Podcasts about s0161

Drs. Sabin Dang, Avni Finn, and Yoshihiro Yonekawa join to discuss four recent publications in major ophthalmology journals.Gender Pay Gap (https://www.aaojournal.org/article/S0161-6420(21)00513-3/fulltext)Pneumatic Retinopexy (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2781202?utm_campaign=articlePDF&utm_medium=articlePDFlink&utm_source=articlePDF&utm_content=jamaophthalmol.2021.1860)Home Monitoring for Wet AMD (https://www.ophthalmologyscience.org/article/S2666-9145(21)00032-4/fulltext)Career Choices of Ophthalmology Trainees (https://www.ajo.com/article/S0002-9394(21)00333-0/fulltext)Relevant Financial Disclosures: Dr. Sridhar has consulted for Alcon, Allergan Dorc, Genentech, Regeneron, and Oxurion. Dr. Dang has consulted for Regeneron and has a paid research grant from Bausch and Lomb. Dr. Finn has consulted for Genentech and Allergan. Dr. Yonekawa has consulted for Alcon, Alimera, Allergan, and Genentech.You can now claim CME credits via the AAO website. Visit https://www.aao.org/browse-multimedia?filter=Audi

Cost-Analysis of Protocal AB (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2780414) Endophthalmitis after MIGS (https://www.aaojournal.org/article/S0161-6420(21)00414-0/fulltext) Gender of Award Recipients in Major Ophthalmology Societies (https://www.ajo.com/article/S0002-9394(21)00314-7/fulltext)

Drs. Avni Finn, Priya Vakharia, and M. Ali Khan join for a journal club discussion of three recent articles from major ophthalmology journals:Persistent Opioid Use After Ophthalmic Surgery (https://www.aaojournal.org/article/S0161-6420(21)00315-8/abstract)Racial Disparities in Clinical Trials (https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2778782)Telehealth During COVID-19 (https://www.ajo.com/article/S0002-9394(21)00213-0/fulltext)Relevant Financial Disclosures: Dr. Sridhar has consulted for Regeneron, Genentech, Alcon, Dorc, and Oxurion. Dr. Finn has consulted for Genentech and Allergan. Dr. Yonekawa has consulted for Alcon, Alimera, Allergan, and Genentech. Dr. Vakharia has consulted for Genentech.

Drs. Avni Finn, Safa Rahmani, and Yoshihiro Yonekawa join for a journal club reviewing four recent publications in major ophthalmology journals:Pneumatic Vitreolysis for VMT with or without Macular Hole (https://www.aaojournal.org/article/S0161-6420(21)00353-5/fulltext)Post-Hoc Analysis of Protocol AB (https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2779735)Retinal Detachment Reoperation (https://www.ajo.com/article/S0002-9394(21)00198-7/fulltext)PIVOT Study Post-Hoc OCT Analysis (https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2778783)Relevant Financial Disclosures: Dr. Sridhar has consulted for Regeneron, Genentech, Alcon, Dorc, and Oxurion. Dr. Finn has consulted for Genentech and Allergan. Dr. Yonekawa has consulted for Alcon, Alimera, Allergan, and Genentech. Dr. Rahmani has no relevant disclosures. You can now claim CME credits via the AAO website. Visit https://www.aao.org/browse-multimedia?filter=Audi

Protocol W (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2778074) Post-Hoc Analysis of CLARITY (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2777497?resultClick=1) Racial and Socioeconomic Differences in DME Treatment (https://www.aaojournal.org/article/S0161-6420(21)00196-2/abstract) Anti-VEGF for Wet AMD Prophylaxis (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2777577?resultClick=1)

COVID-19 Patient Perceptions (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2777498) Vitreoretinal Procedures During COVID-19 (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2777180) Ophthalmology Procedure Reimbursement (https://www.aaojournal.org/article/S0161-6420(21)00194-9/abstract) Financial Disclosures: Dr. Sridhar is a consultant for Alcon. There are no other relevant disclosures.

Drs. M. Ali Khan, Ajay Kuriyan, and Shriji Patel join to discuss three recent articles in major ophthalmology journals:Pediatric Hand Sanitizer Injuries (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2775155)Visual Acuity Mobile Apps for Telehealth (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2774801)Diversity of Ophthalmology Academic Departments (https://www.aaojournal.org/article/S0161-6420(21)00012-9/fulltext)

Metformin Association with Age-Related Macular Degeneration Risk (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2775160) Bariatric Surgery and Diabetic Retinopathy #1 (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2774807) Bariatric Surgery and Diabetic Retinopathy #2 (https://www.ajo.com/article/S0002-9394(21)00007-6/fulltext) Diabetic Retinopathy and Systemic Vascular Events (https://www.aaojournal.org/article/S0161-6420(20)31195-7/fulltext)

Drs. Shaina Rubino, Mrinali Patel Gupta, and Yoshihiro Yonekawa join to discuss four recent publications in major journals.Aflibercept versus Vitrectomy for Vitreous Hemorrhage (https://jamanetwork.com/journals/jama/article-abstract/2774049)Gender Pay Gap in Initial Ophthalmology Salaries (https://www.aaojournal.org/article/S0161-6420(20)31117-9/fulltext)Transparency in the Ophthalmology Residency Match (https://www.aaojournal.org/article/S0161-6420(20)31018-6/fulltext)Ethics of Academic Publishing (https://www.ajo.com/article/S0002-9394(20)30516-X/fulltext)Relevant financial Disclosures: Dr. Sridhar is a consultant for Regeneron. Dr. Yonekawa is a consultant for Alimera, Allergan, and Genentech. Dr. Gupta is a consultant for Allergan. You can now claim CME credits via the AAO website. Visit https://www.aao.org/browse-multimedia?filter=Audio&sub=ONE.ContentTypes.Audio.

Drs. Nicolas Farber, Priya Vakharia, and Yoshihiro Yonekawa join for a journal club examining four publications in major ophthalmology journals.Financial Disclosures: Dr. Sridhar is a consultant for Regeneron, Alcon, Dorc, and Oxurion. Dr. Yonekawa is a consultant for Alcon, Alimera, Allergan, and Genentech. Dr. Farber and Dr. Vakharia have no disclosures.Retinal Detachment Presentation During COVID-19 Pandemic (https://www.aaojournal.org/article/S0161-6420(20)31006-X/fulltext)Racial and Socioeconomic Disparities in Visual Impairment (https://www.aaojournal.org/article/S0161-6420(20)31044-7/fulltext)Hormone Therapy Association with Retinal Vascular Occlusion (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2772809)Ranibizumab Biosimilar Head-to-Head (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2772987)

