Ge Germanium

Abstract: Objective: Motion palpation is integral to most chiropractic techniques and can be found in curricula of most every chiropractic college. Paradoxically, most studies do not show strong reliability for motion palpation. The purpose of this study was to determine if allowing motion palpators to rate their confidence in their findings, as well using a continuous data analytic method, would influence the level of concordance.Methods: Subjects were 52 asymptomatic chiropractic student volunteers. Two palpators assessed posterior to anterior glide of T3-10 in the prone position, alternating in their order and blinded as to each other's results. Each examiner identified the location of maximal restriction in this range and also whether they were “very confident” or “not confident” in their finding.Results: For all subjects combined, the examiners' calls were “poor”: intraclass correlation coefficient [2,1] = .3110 (95% CI, .0458-.5358). In contrast, interexaminer agreement was “good” when both examiners were very confident: intraclass correlation coefficient [2,1] = .8266 (95% CI, 0.6257-0.9253).Conclusion: When each examiner was “very confident” as to the most fixated thoracic segment, the levels they identified were very close. This corresponds to “good” agreement, an uncommon result in most interexaminer motion palpation studies. Thus, the confidence level of examiners had an effect on the interexaminer reliability of thoracic spine. Our novel continuous measures, statistical methodology, and subtyping the subjects according to the confidence of the palpators seem more capable than level-by-level discrete analysis of detecting interexaminer agreement.

Abstract: Objective: Inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP) have not been evaluated in response to a short course of lumbar spinal manipulation. The purpose of this study is to observe the responses of inflammatory markers (IL-6 and CRP) after a series of 9 chiropractic spinal manipulations.Methods: Twenty-one participants were assigned to a treatment or a control group. Only the treatment group received 9 chiropractic interventions. Pre- and postintervention measures were recorded for blood samples for detection of proinflammatory cytokines IL-6 and CRP.Results: Mediators of inflammation (IL-6 and high-sensitivity CRP) were modified by the intervention received in the treatment group, and the effect size demonstrated a tendency toward the control group values.Conclusion: A total of 9 chiropractic lower back manipulations caused the mediators of inflammation to present a normalization response in individuals suffering from chronic low back pain.

Abstract: Objective: The purpose of this article is to provide an overview of the current state of knowledge of poorly understood and underresearched neuroanatomy of selected pyramidal cells of the medial wall of the cingulate gyrus.Methods: A literature review was performed; and separate computerized literature searches of PubMed, Science Direct, Cochrane Library, Science Citation Index, SCOPUS, CINAHL, and the World Wide Web were used for each cell type using individual set time scales for the discovery of each cell. A narrative overview of the literature was developed using information from searches of computerized databases and authoritative texts.Discussion: The medial walls of the cerebral hemispheres, notably the cingulate gyri, contain species-specific neuron fields that to date are not well known within the scientific community and yet have been implicated as the underlying cause of such varying conditions as dysgraphia and autism in children and obsessive-compulsive disorder and Alzheimer disease in adults. As these neurons are late to develop both phylogenetically and ontogenetically, it has been suggested that they may be particularly vulnerable to stressors that potentially could be an underlying factor in a wide range of neurodevelopmental and neuropsychiatric disorders.Conclusion: It is considered that knowledge of these little-known pyramidal fields of the medial wall of the human brain is essential to the understanding of how the brain functions both in sickness and in health.

Abstract: Objective: The purpose of this literature review is to critically review the evidence for chiropractic as a treatment of primary insomnia.Methods: A search of the following databases up to October 2006 was conducted: PubMed, PEDro, MANTIS, CINAHL, and the specialized register of the Cochrane review group. We also performed hand searching of relevant journals. Randomized clinical trials, clinical trials, and case studies of chiropractic treatment of insomnia were included. It was required that each study used at least one form of standard patient outcome measure. Treatment strategies included manual therapy such as spinal manipulative therapy or muscle relaxation techniques. The review focused on articles published in indexed, peer-reviewed journals.Results: Fifteen studies met the selection criteria. There were no randomized clinical trials specific to chiropractic and insomnia. One study was a survey of opinion for treatment regimens for insomnia, which had low methodological scores. Another study assessed osteopathic cranial manipulation for insomnia, which appeared to have positive effects. Four studies identified physiotherapy treatment and manual therapy. A further 9 studies related to mind-body medical therapies and impaired health status, sleep disorders, and pain in the craniomandibular and cervical spinal regions.Conclusion: Some studies have noted improvement in insomnia following manual therapy; however, based on clinical trials, there is minimal evidence of support for chiropractic in insomnia. Further studies with high methodological scores need to be conducted.

