children
The American Chiropractic Association Council on Chiropractic Pediatrics (CCP) announced a new diplomate education program focused on pediatric care. The program will include 300 hours of education covering topics such as pediatric development from birth to age 16, adjusting techniques, working diagnosis, clinical application, integrated care and more…
Development of the diplomate education program has been in the works for several years, with contributions from many members of the CCP, including council president Jennifer Brocker, DC, DICCP. At the helm of course development for this education program are Mary Beth Minser, DC, CACCP, and Kris Tohtz, DC, LAc, educational coordinators for CCP. They agreed that the goal of the new program is to provide education that furthers knowledge of chiropractic pediatrics in an evidence-based, integrative way. “We wanted to make sure that we had something that aligned with ACA’s core principles,” Dr. Tohtz said. “Chiropractic-forward, yes, but scientifically focused.”
Dr. Brocker added, “There was a need for more evidence-informed education [in pediatrics]. I felt like the Council was well positioned to take this on because we had the opportunity to build it from scratch, making it what students and practicing doctors need.” …
Drs. Minser and Tohtz are excited that the diplomate program will also include a research component. “There is some lacking information when it comes to pediatric chiropractic,” Dr. Minser explained. She recently participated in the COURSE Study, an international study seeking to fill knowledge gaps in research relating to pediatric chiropractic treatment. “It was a very easy project to do, and pretty exciting to be involved,” she said. “But you have to know how to treat pediatric patients in order to be involved in those research projects. We want doctors and students [in this program] to be able to go through a case study, to be able to extract information for their clinical application from that case study or from research, or, if they would like, to write up case studies so we can get more published.”
“We feel we could really push pediatric chiropractic to a whole new level having doctors that have this type of knowledge base,” Dr. Minser said. “We just want to be the best pediatric chiropractors that we can be, and this diplomate [education] program helps [us] do that.”
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“There is some lacking information when it comes to pediatric chiropractic.”
Really?
I think the evidence is quite clear: chiropractic has nothing to offer for ill children that other, properly trained healthcare professionals would not do better.
“We feel we could really push pediatric chiropractic to a whole new level.”
Why?
“We just want to be the best pediatric chiropractors that we can be.”
In this case, please study the evidence and you will inevitably arrive at the following conclusion:
THE BEST A CHIROPRACTOR CAN DO FOR A SICK CHILD IS TO REFER IT TO A COMPETENT DOCTOR – A DOCTOR OF MEDICINE, NOT CHIROPRACTIC!
On this blog, we have some people who continue to promote conspiracy theories about Covid and Covid vaccinations. It is, therefore, time, I feel, to present them with some solid evidence on the subject (even though it means departing from our usual focus on SCAM).
This Cochrane review assessed the efficacy and safety of COVID‐19 vaccines (as a full primary vaccination series or a booster dose) against SARS‐CoV‐2. An impressive team of investigators searched the Cochrane COVID‐19 Study Register and the COVID‐19 L·OVE platform (last search date 5 November 2021). They also searched the WHO International Clinical Trials Registry Platform, regulatory agency websites, and Retraction Watch. They included randomized controlled trials (RCTs) comparing COVID‐19 vaccines to placebo, no vaccine, other active vaccines, or other vaccine schedules.
A total of 41 RCTs could be included and analyzed assessing 12 different vaccines, including homologous and heterologous vaccine schedules and the effect of booster doses. Thirty‐two RCTs were multicentre and five were multinational. The sample sizes of RCTs were 60 to 44,325 participants. Participants were aged: 18 years or older in 36 RCTs; 12 years or older in one RCT; 12 to 17 years in two RCTs; and three to 17 years in two RCTs. Twenty‐nine RCTs provided results for individuals aged over 60 years, and three RCTs included immunocompromised patients. No trials included pregnant women. Sixteen RCTs had two‐month follow-ups or less, 20 RCTs had two to six months, and five RCTs had greater than six to 12 months or less. Eighteen reports were based on preplanned interim analyses. The overall risk of bias was low for all outcomes in eight RCTs, while 33 had concerns for at least one outcome. 343 registered RCTs with results not yet available were identified.The evidence for mortality was generally sparse and of low or very low certainty for all WHO‐approved vaccines, except AD26.COV2.S (Janssen), which probably reduces the risk of all‐cause mortality (risk ratio (RR) 0.25, 95% CI 0.09 to 0.67; 1 RCT, 43,783 participants; high‐certainty evidence).High‐certainty evidence was found that BNT162b2 (BioNtech/Fosun Pharma/Pfizer), mRNA‐1273 (ModernaTx), ChAdOx1 (Oxford/AstraZeneca), Ad26.COV2.S, BBIBP‐CorV (Sinopharm‐Beijing), and BBV152 (Bharat Biotect) reduce the incidence of symptomatic COVID‐19 compared to placebo (vaccine efficacy (VE): BNT162b2: 97.84%, 95% CI 44.25% to 99.92%; 2 RCTs, 44,077 participants; mRNA‐1273: 93.20%, 95% CI 91.06% to 94.83%; 2 RCTs, 31,632 participants; ChAdOx1: 70.23%, 95% CI 62.10% to 76.62%; 2 RCTs, 43,390 participants; Ad26.COV2.S: 66.90%, 95% CI 59.10% to 73.40%; 1 RCT, 39,058 participants; BBIBP‐CorV: 78.10%, 95% CI 64.80% to 86.30%; 1 RCT, 25,463 participants; BBV152: 77.80%, 95% CI 65.20% to 86.40%; 1 RCT, 16,973 participants).Moderate‐certainty evidence was found that NVX‐CoV2373 (Novavax) probably reduces the incidence of symptomatic COVID‐19 compared to placebo (VE 82.91%, 95% CI 50.49% to 94.10%; 3 RCTs, 42,175 participants).There is low‐certainty evidence for CoronaVac (Sinovac) for this outcome (VE 69.81%, 95% CI 12.27% to 89.61%; 2 RCTs, 19,852 participants).High‐certainty evidence was found that BNT162b2, mRNA‐1273, Ad26.COV2.S, and BBV152 result in a large reduction in the incidence of severe or critical disease due to COVID‐19 compared to placebo (VE: BNT162b2: 95.70%, 95% CI 73.90% to 99.90%; 1 RCT, 46,077 participants; mRNA‐1273: 98.20%, 95% CI 92.80% to 99.60%; 1 RCT, 28,451 participants; AD26.COV2.S: 76.30%, 95% CI 57.90% to 87.50%; 1 RCT, 39,058 participants; BBV152: 93.40%, 95% CI 57.10% to 99.80%; 1 RCT, 16,976 participants).