Listen as chiropractor and founder of the Cox Technic, Dr. James Cox explains what Cox Technic is and why it is so effective for treating back pain. James M. Cox, DC, DACBR, FICC, Hon.D.Litt., FACO(H) Dr. Cox is the developer of Cox® Technic Flexion Distraction Manipulation and the proud participant in the on-going federal research projects involving the Keiser University, National University of Health Sciences, Palmer College of Chiropractic Research Center, Loyola Stritch School of Medicine, University of Illinois, University of Iowa, Auburn University, etc. He is a member of the postgraduate faculty of the National University of Health Sciences and has been privileged to speak throughout the world. Resources: About Dr. Cox curriculum vitae  More about Cox Technic Find a Back Doctor The Cox 8 Table by Haven Medical References: Chesterton P, Evans W, Wright M, Lolli L, Richardson M, Atkinson G. Influence of Lumbar Mobilizations During the Nordic Hamstring Exercise on Hamstring Measures of Knee Flexor Strength, Failure Point, and Muscle Activity: A Randomized Crossover Trial. J Manipulative Physiol Ther. 2020 Nov 25:S0161-4754(20)30201-3. doi: 10.1016/j.jmpt.2020.09.005. Epub ahead of print. PMID: 33248746. INFLUENCE OF LUMBAR MOBILIZATIONS DURING THE NORDIC HAMSTRING EXERCISE ON HAMSTRING MEASURES OF KNEE FLEXOR STRENGTH, FAILURE POINT, AND MUSCLE ACTIVITY: A RANDOMIZED CROSSOVER TRIAL. AFTER SPINAL MOBILIZATION, IMMEDIATE CHANGES IN BILATERAL HAMSTRING FORCE PRODUCTION AND PEAK TORQUE OCCURRED DURING THE NHE. THE EFFECT ON THE NHE FAILURE POINT WAS UNCLEAR. ELECTROMYOGRAPHIC ACTIVITY INCREASED ON THE IPSILATERAL SIDE. Meet the Nordic hamstring exercise, also known as the Nordic hamstring curl—your potential new favorite go-to that can help keep you healthy while boosting your performance.  me 19 Lead researcher Nicol van Dyk, Ph.D., of Aspetar Orthopaedic and Sports Medicine Hospital in Qatar, told Runner's World the move is simple: Begin in a kneeling position with both ankles secured—tucking your feet under a bar, for example, or having a running buddy hold them down—and then progressively lean forward as slowly as possible while keeping your back straight. When you can't resist anymore, just fall forward, catching yourself with your hands against the floor. Check out the video below for how to do it properly.   Ekşi MŞ, Özcan-Ekşi EE, Özmen BB, Turgut VU, Huet SE, Dinç T, Kara M, Özgen S, Özek MM, Pamir MN. Lumbar intervertebral disc degeneration, end-plates and paraspinal muscle changes in children and adolescents with low-back pain. J Pediatr Orthop B. 2020 Nov 27. doi: 10.1097/BPB.0000000000000833. Epub ahead of print. PMID: 33252539. FATTY INFILTRATION IN THE PARASPINAL MUSCLES AND IVDD WERE CLOSELY ASSOCIATED WITH MODIC CHANGES IN CHILDREN AND ADOLESCENTS WITH LBP. LUMBAR IVDD IN CHILDREN AND ADOLESCENTS COULD BE THE RESULT OF A MECHANICAL PATHOLOGY   Karartı C, Özüdoğru A, Basat HÇ, Özsoy İ, Özsoy G, Kodak Mİ, Sezgin H, Uçar İ. Determination of Biodex Balance System Cutoff Scores in Older People With Nonspecific Back Pain: A Cross-sectional Study. J Manipulative Physiol Ther. 2020 Nov 25:S0161-4754(20)30153-6. doi: 10.1016/j.jmpt.2020.07.006. Epub ahead of print. PMID: 33248744. DETERMINATION OF BIODEX BALANCE SYSTEM CUTOFF SCORES IN OLDER PEOPLE WITH NONSPECIFIC BACK PAIN: A CROSS-SECTIONAL STUDY BBS CUTOFF SCORES ARE SENSITIVE AND SPECIFIC IN DISTINGUISHING BETWEEN POOR AND GOOD POSTURAL PERFORMANCE IN OLDER PEOPLE WITH NSLBP.   TRACTION EFFECTS: TRACTION AND DISTRACTION STUDIES ON WHICH OUR WORK IS BASED. Luigi Albano, DC introduced the first paper on which I built the remaining studies. This gives us foundational understanding as to the benefits of placing a spine into distraction prior to producing ranges of motion – IT FIRST REDUCES STENOTIC EFFECTS THAT COULD CAUSE GREATER NERVE AND DRG COMPRESSION AND CHEMICAL INFLAMMATORY IRRITATION. - JMC   Gaowgzeh RAM, Chevidikunnan MF, BinMulayh EA, Khan F. Effect of spinal decompression therapy and core stabilization exercises in management of lumbar disc prolapse: A single blind randomized controlled trial. J Back Musculoskelet Rehabil. 2020;33(2):225-231. doi: 10.3233/BMR-171099. PMID: 31282394. A COMBINATION OF SPINAL DECOMPRESSION THERAPY WITH CORE STABILIZATION EXERCISE HAS PROVEN TO BE MORE SIGNIFICANT WHEN COMPARED WITH CSE ALONE TO REDUCE PAIN AND DISABILITY IN SUBJECTS WITH CHRONIC LDP.   Demirel A, Yorubulut M, Ergun N. Regression of lumbar disc herniation by physiotherapy. Does non-surgical spinal decompression therapy make a difference? Double-blind randomized controlled trial. J Back Musculoskelet Rehabil. 2017 Sep 22;30(5):1015-1022. doi: 10.3233/BMR-169581. PMID: 28505956. THIS STUDY SHOWED THAT PATIENTS WITH LHNP RECEIVED PHYSIOTHERAPY HAD IMPROVEMENT BASED ON CLINICAL AND RADIOLOGIC EVIDENCE. NON-INVASIVE SPINAL DECOMPRESSION THERAPY (NSDT) CAN BE USED AS ASSISTIVE AGENT FOR OTHER PHYSIOTHERAPY METHODS IN TREATMENT OF LUMBAR DISC HERNIATION.   Karimi N, Akbarov P, Rahnama L. Effects of segmental traction therapy on lumbar disc herniation in patients with acute low back pain measured by magnetic resonance imaging: A single arm clinical trial. J Back Musculoskelet Rehabil. 2017;30(2):247-253. doi: 10.3233/BMR-160741. PMID: 27636836. SEGMENTAL TRACTION THERAPY MIGHT PLAY AN IMPORTANT ROLE IN THE TREATMENT OF ACUTE LBP STIMULATED BY LDH.   Kamanli A1, Karaca-Acet G, Kaya A, Koc M, Yildirim H Conventional physical therapy with lumbar traction; clinical evaluation and magnetic resonance imaging for lumbar disc herniation. Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 2, pp. 247-253, 2017 CONVENTIONAL PHYSICAL THERAPIES WITH LUMBAR TRACTION WERE EFFECTIVE IN THE TREATMENT OF PATIENT WITH SUBACUTE LDH. THESE RESULTS SUGGEST THAT CLINICAL IMPROVEMENT IS NOT CORRELATED WITH THE FINDING OF MRI. PATIENTS WITH LDH SHOULD BE MONITORED CLINICALLY   Choi J, Lee S, Hwangbo G. Influences of spinal decompression therapy and general traction therapy on the pain, disability, and straight leg raising of patients with intervertebral disc herniation. J Phys Ther Sci. 2015 Feb;27(2):481-3. doi: 10.1589/jpts.27.481. Epub 2015 Feb 17. PMID: 25729196; PMCID: PMC4339166. SPINAL DECOMPRESSION THERAPY AND GENERAL TRACTION THERAPY ARE EFFECTIVE AT IMPROVING THE PAIN, DISABILITY, AND SLR OF PATIENTS WITH INTERVERTEBRAL DISC HERNIATION. THUS, SELECTIVE TREATMENT MAY BE REQUIRED   JUDOVICH BD. Herniated cervical disc; a new form of traction therapy. Am J Surg. 1952 Dec;84(6):646-56. doi: 10.1016/0002-9610(52)90127-x. PMID: 12986095. CLINICAL STUDIES INDICATE THAT IN THE AVERAGE INTRACTABLE CASE THE CERVICAL SPINE SHOULD BE STRETCHED BY FORCE RANGING FROM 25 TO 45 POUNDS. ALMOST HALF THE PATIENTS IN A SERIES OF SIXTY CASES EXPERIENCED PARTIAL OR COMPLETE MOMENTARY RELIEF WHEN THIS FORCE WAS APPLIED. ROENTGEN STUDIES REVEAL THAT IN THE AVERAGE PATIENT THE INTERVERTEBRAL SPACES OF THE CERVICAL SPINE BEGIN TO SHOW MEASURABLE WIDENING WITH TRACTION FORCE RANGING FROM 25 TO 50 POUNDS. THE NECESSARY FORCE TO RELIEVE PAIN CANNOT BE TOLERATED BY THE AVERAGE PATIENT WHEN IT IS ADMINISTERED AS A CONSTANT PULL. IF ADMINISTERED INTERMITTENTLY, ADEQUATE AND MUCH GREATER TRACTION LOAD CAN BE TOLERATED WITHOUT THE DISCOMFORT WHICH WOULD NORMALLY ACCOMPANY SUCH FORCE. A NEW METHOD OF MOTORIZED INTERMITTENT TRACTION IS PRESENTED. THE CLINICAL RESULTS OF INTERMITTENT TRACTION, BECAUSE OF ADEQUATE FORCE, HAVE BEEN EXCELLENT AS COMPARED TO CONVENTIONAL TRACTION METHODS.   