important part of DNA within cells. The cells might malfunction when damaged, causing a number of diseases like Parkinson's, cirrhosis of the liver and neuro-degenerative diseases.
10. Soda Used to Contain Cocaine: When Coca-Cola was first created by pharmacist John Pemberton in 1886, it contained cocaine, which was thought to cure various diseases and ailments. The "feel good" drink was said to cure morphine addiction, neurasthenia, headache and dyspepsia. Coca-Cola may have taken out cocaine from the recipe in the early 1900s, but both regular and diet Coca-Cola still use a cocaine-free coca extract in the recipe.

Taken with permission from: http://radiologytechnicianschools.net/10-unsettling-facts-about-diet-soda-2/

We've all heard that if you're going to drink sodas, choose diet. This may seem like the best option for diabetics and people who are watching their weight, but there is more to consider when drinking diet sodas than just calories. We may not know exactly what these carbonated colas are doing to our bodies, but there is plenty of research that suggests they aren't doing much good. Here are 10 unsettling facts about diet soda:

1. Causes Diabetic Complications: Diet sodas are often recommended to diabetics, who have to reduce their sugar intake. However, research suggests that the artificial sweetener, aspartame, may actually cause negative side effects for diabetics. Aspartame may cause diabetic complications or worsen them, such as retinopathy, cataracts and metabolic disorders. The artificial sweetener can also make it harder for diabetics to properly control their insulin levels, in addition to affecting appetite or causing weight gain.
2. Dissolves Tooth Enamel: Even though diet sodas do not directly cause cavities like the sugar in regular sodas, the acid in diet sodas may contribute to enamel breakdown, which makes you more susceptible to tooth decay when sugar is consumed. Diet sodas are very acidic. For example, Diet Coke, Diet Dr. Pepper and Diet 7-Up have pH values ranging from 3.39 to 3.67. Acid starts to dissolve tooth enamel at pH value of 5.5 or less.
3. Contains a High Caffeine Amount: One 12oz can of diet soda contains anywhere from 23 to 54 mg of caffeine. The amount of caffeine varies by diet soda brands, but most diets sodas contain more caffeine than regular sodas. If you're caffeine intake exceeds 500 to 600 mg a day, your health could be in risk. High caffeine consumption may cause headaches, restlessness, anxiety and other potential health problems.
4. Leaches Calcium from Bones: Diet sodas leach calcium from your bones in several ways. The phosphoric acid in diet sodas can increase calcium excretion in urine, therefore promoting calcium loss. Caffeine can also zap calcium from bones and weaken them if the body is not replaced with enough calcium. Getting an adequate amount of calcium and vitamin D every day, as well as limiting caffeine intake to 300 mg or less a day, will help diet soda drinkers maintain strong and healthy bones.
5. Increases Stroke Risk: Recent medical studies have determined a link between diet soda consumption and an increased risk of stroke and heart attack. The study used 2,500 participants to analyze the health effects of daily diet soda consumption. It found that 61 percent of people who drank a diet soda daily had an increased risk of heart problems compared to non-soda drinkers. It also accounted for smoking, exercise, alcohol consumption and calories consumed per day.
6. Causes Weight Gain: Diet sodas have been linked to causing weight because sugar substitutes, such as saccharin, sucralose, aspartame, neotame and acesulfame-K, may actually increase people's cravings for more food to feel satisfied. Research shows that artificial sweeteners are hundreds of times sweeter than real sugar and can be addictive. This may increase cravings and consumption of larger and sweeter desserts to get your sweets fix, which may result in weight gain.
7. Causes Dehydration: Diet soda is a diuretic, which increases the flow of urine and calcium excretion. Depending on how many diet sodas you drink and how much water you consume, this process can cause dehydration. Excessive diet soda consumption can also cause a laxative effect and shed some water weight, but it's very important to be aware of the signs of dehydration and stay replenished with water.
8. Increases Risk of Developing Metabolic Syndrome: Research suggests that drinking diet soda may increase one's chances of developing metabolic syndrome. Metabolic syndrome is characterized by a group of risk factors that could lead to heart disease, stroke and type 2diabetes. Abdominal obesity, high blood pressure, insulin resistance or glucose intolerance and high cholesterol are some of the known risk factors. Daily diet soda drinkers, who don't exercise and eat unhealthy foods, are increasing their chances of developing metabolic syndrome at a faster rate than those who don't drink sodas but eat the same way.
9. Inceases Risk of Cell Damage: A preservative found in diet sodas, called sodium benzoate, has been linked to an increase in cell damage. Sodium benzoate is added to sodas to prevent mold. When mixed with the additive vitamin C, it produces a carcinogenic substance called benzene. Studies also show that sodium benzoate may damage the mitochondria, a very important part of DNA within cells. The cells might malfunction when damaged, causing a number of diseases like Parkinson's, cirrhosis of the liver and neuro-degenerative diseases.
10. Soda Used to Contain Cocaine: When Coca-Cola was first created by pharmacist John Pemberton in 1886, it contained cocaine, which was thought to cure various diseases and ailments. The "feel good" drink was said to cure morphine addiction, neurasthenia, headache and dyspepsia. Coca-Cola may have taken out cocaine from the recipe in the early 1900s, but both regular and diet Coca-Cola still use a cocaine-free coca extract in the recipe.

