Had a few slow weeks there because I’ve been studying for a test, ENJOY.


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Manipulation Under Anesthesia for Lumbopelvic Pain: A Retrospective Review of 18 Cases

Douglas J. Taber, DC
Journal of Chiropractic Medicine
Available online 11 March 2014

Abstract
Objective
The purpose of this case series is to report the effects of manipulation under anesthesia (MUA) for patients with lumbopelvic (lumbar spine, sacroiliac and/or pelvic, hip) pain in an outpatient ambulatory/hospital-based setting.

Methods
A retrospective chart review of cases treated at an outpatient ambulatory surgical center in New York and a general hospital in New York was performed. Patients with pre- and postintervention Oswestry Low Back Pain Disability Index (ODI) scores and lumbopelvic and hip complaints were included (N = 18). No intervention other than MUA was administered between the initial and follow-up ODI scoring. Scores on the ODI were assessed within 1 week prior to MUA and again within 2 weeks postprocedure.

Results
Patients underwent 2 to 4 chiropractic MUA procedures over the course of 7 to 8 days as per National Academy of Manipulation Under Anesthesia physicians’ protocols. Preprocedure ODI scores ranged from 38 to 76, with an average score of 53.4. Postprocedure scores ranged from 0 to 66, with an average score of 32.8. For each patient, ODI scores were lower after MUA, with an average decrease of 20.6. Sixteen of 18 patients experienced a clinically meaningful improvement in ODI score. No adverse reactions were reported.

Conclusions
For 16 of the 18 patients with chronic lumbopelvic pain reported in this study, MUA showed clinically meaningful reduction in low back pain disability.

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Association of Indoor Tanning and Melanoma in Adults

Research · March 12, 2014Journal of the American Academy of Dermatology Home

TAKE-HOME MESSAGE

  • A meta-analysis of 31 studies found that indoor tanning increases the odds of melanoma by 16% overall (23% in North America). There is a further increased risk of developing melanoma with more than 10 tanning sessions and with using indoor tanning prior to age 25. Furthermore, there was no difference in melanoma risk before and after 2000, when the tanning industry changed to newer technology bulbs.
  • It is well known that indoor tanning increases the risk of developing melanoma. Newer technology (higher pressure lamps emitting larger doses of long-wave UVA) does not appear to be safer. The information in this study is useful for patient risk assessment, education, and the development of public policy.

– Sarah Churton, MD

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Association between physical activity and mortality among breast cancer and colorectal cancer survivors

A systematic review and meta-analysis
Annals of Oncology, 03/25/2014  Review Article

Schmid D, et al. – Using prospective studies published through June 2013, the authors conducted a systematic review and random–effects meta–analysis of pre– and post–diagnosis physical activity in relation to total and cancer mortality among breast or colorectal cancer survivors. Physical activity performed before or after cancer diagnosis is related to reduced mortality risk among breast and colorectal cancer survivors.

Methods

  • Using prospective studies published through June 2013, they conducted a systematic review and random-effects meta-analysis of pre- and post-diagnosis physical activity in relation to total and cancer mortality among breast or colorectal cancer survivors.

Results

  • Sixteen studies of breast cancer survivors and seven studies of colorectal cancer survivors yielded 49095 total cancer survivors, including 8129 total mortality cases and 4826 cancer mortality cases.
  • Comparing the highest versus lowest levels of pre-diagnosis physical activity among breast cancer survivors, the summary relative risks (RRs) of total and breast cancer mortality were 0.77 [95% confidence interval (CI) = 0.69–0.88] and 0.77 (95% CI = 0.66–0.90, respectively.
  • For post-diagnosis physical activity, the summary RRs of total and breast cancer mortality were 0.52 (95% CI = 0.42–0.64) and 0.72 (95% CI = 0.60–0.85), respectively.
  • For pre-diagnosis physical activity among colorectal cancer survivors, the summary RRs of total and colorectal cancer mortality were 0.74 (95% CI = 0.63–0.86) and 0.75 (95% CI = 0.62–0.91), respectively.
  • For post-diagnosis physical activity, the summary RRs of total and colorectal cancer mortality were 0.58 (95% CI = 0.48–0.70) and 0.61 (95% CI = 0.40–0.92), respectively.
  • Each 10 metabolic equivalent task-hour/week increase in post-diagnosis physical activity (equivalent to current recommendations of 150 min/week of at least moderate intensity activity) was associated with 24% (95% CI = 11-36%) decreased total mortality risk among breast cancer survivors and 28% (95% CI = 20–35%) decreased total mortality risk among colorectal cancer survivors.
  • Breast or colorectal cancer survivors who increased their physical activity by any level from pre- to post-diagnosis showed decreased total mortality risk (RR = 0.61; 95% CI = 0.46–0.80) compared with those who did not change their physical activity level or were inactive/insufficiently active before diagnosis.