Burton AK, Tillotson KM, Cleary J. Single-blind randomised controlled trial of chemonucleolysis and manipulation in the treatment of symptomatic lumbar disc herniation. Eur Spine J. 2000 Jun;9(3):202-7. doi: 10.1007/s005869900113. PMID: 10905437; PMCID: PMC3611397. BECAUSE OSTEOPATHIC MANIPULATION PRODUCED A 12-MONTH OUTCOME THAT WAS EQUIVALENT TO CHEMONUCLEOLYSIS, IT CAN BE CONSIDERED AS AN OPTION FOR THE TREATMENT OF SYMPTOMATIC LUMBAR DISC HERNIATION, AT LEAST IN THE ABSENCE OF CLEAR INDICATIONS FOR SURGERY. Further study into the value of manipulation at a more acute stage is warranted.   Kirkaldy-Willis WH, Cassidy JD. Spinal manipulation in the treatment of low-back pain. Can Fam Physician. 1985 Mar;31:535-40. PMID: 21274223; PMCID: PMC2327983. RESULTS OF SPINAL MANIPULATION IN 283 PATIENTS WITH LOW BACK PAIN ARE PRESENTED. THE PHYSICIAN WHO MAKES USE OF THIS RESOURCE WILL PROVIDE RELIEF FOR MANY PATIENTS.   Oliphant D. Safety of spinal manipulation in the treatment of lumbar disk herniations: a systematic review and risk assessment. J Manipulative Physiol Ther. 2004 Mar-Apr;27(3):197-210. doi: 10.1016/j.jmpt.2003.12.023. PMID: 15129202. THE APPARENT SAFETY OF SPINAL MANIPULATION, ESPECIALLY WHEN COMPARED WITH OTHER “MEDICALLY ACCEPTED” TREATMENTS FOR LDH, SHOULD STIMULATE ITS USE IN THE CONSERVATIVE TREATMENT PLAN OF LDH.   Kane MD, Karl RD, Swain JH. Effects of Gravity-Facilitated Traction on lntervertebral Dimensions of the Lumbar Spine*. J Orthop Sports Phys Ther. 1985;6(5):281-8. doi: 10.2519/jospt.1985.6.5.281. PMID: 18802302. MEAN POSTERIOR SEPARATION WAS SIGNIFICANT AT ALL LEVELS EXCEPT L1-L2 AND L5-S1. MEAN INTERVERTEBRAL FORAMINAL SEPARATION WAS SIGNIFICANT AT ALL LEVELS BUT L5-S1. IF INCREASES IN INTERVERTEBRAL DIMENSIONS PLAY A ROLE IN THE RELIEF OF LOW BACK SYNDROME, THEN GRAVITY-FACILITATED TRACTION MAY BE AN EFFECTIVE MODALITY IN THE TREATMENT OF THIS CONDITION.   Unlu Z, Tasci S, Tarhan S, Pabuscu Y, Islak S. Comparison of 3 physical therapy modalities for acute pain in lumbar disc herniation measured by clinical evaluation and magnetic resonance imaging. J Manipulative Physiol Ther. 2008 Mar;31(3):191-8. doi: 10.1016/j.jmpt.2008.02.001. PMID: 18394495. TRACTION, ULTRASOUND, AND LOW POWER LASER THERAPIES WERE ALL EFFECTIVE IN THE TREATMENT OF THIS GROUP OF PATIENTS WITH ACUTE LDH. THESE RESULTS SUGGEST THAT CONSERVATIVE MEASURES SUCH AS TRACTION, LASER, AND ULTRASOUND TREATMENTS MIGHT HAVE AN IMPORTANT ROLE IN THE TREATMENT OF ACUTE LDH   Chung TS, Yang HE, Ahn SJ, Park JH. Herniated Lumbar Disks: Real-time MR Imaging Evaluation during Continuous Traction. Radiology. 2015 Jun;275(3):755-62. doi: 10.1148/radiol.14141400. Epub 2015 Jan 22. Erratum in: Radiology. 2015 Jun;275(3):934-5. PMID: 25611735. HERNIATED LUMBAR DISKS: REAL-TIME MR IMAGING EVALUATION DURING CONTINUOUS TRACTION CONTINUOUS TRACTION ON HERNIATED LUMBAR DISKS AND SURROUNDING STRUCTURES RESULTED IN CHANGE IN DISK SHAPE, DISK REDUCTION WITH OPENING IN THE INTERVERTEBRAL DISK, REDUCTION OF HERNIATED DISK VOLUME, SEPARATION OF THE DISK AND ADJOINING NERVE ROOT, AND WIDENING OF THE FACET JOINT.   Isner-Horobeti ME, Dufour SP, Schaeffer M, Sauleau E, Vautravers P, Lecocq J, Dupeyron A. High-Force Versus Low-Force Lumbar Traction in Acute Lumbar Sciatica Due to Disc Herniation: A Preliminary Randomized Trial. J Manipulative Physiol Ther. 2016 Nov-Dec;39(9):645-654. doi: 10.1016/j.jmpt.2016.09.006. Epub 2016 Nov 9. PMID: 27838140. HIGH-FORCE VERSUS LOW-FORCE LUMBAR TRACTION IN ACUTE LUMBAR SCIATICA DUE TO DISC HERNIATION: A PRELIMINARY RANDOMIZED TRIAL PATIENTS WITH ACUTE LUMBAR SCIATICA SECONDARY TO DISC HERNIATION WHO RECEIVED 2 WEEKS OF LUMBAR TRACTION REPORTED REDUCED RADICULAR PAIN AND FUNCTIONAL IMPAIRMENT AND IMPROVED WELL-BEING REGARDLESS OF THE TRACTION FORCE GROUP TO WHICH THEY WERE ASSIGNED. THE EFFECTS OF THE TRACTION TREATMENT WERE INDEPENDENT OF THE INITIAL LEVEL OF MEDICATION AND APPEARED TO BE MAINTAINED AT THE 2-WEEK FOLLOW-UP. DURING THE 2-WEEK FOLLOW-UP AT DAY 28, ONLY THE LT10 GROUP IMPROVED (P < .05) IN VAS (–52%) AND EIFEL SCORES (–46%).   Onel D, Tuzlaci M, Sari H, Demir K. Computed tomographic investigation of the effect of traction on lumbar disc herniations. Spine (Phila Pa 1976). 1989 Jan;14(1):82-90. doi: 10.1097/00007632-198901000-00017. PMID: 2913674. COMPUTED TOMOGRAPHIC INVESTIGATION OF THE EFFECT OF TRACTION ON LUMBAR DISC HERNIATIONS. CHANGES OCCURRING UNDER THE EFFECT OF A TRACTION LOAD OF 45 KG HAVE BEEN EVALUATED IN 30 PATIENTS WITH LUMBAR DISC HERNIATION WITH CT INVESTIGATION. THE HERNIATED NUCLEAR MATERIAL (HNM) HAS RETRACTED IN 11 (78.5%) OF MEDIAN, SIX (66.6%) OF POSTEROLATERAL, AND FOUR (57.1%) OF LATERAL HERNIATIONS.   Clarke J, van Tulder M, Blomberg S, de Vet H, van der Heijden G, Bronfort G. Traction for low back pain with or without sciatica: an updated systematic review within the framework of the Cochrane collaboration. Spine (Phila Pa 1976). 2006 Jun 15;31(14):1591-9. doi: 10.1097/01.brs.0000222043.09835.72. PMID: 16778694. INTERMITTENT OR CONTINUOUS TRACTION AS A SINGLE TREATMENT FOR LBP CANNOT BE RECOMMENDED FOR MIXED GROUPS OF PATIENTS WITH LBP WITH AND WITHOUT SCIATICA. NEITHER CAN TRACTION BE RECOMMENDED FOR PATIENTS WITH SCIATICA BECAUSE OF INCONSISTENT RESULTS AND METHODOLOGICAL PROBLEMS IN MOST OF THE STUDIES INVOLVED. HOWEVER, BECAUSE HIGH-QUALITY STUDIES WITHIN THE FIELD ARE SCARCE, BECAUSE MANY ARE UNDERPOWERED, AND BECAUSE TRACTION OFTEN IS SUPPLIED IN COMBINATION WITH OTHER TREATMENT MODALITIES, THE LITERATURE ALLOWS NO FIRM NEGATIVE CONCLUSION THAT TRACTION, IN A GENERALIZED SENSE, IS NOT AN EFFECTIVE TREATMENT FOR PATIENTS WITH LBP   Beattie PF, Nelson RM, Michener LA, Cammarata J, Donley J. Outcomes after a prone lumbar traction protocol for patients with activity-limiting low back pain: a prospective case series study. Arch Phys Med Rehabil. 2008 Feb;89(2):269-74. doi: 10.1016/j.apmr.2007.06.778. PMID: 18226650. TRACTION APPLIED IN THE PRONE POSITION USING THE VAX-D FOR 8 WEEKS WAS ASSOCIATED WITH IMPROVEMENTS IN PAIN INTENSITY AND RMDQ SCORES AT DISCHARGE, AND AT 30 AND 180 DAYS AFTER DISCHARGE IN A SAMPLE OF PATIENTS WITH ACTIVITY-LIMITING LBP. CAUSAL RELATIONSHIPS BETWEEN THESE OUTCOMES AND THE INTERVENTION SHOULD NOT BE MADE UNTIL FURTHER STUDY IS PERFORMED USING RANDOMIZED COMPARISON GROUPS.   REAL-TIME MR IMAGING WHILE PERFORMING TRACTION IS POSSIBLE. Mitchell UH, Beattie PF, Bowden J, Larson R, Wang H. Age-related differences in the response of the L5-S1 intervertebral disc to spinal traction. Musculoskelet Sci Pract. 