Taken with permission from: http://radiologytechnicianschools.net/10-unsettling-facts-about-diet-soda-2/

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Poor sleep quality is associated with greater disability in rheumatoid arthritis patients

The relationship between sleep quality and disability mediated by pain severity and fatigue
DARIEN, Ill. – A study in the Feb. 15 issue of the Journal of Clinical Sleep Medicine found that poor sleep quality correlated with higher levels of depressive symptoms, greater pain severity, increased fatigue, and greater functional disability in patients with Rheumatoid Arthritis (RA). The study suggests that addressing sleep problems via pharmacological or behavioral interventions may have a critical impact on the health and lives of patients with RA.

The study represents a cross-sectional examination of the relationship between sleep quality and functional disability in 162 patients with RA. The sample had an average age of 58.5 years, and 76 percent were female. All patients had been diagnosed with RA for at least two years; on average, patients had RA for 14 years.

Participants completed the following questionnaires: Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory-II, Medical Outcomes Study Short Form - 36, and the Health Assessment Questionnaire. The results provided input on their sleep quality, depression, fatigue, and functional disability and pain severity, respectively. Patients also provided sociodemographic information and their medical history.

Results show that sleep quality has an indirect effect on functional disability after controlling for age, gender and number of comorbities. According to the PSQI results, 61 percent of patients were poor sleepers and 33 percent reported having pain that disturbed their sleep three or more times per week.

"The primary finding of our study is that poor sleep quality is associated with greater functional disability among patients with RA and this relationship may be explained by pain severity and fatigue," said lead author Dr. Faith S. Luyster, research assistant professor at the University of Pittsburgh School of Nursing in Pittsburgh, Pa. "These results highlight the importance of addressing sleep complaints among patients with RA. By treating sleep problems either pharmacologically or behaviorally, symptoms and activity limitations associated with RA may be reduced."

The study's finding that poorer sleep quality is associated with greater pain severity is consistent with recent evidence suggesting that sleep disruption may lower pain threshold and enhance pain in RA and otherwise healthy adults.

According to the National Institute of Health, RA is an inflammatory disease affecting about 1.3 million U.S. adults, and causes pain, swelling, stiffness, and loss of function in the joints. Disturbed sleep has been found to be a major concern among persons with RA.

Physical disability resulting from polyarticular joint disease in patients with RA may limit their ability to carry out daily activities such as dressing, walking, grooming, and writing - tasks that can be further restricted by fatigue, pain severity, and depression.

It is possible that functional disability may affect depression, pain severity and fatigue, which in turn may affect sleep quality. It is likely that the relationships are bidirectional to some extent.

"Not sleeping well at night can contribute to greater pain sensitivity and fatigue during the day which in turn can limit a patient's ability to engage in activities of daily living and discretionary activities," Luyster said.

Luyster noted that treating sleep disturbances in RA patients might have beneficial effects beyond improving sleep.

The relationship between sleep quality and disability mediated by pain severity and fatigue
DARIEN, Ill. – A study in the Feb. 15 issue of the Journal of Clinical Sleep Medicine found that poor sleep quality correlated with higher levels of depressive symptoms, greater pain severity, increased fatigue, and greater functional disability in patients with Rheumatoid Arthritis (RA). The study suggests that addressing sleep problems via pharmacological or behavioral interventions may have a critical impact on the health and lives of patients with RA.