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Egg consumption and cardiovascular disease among diabetic individuals

Systematic review of the literature

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 03/28/2014  Review Article

Tran NL, et al. – This study reviewed epidemiological and experimental evidence on the relationship between egg consumption and cardiovascular disease (CVD) risks among type II diabetes mellitus (T2DM) individuals, and T2DM risk in nondiabetic subjects. Differences in study design, T2DM status, exposure measurement, subject age, control for confounders and follow–up time present significant challenges for conducting a meta–analysis. Conflicting results, coupled with small sample sizes, prevent broad interpretation. Given the study limitations, these findings need to be further investigated.

  • Four of the six studies that examined CVD and mortality and egg consumption among diabetics found a statistically significant association.
  • Of the eight studies evaluating incident T2DM and egg consumption, four prospective studies found a statistically significant association.
  • Lack of adjustment for dietary confounders was a common study limitation.
  • A small number of experimental studies examined the relationship between egg intake and CVD risk biomarkers among diabetics or individuals with T2DM risk factors.
  • Studies among healthy subjects found suggestive evidence that dietary interventions that include eggs may reduce the risk of T2DM and metabolic syndrome.

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The effect of green tea on blood pressure and lipid profile

A systematic review and meta-analysis of randomized clinical trials Nutrition, Metabolism and Cardiovascular Diseases
Nutrition, Metabolism & Cardiovascular Diseases, 03/27/2014  Evidence Based Medicine  Review Article

Onakpoya I, et al. – The aim of this systematic review was to evaluate the evidence for or against the effectiveness of green tea (Camellia sinensis) on blood pressure and lipid parameters. Green tea intake results in significant reductions in systolic blood pressure, total cholesterol, and LDL cholesterol. The effect size on systolic blood pressure is small, but the effects on total and LDL cholesterol appear moderate. Longer–term independent clinical trials evaluating the effects of green tea are warranted.

Methods

  • Electronic searches were conducted in Medline, Embase, Amed, Cinahl and the Cochrane Library to identify relevant human randomized clinical trials (RCTs).
  • Hand searches of bibliographies were also conducted.
  • The reporting quality of included studies was assessed using a checklist adapted from the CONSORT Statement.
  • Two reviewers independently determined eligibility, assessed the reporting quality of the included studies, and extracted the data.
  • As many as 474 citations were identified and 20 RCTs comprising 1536 participants were included.
  • There were variations in the designs of the RCTs.

Results

  • A meta-analysis revealed a significant reduction in systolic blood pressure favouring green tea (MD: -1.94 mmHg; 95% CI: -2.95 to -0.93; I2 = 8%; p = 0.0002).
  • Similar results were also observed for total cholesterol (MD: -0.13 mmol/l; 95% CI: -0.2 to -0.07; I2 = 8%; p < 0.0001) and LDL cholesterol (MD: -0.19 mmol/l; 95% CI: -0.3 to -0.09; I2 = 70%; p = 0.0004).
  • Adverse events included rash, elevated blood pressure, and abdominal discomfort.

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Lifestyle Changes Staves Off Diabetes, Death

Published: Apr 2, 2014 | Updated: Apr 3, 2014
By Nancy Walsh, Senior Staff Writer, MedPage Today

A 6-year lifestyle intervention decreased the incidence of diabetes, cardiovascular mortality, and all-cause mortality in adults with impaired glucose tolerance, a Chinese study found.

During 23 years of follow-up, individuals in the intervention group had a 45% lower risk of developing diabetes (HR 0.55, 95% CI 0.40-0.76, P=0.001) than those who did not take part in the intervention, according to Guangwei Li, MD, of China-Japan Friendship Hospital in Beijing, and colleagues.

In addition, they had a 41% decrease in cardiovascular mortality (HR 0.59, 95% CI 0.36-0.96,P=0.033) and a 29% decrease in all-cause mortality (HR 0.71, 95% CI 0.51-0.99, P=0.049), the researchers reported online in The Lancet Diabetes & Endocrinology.