2017 Oct;31:1-8. doi: 10.1016/j.msksp.2017.06.004. Epub 2017 Jun 9. PMID: 28624722. TO DETERMINE DIFFERENCES IN THE APPARENT DIFFUSION COEFFICIENT (ADC) OBTAINED WITH LUMBAR DIFFUSION-WEIGHTED IMAGING (DWI) OF THE L5-S1 IVD BEFORE, AND DURING, THE APPLICATION OF LUMBAR TRACTION STATIC TRACTION WAS ASSOCIATED WITH AN INCREASE IN DIFFUSION OF WATER WITHIN THE L5-S1 IVDS OF MIDDLE-AGE INDIVIDUALS, BUT NOT IN YOUNG ADULTS, SUGGESTING AGE-RELATED DIFFERENCES IN THE DIFFUSION RESPONSE. FURTHER STUDY IS NEEDED TO ASSESS THE RELATIONSHIP BETWEEN THESE FINDINGS AND THE SYMPTOMS OF BACK PAIN. HIGHLIGHTS: STATIC TRACTION IS ASSOCIATED WITH AN INCREASE IN ADC IN OLDER DISCS, NOT YOUNGER. INVERSE RELATIONSHIP BETWEEN BASELINE ADC AND PERCENT INCREASE WITH TRACTION. FINDINGS SUGGEST PRESENCE OF AGE-RELATED CHANGES IN THE RATE OF DIFFUSION RESPONSE.   SAAL, JEFFREY A., MD; SAAL, JOEL S., MD Nonoperative Treatment of Herniated Lumbar Intervertebral Disc with Radiculopathy: An Outcome Study, Spine: April 1989 - Volume 14 - Issue 4 - p 431-437 64 PATIENTS WITH LUMBAR HERNIATED NUCLEUS PULPOSUS WITHOUT SIGNIFICANT STENOSIS WERE TREATED NON SURGICALLY. 90% GOOD OR EXCELLENT OUTCOME WITH A 92% RETURN TO WORK RATE. FOR THE SUBGROUPS WITH EXTRUDED DISCS AND SECOND OPINIONS, 87% AND 83% HAD GOOD OR EXCELLENT OUTCOMES, RESPECTIVELY, ALL (100%) OF WHOM RETURNED TO WORK. SICK LEAVE TIME FOR THESE SUBGROUPS WAS 2.9 MONTHS (+/- 1.4 MONTHS) AND 3.4 MONTHS (+/- 1.7 MONTHS), RESPECTIVELY. THESE RESULTS COMPARED FAVORABLY WITH PREVIOUSLY PUBLISHED SURGICAL STUDIES. FOUR OF SIX PATIENTS WHO REQUIRED SURGERY WERE FOUND TO HAVE STENOSIS AT OPERATION.   Sari H, Akarirmak U, Karacan I, Akman H. Computed tomographic evaluation of lumbar spinal structures during traction. Physiother Theory Pract. 2005 Jan-Mar;21(1):3-11. PMID: 16385939. DURING TRACTION OF INDIVIDUALS WITH ACUTE LDH THERE WAS A REDUCTION OF THE SIZE OF THE HERNIATION, INCREASED SPACE WITHIN THE SPINAL CANAL, WIDENING OF THE NEURAL FORAMINA, AND DECREASED THICKNESS OF THE PSOAS MUSCLE.   Park WM, Kim K, Kim YH. Biomechanical analysis of two-step traction therapy in the lumbar spine. Man Ther. 2014 Dec;19(6):527-33. doi: 10.1016/j.math.2014.05.004. Epub 2014 May 22. PMID: 24913413. A COMBINATION OF GLOBAL AXIAL TRACTION AND LOCAL DECOMPRESSION WOULD BE HELPFUL FOR REDUCING TENSILE STRESS ON THE FIBERS OF THE ANNULUS FIBROSUS AND LIGAMENTS, AND INTRADISCAL PRESSURE IN TRACTION THERAPY. THIS STUDY COULD BE USED TO DEVELOP A SAFER AND MORE EFFECTIVE TYPE OF TRACTION THERAPY   Chow DHK, Yuen EMK, Xiao L, Leung MCP. Mechanical effects of traction on lumbar intervertebral discs: A magnetic resonance imaging study. Musculoskelet Sci Pract. 2017 Jun;29:78-83. doi: 10.1016/j.msksp.2017.03.007. Epub 2017 Mar 20. PMID: 28347933. HORIZONTAL TRACTION WAS EVIDENTLY EFFECTIVE IN INCREASING THE DISC HEIGHT OF LOWER LUMBAR LEVELS, PARTICULARLY IN THE POSTERIOR REGIONS OF THE DISCS. FURTHER EVIDENCE OF THE EFFECTS OF TRACTION OF DIFFERENT MODES, MAGNITUDES, AND DURATIONS ON THE CHANGE IN DISC HEIGHT IS REQUIRED FOR PROPER CONTROL OF TRACTION APPLIED TO SPECIFIC DISC LEVELS. HIGHLIGHTS: MECHANICAL EFFECTS OF TRACTION ON LUMBAR DISCS WAS EVALUATED USING MRI. HORIZONTAL TRACTION USING 42% OF BODY WEIGHT WAS ASSOCIATED WITH AN INCREASED DISC HEIGHT OF LOWER LUMBAR DISCS. HORIZONTAL TRACTION ALSO RESULTED IN REDUCED LORDOSIS AND CHANGE IN TILT ANGLE. THE EFFECTS WERE MORE PROMINENT AT THE POSTERIOR DISCAL REGIONS.   Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514-530. doi: 10.7326/M16-2367. Epub 2017 Feb 14. PMID: 28192789. a  systematic  review  of  randomized, controlled  trials  and  systematic  reviews  published  through  April 2015  on  noninvasive  pharmacologic  and  nonpharmacologic treatments  for  low  back  pain.  Updated  searches  were  performed through  November  2016. Recommendation  1: Given  that  most  patients  with  acute  or subacute  low  back  pain  improve  over  time  regardless  of  treat-ment,  clinicians  and  patients  should  select  nonpharmacologic treatment  with  superficial  heat  (moderate-quality  evidence),  massage,  acupuncture,  or  spinal  manipulation  (low-quality  evidence). If  pharmacologic  treatment  is  desired,  clinicians  and  patients should  select  nonsteroidal  anti-inflammatory  drugs  or  skeletal muscle  relaxants  (moderate-quality  evidence).  (Grade:  strong recommendation) Recommendation  2: For  patients  with  chronic  low  back  pain, clinicians  and  patients  should  initially  select  nonpharmacologic treatment  with  exercise,  multidisciplinary  rehabilitation,  acupuncture,  mindfulness-based  stress  reduction  (moderate-quality  evidence),  tai  chi,  yoga,  motor  control  exercise,  progressive relaxation,  electromyography  biofeedback,  low-level  laser therapy,  operant  therapy,  cognitive  behavioral  therapy,  or  spinal manipulation  (low-quality  evidence).  (Grade:  strong recommendation) Recommendation  3: In  patients  with  chronic  low  back  pain  who have  had  an  inadequate  response  to  nonpharmacologic  therapy, clinicians  and  patients  should  consider  pharmacologic  treatment with  nonsteroidal  anti-inflammatory  drugs  as  first-line  therapy,  or tramadol  or  duloxetine  as  second-line  therapy.  Clinicians  should only  consider  opioids  as  an  option  in  patients  who  have  failed  the aforementioned  treatments  and  only  if  the  potential  benefits  out-weigh  the  risks  for  individual  patients  and  after  a  discussion  of known  risks  and  realistic  benefits  with  patients.  (Grade:  weak  recommendation,  moderate-quality  evidence) Low  back  pain  is  one  of  the  most  common  reasons for  physician  visits  in  the  United  States.  Most  Americans  have  experienced  low  back  pain,  and  approximately  one  quarter  of  U.S.  adults  reported  having  low back  pain  lasting  at  least  1  day  in  the  past  3  months  (1).Low  back  pain  is  associated  with  high  costs,  including those  related  to  health  care  and  indirect  costs  from missed  work  or  reduced  productivity  (2).  The  total  costs attributable  to  low  back  pain  in  the  United  States  were estimated  at  $100  billion  in  2006,  two  thirds  of  which were  indirect  costs  of  lost  wages  and  productivity  (3).Low  back  pain  is  frequently  classified  and  treated on  the  basis  of  symptom  duration,  potential  cause, presence  or  absence  of  radicular  symptoms,  and  corresponding  anatomical  or  radiographic  abnormalities. Acute  back  pain  is  defined  as  lasting  less  than  4  week   Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M, Fu R, Dana T, Kraegel P, Griffin J, Grusing S, Brodt ED. Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017 Apr 4;166(7):493-505. doi: 10.7326/M16-2459. Epub 2017 Feb 14. PMID: 28192793. Background: A  2007  American  College  of  Physicians  guideline addressed  nonpharmacologic  treatment  options  for  low  back pain. The  current  evidence  on  non-pharmacologic  therapies  for  acute  or  chronic  nonradicular  or  ra-dicular  low  back  pain from  MEDLINE  (January  2008  through  February 2016),  Cochrane  Central  Register  of  Controlled  Trials,  CochraneDatabase  of  Systematic  Reviews,  and  reference  lists. Evidence  continues  to  support  the  effectiveness  of  exercise,  psychological  therapies,  multidisciplinary  rehabilitation,  spinal  manipulation,  massage,  and  acupuncture  for  chronic  low  back  pain. Funding  Source:Agency  for  Healthcare  Research  and Quality.  (PROSPERO:  CRD42014014735)Ann  Intern  Med.2017;166:xxx-xxx.  doi:10.7326/M16-2459Annals.org the  American  College  of  Physicians  (ACP)and  American  Pain  Society  (APS)  recommended  spinal manipulation  as  a  treatment  option  for  acute  low  back pain  and  several  nonpharmacologic  therapies  for  sub-acute  or  chronic  low  back  pain.    Stochkendahl MJ, Kjaer P, Hartvigsen J, Kongsted A, Aaboe J, Andersen M, Andersen MØ, Fournier G, Højgaard B, Jensen MB, Jensen LD, Karbo T, Kirkeskov L, Melbye M, Morsel-Carlsen L, Nordsteen J, Palsson TS, Rasti Z, Silbye PF, Steiness MZ, Tarp S, Vaagholt M. National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy. Eur Spine J. 2018 Jan;27(1):60-75. doi: 10.1007/s00586-017-5099-2. Epub 2017 Apr 20. PMID: 28429142. Purpose: To summarise recommendations about 20 non-surgical interventions for recent onset ( If treatment is needed, the guidelines suggest using patient education, different types of supervised exercise, and manual therapy. The guidelines recommend against acupuncture, routine use of imaging, targeted treatment, extraforaminal glucocorticoid injection, paracetamol, NSAIDs, and opioids.   Krekoukias G1, Gelalis ID1,2, Xenakis T1, Gioftsos G3, Dimitriadis Z4, Sakellari V3. Spinal mobilization vs conventional physiotherapy in the management of chronic low back pain due to spinal disk degeneration: a randomized controlled trial. J Man Manip Ther. 2017 May;25(2):66-73. doi: 10.1080/10669817.2016.1184435. Epub 2016 Jun 23. MANUAL THERAPY SPINAL MOBILIZATION IS PREFERABLE TO CONVENTIONAL PHYSIOTHERAPY IN ORDER TO REDUCE THE PAIN INTENSITY AND DISABILITY IN SUBJECTS WITH CHRONIC LBP AND ASSOCIATED DISK DEGENERATION. THE FINDINGS OF THIS STUDY MAY LEAD TO THE ESTABLISHMENT OF SPINAL MOBILIZATION AS ONE OF THE MOST PREFERABLE APPROACHES FOR THE MANAGEMENT OF LBP DUE TO DISK DEGENERATION.   REFERENCES FOR 25% RELIEF PAPER BY WIRTH ET AL Wirth B1, Riner F1, Peterson C1, Humphreys BK1, Farshad M2, Becker S3, Schweinhardt P1. An observational study on trajectories and outcomes of chronic low back pain patients referred from a spine surgery division for chiropractic treatment. Chiropr Man Therap. 2019 Feb 5;27:6. doi: 10.1186/s12998-018-0225-8. eCollection 2019. Refs on minimal clinical improvement determination: Farrar JT, Young JP, Jr, LaMoreaux L, Werth JL, Poole RM. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001;94:149–158. doi: 10.1016/S0304-3959(01)00349-9. [PubMed] [CrossRef] Kovacs FM, Abraira V, Royuela A, Corcoll J, Alegre L, Cano A, et al. Minimal clinically important change for pain intensity and disability in patients with nonspecific low back pain. Spine (Phila Pa 1976) 2007;32:2915–2920. doi: 10.1097/BRS.0b013e31815b75ae. [PubMed] [CrossRef] Salaffi F, Stancati A, Silvestri CA, Ciapetti A, Grassi W. Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale. Eur J Pain. 2004;8:283–291. doi: 10.1016/j.ejpain.2003.09.004. [PubMed] [CrossRef] Robinson-Papp J, George MC, Dorfman D, Simpson DM. Barriers to chronic pain measurement: a qualitative study of patient perspectives.Pain Med. 2015;16:1256–1264. doi: 10.1111/pme.12717. [PMC free article] [PubMed] [CrossRef] Ostelo RW, Deyo RA, Stratford P, Waddell G, Croft P, Von Korff M, et al. Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine (Phila Pa 1976) 2008;33:90–94. doi: 10.1097/BRS.0b013e31815e3a10. [PubMed] [CrossRef]   Chung TS1, Yang HE, Ahn SJ, Park JH. Herniated Lumbar Disks: Real-time MR Imaging Evaluation during Continuous Traction. Radiology 2015 Jan 22:141400. CONTINUOUS TRACTION ON HERNIATED LUMBAR DISKS AND SURROUNDING STRUCTURES RESULTED IN CHANGE IN DISK SHAPE, DISK REDUCTION WITH OPENING IN THE INTERVERTEBRAL DISK, REDUCTION OF HERNIATED DISK VOLUME, SEPARATION OF THE DISK AND ADJOINING NERVE ROOT, AND WIDENING OF THE FACET JOINT.    Wong A, Parent E, Dhillon S, Prasad N, Kawchuk G: Do Participants With Low Back Pain Who Respond to Spinal Manipulative Therapy Differ Biomechanically From Nonresponders, Untreated Controls or Asymptomatic Controls? Spine: 01 September 2015 - Volume 40 - Issue 17 - p 1329–1337  doi: 10.1097/BRS.0000000000000981 PARTICIPANTS WITH LBP AND ASYMPTOMATIC CONTROLS ATTENDED 3 SESSIONS FOR 7 DAYS. ON SESSIONS 1 AND 2, PARTICIPANTS WITH LBP RECEIVED SMT (+LBP/+SMT, N = 32) WHEREAS ASYMPTOMATIC CONTROLS DID NOT (−LBP/−SMT, N = 57). IN THESE SESSIONS, SPINAL STIFFNESS AND MULTIFIDUS THICKNESS RATIOS WERE OBTAINED BEFORE AND AFTER SMT AND ON DAY 7. RESULTS. AFTER THE FIRST SMT, SMT RESPONDERS DISPLAYED STATISTICALLY SIGNIFICANT DECREASES IN SPINAL STIFFNESS AND INCREASES IN MULTIFIDUS THICKNESS RATIO SUSTAINED FOR MORE THAN 7 DAYS; THESE FINDINGS WERE NOT OBSERVED IN OTHER GROUPS. SIMILARLY, ONLY SMT RESPONDERS DISPLAYED SIGNIFICANT POST-SMT IMPROVEMENT IN APPARENT DIFFUSION COEFFICIENTS.     Wong AYL1,2, Parent EC3, Dhillon SS4, Prasad N5, Samartzis D6, Kawchuk GN3. Differential patient responses to spinal manipulative therapy and their relation to spinal degeneration and post-treatment changes in disc diffusion. Eur  Spine J. 2019 Jan 2. doi: 10.1007/s00586-018-5851-2. NON-SPECIFIC LOW BACK PAIN PATIENTS WHO RESPOND WITH >30% RELIEF SHOW HIGHER APPARENT DIFFUSION COEFFICIENT DISC DIFFUSION OF WATER THAN NON POSITIVE RESPONDERS. MRI WAS PERFORMED BEFORE AND AFTER SMT ON DAY 1 OF CARE. OSWESTRY DISABILITY TEST WAS ALSO USED.     Beattie PF, Butts R, Donley JW, Liuzzo DM. The Within-Session Change in Low Back Pain Intensity Following Spinal Manipulative Therapy is Related to Differences in Diffusion of Water in the Intervertebral Discs of the Upper Lumbar Spine and L5-S1. Orthop Sports Phys Ther. 2013 Nov 21. Doctoral Program in Physical Therapy, Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC. STUDY TO DETERMINE DIFFERENCES IN THE CHANGES IN DIFFUSION OF WATER WITHIN THE LUMBAR INTERVERTEBRAL DISCS BETWEEN THOSE SUBJECTS WITH LOW BACK PAIN (LBP) WHO DID, AND DID NOT, REPORT A WITHIN-SESSION REDUCTION IN PAIN INTENSITY FOLLOWING A SINGLE TREATMENT OF SPINAL MANIPULATIVE THERAPY (SMT) WAS DONE. CHANGES IN THE DIFFUSION OF WATER WITHIN THE LUMBAR INTERVERTEBRAL DISCS AT THE L1-2, L2-3, AND L5-1 LEVELS APPEAR TO BE RELATED TO DIFFERENCES IN WITHIN-SESSION PAIN REPORTS FOLLOWING A SINGLE TREATMENT OF SPINAL MANIPULATIVE THERAPY. PARTICIPANTS UNDERWENT T2- AND DIFFUSION-WEIGHTED LUMBAR MAGNETIC RESONANCE IMAGING SCANS IMMEDIATELY BEFORE, AND AFTER, RECEIVING A SINGLE TREATMENT OF SMTJ     Kuo, Ya-Wen PhD; Hsu, Yu-Chun MS; Chuang, I-Ting MS; Chao, Pen-Hsiu Grace PhD; Wang, Jaw-Lin PhD Spinal Traction Promotes Molecular Transportation in a Simulated Degenerative Intervertebral Disc Model. Spine: April 20th, 2014 - Volume 39 - Issue 9 - p E550 Traction biomechanics studied in the porcine model biomechanical benefits include disc height recovery, foramen enlargement, and intradiscal pressure reduction. 48 thoracic discs were dissected from 8 porcine spines and then divided into 3 groups: intact, degraded without traction, and degraded with traction. From Day 4 to Day 6, half of the degraded discs received a 30 min traction treatment per day (traction force: 20 kg, loading: unloading = 30 sec: 10 sec). Traction treatment is effective in enhancing nutrition supply and promoting disc cell proliferation of the degraded discs.  