The study represents a cross-sectional examination of the relationship between sleep quality and functional disability in 162 patients with RA. The sample had an average age of 58.5 years, and 76 percent were female. All patients had been diagnosed with RA for at least two years; on average, patients had RA for 14 years.

Participants completed the following questionnaires: Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory-II, Medical Outcomes Study Short Form - 36, and the Health Assessment Questionnaire. The results provided input on their sleep quality, depression, fatigue, and functional disability and pain severity, respectively. Patients also provided sociodemographic information and their medical history.

Results show that sleep quality has an indirect effect on functional disability after controlling for age, gender and number of comorbities. According to the PSQI results, 61 percent of patients were poor sleepers and 33 percent reported having pain that disturbed their sleep three or more times per week.

"The primary finding of our study is that poor sleep quality is associated with greater functional disability among patients with RA and this relationship may be explained by pain severity and fatigue," said lead author Dr. Faith S. Luyster, research assistant professor at the University of Pittsburgh School of Nursing in Pittsburgh, Pa. "These results highlight the importance of addressing sleep complaints among patients with RA. By treating sleep problems either pharmacologically or behaviorally, symptoms and activity limitations associated with RA may be reduced."

The study's finding that poorer sleep quality is associated with greater pain severity is consistent with recent evidence suggesting that sleep disruption may lower pain threshold and enhance pain in RA and otherwise healthy adults.

According to the National Institute of Health, RA is an inflammatory disease affecting about 1.3 million U.S. adults, and causes pain, swelling, stiffness, and loss of function in the joints. Disturbed sleep has been found to be a major concern among persons with RA.

Physical disability resulting from polyarticular joint disease in patients with RA may limit their ability to carry out daily activities such as dressing, walking, grooming, and writing - tasks that can be further restricted by fatigue, pain severity, and depression.

It is possible that functional disability may affect depression, pain severity and fatigue, which in turn may affect sleep quality. It is likely that the relationships are bidirectional to some extent.

"Not sleeping well at night can contribute to greater pain sensitivity and fatigue during the day which in turn can limit a patient's ability to engage in activities of daily living and discretionary activities," Luyster said.

Luyster noted that treating sleep disturbances in RA patients might have beneficial effects beyond improving sleep.

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Cholesterol 'does not predict stroke in women'

High levels of cholesterol do not predict the risk of stroke in women, according to researchers in Denmark.

They did detect an increased risk in men, but only when cholesterol was at almost twice the average level.

The report in Annals of Neurology recommends using a different type of fat in the blood, non-fasting triglycerides, to measure the risk.

The Stroke Association said triglyceride tests needed to become routine to reduce the risk of stroke.

A total of 150,000 people have a stroke in the UK each year. Most are ischemic strokes, in which a clot in an artery disrupts the brain's blood supply.

The research followed 13,951 men and women, who took part in the Copenhagen City Heart Study.

During the 33-year study, 837 men and 837 women had strokes.

Poor predictor

They reported that the cholesterol levels in women were not associated with stroke, while there was only an association in men with levels higher than 9mmol/litre. The average in UK men is 5.5.

The researchers at Copenhagen University Hospital said this was "difficult to explain" as LDL, or bad, cholesterol is known to cause atherosclerosis which can block arteries.

They did notice a link, in both men and women, between the risk of stroke and non-fasting triglycerides.

They believe these fats are a marker for "remnant cholesterol" which is left behind when other forms of cholesterol are made.

Dr Peter Coleman, deputy director of research at The Stroke Association said: "Tests for triglyceride levels aren't routinely carried out in the UK unless there is significant concern."

"We know that high levels of fats, such as cholesterol, increase your risk of having a stroke. However, this research shows the importance of measuring the fat triglyceride, as well as cholesterol.

"This study highlights the importance of measuring triglycerides routinely in order to reduce a person's risk of stroke."

High levels of cholesterol do not predict the risk of stroke in women, according to researchers in Denmark.

They did detect an increased risk in men, but only when cholesterol was at almost twice the average level.

The report in Annals of Neurology recommends using a different type of fat in the blood, non-fasting triglycerides, to measure the risk.

The Stroke Association said triglyceride tests needed to become routine to reduce the risk of stroke.

A total of 150,000 people have a stroke in the UK each year. Most are ischemic strokes, in which a clot in an artery disrupts the brain's blood supply.

The research followed 13,951 men and women, who took part in the Copenhagen City Heart Study.