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Do Fat Teens Face an Early Death?

Image from MedPageToday

Published: Apr 2, 2014
By Salynn Boyles, Contributing Writer, MedPage Today

Life expectancy gains seen over the last half-century do not appear to extend to adults who were overweight or obese in adolescence, according to a large study spanning several decades.

Overweight and obese teens in the study were more likely to die before reaching the age of 50 than their normal-weight peers, and the mortality trends of those born between 1970 and 1980 were no better than for those born decades earlier, Amir Tirosh, MD, PhD, of Harvard Medical School and Brigham and Women’s Hospital, and colleagues wrote in theJournal of Clinical Endocrinology and Metabolism.

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Inter-clinician and intra-clinician reliability of force application during joint mobilization

Manual Therapy
Volume 19, Issue 2 , Pages 90-96, April 2014
Kara S. Gorgos

Abstract
Joint mobilizations are commonly used by clinicians to decrease pain and restore joint arthrokinematics following musculoskeletal injury. The force applied during a joint mobilization treatment is subjective to the individual clinician but may have an effect on patient outcomes. The purpose of this systematic review was to critically appraise and synthesize the studies which examined the reliability of clinicians’ force application during joint mobilization. A systematic search of PubMed and EBSCO Host databases from inception to March 1, 2013 was conducted to identify studies assessing the reliability of force application during joint mobilizations. Two reviewers utilized the Quality Appraisal of Reliability Studies (QAREL) assessment tool to determine the quality of included studies. The relative reliability of the included studies was examined through intraclass correlation coefficients (ICC) to synthesize study findings. All results were collated qualitatively with a level of evidence approach. A total of seven studies met the eligibility and were included. Five studies were included that assessed inter-clinician reliability, and six studies were included that assessed intra-clinician reliability. The overall level of evidence for inter-clinician reliability was strong for poor-to-moderate reliability (ICC = −0.04 to 0.70). The overall level of evidence for intra-clinician reliability was strong for good reliability (ICC = 0.75–0.99). This systematic review indicates there is variability in force application between clinicians but individual clinicians apply forces consistently. The results of this systematic review suggest innovative instructional methods are needed to improve consistency and validate the forces applied during of joint mobilization treatments. This is particularly evident for improving the consistency of force application across clinicians.

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Deep massage to posterior calf muscles in combination with neural mobilization exercises as a treatment for heel pain

A pilot randomized clinical trial
Manual Therapy
Volume 19, Issue 2 , Pages 102-108, April 2014
Bernice Saban

Abstract
Background
Plantar heel pain syndrome (PHPS) is a common foot disorder; however, there is limited clinical evidence on which to base treatment. Repeated clinical observations indicating heel pain during heel rise and minisquat on the affected leg, involving activation of posterior calf muscles, formed the basis of this study.

Objective
To compare deep massage therapy to posterior calf muscles and neural mobilization with a self-stretch exercise program (DMS) to a common treatment protocol of ultrasound therapy to the painful heel area with the same self-stretch exercises (USS).

Methods
Patients with PHPS were assigned to a program of 8 treatments over a period of 4–6 weeks in a single-blind randomized clinical trial. Functional status (FS) at admission and discharge from therapy as measured by the Foot & Ankle Computerized Adaptive Test was the main outcome measure.

Results
Sixty-nine patients were included in the trial (mean age 53, standard deviation (SD) 13, range 25–86, 57% women), 36 received DMS treatment and 33 with USS. The overall group-by-time interaction for the mixed-model analysis of variance (ANOVA) was found statistically significant (p=0.034), with a change of (mean (confidence interval, CI)) 15 (9–21) and 6 (1–11) FS points for the DMS and USS groups, respectively.

Conclusions
Data indicated that both treatment protocols resulted in an overall short-term improvement, however, DMS treatment was significantly more effective in treating PHPS than USS treatment.

