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Volume 1, Number 2, June 1991

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Angelina Klanchar", "links": { "alternate": { "href": "https://www.zotero.org/angel_klanchar", "type": "text/html" } } }, "creatorSummary": "McMorland and Suter", "parsedDate": "2000-06", "numChildren": 0 }, "data": { "key": "885QMXF3", "version": 1, "itemType": "journalArticle", "title": "Chiropractic management of mechanical neck and low-back pain: a retrospective, outcome-based analysis", "creators": [ { "creatorType": "author", "firstName": "G", "lastName": "McMorland" }, { "creatorType": "author", "firstName": "E", "lastName": "Suter" } ], "abstractNote": "BACKGROUND\n\nEvidence suggests that spinal manipulation is an effective treatment for mechanical neck and low-back pain (LBP). Treatment efficacy is important to establish for these symptoms because combined they account for a considerable amount of disability and substantial associated direct and indirect costs to society.\n\n\nOBJECTIVE\n\nThe purpose of this study was to examine the outcome of patients undergoing chiropractic treatment for mechanical neck or LBP. Design and Setting: A retrospective, outcome-based analysis was done for patients seeking care at a private chiropractic practice over a 1-year period. A total of 512 files were reviewed, with 119 patients selected for inclusion. Patients were included if their chief symptom was uncomplicated mechanical neck or LBP. Diagnoses included cervical, lumbar, or sacroiliac joint sprain/strain (International Code of Diagnostics version 9 [ICD-9] code: 847.1, 847.3, 846.1, respectively), discogenic LBP (ICD-9: 722.1), and headaches (ICD-9: 784.0) because many patients with neck pain presented with concomitant headaches. Disability and pain were measured with the modified Oswestry scale (for the patients with LBP), Neck Disability Index, and an 11-box visual analogue pain scale before and after treatment. Treatment consisted of spinal manipulation, various soft-tissue techniques, home-care instructions, and ergonomic and return-to-activity advice, including rehabilitative exercises. Patients received an average of 12 treatments over a 4-week period. Statistical analysis was performed on pretreatment and posttreatment values for both disability and pain. Stratification was based on duration (acute/subacute, chronic, acute exacerbation of a chronic condition) and severity (mild, moderate, or severe) of symptoms.\n\n\nRESULTS\n\nStatistically significant reductions in disability and pain scores were achieved in all groups. An average 52.5% and 52.9% reduction in pain and disability, respectively, was achieved in the low-back group. The chronic LBP group realized a less statistically significant reduction of pain and disability (19.7% and 19.8%, respectively) than the acute/subacute (66.8% and 62.5%) or the chronic/recurrent group (56. 5% and 63.4%). The differences were statistically significant. Patients with neck pain had an average 53.8% and 48.4% reduction in their pain and disability, respectively. Patients with concomitant neck pain and headaches had statistically significant higher pretreatment and posttreatment disability and pain scores than those with only neck pain. There was no statistically significant difference in outcomes between groups stratified according to pain intensity.\n\n\nCONCLUSIONS\n\nPatients attending a private chiropractic clinic for treatment of mechanical neck pain or LBP had statistically significant reductions in their pain-related disability after treatment. These results indicate that chiropractic manipulation is beneficial for the treatment of mechanical neck pain and LBP. However, care must be taken when drawing conclusions from these outcomes. The study design does not account for the natural history of low back- or neck pain-related disability and therefore does not allow for claims of treatment efficacy. 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Angelina Klanchar", "links": { "alternate": { "href": "https://www.zotero.org/angel_klanchar", "type": "text/html" } } }, "creatorSummary": "Sing et al.", "parsedDate": "2001-06", "numChildren": 0 }, "data": { "key": "NIM8964K", "version": 1, "itemType": "journalArticle", "title": "Problems and risks of unsolicited e-mails in patient-physician encounters in travel medicine settings", "creators": [ { "creatorType": "author", "firstName": "A", "lastName": "Sing" }, { "creatorType": "author", "firstName": "J", "lastName": "Salzman" }, { "creatorType": "author", "firstName": "D", "lastName": "Sing" } ], "abstractNote": "BACKGROUND\n\nInternational travel and use of modern information technology are expressions of modern life style. Seeking on-line travel health advice via E-mail for preventive (teleprevention) or diagnostic reasons may become increasingly popular among patients with financial resources and Internet access. This study was undertaken to compare the behavior of travel clinic or tropical medicine physicians and other providers of travel-related medical information services toward unsolicited E-mails from fictitious patients in pretravel and post-travel scenarios. We also wanted to test the potential of E-mail advice for preventive medicine (teleprevention), and to find out how the \"Good Samaritan Law\" is observed.