During the 33-year study, 837 men and 837 women had strokes.

Poor predictor

They reported that the cholesterol levels in women were not associated with stroke, while there was only an association in men with levels higher than 9mmol/litre. The average in UK men is 5.5.

The researchers at Copenhagen University Hospital said this was "difficult to explain" as LDL, or bad, cholesterol is known to cause atherosclerosis which can block arteries.

They did notice a link, in both men and women, between the risk of stroke and non-fasting triglycerides.

They believe these fats are a marker for "remnant cholesterol" which is left behind when other forms of cholesterol are made.

Dr Peter Coleman, deputy director of research at The Stroke Association said: "Tests for triglyceride levels aren't routinely carried out in the UK unless there is significant concern."

"We know that high levels of fats, such as cholesterol, increase your risk of having a stroke. However, this research shows the importance of measuring the fat triglyceride, as well as cholesterol.

"This study highlights the importance of measuring triglycerides routinely in order to reduce a person's risk of stroke."

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Shoppers Wary of GM Foods Find They're Everywhere

You may not want to eat genetically engineered foods. Chances are, you are eating them anyway.
Genetically modified plants grown from seeds engineered in labs now provide much of the food we eat. Most corn, soybean and cotton crops grown in the United States have been genetically modified to resist pesticides or insects, and corn and soy are common food ingredients.

The Agriculture Department has approved three more genetically engineered crops in the past month, and the Food and Drug Administration could approve fast-growing genetically modified salmon for human consumption this year.

Agribusiness and the seed companies say their products help boost crop production, lower prices at the grocery store and feed the world, particularly in developing countries. The FDA and USDA say the engineered foods they've approved are safe — so safe, they don't even need to be labeled as such — and can't be significantly distinguished from conventional varieties.

Organic food companies, chefs and consumer groups have stepped up their efforts — so far, unsuccessfully — to get the government to exercise more oversight of engineered foods, arguing the seeds are floating from field to field and contaminating pure crops. The groups have been bolstered by a growing network of consumers who are wary of processed and modified foods.

Many of these opponents acknowledge that there isn't much solid evidence showing genetically modified foods are somehow dangerous or unhealthy. It just doesn't seem right, they say. It's an ethical issue.

"If you mess with nature there's a side effect somewhere," says George Siemon, CEO of Organic Valley, the nation's largest organic farming cooperative, which had more than $600 million in sales last year. "There is a growing awareness that our system makes us all guinea pigs of sorts."

The U.S. government has insisted there's not enough difference between the genetically modified seeds its agencies have approved and natural seeds to cause concern. But Agriculture Secretary Tom Vilsack, more so than his predecessors in previous administrations, has acknowledged the debate over the issue and a growing chorus of consumers concerned about what they are eating.

You may not want to eat genetically engineered foods. Chances are, you are eating them anyway.
Genetically modified plants grown from seeds engineered in labs now provide much of the food we eat. Most corn, soybean and cotton crops grown in the United States have been genetically modified to resist pesticides or insects, and corn and soy are common food ingredients.

The Agriculture Department has approved three more genetically engineered crops in the past month, and the Food and Drug Administration could approve fast-growing genetically modified salmon for human consumption this year.

Agribusiness and the seed companies say their products help boost crop production, lower prices at the grocery store and feed the world, particularly in developing countries. The FDA and USDA say the engineered foods they've approved are safe — so safe, they don't even need to be labeled as such — and can't be significantly distinguished from conventional varieties.

Organic food companies, chefs and consumer groups have stepped up their efforts — so far, unsuccessfully — to get the government to exercise more oversight of engineered foods, arguing the seeds are floating from field to field and contaminating pure crops. The groups have been bolstered by a growing network of consumers who are wary of processed and modified foods.

Many of these opponents acknowledge that there isn't much solid evidence showing genetically modified foods are somehow dangerous or unhealthy. It just doesn't seem right, they say. It's an ethical issue.

"If you mess with nature there's a side effect somewhere," says George Siemon, CEO of Organic Valley, the nation's largest organic farming cooperative, which had more than $600 million in sales last year. "There is a growing awareness that our system makes us all guinea pigs of sorts."

The U.S. government has insisted there's not enough difference between the genetically modified seeds its agencies have approved and natural seeds to cause concern. But Agriculture Secretary Tom Vilsack, more so than his predecessors in previous administrations, has acknowledged the debate over the issue and a growing chorus of consumers concerned about what they are eating.