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The effects of Kinesio taping on muscle tone in healthy subjects

A double-blind, placebo-controlled crossover trial

Manual Therapy
Volume 19, Issue 2 , Pages 131-136, April 2014
Julio Gómez-Soriano

Abstract
Kinesio taping (KT) has been proposed to modulate muscle tone. However no studies have systematically studied the efficacy of KT on this primary outcome measure. The objective of this study was to determine the effect of Kinesio taping (KT) applied over the gastrocnemius muscles on muscle tone, extensibility, electromyography (EMG) and strength. Nineteen healthy subjects were enrolled in a double-blind, placebo-controlled crossover trial. KT and sham-tape were applied onto the gastrocnemius muscles of all subjects in two randomized sessions. Measurements before, at 10 min and 24 h after the intervention were taken. Outcome measurements included passive resistive torque to ankle dorsiflexion, dorsiflexion passive range of motion (PROM), surface Gastrocnemius Medialis (GM) EMG and maximal isometric voluntary force (MIVF). No significant differences were found between the sham-tape and KT groups for passive resistive torque, PROM nor maximal plantarflexion isometric voluntary force. A short-term increase of GM EMG activity was found in the KT group during the PROM mobilization, which was not maintained at 24 h following treatment. A short-term decrease in dorsiflexion force was produced 10 min after KT with respect to sham-tape application. These results demonstrate that the application of KT in the gastrocnemius muscles has no effect on healthy muscle tone, extensibility nor strength. However a short-term increase of GM EMG activity after KT treatment suggests the activation of central nervous system mechanisms, although without a therapeutic implication. Further studies with more appropriate designs are needed to clarify the physiological and therapeutic effects of this taping technique.

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Physiotherapists’ knowledge, attitudes and practices regarding clinical prediction rules for low back pain

Manual Therapy
Volume 19, Issue 2 , Pages 142-151, April 2014
Robin Haskins

Abstract
Clinical Prediction Rules (CPRs) have been developed to assist in the physiotherapy management of low back pain (LBP) although little is known about the factors that may influence their implementation in clinical practice. This study used qualitative research methodology to explore the knowledge, attitudes and practices/behaviours of physiotherapists in relation to these tools. Four semi-structured focus groups involving 26 musculoskeletal physiotherapists were conducted across three Australian geographic regions. A fictitious LBP case scenario was developed and used to facilitate group discussion. Participant knowledge of CPRs was found to be mixed, with some clinicians never having previously encountered the term or concept. LBP CPRs were often conceptualised as a formalisation of pattern recognition. Attitudes towards CPRs expressed by study participants were wide-ranging with several facilitating and inhibiting views identified. It was felt that more experienced clinicians had limited need of such tools. Only a small number of participants expressed that they had ever used LBP CPRs in clinical practice. To optimise the successful adoption of an LBP CPR, researchers should consider avoiding the use of the term ‘rule’ and ensure that the tool and its interface are uncomplicated and easy to use. Understanding potential barriers, the needs of clinicians and the context in which CPRs will be implemented will help facilitate the development of tools with the highest potential to positively influence physiotherapy practice

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Anatomical landmark position – Can we trust what we see?

Manual Therapy
Volume 19, Issue 2 , Pages 158-164, April 2014
Elise Pattyn, Dévan Rajendran

Abstract
Background
Practitioners traditionally use observation to classify the position of patients’ anatomical landmarks. This information may contribute to diagnosis and patient management.

Objectives
To calculate a) Inter-rater reliability of categorising the sagittal plane position of four anatomical landmarks (lateral femoral epicondyle, greater trochanter, mastoid process and acromion) on side-view photographs (with landmarks highlighted and not-highlighted) of anonymised subjects; b) Intra-rater reliability; c) Individual landmark inter-rater reliability; d) Validity against a ‘gold standard’ photograph. Design: Online inter- and intra-rater reliability study.

Subjects
Photographed subjects: convenience sample of asymptomatic students; raters: randomly selected UK registered osteopaths.

Methods
40 photographs of 30 subjects were used, a priori clinically acceptable reliability was ≥0.4. Inter-rater arm: 20 photographs without landmark highlights plus 10 with highlights; Intra-rater arm: 10 duplicate photographs (non-highlighted landmarks). Validity arm: highlighted landmark scores versus ‘gold standard’ photographs with vertical line. Research ethics approval obtained.

Raters
Osteopaths (n = 48) categorised landmark position relative to imagined vertical-line; Gwet’s Agreement Coefficient 1 (AC1) calculated and chance-corrected coefficient benchmarked against Landis and Koch’s scale; Validity calculation used Kendall’s tau-B.

Results
Inter-rater reliability was ‘fair’ (AC1 = 0.342; 95% confidence interval (CI) = 0.279–0.404) for non-highlighted landmarks and ‘moderate’ (AC1 = 0.700; 95% CI = 0.596–0.805) for highlighted landmarks. Intra-rater reliability was ‘fair’ (AC1 = 0.522); range was ‘poor’ (AC1 = 0.160) to ‘substantial’ (AC1 = 0.896). No differences were found between individual landmarks. Validity was ‘low’ (TB = 0.327; p = 0.104).