Moderate‐certainty evidence was found that NVX‐CoV2373 probably reduces the incidence of severe or critical COVID‐19 (VE 100.00%, 95% CI 86.99% to 100.00%; 1 RCT, 25,452 participants).
Two trials reported high efficacy of CoronaVac for severe or critical disease with wide CIs, but these results could not be pooled.
mRNA‐1273, ChAdOx1 (Oxford‐AstraZeneca)/SII‐ChAdOx1 (Serum Institute of India), Ad26.COV2.S, and BBV152 probably result in little or no difference in serious adverse events (SAEs) compared to placebo (RR: mRNA‐1273: 0.92, 95% CI 0.78 to 1.08; 2 RCTs, 34,072 participants; ChAdOx1/SII‐ChAdOx1: 0.88, 95% CI 0.72 to 1.07; 7 RCTs, 58,182 participants; Ad26.COV2.S: 0.92, 95% CI 0.69 to 1.22; 1 RCT, 43,783 participants); BBV152: 0.65, 95% CI 0.43 to 0.97; 1 RCT, 25,928 participants). In each of these, the likely absolute difference in effects was fewer than 5/1000 participants.
Evidence for SAEs is uncertain for BNT162b2, CoronaVac, BBIBP‐CorV, and NVX‐CoV2373 compared to placebo (RR: BNT162b2: 1.30, 95% CI 0.55 to 3.07; 2 RCTs, 46,107 participants; CoronaVac: 0.97, 95% CI 0.62 to 1.51; 4 RCTs, 23,139 participants; BBIBP‐CorV: 0.76, 95% CI 0.54 to 1.06; 1 RCT, 26,924 participants; NVX‐CoV2373: 0.92, 95% CI 0.74 to 1.14; 4 RCTs, 38,802 participants).
The authors’ conclusions were as follows: Compared to placebo, most vaccines reduce, or likely reduce, the proportion of participants with confirmed symptomatic COVID‐19, and for some, there is high‐certainty evidence that they reduce severe or critical disease. There is probably little or no difference between most vaccines and placebo for serious adverse events. Over 300 registered RCTs are evaluating the efficacy of COVID‐19 vaccines, and this review is updated regularly on the COVID‐NMA platform (covid-nma.com).
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As some conspiratorial loons will undoubtedly claim that this review is deeply biased; it might be relevant to add the conflicts of interest of its authors:
- Carolina Graña: none known.
- Lina Ghosn: none known.
- Theodoros Evrenoglou: none known.
- Alexander Jarde: none known.
- Silvia Minozzi: no relevant interests; Joint Co‐ordinating Editor and Method editor of the Drugs and Alcohol Group.
- Hanna Bergman: Cochrane Response – consultant; WHO – grant/contract (Cochrane Response was commissioned by the WHO to perform review tasks that contribute to this publication).
- Brian Buckley: none known.
- Katrin Probyn: Cochrane Response – consultant; WHO – consultant (Cochrane Response was commissioned to perform review tasks that contribute to this publication).
- Gemma Villanueva: Cochrane Response – employment (Cochrane Response has been commissioned by WHO to perform parts of this systematic review).
- Nicholas Henschke: Cochrane Response – consultant; WHO – consultant (Cochrane Response was commissioned by the WHO to perform review tasks that contributed to this publication).
- Hillary Bonnet: none known.
- Rouba Assi: none known.
- Sonia Menon: P95 – consultant.
- Melanie Marti: no relevant interests; Medical Officer at WHO.
- Declan Devane: Health Research Board (HRB) – grant/contract; registered nurse and registered midwife but no longer in clinical practice; Editor, Cochrane Pregnancy and Childbirth Group.
- Patrick Mallon: AstraZeneca – Advisory Board; spoken of vaccine effectiveness to media (print, online, and live); works as a consultant in a hospital that provides vaccinations; employed by St Vincent’s University Hospital.
- Jean‐Daniel Lelievre: no relevant interests; published numerous interviews in the national press on the subject of COVID vaccination; Head of the Department of Infectious Diseases and Clinical Immunology CHU Henri Mondor APHP, Créteil; WHO (IVRI‐AC): expert Vaccelarate (European project on COVID19 Vaccine): head of WP; involved with COVICOMPARE P et M Studies (APHP, INSERM) (public fundings).
- Lisa Askie: no relevant interests; Co‐convenor, Cochrane Prospective Meta‐analysis Methods Group.