Episode 268: Discussion of Gender Equity in the Ophthalmology Literature and Meeting Podium with Drs. Mrinali Gupta and Rohit LakhanpalDrs. Mrinali Gupta and Rohit Lakhanpal join the program to discuss three recent publications in major ophthalmology journals regarding trends in female representation in the ophthalmology literature and in ophthalmology academic meetings.Gender Trends in Ophthalmology Literature (https://www.aaojournal.org/article/S0161-6420(20)30850-2/fulltext)Representation of Women at Retina Meetings (https://www.ajo.com/article/S0002-9394(20)30491-8/fulltext)Gender Trends among Academic Cornea Specialists (https://www.ajo.com/article/S0002-9394(20)30504-3/fulltext)Financial Disclosures: None of the contributors have any relevant financial disclosures.

COVID-19 in Tears (https://www.aaojournal.org/article/S0161-6420(20)30847-2/fulltext) Association of Daily Eyewear with COVID-19 Risk (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2770872) Simulated Respiratory Droplet Spread with Slit Lamp Examination (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2769739)

Practice Patterns During COVID-19 (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2769193) Systemic Adverse Events with Anti-VEGF Therapy (https://www.aaojournal.org/article/S0161-6420(20)30782-X/fulltext) Predatory Publishing in Ophthalmology (https://www.ajo.com/article/S0002-9394(20)30433-5/fulltext) Caring for VIPs in Ophthalmology (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2769561)