Conclusion
Both inter- and intra-rater reliability was ‘fair’ but below clinically acceptable levels, validity was ‘low’. Together these results challenge the clinical practice of using observation to categorise anterio-posterior landmark position.

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Run or Walk: Gains in Heart Health Similar

Published: Apr 4, 2013
By Michael Smith , North American Correspondent, MedPage Today

Walking and running have about the same health benefits, researchers found – you just have to walk more to get them.

Spending the same amount of energy yielded similar reductions in the risks of high blood pressure, high cholesterol, diabetes, and coronary heart disease, according to Paul Williams, PhD, of Lawrence Berkeley National Laboratory in Berkeley, Calif., and Paul Thompson, MD, of Hartford Hospital in Hartford, Conn.

But analysis of two large cohorts suggested that runners usually expend about twice as much energy as walkers and therefore reap greater health benefits, Williams and Thompson reported online in Arteriosclerosis, Thrombosis and Vascular Biology…..

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The role of selected variables in the diagnosis of cervical derangement syndromes

Guzy G, et al.
Ortop Traumatol Rehabil. 2013 Oct 24;15(6):531-44. doi: 10.5604/15093492.1091509.

Abstract
Background. The study analyzed correlations between selected variables in cervical derangement syndromes. Material and methods. We analyzed data from 63 patients regarding pain (VAS, McGill Pain Questionnaire), mobility (CROM goniometer), dizziness, nausea, the duration of the current episode, and the number of previous episodes (history). Student’s t and chi2 tests and Pearson’s r correlation were used. Results. Overall pain intensity correlated positively with the indexes of the McGill Pain Questionnaire, the duration of the current episode, intensity of the proximal and distal symptoms and negatively with protraction or extension. Headache correlated positively with neck pain and negatively with retraction. Neck pain cor-related negatively with multiple cervical movements and positively with intensity of the distal symptoms. A positive relationship between shoulder and upper limb pain was observed. Patients with higher overall pain intensity or lower shoulder pain intensity experienced dizziness more often. The duration of the current episode correlated positively with the number of previous episodes, the frequency of nausea, limited extension and limited protraction. Nausea coexisted with dizziness and reduced protraction. The degree of flexion restriction correlated positively with the number of previous episodes. Conclusions. 1. Overall and proximal pain intensity, mobility of the cervical spine, the duration of the current episode and dizziness are useful in diagnosis of cervical derangement syndromes. 2. Intensity of the distal symptoms, the number of previous episodes and nausea should be particularly monitored.

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Low Back Manipulation – How Does it Work?

By ChiroTrust on February 6, 2014ChiroTrust

Low back pain (LBP) is such a common problem that if you haven’t suffered from it yet, you probably will eventually. Here are a few facts to consider:  1) LBP affects men and women equally; 2) It is most common between ages 30-50; 3) Sedentary (non-active) lifestyles contribute a lot to causation; 4) Too much or too little exercise can result in LBP; 5) A BMI around 25 is “ideal” for weight management, which helps prevent LBP; 6) Causes of LBP include lifestyle (activity level), genetics – including, but not limited to, weight and osteoarthritis; 7) Occupation; 8) Exercise habits, and the list can go on and on. Let’s next look at how an adjustment is done….

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Doubt Over Role of Vitamin D, Even to Limit Fractures

Becky McCall
April 03, 2014

New results from extensive analyses of observational and randomized clinical trials (RCTs) suggest that vitamin D given alone does not appear to increase bone-mineral density or reduce the risk for fractures or falls in older people, contrary to many previous reports.

The research also signifies that a clear role for vitamin-D supplementation for any other indication remains to be established — no significant effect on mortality overall in RCTs was seen for any indication. However, there was a suggestion of a potential benefit for vitamin D in pregnant women, against tooth decay in children, and in patients with chronic renal disease.

The work consists of 2 papers and an editorial, published in this week’s BMJ examining vitamin D and multiple health outcomes. The first paper is an umbrella review of observational studies and RCTs; the second looks at vitamin D and risk for cause-specific death by systematic review and meta-analysis of observational cohort and randomized intervention studies.