- Tamara Kredo: no relevant interests; Medical Officer in an Infectious Diseases Clinic at Tygerberg Hospital, Stellenbosch University.
- Gabriel Ferrand: none known.
- Mauricia Davidson: none known.
- Carolina Riveros: no relevant interests; works as an epidemiologist.
- David Tovey: no relevant interests; Emeritus Editor in Chief, Feedback Editors for 2 Cochrane review groups.
- Joerg J Meerpohl: no relevant interests; member of the German Standing Vaccination Committee (STIKO).
- Giacomo Grasselli: Pfizer – speaking engagement.
- Gabriel Rada: none known.
- Asbjørn Hróbjartsson: no relevant interests; Cochrane Methodology Review Group Editor.
- Philippe Ravaud: no relevant interests; involved with Mariette CORIMUNO‐19 Collaborative 2021, the Ministry of Health, Programme Hospitalier de Recherche Clinique, Foundation for Medical Research, and AP‐HP Foundation.
- Anna Chaimani: none known.
- Isabelle Boutron: no relevant interests; member of Cochrane Editorial Board.
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And as some might say this analysis is not new, here are two further papers just out:
Objectives To determine the association between covid-19 vaccination types and doses with adverse outcomes of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection during the periods of delta (B.1.617.2) and omicron (B.1.1.529) variant predominance.
Design Retrospective cohort.
Setting US Veterans Affairs healthcare system.
Participants Adults (≥18 years) who are affiliated to Veterans Affairs with a first documented SARS-CoV-2 infection during the periods of delta (1 July-30 November 2021) or omicron (1 January-30 June 2022) variant predominance. The combined cohorts had a mean age of 59.4 (standard deviation 16.3) and 87% were male.
Interventions Covid-19 vaccination with mRNA vaccines (BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna)) and adenovirus vector vaccine (Ad26.COV2.S (Janssen/Johnson & Johnson)).
Main outcome measures Stay in hospital, intensive care unit admission, use of ventilation, and mortality measured 30 days after a positive test result for SARS-CoV-2.
Results In the delta period, 95 336 patients had infections with 47.6% having at least one vaccine dose, compared with 184 653 patients in the omicron period, with 72.6% vaccinated. After adjustment for patient demographic and clinical characteristics, in the delta period, two doses of the mRNA vaccines were associated with lower odds of hospital admission (adjusted odds ratio 0.41 (95% confidence interval 0.39 to 0.43)), intensive care unit admission (0.33 (0.31 to 0.36)), ventilation (0.27 (0.24 to 0.30)), and death (0.21 (0.19 to 0.23)), compared with no vaccination. In the omicron period, receipt of two mRNA doses were associated with lower odds of hospital admission (0.60 (0.57 to 0.63)), intensive care unit admission (0.57 (0.53 to 0.62)), ventilation (0.59 (0.51 to 0.67)), and death (0.43 (0.39 to 0.48)). Additionally, a third mRNA dose was associated with lower odds of all outcomes compared with two doses: hospital admission (0.65 (0.63 to 0.69)), intensive care unit admission (0.65 (0.59 to 0.70)), ventilation (0.70 (0.61 to 0.80)), and death (0.51 (0.46 to 0.57)). The Ad26.COV2.S vaccination was associated with better outcomes relative to no vaccination, but higher odds of hospital stay and intensive care unit admission than with two mRNA doses. BNT162b2 was generally associated with worse outcomes than mRNA-1273 (adjusted odds ratios between 0.97 and 1.42).
Conclusions In veterans with recent healthcare use and high occurrence of multimorbidity, vaccination was robustly associated with lower odds of 30 day morbidity and mortality compared with no vaccination among patients infected with covid-19. The vaccination type and number of doses had a significant association with outcomes.
SECOND EXAMPLE Long COVID, or complications arising from COVID-19 weeks after infection, has become a central concern for public health experts. The United States National Institutes of Health founded the RECOVER initiative to better understand long COVID. We used electronic health records available through the National COVID Cohort Collaborative to characterize the association between SARS-CoV-2 vaccination and long COVID diagnosis. Among patients with a COVID-19 infection between August 1, 2021 and January 31, 2022, we defined two cohorts using distinct definitions of long COVID—a clinical diagnosis (n = 47,404) or a previously described computational phenotype (n = 198,514)—to compare unvaccinated individuals to those with a complete vaccine series prior to infection. Evidence of long COVID was monitored through June or July of 2022, depending on patients’ data availability. We found that vaccination was consistently associated with lower odds and rates of long COVID clinical diagnosis and high-confidence computationally derived diagnosis after adjusting for sex, demographics, and medical history.
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There are, of course, many more articles on the subject for anyone keen to see the evidence. Sadly, I have little hope that the COVID loons will be convinced by any of them. Yet, I thought I should give it nevertheless a try.
In response to yesterday’s post, I received a lengthy comment from ‘Stan’. Several readers have already commented on it. Therefore, I can make my arguments short. In this post, will repeat Stan’s points each followed by my comments (in bold). Here we go:
Seven Reasons Homœopathy is Not Placebo Effect
Sorry, Stan, but your heading is not proper English; I have therefore changed it for the title of this post.
1. Homeopathic remedies work on babies, animals, plants and people in a coma. Biodynamic farmers use homeopathic remedies to repel pests and treat plant diseases. Some organic ranchers rely on homeopathic remedies to treat their herds. Some “placebo by proxy” effect has been shown for children but its doubtful that it could be shown for a herd of cattle or crops in a field. Farmers can’t rely on wishful thinking to stay in business.