\n\n\nMETHODS\n\nTwo different E-mails were posted to E-mail addresses of 171 physicians (members of travel health and/or tropical medicine societies) and services offering advice on travel health issues identified by an AltaVista search. These E-mails, from two different fictitious travelers, were asking for advice regarding malaria prophylaxis in a pretravel scenario and describing symptoms suggesting acute malaria.\n\n\nRESULTS\n\nOf the contacted addresses 43.3% and 49.7% respectively, replied to the pre- and post-travel E-mail. Of those suggesting antimalarial chemoprophylaxis in the pretravel scenario, 13.2% proposed inadequate regimens, and at least 3.5% of the post-travel replies were inappropriate. The \"Good Samaritan Law\" was observed by a significant number of physicians.\n\n\nCONCLUSION\n\nBoth patients and physicians have to be aware of the limitations of E-mail communication. Guidelines protecting physicians against legal and ethical consequences of this new communication technology are urgently needed.", "publicationTitle": "Journal of Travel Medicine", "publisher": "", "place": "", "date": "2001 May-Jun", "volume": "8", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "109-112", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J Travel Med", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/11468110", "accessDate": "2011-11-10T14:15:45Z", "PMID": "", "PMCID": "", "ISSN": "1195-1982", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 11468110", "tags": [ { "tag": "Computer Communication Networks", "type": 1 }, { "tag": "Ethics, Medical", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Internet", "type": 1 }, { "tag": "Malaria", "type": 1 }, { "tag": "Physician-Patient Relations", "type": 1 }, { "tag": "Practice Guidelines as Topic", "type": 1 }, { "tag": "Remote Consultation", "type": 1 }, { "tag": "Travel", "type": 1 } ], "collections": [ "BV83XSZN" ], "relations": {}, "dateAdded": "2011-11-10T14:15:45Z", "dateModified": "2011-11-10T14:15:45Z" } }, { "key": "RE32MM4J", "version": 1, "library": { "type": "group", "id": 58887, "name": "PhD 810 Ethics", "links": { "alternate": { "href": "https://www.zotero.org/groups/phd_810_ethics", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/58887/items/RE32MM4J", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/phd_810_ethics/items/RE32MM4J", "type": "text/html" } }, "meta": { "createdByUser": { "id": 405423, "username": "Angel_Klanchar", "name": "S. Angelina Klanchar", "links": { "alternate": { "href": "https://www.zotero.org/angel_klanchar", "type": "text/html" } } }, "creatorSummary": "Walker", "parsedDate": "2001", "numChildren": 0 }, "data": { "key": "RE32MM4J", "version": 1, "itemType": "journalArticle", "title": "To stop or not. Good Samaritan 2001", "creators": [ { "creatorType": "author", "firstName": "M", "lastName": "Walker" } ], "abstractNote": "", "publicationTitle": "Journal of Christian Nursing: A Quarterly Publication of Nurses Christian Fellowship", "publisher": "", "place": "", "date": "2001", "volume": "18", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "34-35", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J Christ Nurs", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/11915111", "accessDate": "2011-11-10T14:15:45Z", "PMID": "", "PMCID": "", "ISSN": "0743-2550", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 11915111", "tags": [ { "tag": "Accidents, Traffic", "type": 1 }, { "tag": "Attitude of Health Personnel", "type": 1 }, { "tag": "Christianity", "type": 1 }, { "tag": "First Aid", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Liability, Legal", "type": 1 }, { "tag": "Malpractice", "type": 1 }, { "tag": "Nurses", "type": 1 }, { "tag": "United States", "type": 1 } ], "collections": [ "BV83XSZN" ], "relations": {}, "dateAdded": "2011-11-10T14:15:45Z", "dateModified": "2011-11-10T14:15:45Z" } }, { "key": "97IMDTJ9", "version": 1, "library": { "type": "group", "id": 58887, "name": "PhD 810 Ethics", "links": { "alternate": { "href": "https://www.zotero.org/groups/phd_810_ethics", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/58887/items/97IMDTJ9", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/phd_810_ethics/items/97IMDTJ9", "type": "text/html" } }, "meta": { "createdByUser": { "id": 405423, "username": "Angel_Klanchar", "name": "S. 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