Face-down positioning for macular holes randomized clinical trial (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2765648) Editorial on face-down positioning for macular holes (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2765646) Pseudophakic Retinal Detachments (https://www.aaojournal.org/article/S0161-6420(20)30428-0/fulltext) COVID-19 in NYC (https://www.aaojournal.org/article/S0161-6420(20)30430-9/fulltext) Mentoring Millenials (https://jamanetwork.com/journals/jama/fullarticle/2765430)

Effect of Positioning after RD Repair (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2764385) Abicipar Pegol Phase 3 Results (https://www.aaojournal.org/article/S0161-6420(20)30320-1/fulltext) Protocol T Extension Study (https://www.aaojournal.org/article/S0161-6420(20)30304-3/fulltext) P Value Discussion (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2763868)

In this episode, Dr. Cox continues his discussion on the influence of the vagus nerve in health and healing. He also shares a paper on mechanobiology, that is, how the cells of the body are constantly remodeling and adapting to their ever-changing mechanical environment. He concludes with a paper that goes beyond the 5 senses of sight, hearing, touch, smell, and taste to the newly described seventh sense. James M. Cox, DC, DACBR, FICC, Hon.D.Litt., FACO(H) Dr. Cox is the developer of Cox® Technic Flexion Distraction Manipulation and the proud participant in the on-going federal research projects involving the Keiser University, National University of Health Sciences, Palmer College of Chiropractic Research Center, Loyola Stritch School of Medicine, University of Illinois, University of Iowa, Auburn University, etc. He is a member of the postgraduate faculty of the National University of Health Sciences and has been privileged to speak throughout the world. Resources: About Dr. Cox curriculum vitae  More about Cox Technic Find a Back Doctor The Cox 8 Table by Haven Medical References: HHS Public Access Author manuscript Brain Behav Immun . Author manuscript; available in PMC 2019 January 04. Published in final edited form as: Brain Behav Immun . 2018 October ; 73: 441–449. doi:10.1016/j.bbi.2018.06.005. Joanna L. Ng, Mariana E. Kersh, Sharon Kilbreath and  M. Knothe Tate. Establishing the Basis for Mechanobiology-Based Physical Therapy Protocols to Potentiate Cellular Healing and Tissue Regeneration. Front.physiol.,06 June 2017 https://doi.org/10.3389/fphys.2017.00303 Kevin P. Cheng,  Sarah K. Brodnick, Stephan L. Blanz, Weifeng Zeng, Jack Kegel, Jane A. Pisaniello, Jared P. Ness, Erika Ross,  View ORCID ProfileEvan N. Nicolai, Megan L. Settell,  Is Vagus Nerve Stimulation Brain Washing? doi: https://doi.org/10.1101/733410 Cuoco J, Fnnie C, Cheriyan G: Hypothetical Link Between Osteopathic Suboccipital Decompression and Neuroimmunomodulation. J Neurol Neurosci. 2016, 7: S3. Christopher Bergland. Vagus Nerve Stimulation Dramatically Reduces Inflammation: Stimulating the vagus nerve reduces inflammation and the symptoms of arthritis. PSYCHOLOGY TODAY, posted July 6, 2016 Stanley Rosenberg: Accessing The Healing Power Of The Vagus Nerve. North Atlantic Books, Berkeley, CA Berrueta L, Muskaj I, Olenich S, Butler T, Badger GJ, Colas RA, Spite M, Serhan CN, Langevin HM. Stretching Impacts Inflammation Resolution in Connective Tissue. J Cell Physiol. 2015 Nov 20. doi: 10.1002/jcp.25263. [Epub ahead of print] Teodorczyk-Injeyan JA1, Triano JJ1, Injeyan HS2. Non-specific Low Back Pain: Inflammatory Profiles of Patients with Acute and Chronic Pain. Clin J Pain. 2019 Jul 5. doi: 10.1097/AJP.0000000000000745. [Epub ahead of print] Song XJ, Huang ZJ, Song WB, Song XS, Fuhr AF, Rosner AL, Ndtan H, Rupert RL. Attenuation Effect of Spinal Manipulation on Neuropathic and Postoperative Pain Through Activating Endogenous Anti-Inflammatory Cytokine Interleukin 10 in Rat Spinal Cord. J Manipulative Physiol Ther. 2016 Jan 30. pii: S0161-4754(15)00211-0. doi: 10.1016/j.jmpt.2015.12.004. Compiled by James M. Cox, DC, DACBR

Drs. Ajay Kuriyan and Yoshihiro Yonekawa join the podcast for a journal club episode first to discuss COVID-19 practice measures then four recent articles in major ophthalmology journals:Tribute to Dr. Li Wenliang (https://www.ajo.com/article/S0002-9394(20)30067-2/fulltext)PRO phakic RD study (https://www.aaojournal.org/article/S0161-6420(20)30237-2/fulltext)Ophthalmology resident surgical competence (https://www.aaojournal.org/article/S0161-6420(20)30179-2/fulltext)Applicant perceptions of ophthalmology residency match (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2762567)Relevant Disclosures: Drs. Yonekawa and Sridhar are consultants for Alcon. Dr. Kuriyan is a consultant for Bausch and Lomb.

Jimmy and Roya meet with guest Greg Hines, to discuss age-related macular degeneration.SOURCES:Corona Virus Statement: HPI CoronaVirus Statement 1-30-20.pdfProgression of Geographic Atrophy in ARMD: https://www.aaojournal.org/article/S0161-6420(18)30875-3/abstractNo CFH or ARMS2 Interaction with Omega-3 Fatty Acids, Low versus High Zinc, or β-Carotene versus Lutein and Zeaxanthin on Progression of Age-Related Macular Degeneration in the Age-Related Eye Disease Study 2https://www.aaojournal.org/article/S0161-6420(18)32155-9/fulltextCFH and ARMS2 genetic risk determines progression to neovascular age-related macular degeneration after antioxidant and zinc supplementation. https://www.ncbi.nlm.nih.gov/pubmed/29311295Response to AREDS supplements according to genetic factors: survival analysis approach using the eye as the unit of analysis. https://www.ncbi.nlm.nih.gov/pubmed/27471039Treatment response to antioxidants and zinc based on CFH and ARMS2 genetic risk allele number in the Age-Related Eye Disease Study. https://www.ncbi.nlm.nih.gov/pubmed/25200399ArticDx: https://arcticdx.com/

NBA Eye Injuries (https://www.aaojournal.org/article/S0161-6420(19)32368-1/fulltext) Private Equity Acquisitions (https://www.aaojournal.org/article/S0161-6420(20)30012-9/fulltext) Ocular Anesthesia Claims (https://www.aaojournal.org/article/S0161-6420(19)32371-1/fulltext) Gender Trends in Collections (https://www.ajo.com/article/S0002-9394(20)30004-0/fulltext)

Drs. Priya Sharma and Shriji Patel join for a journal club to discuss four recent ophthalmology publications: Cost Benefits of anti-VEGF injections for AMD: https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2755409 DME treatment trends IRIS study: https://www.aaojournal.org/article/S0161-6420(19)32176-1/fulltext Pentosan polysulfate maculopathy database study: https://www.aaojournal.org/article/S0161-6420(19)32211-0/fulltext PVDs and retinal breaks: https://www.aaojournal.org/article/S0161-6420(19)32177-3/fulltext Want to be on the podcast? Now is your chance! Vit-Buckle Society is looking for videos to be presented on the podium during the Complications session of the Annual Meeting in Miami March 26-28 2020. Videos can be identifying or anonymous but should include text descriptions and be 1-4 minutes in length. The top five entries will be invited to come on the podcast for a one-on-one interview discussing the case. Submit entries now to paulapecen@gmail.com or mklufas@gmail.com Financial Disclosures: Dr. Sridhar is a consultant for Alcon, Alimera, and Oxurion. Drs. Sharma and Patel have no financial disclosures. You can now claim CME credits via the AAO website. Visit https://www.aao.org/browse-multimedia?filter=Audio&sub=ONE.ContentTypes.Audio.

Drs. M. Ali Khan, Priya Sharma, and Yoshihiro Yonekawa join the program for a traditional journal club episode. Articles covered are listed below: Online Physician Reviews (https://www.aaojournal.org/article/S0161-6420(19)32150-5/fulltext) Systematic Review Reliability (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2752550) SCORE2 24 month Data (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2752549) Ranibizumab versus Aflibercept (https://www.aaojournal.org/article/S0161-6420(19)32137-2/fulltext) Dr. Sridhar has received consulting fees from Alimera, Alcon, and Oxurion. Dr. Khan has received consulting fees from Allergan. Dr. Sharma has no financial disclosures. Dr. Yonekawa receives consulting fees from Alcon. You can now claim CME credits via the AAO website. Visit https://www.aao.org/browse-multimedia?filter=Audio&sub=ONE.ContentTypes.Audio.

Drs. Shriji Patel and Priya Sharma Vakharia join for a journal club about four recent publications in major ophthalmology journals. Article links below: Gender Differences in Resident Case Volume (https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2738409) Preoperative Disclosure of Resident Involvement (https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2739234) Cost-effectiveness of Gene Therapy (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2738410) Surgical Errors (https://www.aaojournal.org/article/S0161-6420(19)30859-0/fulltext) Dr. Patel and Dr. Vakharia have no financial disclosures. Dr. Sridhar has received consulting fees from Alcon, Alimera, and Thrombogenics. You can now claim CME credits via the AAO website. Visit https://www.aao.org/browse-multimedia?filter=Audio&sub=ONE.ContentTypes.Audio.