As discussed ad nauseam on this blog, homeopathic remedies do not work on babies or animals better than placebos. I don’t know of any studies with “people in a coma” (if you do, Stan, please let me know). The fact that ranchers rely on homeopathy is hilarious but does not prove anything.
2. The correct curative remedy will initially cause a worsening of the condition being cured if it is given in too strong (i.e. too dilute) a dose. A placebo might only cause a temporary improvement of the condition being treated; certainly not an aggravation.
The ‘homeopathic aggravation’ is a myth created by homeopaths. It disappears if we try to systematically research it; see here, for instance.
3. One can do a “proving” of an unknown homeopathic remedy by taking it repeatedly over several days and it will temporarily cause symptoms that one has never experienced previously – symptoms it will cure in a sick person. This is a repeatable scientific experiment used to determine the scope of a new remedy, or confirm the effects of an already proven remedy. A placebo might possibly have an effect if the individual taking it has been “prepared” by being told what they are taking but it likely wouldnt match previously recorded symptoms in the literature.
Homeopathic provings are rubbish and not reproducible when done rigorously; see here.
4. One can treat simple acute (self-limiting) conditions (e.g. minor burns, minor injuries, insect bites, etc.) and see unusually rapid cures with homeopathic remedies. A placebo might only cause a temporary improvement of the condition being treated while taken. Placebos have been found mostly effective in conditions with a strong psychological component like pain.
You mean like using Arnica for cuts and bruises? Sadly, it does not work.
5. One can get homeopathic treatment for long term chronic (non self-limiting) conditions and see a deep lasting cure, as has been documented clinically for a couple centuries. A placebo might only cause a temporary partial improvement of the condition being treated while the placebo is being taken.
You mean like asthma, eczema, or insomnia?
6. There is over 200 years worth of extensive documentation from around the world, of the clinical successes of homeopathy for both acute and chronic conditions of all types. As Dr Hahn has said you have throw out 90% of the evidence to conclude that homeopathy doesnt work. The Sheng et al meta-analysis in 2005 Lancet that was supposedly the death knell of homeopathy used only 8 studies, excluding hundreds of others. Unsurprisingly homeopathy was found wanting. So-called Skeptics see what they want to see in the science. There is relatively little documentation of placebo usage. A few recent studies have been done showing the limited temporary benefits of placebos.
What Hahn wrote is understandably liked by homeopaths but it nevertheless is BS. If you don’t trust me, please rely on independent bodies from across the world.
7. Homeopathic remedies have been shown to have a very weak electromagnetic signature and contain some nano-particles. Some believe this explains their mechanism. An exciting new potential field of research is the subtle cell signalling that has been found to direct the development of stem cells. Scientists have created double-headed planeria worms and this trait has been found to be inherited by their offspring without any change in the genes or epigenetics. Until now we had no idea how a single fertilized ovum could evolve into a complex creature that is bilateral and has multiple cell types. It is possible that the very subtle electromagnetic signature or some other unknown effect of homeopathic remedies is effecting this subtle cell signalling.
The homeopathic nano-myth is nonsense. And so is the rest of your assumptions.
Every conventional drug has “side effects” that match the symptoms for which it is indicated! Aspirin can cause headaches and fever, ritalin can cause hyperactive effects, radiation can cause cancer. Conventional doctors are just practicing bad homeopathy. They are prescribing Partially similar medicines. If their drugs were homeopathic (i.e. similar) to the patients symptoms on all levels they would be curative. Radiation sometimes does cure cancer instead of just suppressing it per usual.
Even if this were true, what would it prove? Certainly not that homeopathy works!
Dr Hahneman did forbid mixing homeopathy and conventional medicine. In his day doctors commonly used extensive blood letting and extreme doses of mercury. Its not Quite as bad now.
You evidently did not read Hahnemann’s writings.
Just because we dont know how extremely dilute homeopathic remedies work, doesn’t discount that they Do work. Homeopathy seems to fly in the face of Known science. In no way is it irrational or unscientific. There are lots of phenomena in the universe that cant be explained yet, like dark energy and dark matter effects and even consciousness!
Not knowing how a treatment works has not stopped science to test whether it works (e.g. Aspirin). In the case of homeopathy, the results of these endeavors were not positive.
The assumption that the moon is made of cheese also flies in the face of science; do you perhaps think that this makes it true?
The actions of homeopathy can and have been well-explained: they are due to placebo effects.
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Stan, thank you for this entertaining exercise. But, next time, please remember to supply evidence for your statements.
Following the death from cancer of a 14-year-old Carinthian girl, the Klagenfurt public prosecutor’s office has launched an investigation against the girl’s parents. In February this year, the 14-year-old was taken to a hospital in Graz, Austria, where she died a few days later from cancer. The hospital filed charges because the tumor had been treated incorrectly with so-called alternative medicine (SCAM).
Investigations are underway on suspicion of torturing or neglecting underage, younger, or defenseless persons. Currently, the accused and witnesses are being questioned. The parents’ lawyer, Alexander Todor-Kostic, stated that the accusations were without any basis and claimed that the 14-year-old girl had decided of her own free will against being treated with chemotherapy and surgery. The parents respected this, allowed her alternative treatment methods, and acted in accordance with the applicable legal situation.
The girl had developed cancer the previous year that was not detected. Instead of seeing conventional oncologists for a reliable diagnosis and effective treatments, the parents consulted private doctors. Instead of chemotherapy, radiation, and surgery, the girl had deliberately chosen “alternative treatments” herself, the lawyer stressed.