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Most People Don’t Consume Too Much Sodium, Study Suggests

New research suggests that sodium consumption between 2645 and 4945 mg/d is linked with lower mortality and cardiovascular disease risks than much lower or higher levels. (Image: ©iStock.com/Elena Elisseeva)

Image from news@JAMA

news@JAMA
BY REBECCA VOELKER on APRIL 2, 2014

Most people may be better off healthwise if they don’t change their current sodium consumption levels, new research suggests.

Sodium intake has become controversial recently, as newer studies questioned recommendations limiting daily intake to no more than 2300 mg, which is the equivalent of about 1 teaspoon of salt. So researchers in Denmark and the United States set out to see if they could find a sodium intake range associated with the least risk of having a cardiovascular disease event or dying from any cause.

The investigators analyzed data from 23 prospective cohort studies and 2 randomized controlled trials that included 274 683 study participants. They examined mortality and cardiovascular disease risks according to 4 sodium consumption levels: less than 2645 mg/d, between 2645 and 4945 mg/d, and more than 4945 mg/d.

Their findings showed that people whose sodium intake is between 2645 and 4945 mg/d —90% of the world’s population consumes sodium amounts within that range—had the lowest mortality and cardiovascular disease risks. The investigators found no difference in health outcomes between the lowest and highest intake levels of that range.

However, excessively high or low sodium consumption levels were associated with reduced survival and increased cardiovascular events, according to the data published today in the American Journal of Hypertension. One exception was stroke risk, which was no different between those with low intake and study participants whose sodium consumption was in the middle range.

“Our results are in line with the [Institute of Medicine’s] concern that lower levels could produce harm, and they provide a concrete basis for revising the recommended range in the best interest of public health,” lead author Niels Graudal, MD, of the University of Copenhagen Hospital, said in a statement.

Graudal was a member of the Institute’s Food and Nutrition Board that in 2013 released a new report indicating that existing scientific evidence isn’t sufficient enough to establish an upper limit for sodium consumption. In 2004, however, the Institute defined the upper limit intake as 2300 mg/d and adequate consumption as 1200 to 1500 mg/d. The average US resident consumes about 3400 mg/d.

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Lack of proficiency in musculoskeletal medicine among emergency medicine physicians

Comer GC, et al.
J Orthop Trauma. 2014 Apr;28(4):e85-7. doi: 10.1097/BOT.0b013e3182a66829.

Affiliation
Abstract
OBJECTIVES: Emergency medicine (EM) physicians are frequently responsible for evaluating and treating patients with urgent or emergent musculoskeletal conditions, so it is critical that they achieve a basic level of proficiency in musculoskeletal medicine. However, inadequacies in musculoskeletal education have previously been documented among medical students, residents, and attending physicians in a number of specialties. The goal of this study was to assess the proficiency with musculoskeletal medicine among EM physicians in particular.

METHODS: A validated musculoskeletal medicine competency examination was administered to the EM residents and faculty at a university-affiliated level 1 trauma center. Demographic data and satisfaction with musculoskeletal education were also surveyed.

RESULTS: Twenty-three EM residents and 21 attending physicians completed the survey. Thirty-five percent of residents and 43% of attending physicians failed to demonstrate proficiency on the examination. Pass rates were not significantly different among junior residents, senior residents, or attending physicians. Twenty-three percent of respondents indicated that they were dissatisfied with their musculoskeletal education.

CONCLUSIONS: Significant deficiencies in musculoskeletal education exist among EM physicians in training and attending staff. Given the frequency with which these physicians evaluate and treat acute musculoskeletal conditions, additional resources should be committed to their training.

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Plant-Rich Diet, Longevity Linked Again

Published: Apr 1, 2014
By Salynn Boyles, Contributing Writer, MedPage Today

New evidence backs up the advice of generations of moms (“eat your vegetables”) and journalist/food activist Michael Pollan, who has told the world to “eat food, not too much, mostly plants.”

A population-based observational study conducted in England found a “robust inverse association” between fruit and vegetable consumption and death from all causes, including cancer and cardiovascular disease.

The largest benefits were seen in people who ate seven or more servings of fruits and vegetables a day compared with those who ate less than one serving, with the higher level of consumption associated with significantly lower all-cause mortality (hazard ratio 0.67; 95% CI 0.58-0.78), lead researcher Oyinlola Oyebode of University College London, and colleagues, reported online in the Journal of Epidemiology and Community Health…..

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