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Pregnancy Testing in Cats

Digangi BA, Griffin B, Levy JK et al: Use of a commercially available relaxin test for detection of pregnancy in cats, J Am Vet Med Assoc 237:1267, 2010.

Relaxin is the only pregnancy-specific hormone reported in cats. In this study, investigators determined the earliest day of gestation at which relaxin could be detected in pregnant queens using a commercially available point-of-care test designed for use in dogs. They also calculated the sensitivity and specificity of the test for pregnancy detection on any specific day of gestation. The study looked at 162 female cats—24 queens from a breeding colony, 128 stray and feral queens undergoing ovariohysterectomy, and 10 ovariectomized cats. The 24 queens in the breeding colony were monitored for pregnancy while blood samples were taken daily to test for relaxin until 2 consecutive positive tests were obtained. Pregnancy was detected as early as gestational day 20 by use of the relaxin test kit. Maximum accuracy was achieved on day 29, when sensitivity reached 100%. False-positive tests were detected in 3 queens. Utilizing the test, pregnancy can be confirmed at an earlier date than with the use of radiography and without the safety concerns related to radiography. While ultrasonography is a more sensitive method for detection of pregnancy, it may not always be available and may be more expensive than blood sampling and point-of-care testing. When breeding dates are known, the predictive value and convenience of the relaxin test make it an excellent choice for diagnosis of pregnancy in cats. When breeding dates are unknown or when multiple dates are possible, interpretation of negative results becomes more complex and must be considered within the context of the patient’s history.  [VT]

Related articles:
de Haas van Dorsser FJ, Lasano S, Steinetz BG: Pregnancy diagnosis in cats using a rapid, bench-top kit to detect relaxin in urine, Reprod Domest Anim 42:111, 2007.

More on cat health: Winn Feline Foundation Library
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Digangi BA, Griffin B, Levy JK et al: Use of a commercially available relaxin test for detection of pregnancy in cats, J Am Vet Med Assoc 237:1267, 2010.

Relaxin is the only pregnancy-specific hormone reported in cats. In this study, investigators determined the earliest day of gestation at which relaxin could be detected in pregnant queens using a commercially available point-of-care test designed for use in dogs. They also calculated the sensitivity and specificity of the test for pregnancy detection on any specific day of gestation. The study looked at 162 female cats—24 queens from a breeding colony, 128 stray and feral queens undergoing ovariohysterectomy, and 10 ovariectomized cats. The 24 queens in the breeding colony were monitored for pregnancy while blood samples were taken daily to test for relaxin until 2 consecutive positive tests were obtained. Pregnancy was detected as early as gestational day 20 by use of the relaxin test kit. Maximum accuracy was achieved on day 29, when sensitivity reached 100%. False-positive tests were detected in 3 queens. Utilizing the test, pregnancy can be confirmed at an earlier date than with the use of radiography and without the safety concerns related to radiography. While ultrasonography is a more sensitive method for detection of pregnancy, it may not always be available and may be more expensive than blood sampling and point-of-care testing. When breeding dates are known, the predictive value and convenience of the relaxin test make it an excellent choice for diagnosis of pregnancy in cats. When breeding dates are unknown or when multiple dates are possible, interpretation of negative results becomes more complex and must be considered within the context of the patient’s history.  [VT]

Related articles:
de Haas van Dorsser FJ, Lasano S, Steinetz BG: Pregnancy diagnosis in cats using a rapid, bench-top kit to detect relaxin in urine, Reprod Domest Anim 42:111, 2007.

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

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Evidence-Based Medicine: The Current System of Scoliosis Management in the United States is Not Supported by EBM

Evidence-based medicine (EBM) or evidence-based practices (EBP) are poorly understand by the general public and also by many members of the healthcare profession. They are often misinterpreted to mean that only interventions with published research can be considered part of EBM; this is untrue. EBM began in Ontario, Canada, at McMaster's University, as a way of closing the gap between clinical practice and clinical research. David Sackett, one of the originators, describes EBM as: "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of EBM means integrating individual clinical expertise with the best available external clinical evidence from systematic research. [emphasis added]"

It is also important to note that it is the patient who has the final say in accepting, rejecting, or modifying care. For example, if surgery is found to be the best intervention through research and the clinical expertise of the doctor, but the patient either does not want surgery or there are reasons why that individual patient might be at a greater risk in having the surgery performed, the published research & doctor's expertise play only a secondary role to the free will of the patient.