Even though the case has been reported in several Austrian papers, I did not succeed in finding further details about it. In particular, it is unclear what type of cancer the girl had been suffering from and what type of SCAMs she received.
The Austrian skeptic Christian Kreil commented: “Sugar pills in the pharmacies, homeopathic advanced training for doctors, a proliferation of energetics offering every conceivable bullshit … the dead girl is the logical result of this esoteric foolishness covered by politics and chambers.”
I am afraid that he might have a point here: as we have discussed repeatedly on this blog, Austria is currently particularly prone to misinformation about SCAM. Here are a few examples of previous blog posts on this subject:
- Austrian osteopaths seem to violate legal, ethical and moral rules and conventions
- An open letter to the President of the Austrian Medical Association aims to stop medical quackery
- Has the ‘Vienna Medical Association’ taken leave of its senses?
- When politicians become snake-oil salesmen
- Michael Frass’ research into homeopathy for cancer: “numerous breaches of scientific integrity”
- A well-known opponent of vaccination has died of COVID after self-treatment with MMS
- The case of a boy tortured to death with homeopathy
- A truly perplexing homeopath – is it time for an official investigation?
Misinformation about SCAM can be lethal. This is one of the reasons why responsible information is so very important.
I came across an article entitled “Consent for Paediatric Chiropractic Treatment (Ages 0-16)“. Naturally, it interested me. Here is the full paper; I have only inserted a few numbers in square brackets which refer to my comments below:
By law, all Chiropractors are required to inform you of the risks and benefits of chiropractic spinal manipulation and the other types of care we provide. Chiropractors use manual therapy alongside taking a thorough history, and doing a neurological, orthopaedic and chiropractic examination to both diagnose and to treat spinal, cranial and extremity dysfunction. This may include taking joints to the end range of function, palpating soft tissues (including inside the mouth and the abdomen), mobilisation, soft tissue therapy and very gentle manipulation [1]. Our Chiropractors have been educated to perform highly specific types of bony or soft tissue manipulation and we strive to follow a system of evidence-based care [2]. At the core of our belief system is “Do No Harm”. We recognise that infants and children are not tiny adults. The force of an adjustment used in a child is at least less than half of what we might use with a fully grown adult. Studies by Hawk et al (2016) and Marchand (2013) agreed that Chiropractors use 15 – 35 x less force in the under 3-month age group when compared to medical practitioners doing manipulation (Koch, 2002) [3]. We also use less force in all other paediatrics groups, especially when compared to adults (Marchand, 2013). In addition to using lower force, depth, amplitude and speed in our chiropractic adjustments [4], we utilise different techniques. We expect all children under the age of 16 years to be accompanied by a responsible adult during appointments unless prior permission to treat without a consenting adult e.g., over the age of 14 has been discussed with the treating chiropractor.
Risks
- Research into chiropractic care for children in the past 70 years has shown it to have a low risk of adverse effects (Miller, 2019) [5]. These effects tend to be mild and of short duration e.g., muscular or ligament irritation. Vorhra et al (2007) found the risk of severe of adverse effects (e.g. fracture, quadriplegia, paraplegia, and death) is very, very rare and was more likely to occur in individuals where there is already serious underlying pathology and missed diagnosis by other medical profession [6]. These particular cases occurred more than 25 years ago and is practically unheard of now since research and evidence-based care has become the norm [7].
- The most common side effect in infants following chiropractic treatment includes fussiness or irritability for the first 24 hours, and sleeping longer than usual or more soundly. (Miller and Benfield, 2008) [8]
- In older children, especially if presenting with pain e.g., in the neck or lower back, the greatest risk is that this pain may increase during examination due to increasing the length of involved muscles or ligaments [9]. Similarly, the child may also experience pain, stiffness or irritability after treatment (Miller & Benfield, 2008) [10]. Occasionally children may experience a headache.[11] We find that children experience side effects much less often than adults.[12]
Benefits
- Your child might get better with chiropractic care. [13] If they don’t, we will refer you on [14].
- Low risk of side effects and very rare risk of serious adverse effects [15].
- Drug-free health care. We are not against medication, but we do not prescribe [16].
- Compared with a medical practitioner, manual therapy carried out by a chiropractor is 20 x less likely to result in injury (Koch et al 2002, Miller 2009).[17]
- Children do not often require long courses of treatment (>3 weeks) unless complicating factors are present.[18]
- Studies have shown that parents have a high satisfaction rate with Chiropractic care [19].
- Physical therapies are much less likely to interfere with biomedical treatments. (McCann & Newell 2006) [20]
- You will have a better understanding of diagnosis of any complain and we will let you know what you can do to help.[21]
We invite you to have open discussions and communication with your treating chiropractor at all times. Should you need any further clarification please just ask.
References
- Hawk, C. Shneider, M.J., Vallone, S and Hewitt, E.G. (2016) – Best practises recommendations for chiropractic care of children: A consensus update. JMPT, 39 (3), 158-168.
- Marchand, A. (2013) – A Proposed model with possible implications for safety and technique adaptations for chiropractic spinal manipulative therapy for infants and children. JMPT, 5, 1-14
- Koch L. E., Koch, H, Graumann-Brunnt, S. Stolle, D. Ramirez, J.M., & Saternus, K.S. (2002) – Heart rate changes in response to mild mechanical irritation of the high cervical cord region in infants. Forensic Science International, 128, 168-176
- Miller J (2019) – Evidence-Based Chiropractic Care for Infants: Rational, Therapies and Outcomes. Chapter 11: Safety of Chiropractic care for Infants p111. Praeclarus Press
- Vohra, S. Johnston, B.C. Cramer, K, Humphreys, K. (2007) – Adverse events associated with paediatric spinal manipulation: A Systematic Review. Pediatrics, 119 (1) e275-283
- Miller, J and Benfield (2008) – Adverse effects of spinal manipulative therapy in children younger than 3 years: a retrospective study in a chiropractic teaching clinic. JMPT Jul-Aug;31(6):419-23.
