Hello and welcome to this week’s edition of HealthBeat, Chiropractic OnLine Today’s Health, News and Informational Podcast, and Proud to be the #1 Search Result for Chiropractic Podcasts in the iTunes Podcast Directory.
In this week’s news: We’ll Be Looking At –
- Donations for Superstorm Sandy
- New Guidance on De-Identifying Health Information
- Epidural Injections and Bone Mineral Density
- And Finally, a Story about Conservative Care of Prolapsed Herniated Lumbar Discs
For HealthBeat, This is Dr. Todd Eglow!
Welcome to HealthBeat Podcast #388, recorded December 14, 2012.
HealthBeat is Chiropractic OnLine Today’s radio program, providing current news and commentary about Chiropractic and Health.
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And Now for some news ….
Donations for Hurricane Sandy
The New York State Chiropractic Association, the NYSCA has sent out an email related to an offer from a CA located at a Florence, Kentucky Chiropractors office, related to donations for those chiropractors affected by the recent Superstorm Sandy.
Their office number for those interested or affected is
New Guidance on De-Identifying Health Information
A recent emailing from the ChiroCode Institute discussed how HIPAA places tight restrictions on the use and disclosure of protected health information, but there are many ways to “de-identify” it, freeing it from HIPAA’s constraints.
Covered entities and business associates can use de-identification to reduce their exposure to HIPAA and expand their use of health data.
On Nov. 26, 2012, the HHS Office for Civil Rights released guidance on how health information may be de-identified. While the guidance does not break much new ground, it offers some helpful clarification.
The guidance on de-identification, which was mandated by the Health Information Technology for Economic and Clinical Health (“HITECH”) Act, part of the American Recovery and Reinvestment Act of 2009, discusses the two methods of de-identification under HIPAA: (1) the “expert determination method” and (2) the “safe harbor method.”
Surf to our Show Notes for Details – http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/De-identification/guidance.html
Epidural Injections and Bone Mineral Density
Previous studies have established that one of the major adverse effects of steroid use is glucocorticoid-induced osteoporosis.
In a recent study published in the journal Spine, researchers have suggested that postmenopausal women who were administered a single epidural steroid injection as treatment for back pain adversely experienced significant BMD loss of the hip.
The findings of our study suggest that epidural steroid injections (ESI) for back pain relief should be approached cautiously in patients at risk for bone fragility.
“Physicians who do prescribe them should consider measures that optimize bone health such as calcium and vitamin D supplements and exercise as part of their patient’s treatment plan.
The study concluded that a single epidural steroid injection in postmenopausal women adversely affects BMD of the hip. This is in conjunction with a rise in bone remodeling activity, as evidenced by an increase in bone-specific alkaline phosphatase and C-telopeptide of collagen I.
In addition, when compared with an age-matched control population, our study population exhibited a greater decline in BMD. Our findings show that epidural administration of corticosteroids has a deleterious effect on bone, which should be considered when contemplating treatment options for radiculopathy.
The resulting decrease in BMD, while slight, suggests that epidural steroid injections should be used with caution in those at a risk for fracture.
Remember to discuss all recommendations, including Nutritional Recommendations with your Qualified Health Care Provider – http://journals.lww.com/spinejournal/Abstract/2012/12010/Effect_of_Epidural_Steroid_Injection_on_Bone.13.aspx
Conservative Care of Prolapsed Herniated Lumbar Discs
The natural history of a lumbar hernia of the nucleus pulposus (HNP) is not fully known and clear indications for operative intervention cannot be established from the literature.
Several studies have shown that the largest discs appear to have the greatest tendency to resolve. The aim of this study was to investigate whether massive prolapsed discs can be safely managed conservatively once clinical improvement has occurred.
Thirty-seven patients were studied by clinical assessments and serial magnetic resonance imaging (MRI) over 2 years. Patients had severe sciatica at first, but began to show clinical improvement despite the large disc herniations.
Clinical assessment included the Lasegue test and neurological appraisal. The Oswestry Disability Index was used to measure function and changes in function. Serial MRI studies allowed measurement of volume changes of the herniated disc material over a period of time.
The study concluded that a massive disc herniation can pursue a favorable clinical course. If early progress is shown, the long-term prognosis is very good and even massive disc herniations can be treated conservatively.
Surf to our Show Notes for the Full Article – http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025225/
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Finally, I leave you with the following quote:
“A single rose can be my garden… a single friend, my world.”
– Leo Buscaglia
For Chiropractic OnLine Today’s HealthBeat, This is Dr. Todd Eglow.