Jimmy and Roya talk about some common pitfalls and best practices when placing prescriptions.SOURCES https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2738409https://bjo.bmj.com/content/early/2019/07/23/bjophthalmol-2019-314567 https://www.pharmacytimes.com/contributor/brady-cole-bs-pharmacy/2017/04/5-things-you-should-not-say-at-the-pharmacyhttps://bjo.bmj.com/content/early/2019/07/03/bjophthalmol-2019-314256Bjophthalmol-2018-312603https://www.ajo.com/article/S0002-9394(19)30099-6/fulltexthttps://www.aaojournal.org/article/S0161-6420(18)33328-1/fulltext

Dr. Ferhina Ali and Dr. M. Ali Khan join for a journal club discussion of three recent publications in major ophthalmology journals. Articles discussed: Preoperative anti-VEGF for diabetic vitrectomy (https://www.ajo.com/article/S0002-9394(19)30231-4/fulltext) Retinal detachment after intravitreal injection (https://www.aaojournal.org/article/S0161-6420(18)33327-X/fulltext) CATT Trial Effect on Anti-VEGF Usage (https://www.ajo.com/article/S0002-9394(19)30231-4/fulltext) Dr. Sridhar has received fees for consulting for Alimera, Alcon, and Thrombogenics. Dr. Ali is a Genentech employee and stock holder and has consulted for Voyant biotherapeutics and Forsight. Dr. Khan has received fees for consulting from Allergan. Some podcast episodes now qualify for CME credits. To claim your credits visit https://www.aao.org/browse-multimedia?filter=Audio&sub=ONE.ContentTypes.Audio.

Dr. Ajay Kuriyan from University of Rochester and Dr. Shriji Patel from Vanderbilt University the show for a journal club focusing on 3 recent publications in major ophthalmology journals, including a prospective study examining ranibizumab and aflibercept for wet macular degeneration, a sub analysis examining factors associated with better anatomic and visual improvements in Protocol T, and paper detailing the natural history of central serous retinopathy. IVR versus IVA for wet AMD (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2722672) Protocol T subanalysis (https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2722673) CSR natural history (https://www.aaojournal.org/article/S0161-6420(17)32067-5/fulltext) Financial Disclosures: Dr. Kuriyan is a consultant for Regeneron, Allergan, Alimera, and Valeant and receives grant funding from Second Sight. Dr. Patel has no disclosures. Dr. Sridhar is a consultant for Allergan, Alimera Science, and Alcon Laboratories.

Are chiropractors real doctors? Do they only crack necks and backs? Anthony and Stephanie dispel common myths about chiropractors and what they do. Are Chiropractors Real Doctors? Did you know that a Doctor of Chiropractic takes approximately the same course load as a Doctor of Medicine? Doctors of Chiropractic take 4200 - 4700 hours of postgraduate coursework and they have a a very similar postgraduate educational background as a medical doctor. Chiropractors are officially governed and licensed by their state licensure board to practice their trade. Where chiropractic ideologies differ from medical doctors often comes with their views on how to treat their patients. Most medical doctors apply a pharmacological treatment model, while chiropractors employ treatments to the musculoskeletal system. Do Chiropractors Only Crack Necks and Backs? Chiropractors often have a very large scope of work. While chiropractors are best known for spinal adjustments, they tend to look at the patient more holistically for treatment solutions. Chiropractors focus on understanding the root cause of the problem before treatment. Your chiropractor may utilize lifestyle modifications, nutrition plans, soft tissue techniques and, and of course, spinal adjustments. A chiropractor's ability to keep the body functioning at a high level makes them a strong asset to any professional sports team. Is Chiropractic Care Effective? Chiropractic care is most effective at dealing with chronic pain. Pharmaceutical drugs often mask the symptoms and issues you are dealing with. Chiropractors are specifically trained to investigate the source of the pain so that the problem can actually be solved. After relieving the pain, they can prescribe physical therapy for you to strengthen the surrounding muscles to avoid the issue returning in the future. Since chiropractic care is often more cost-effective than going to a medical doctor, it can be a worthwhile pursuit if you are suffering from pain. References 1. More than 80% of the population will experience an episode of low back pain at some time during their lives. 2. Dr. Bill Moreau, DC, DACBSP, CSCS, FACSM, currently serves as the Vice President of Sports Medicine, United States Olympic Committee. 3. The use and role of sport chiropractors in the National Football League.   Visit our website: https://www.chirolab.org/

Jay is joined in our final episode of 2018 for journal club by Drs. Daniel Chao and Ajay Kuriyan to discuss 3 recent publications: first the PIVOT trial comparing primary vitrectomy and pneumatic retinopexy, then the FLUID study looking at the effect of residual SRF in wet AMD, and finally a study out of Stanford University looking at timing of macula-off retinal detachment repair. Articles: PIVOT Trial (https://www.aaojournal.org/article/S0161-6420(18)32275-9/fulltext) FLUID Study (https://www.aaojournal.org/article/S0161-6420(18)32316-9/fulltext) Timing of Macula-Off RD Repair (https://bjo.bmj.com/content/early/2018/12/01/bjophthalmol-2018-313191.long)

Drs. Daniel Chao and Will Parke join for a journal club discussing 3 recent published peer-reviewed articles: 27-gauge trochar IOL fixation (hyperlink:https://journals.lww.com/retinajournal/Abstract/publishahead/27_GAUGE_SUTURELESS_INTRASCLERAL_FIXATION_OF.96416.aspx) Bilateral intravitreal injections and endophthalmitis (hyperlink:https://www.ajo.com/article/S0002-9394(18)30326-X/fulltext) Protocol S predictors (hyperlink: https://www.aaojournal.org/article/S0161-6420(18)30577-3/fulltext)

Follow-up in Proliferative Diabetic Retinopathy (hyperlink: http://www.aaojournal.org/article/S0161-6420(17)33569-8/fulltext ) ILM Peeling in Grade B PVR RRD (hyperlink: http://www.ajo.com/article/S0002-9394(18)30152-1/fulltext) Wide-field OCT Imaging of PVD (hyperlink: https://www.aaojournal.org/article/S0161-6420(17)33234-7/fulltext?code=ophtha-site )

Dr. Jonathan Chang of the University of Wisconsin-Madison and Dr. Ali Khan of the Doheny Eye Institute join the show to discuss three recent articles, the first concerning aqueous biomarkers associated with diabetic macular edema treated with intravitreal ranibizumab, the second regarding systemic VEGF levels after different anti-VEGF intravitreal medications, and the third regarding macular rotation after macular hole surgery. Articles in order: https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2674061 http://www.aaojournal.org/article/S0161-6420(17)32232-7/fulltext http://www.ajo.com/article/S0002-9394(18)30096-5/fulltext

Drs. Jonathan Chang of the University of Wisconsin-Madison and Ajay Kuriyan of the University of Rochester stop by to discuss two recent publications in Ophthalmology. The first (http://www.aaojournal.org/article/S0161-6420(17)30138-0/fulltext) reports results of the WAVE trial assessing the efficacy of panretinal laser photocoagulation in reducing intravitreal injection burden of macular edema associated with retinal vein occlusion. The second (http://www.aaojournal.org/article/S0161-6420(16)31774-2/fulltext) describes outcomes of the utilization of a new deep learning algorithm to detect diabetic retinopathy.

Drs. Daniel Chao of University of California-San Diego, M. Ali Khan of University of California-Los Angeles, Ajay Kuriyan of University of Rochester, and Yasha Modi of New York University join the show for a group journal club discussion of two recent publications in Ophthalmology. The first publication reports the results of a randomized prospective clinical trial assessing the efficacy of intravitreal dexamethasone in improving outcomes in eyes with retinal detachment and advanced proliferative vitreoretinopathy (found here, https://www.ncbi.nlm.nih.gov/pubmed/28237428). The second publication reports the efficacy of ranibizumab and pan retinal laser photocoagulation in reducing progression of proliferative diabetic retinopathy (found here, http://www.aaojournal.org/article/S0161-6420(16)31179-4/abstract).

Dr. Ravi Parikh joins the show to discuss his publication in Ophthalmology concerning utilization trends of intravitreal injections in the U.S., published here (http://www.aaojournal.org/article/S0161-6420(16)31834-6/abstract). Then Jay does a brief State of the Podcast regarding where the podcast stands after 30 episodes.