- McCann, L.J. & Newell, S.J. (2006). Survey of paediatric complementary and alternative medicine in health and chronic disease. Archives of Diseases of Childhood, 91, 173-174
- Corso, M., Cancelliere, C. , Mior., Taylor-Vaise, A. Côté, P. (2020) – The safety of spinal manipulative therapy in children under 10 years: a rapid review. Chiropractic Manual therapy 25: 12
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- “taking joints to the end range of function” (range of motion, more likely) is arguably not “very gently”;
- “we strive to follow a system of evidence-based care”; I do not think that this is possible because pediatric chiropractic care is hardy evidence-based;
- as a generalizable statement, this seems to be not true;
- ” lower force, depth, amplitude and speed”; I am not sure that there is good evidence for that;
- research has foremost shown that there might be significant under-reporting;
- to blame the medical profession for diagnoses missed by chiropractors seems odd;
- possibly because of under-reporting;
- possibly because of under-reporting;
- possibly because of under-reporting;
- possibly because of under-reporting;
- possibly because of under-reporting;
- your impressions are not evidence;
- your child might get even better without chiropractic care;
- referral rates of chiropractors tend to be low;
- possibly because of under-reporting;
- chiropractors have no prescription rights but some lobby hard for it;
- irrelevant if we consider the intervention useless and thus obsolete;
- any evidence for this statement?;
- satisfaction rates are no substitute for real evidence;
- that does not mean they are effective, safe, or value for money;
- this is perhaps the strangest statement of them all – do chiropractors think they are the optimal diagnosticians for all complaints?
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According to its title, the paper was supposed to deal with consent for chiropractic pediatric care. It almost totally avoided the subject and certainly did not list the information chiropractors must give to parents before commencing treatment.
Considering the arguments that the article did provide has brought me to the conclusion that chiropractors who treat children are out of touch with reality and seem in danger of committing child abuse.
This meta-analysis aimed “to provide better evidence of the efficacy of manual therapy (MT) on adolescent idiopathic scoliosis (AIS)”.
All RCTs of MT for the management of patients with AIS were included in the present study. The treatment difference between the experimental and control group was mainly MT. The outcomes consisted of the total effective rate, the Cobb angle, and Scoliosis Research Society-22 (SRS-22) questionnaire score. Electronic database searches were conducted from database inception to July 2022, including the Cochrane Library, PubMed, Web of Science, Embase, Wanfang Data, CNKI, and VIP. The pooled data were analyzed using RevMan 5.4 software.
Four RCTs with 213 patients in the experimental groups were finally included. There are 2 studies of standalone MT in the experimental group and 3 studies of MT with identical conservative treatments in the control group. Three trials reported the total effective rate and a statistically significant difference was found (P = 0.004). Three trials reported Cobb angle; a statistical difference was found (P = 0.01). Then, sensitivity analysis showed that there was a significant difference in the additional MT subgroup (P < 0.00001) while not in the standalone MT subgroup (P = 0.41). Three trials reported SRS-22 scores (P = 0.55) without significant differences.
The authors concluded that there is insufficient data to determine the effectiveness of spinal manipulation limited by the very low quality of included studies. High-quality studies with appropriate design and follow-up periods are warranted to determine if MT may be beneficial as an adjunct therapy for AIS. Currently, there is no evidence to support spinal manipulation.
The treatment of idiopathic scoliosis depends on the age, curve size, and progression of the condition. Therapeutic options include observation, bracing, physiotherapy, and surgery. They do NOT include MT because it is neither a plausible nor effective solution to this problem. It follows that further studies are not warranted and should be discouraged.
And, even if you disagree with me here and feel that further studies might be justified, let me remind you that proper research is never aimed at providing better evidence that a therapy works (as the authors of this odd paper seem to think); it must be aimed at testing whether it is effective!
It has been reported that the PLASTIC SURGERY INSTITUTE OF ·UTAH, INC.; MICHAEL KIRK MOORE JR.; KARI DEE BURGOYNE; KRISTIN JACKSON ANDERSEN; AND SANDRA FLORES, stand accused of running a scheme out of the Plastic Surgery Institute of Utah, Inc. to defraud the United States and the Centers for Disease Control and Prevention.
Dr. Michael Kirk Moore, Jr. and his co-defendants at the Plastic Surgery Institute of Utah have allegedly given falsified vaccine cards to people in exchange for their donating $50 to an unnamed organization, one which exists to “liberate the medical profession from government and industry conflicts of interest.” As part of the scheme, Moore and his co-defendants are accused of giving children saline injections so that they would believe they were really being vaccinated.
The co-defendants are Kari Dee Burgoyne, an office manager at the Plastic Surgery Institute of Utah; Sandra Flores, the office’s receptionist; and, strangest of all, a woman named Kristin Jackson Andersen, who according to the indictment is Moore’s neighbor. Andersen has posted copious and increasingly conspiratorial anti-vaccine content on Facebook and Instagram; Dr. Moore himself was a signatory on a letter expressing support for a group of COVID-skeptical doctors whose certification was under review by their respective medical boards. The letter expresses support for ivermectin, a bogus treatment for COVID.