Abstract: Objective: The purpose of this report is to present the case of a 54-year-old female patient with a pathologically confirmed diagnosis of soft tissue lipoma. The clinical presentation, pathophysiology, differential diagnosis, and treatment options for lipoma are described.Clinical Features: The patient presented to a chiropractic clinic with painful swelling in the right anterior thigh. Physical examination revealed a palpable mobile mass with minimal tenderness.Intervention and Outcome: The initial consultation was with the primary care physician, and it resulted in a sonographic examination as the initial imaging modality to rule out deep venous thrombosis. The result of this examination was negative. Following a delay by additional incorrect diagnoses and treatments, a diagnosis of an intermuscular lipoma was established by magnetic resonance imaging and confirmed on biopsy as a soft tissue lipoma. The patient underwent complete excision of the mass.Conclusion: Lipomas are common benign soft tissue masses and should be considered in the differential diagnosis of a thigh mass. Magnetic resonance imaging with contrast depicts the lipomatous mass as having a characteristic high-intensity fat signal without enhancement. It is important for clinicians to have an increased awareness in recognizing the clinical and imaging manifestations of a soft tissue lipoma to optimize an initial diagnosis and treatment.

Abstract: Objective: This case report describes a patient with nocturnal bruxism and related neck pain treated with botulinum toxin type A (BTX-A).Clinical Features: The patient was a 27-year-old man with nocturnal bruxism and difficulty in active mouth opening and chewing and neck pain at rest. His numeric pain score was 7 of 10. Surface electromyography of the temporalis and masseter muscles showed typical signs of hyperactivity, characterized by compound muscle action potential amplitude alterations.Intervention and Outcome: After clinical evaluation, he was treated with BTX-A to reduce masseter and temporalis muscle hyperactivity. After 3 days of treatment with BTX-A, with each masseter muscle injected with a dose of about 40 mouse units with a dilution of 1 mL and with temporal muscle bilaterally injected with 25 mouse units with the same dilution, a decrease in bruxism symptoms was reported. Neck pain also decreased after the first treatment (visual analog scale of 2/10) and then resolved completely. After 4 weeks, electromyography showed the reduction of muscle hyperactivity with a decrease in the amplitude of the motor action potential. The same reduction in signs and symptoms was still present at assessment 3 months posttreatment.Conclusion: These findings suggest that BTX-A may be a therapeutic option for the treatment of bruxism and related disorders.

Abstract: Objective: The purpose of this case report is to describe the chiropractic care of a 10-year-old boy who presented with developmental delay syndromes, asthma, and chronic neck and head pain and to present an overview of his muscular imbalances during manual muscle testing evaluation that guided the interventions offered to this child.Clinical Features: The child was a poor reader, suffered eye strain while reading, had poor memory for classroom material, and was unable to move easily from one line of text to another during reading. He was using 4 medications for the asthma but was still symptomatic during exercise.Intervention and Outcome: Chiropractic care, using applied kinesiology, guided evaluation, and treatment. Following spinal and cranial treatment, the patient showed improvement in his reading ability, head and neck pain, and respiratory distress. His ability to read improved (in 3 weeks, after 5 treatments), performing at his own grade level. He has remained symptom free for 2 years.Conclusion: The care provided to this patient seemed to help resolve his chronic musculoskeletal dysfunction and pain and improve his academic performance.

Abstract: Several primary studies have shown that an anatomical short leg predicts anterior rotation of the ipsilateral ilium, whereas anatomical long leg predicts posterior rotation of the ilium on the long leg side. At the same time, in chiropractic and other manual therapy professions, it is widely believed that the leg check finding of a short leg is associated with posterior ilium rotation, and a long leg with anterior ilium rotation. The purpose of this commentary is to explore the consequences of this paradox for the manual therapy professions, insofar as leg checking procedures are commonly used to derive appropriate vectors for chiropractic manipulation/adjustive procedures.