DANGERS OF WEIGHT-LOSS SURGERY GROWING AND RAISING CONCERNS OF NUMEROUS HEALTH EXPERTS

Linda Culpepper was admitted to Vanderbilt University Medical Center, hair falling out, skin flaking, and barely able to walk. She had frequent bouts of diarrhea and couldn’t eat without vomiting. She was admitted to the hospital with life-threatening malnutrition; complications that resulted from a recent weightloss operation at another hospital. 

In 1995, some 20,000 weight loss operations were performed in the U.S. In 2003, that number increased to 103,000 and 144,000 weight loss surgeries are expected to be performed in 2004.

Bariatric surgery, or gastric bypass, is a weight-loss surgery that closes most of the stomach and shortens the small intestine. Patients often lose 100 pounds following this surgery. 

Despite the popularity, some medical experts are expressing their concerns, warning patients about inexperienced surgeons and inadequate screening procedures that may result in problems later on.

According to Gordon Jensen, director of the Vanderbilt Center for Human Nutrition in Nashville, TN, there has been a “tremendous surge” in patient complications following surgery.

Like Linda Culpepper, patients aren’t always taught how to change their eating habits to adapt to the drastic changes made in their digestive system. 

Jenson noted that some surgeons perform the surgery on children and teenagers, despite the lack of evidence of the procedure’s long term effects. And, some doctors encourage their obese patients to gain more weight in order to qualify for the surgery, as the procedure is typically limited to people 100 pounds overweight. 

According to Dr. Philip Schauer, director of Bariatric surgery, at Magee-Women’s Hospital of the University of Pittsburgh, “There are a lot of surgeons who are new to this field and haven’t had much training…I’ve got three patients now that were treated by other surgeons, with major complications.”

A recent study of gastric bypass suggests that the overall death rate is two times as high as .5% to 1%, and even higher if the surgeon lacks experience. 

Due to the associated dangers and increased costs of the surgery, some insurance companies have stopped covering this procedure. The Massachusetts State Health Department convened an expert panel after three patients died during or after the operation last year; and the National Institute of Health has also launched a study on this procedure. 

SOURCE: New York Times, 2004; International Herald Tribune, www.iht.com, May 6, 2004.

Study Shows Chiropractic for Young Children Safe and Effective

Scientists at the University of Rochester have taken a new step toward understanding how Acupuncture works at the molecular level to ease pain.

A 3-year retrospective study of pediatric case files of Chiropractic treatments for young children and infants has revealed improvement with remarkably few adverse reactions, all temporary and very mild.

To perform the study, researchers pulled all the case files for pediatric patients younger than 3 years old, totaling 781 cases, at the Anglo-European College of Chiropractic (AECC) in Bournemouth, England. Files were viewed manually and in sequential order, with no prequalification other than the target age group.

It was found that 697 children received a total of 5,242 Chiropractic treatments. Most of the young patients, about 73 percent, were 12 weeks of age or younger when they arrived for treatment.

Obviously, a 12-week-old infant cannot communicate about possible adverse effects. Parents were therefore consulted to help determine the effects of treatment. No parents reported a worsening of their child's presenting symptoms, and only seven reported reactions, six of which were increased crying.

This translates to a reaction rate of approximately 1 child in 100. The actual rate of adverse reactions, says the study, would be about 1 case in approximately 1300 Chiropractic treatments.

There were no serious complications resulting from Chiropractic treatment, such as a reaction lasting more than 24 hours or severe enough to require hospital care. The reactions were short-lived — less than 24 hours — and had no effect on the usual activities of daily living, such as normal movement and mobility, nursing and eating.

Since it is well known that adults can have mild reactions to Spinal Manipulation Therapy (SMT), such as increased soreness, the researchers noted that it’s entirely possible that infants might experience the same type of reaction — even when pediatric SMT forces are reduced to match the patient's size and weight.

The authors of the study say it is difficult to compare the reported adverse reactions risk assessment with already published work in the literature because there have been no similar studies. One systematic review showed a very low risk of severe reactions to Pediatric Chiropractic care — nine cases in a 30-year period.

Also, the authors note that it is difficult to precisely compare pediatric adverse effect rates to those of adults, as the negative side effects experienced by adults are different. In adults, the range of temporary and mild side effects is reported to include local discomfort, headache, tiredness, and radiating discomfort — information impossible to obtain from the youngest patients, which were in the majority.

Similarities with reported infant side effects were that the discomfort occurred the same day or one day after treatment, and lasted a short period — less than 2 days in adults and less than 24 hours in infants. In adults, 11 percent of those with an adverse effect experienced loss in activity of daily living, whereas none was reported in the infants.

The report says more research is required into adverse effects in all age groups of children. But with 85 percent of parents reporting an improvement, and only seven reporting adverse effects, and those being very mild and short-lived, the safety of Chiropractic treatment for infants and children appears to be well under control.

SOURCE: http://www.chiro.org/pediatrics/ABSTRACTS/Adverse_Effects_of_SMT_in_Children.html