According to the indictment, the Plastic Surgery Center of Utah was certified as a real vaccine provider and signed a standard agreement with the CDC, which among other things requires doctor’s offices not to “sell or seek reimbursement” for vaccines.
Prosecutors allege that, when people seeking falsified vaccine cards contacted the office, Burgoyne, the office manager, referred them to Andersen, Dr. Moore’s neighbor. Andersen, according to the indictment, would ask for the name of someone who’d referred them—it had to be someone who’d previously received a fraudulent vaccine card, per the indictment—then direct people to make a $50 donation to a charitable organization, referred to in the indictment only as “Organization 1.” Each vaccine card seeker was required to put an orange emoji in the memo line of their donation.
After making a donation to the unnamed charitable organization, prosecutors allege, Andersen would send a link to vaccine card seekers to enable them to make an appointment at the Plastic Surgery Institute. With adult patients, Moore would allegedly use a real COVID vaccine dose in a syringe, but squirt it down the drain. Flores, the office’s receptionist, gave an undercover agent a note, reading “with 18 & younger, we do a saline shot,” meaning that kids were injected with saline instead of a vaccine. Prosecutors allege the team thus disposed of at least 1,937 doses of COVID vaccines.
All four people are charged with conspiracy to defraud the United States; conspiracy to convert, sell, convey, and dispose of government property; and conversion, sale, conveyance, and disposal of government property and aiding and abetting.
Throughout the scheme, the group reported the names of all the vaccine seekers to the Utah Statewide Immunization Information System, indicating that the practice had administered 1,937 doses of COVID-19 vaccines, which included 391 pediatric doses. The value of all the doses totaled roughly $28,000. With the money from the $50 vaccination cards totaling nearly $97,000, the scheme was valued at nearly $125,000, federal prosecutors calculated.
“By allegedly falsifying vaccine cards and administering saline shots to children instead of COVID-19 vaccines, not only did this provider endanger the health and well-being of a vulnerable population, but also undermined public trust and the integrity of federal health care programs,” Curt Muller, special agent in charge with the Department of Health and Human Services for the Office of the Inspector General, said in a statement.
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I am already baffled by anti-vax attitudes when they originate from practitioners of so-called alternative medicine (SCAM). When they come from real physicians and are followed by real actions, I am just speechless. As I stated many times before: studying medicine does unfortunately not protect you from recklessness, greed, or stupidity.
Aromatherapy is popular yet it has a problem: there is no indication for it. Yes, it can make you feel better but this is hardly a true medical indication. I know of many things that make me feel better, and I would not call them a THERAPY! But perhaps this new study from Iran offers a solution for the dilemna:
Sleep plays an essential role in infant development. This randomized clinical trial investigated the effect of aromatherapy with rose water on the deep sleep status of premature infants admitted to a neonatal intensive care unit (NICU).
The study was conducted on 64 infants hospitalized in NICUs. In the intervention group, two drops of rose water were poured on gas and placed next to the babies’ heads. The control group was treated in the same way except that distilled water was employed. The ALS scale was used to assess the sleep status.
Of the 66 infants in this study, 30 were female and 36 were male. The average gestational age of the infants was 32.5 ± 1.99 weeks. The results showed that the amount of deep sleep (type A and B) in the intervention group was significantly higher than the control group during and after the intervention (p=0.001).
The authors concluded that, considering the positive impact of rose water in improve of sleep quality in premature babies; it can be used to improve sleeping condition of infants in hospitals, along with main treatment.
The study has many flaws and it is badly written. Yet, I find it interesting. If its results can be confirmed with a more rigorous trial, aromatherapy might finally find a true medical purpose.
Lower respiratory tract infections (LRTIs) in early childhood are known to influence lung development and lifelong lung health, but their link to premature adult death from respiratory disease is unclear. This analysis aimed to estimate the association between early childhood LRTI and the risk and burden of premature adult mortality from respiratory disease.
This longitudinal observational cohort study used data collected prospectively by the Medical Research Council National Survey of Health and Development in a nationally representative cohort recruited at birth in March 1946, in England, Scotland, and Wales. It evaluated the association between LRTI during early childhood (age <2 years) and death from respiratory disease from age 26 through 73 years. Early childhood LRTI occurrence was reported by parents or guardians. Cause and date of death were obtained from the National Health Service Central Register. Hazard ratios (HRs) and population attributable risk associated with early childhood LRTI were estimated using competing risks Cox proportional hazards models, adjusted for childhood socioeconomic position, childhood home overcrowding, birthweight, sex, and smoking at age 20–25 years. The researchers compared mortality within the cohort studied with national mortality patterns and estimated corresponding excess deaths occurring nationally during the study period.
5362 participants were enrolled in March, 1946, and 4032 (75%) continued participating in the study at age 20–25 years. 443 participants with incomplete data on early childhood (368 [9%] of 4032), smoking (57 [1%]), or mortality (18 [<1%]) were excluded. 3589 participants aged 26 years (1840 [51%] male and 1749 [49%] female) were included in the survival analyses from 1972 onwards. The maximum follow-up time was 47·9 years. Among 3589 participants, 913 (25%) who had an LRTI during early childhood were at greater risk of dying from respiratory disease by age 73 years than those with no LRTI during early childhood (HR 1·93, 95% CI 1·10–3·37; p=0·021), after adjustment for childhood socioeconomic position, childhood home overcrowding, birthweight, sex, and adult smoking. This finding corresponded to a population attributable risk of 20·4% (95% CI 3·8–29·8) and 179 188 (95% CI 33 806–261 519) excess deaths across England and Wales between 1972 and 2019.