The triad of EBM is thus; the patient's preferences, combined with the doctor's clinical expertise, and the best available research evidence.

The difficulties arise when no high-quality evidence is available on a specific intervention. In these cases, it is appropriate to apply lower levels of evidence, such as observational studies and case reports. According to a study published in the British Medical Journal in 2007, 15% of the interventions evaluated so far have been proven to be beneficial; 22% are likely to be beneficial; 2% appear to be a "trade-off" between potential risks & benefits; 5% are unlikely to be beneficial; and, 4% have been shown to be likely to harm. The remainder of interventions, 47%, do not have sufficient evidence to make a decision either way.

One of the most interesting facts about EBM is that it itself fails its own test! The process of EBP has not been rigorously tested according to its own standards, so we do not know for certain if it actually results in improved health. (Straus & McAlister 2000) This does not mean that EBP has been proven to be ineffective; it means, quite simply, we do not know enough to decide either way. "No evidence of effect is not the same asevidence of no effect." (Tarnow-Mordi & Healy 1999)

When the standards of EBM are applied to bracing (Surgical rates after observation and bracing for adolescent idiopathic scoliosis: an evidence-based review, Dolan & Weinstein, Spine 2007), the conclusion is, "Comparing the pooled rates for these two interventions shows no clearadvantage of either approach. Based on the evidence presented here, one cannot recommend one approach over the other to prevent the need for surgery in AIS. This recommendation carries a grade of D, indicating that the use of bracing relative to observation is supported by 'troublingly inconsistent or inconclusive studies of any level.'"

When EBM is applied to surgery, "a medical indication for this treatment cannot be established in view of the lack of evidence." (Weiss & Goodall, Rate of complications in scoliosis surgery - a systematic review of the literature, Scoliosis 2008)

Interestingly enough, exercises have been shown to have the most evidence to support their use in the treatment of scoliosis, yet there are no medical scoliosis centers in the United States that currently utilize these methods.

"A growing body of evidence from independent sources is consistent with the hypothesis that exercise-based approaches can be used effectively to reverse the signs and symptoms of spinal deformity and to prevent progression in children and adults." (The use of exercises in the treatment of scoliosis: an evidence-based critical review of the literature, Hawes 2003)

"Contrary to current dogma, the condition may be corrected with this therapy." (Mooney et al, Exercise for managing adolescent idiopathic scoliosis, Journal of Musculoskeletal Medicine, 2007, 6th Interdisciplinary World Congress on Low Back & Pelvic Pain)

"Results show that in literature there is proof of level 1b on exercises." (Negrini et al, Rehabilitation of adolescent idiopathic scoliosis: results of exercises and bracing from a series of clinical studies, Europa Medicophysica-SIMFER 2007 Award Winner, Eur J Phys Rehabil Med 2008)

On the topic of chiropractic and scoliosis, preliminary evidence appears to indicate that manual therapy alone (e.g., chiropractic adjustments performed in the absence of any other modalities) does not alter the natural history of scoliosis (Negrini et al, Manual therapy as a conservative treatment for adolescent idiopathic scoliosis: a systematic review, Scoliosis 2008). However, a growing body of case reports have reported positive results when manual therapy is combined with other rehabilitation approaches (Brooks 2009, Chen 2008, Brooks 2007, Morningstar 2004 & 2006). According to the standards of EBM, case reports and case series are considered level 3 evidence - above expert opinion, but below case-control studies, RCT's & systematic reviews. This places the level of evidence in support of CLEAR's treatment approach as equal to the level of evidence in favor of bracing. All it will take is one well-conducted case-control study to place the level of evidence in favor of CLEAR above the level of evidence in favor of bracing(and believe me, I'm working overtime and donating all of my time to make that happen!).