The authors concluded that, in this perspective, life-spanning, nationally representative cohort study, LRTI during early childhood was associated with almost a two times increased risk of premature adult death from respiratory disease, and accounted for one-fifth of these deaths.
What has that got to do with so-called alternative medicine?
Nothing!
Yet, I feel that this study is so remarkable that I need to report on it nonetheless.
What do the findings indicate?
I am not sure. Perhaps they confirm that our genetic makeup is hugely important in determining our health. Thus even the earliest signs of weakness can provide an indication of what might happen in later life.
Whatever the meaning, I find this study fascinating and hope you agree.
Brillia for Children is probably the most amazing homeopathic quackery I have ever encountered:
Uses: Enhance clarity, improve concentration of attention, reduce feelings of anxiety & stress, excitability, irritability and hyperactivity to improve attention, focus and mood regulation.
Active Ingredient: Lapine S-100 immune globulin mixture of homeopathic dilutions 12C, 30C and 50C.
Brillia is a unique combination of antibody science and homeopathic formulation. The active ingredient of Brillia is antibodies to the brain-specific S100 protein (S100B). This protein is an important regulator of many different intracellular and extracellular brain processes, e.g. various enzymes activities, calcium homeostasis, communication between neurons, etc. Since almost all mental and neurological diseases as well as temporal stress-induced conditions are accompanied by disturbance of the above-mentioned processes, especially communication between neurons, the normalization of these processes is considered to be a prospective way to treat people with such undesirable conditions. Brillia is an antibody conjugated to the S100B protein and does not alter the concentration of the S100B protein in the bloodstream. Brillia’s efficacy stems from its ability to regulate the activity of the S100B protein and does not alter its concentration. In order for a protein to have an effect in the body, it needs to bind to its target, such as an enzyme. Proteins have very specific conformations that ensure that only the correct protein binds to the correct target molecule. Once the protein correctly orients itself into the active site of the target molecule, this is when the protein causes an effect in the body. When Brillia binds to the S100B protein, the overall shape of the protein is altered, hindering its ability to bind to its target molecule and thereby controlling its activity in the body. In short, Brillia stops the S100B protein from acting in the body by changing its shape, consequently regulating levels of anxiety and hyperactivity.
PARENT TOOL | WATCH: DISCOVER BRILLIA
WATCH: WHY & HOW BRILLIA WORKS
Inactive Ingredients: Lactose monohydrate, magnesium stearate, microcrystalline cellulose. Does not contain artificial colors or artificial flavors.
Food Allergy Warning: This product contains lactose. Brillia is gluten free and nut free.
About active ingredients, the website tells us this:
Let’s start off with the active ingredient, registered with the FDA as Lapine S-100B immune globulin. Now we know this name can be intimidating, so we are going to break it down for you. Working backwards, “immune globulin” is just the “sciency” way of saying “antibody”, and don’t worry, we will get into what an antibody actually is in just a second. Next, “S-100B” is the name of the protein the antibody is designed to recognize in the body. Lastly, “Lapine” is just a descriptor of the origin of the antibody, just like the millions of other antibodies used each and every day in laboratories all across the world.
So, what exactly is an antibody? Antibodies are a naturally occurring protein and component of our immune system that are individually programmed to target a very specific protein, in the case of Brillia, the S-100B protein. It is important to understand that antibodies are one of the most specific and targeted molecules in our bodies, resulting in zero off-target effects — meaning that antibodies specifically look for and attach to their target only. This is why Brillia has no harmful side effects, because it only interacts with the S-100B protein. Not only does Brillia have absolutely zero side effects, it also has no contraindications with any other medications or supplements your child may be taking. This is due to Brillia’s extremely high level of target specificity, meaning that Brillia is so well targeted to the S-100B protein, it won’t even think about touching anything else in the body, including any other drugs or supplements.
Now that we know more about the active ingredient, let’s talk about its target, the S-100B protein.
The S-100B protein is a naturally occurring protein and is most prevalent in the brain. It is an important regulator of many processes such as regulating calcium levels and helping neurons communicate, but in our case, we care about how it influences the symptoms we mentioned earlier, such as anxiety and hyperactivity.
Given that S-100B protein influences these symptoms, it is quite intuitive that when the S-100B protein doesn’t do its job properly, these symptoms become more prevalent, and this is exactly what happens in those who suffer from anxiety, hyperactivity, stress and lack of focus.
So, what makes the S-100B protein, for a lack of a better term, mess up? The answer is quite simple, when the S-100B protein is overproduced or overactive, its activity becomes unnecessarily high, making it capable of causing these symptoms.
The firm even has something vaguely resembling evidence: a study that “shows that over the course of 12 weeks, Brillia had a significantly better effect on the severity of anxiety over those that did not take Brillia, therefore proving Brillia’s efficacy.” They show some actual results but the methods or source of the study are not disclosed. On Medline, I could not find it either. Therefore, I asked the firm to send it to me. This is the answer I got:
“Our studies were conducted in Europe and then published on our website. Please click here to view the full details found on our site.”
So, they have a study that they commissioned in Europe; it was done by researchers unnamed. The firm then put some data of it on their website. In other words:
- we don’t know who was responsible for the study;
- we cannot evaluate how rigorous it was;
- it has never been peer-reviewed;
- it is now being used for promotional purposes.
Personally, I don’t find this acceptable. In my view, this does not provide a legitimation to make far-reaching claims about the remedy. Until I have evidence to the contrary, I thus deem it safe to conclude that Brillia has no effect other than enriching the manufacturer.