Warm Regards,
Josh Woggon DC
Director of Research, CLEAR Institute
jwoggon@clear-institute.org

Evidence-based medicine (EBM) or evidence-based practices (EBP) are poorly understand by the general public and also by many members of the healthcare profession. They are often misinterpreted to mean that only interventions with published research can be considered part of EBM; this is untrue. EBM began in Ontario, Canada, at McMaster's University, as a way of closing the gap between clinical practice and clinical research. David Sackett, one of the originators, describes EBM as: "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of EBM means integrating individual clinical expertise with the best available external clinical evidence from systematic research. [emphasis added]"

It is also important to note that it is the patient who has the final say in accepting, rejecting, or modifying care. For example, if surgery is found to be the best intervention through research and the clinical expertise of the doctor, but the patient either does not want surgery or there are reasons why that individual patient might be at a greater risk in having the surgery performed, the published research & doctor's expertise play only a secondary role to the free will of the patient.

The triad of EBM is thus; the patient's preferences, combined with the doctor's clinical expertise, and the best available research evidence.

The difficulties arise when no high-quality evidence is available on a specific intervention. In these cases, it is appropriate to apply lower levels of evidence, such as observational studies and case reports. According to a study published in the British Medical Journal in 2007, 15% of the interventions evaluated so far have been proven to be beneficial; 22% are likely to be beneficial; 2% appear to be a "trade-off" between potential risks & benefits; 5% are unlikely to be beneficial; and, 4% have been shown to be likely to harm. The remainder of interventions, 47%, do not have sufficient evidence to make a decision either way.

One of the most interesting facts about EBM is that it itself fails its own test! The process of EBP has not been rigorously tested according to its own standards, so we do not know for certain if it actually results in improved health. (Straus & McAlister 2000) This does not mean that EBP has been proven to be ineffective; it means, quite simply, we do not know enough to decide either way. "No evidence of effect is not the same asevidence of no effect." (Tarnow-Mordi & Healy 1999)

When the standards of EBM are applied to bracing (Surgical rates after observation and bracing for adolescent idiopathic scoliosis: an evidence-based review, Dolan & Weinstein, Spine 2007), the conclusion is, "Comparing the pooled rates for these two interventions shows no clearadvantage of either approach. Based on the evidence presented here, one cannot recommend one approach over the other to prevent the need for surgery in AIS. This recommendation carries a grade of D, indicating that the use of bracing relative to observation is supported by 'troublingly inconsistent or inconclusive studies of any level.'"

When EBM is applied to surgery, "a medical indication for this treatment cannot be established in view of the lack of evidence." (Weiss & Goodall, Rate of complications in scoliosis surgery - a systematic review of the literature, Scoliosis 2008)

Interestingly enough, exercises have been shown to have the most evidence to support their use in the treatment of scoliosis, yet there are no medical scoliosis centers in the United States that currently utilize these methods.

"A growing body of evidence from independent sources is consistent with the hypothesis that exercise-based approaches can be used effectively to reverse the signs and symptoms of spinal deformity and to prevent progression in children and adults." (The use of exercises in the treatment of scoliosis: an evidence-based critical review of the literature, Hawes 2003)

"Contrary to current dogma, the condition may be corrected with this therapy." (Mooney et al, Exercise for managing adolescent idiopathic scoliosis, Journal of Musculoskeletal Medicine, 2007, 6th Interdisciplinary World Congress on Low Back & Pelvic Pain)

"Results show that in literature there is proof of level 1b on exercises." (Negrini et al, Rehabilitation of adolescent idiopathic scoliosis: results of exercises and bracing from a series of clinical studies, Europa Medicophysica-SIMFER 2007 Award Winner, Eur J Phys Rehabil Med 2008)

On the topic of chiropractic and scoliosis, preliminary evidence appears to indicate that manual therapy alone (e.g., chiropractic adjustments performed in the absence of any other modalities) does not alter the natural history of scoliosis (Negrini et al, Manual therapy as a conservative treatment for adolescent idiopathic scoliosis: a systematic review, Scoliosis 2008). However, a growing body of case reports have reported positive results when manual therapy is combined with other rehabilitation approaches (Brooks 2009, Chen 2008, Brooks 2007, Morningstar 2004 & 2006). According to the standards of EBM, case reports and case series are considered level 3 evidence - above expert opinion, but below case-control studies, RCT's & systematic reviews. This places the level of evidence in support of CLEAR's treatment approach as equal to the level of evidence in favor of bracing. All it will take is one well-conducted case-control study to place the level of evidence in favor of CLEAR above the level of evidence in favor of bracing(and believe me, I'm working overtime and donating all of my time to make that happen!).


Warm Regards,
Josh Woggon DC
Director of Research, CLEAR Institute
jwoggon@clear-institute.org

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