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1.  RISK MANAGEMENT FOR CHIROPRACTORS AND OSTEOPATHS 
This article is the second in a series of articles dealing with risk management in the practise of chiropractic and osteopathy, prepared by the COCA Risk Management Subcommittee.
Background: Radiographic examination carries risks that must be weighed against the possible benefits when determining patient care.
Objective: The objective of this article is to propose guidelines for the use of imaging in chiropractic and osteopathic practice.
Discussion: Plain film radiography, CT scan, magnetic resonance imaging (MRI) and other forms of imaging are available for use in chiropractic and osteopathic practice in Australia. The astute practitioner utilises these imaging procedures for clinical decision making in order to make an accurate diagnosis that will determine a patient’s management. This article attempts to guide the practitioner in the proper use of these imaging procedures for different regions of the body.
PMCID: PMC2051318  PMID: 17987210
Chiropractic; risk management; osteopathy
2.  RISK MANAGEMENT FOR CHIROPRACTORS AND OSTEOPATHS 
Although rare, vertebrobasilar stroke is the best known of the possible side effects of cervical manipulation. Due to the serious sequelae that may result from cervical manipulation, chiropractors and osteopaths must take the appropriate steps to ensure the risk is minimised. This article outlines how the astute practitioner can minimise this risk. Practitioners must decide on the options for treatment of a patient with neck problems. Practitioners must also advise the patient of these options as part of an appropriate informed consent.
PMCID: PMC2051301  PMID: 17987199
Chiropractic; stroke; manipulation
3.  A USER’S GUIDE TO THE CHIROPRACTIC AND OSTEOPATHIC LITERATURE 
PMCID: PMC2051075  PMID: 17987180
Systematic review; chiropractic; osteopathy
4.  HOW TO READ A SYSTEMATIC REVIEW 
PMCID: PMC2051071
Clinical challenge; systematic review
5.  SOFT TISSUE & ANCILLARY TECHNIQUES 
PMCID: PMC2050811
Soft tissue techniques; chiropractic
6.  CHIROPRACTIC AND OSTEOPATHIC EDUCATION AT ROYAL MELBOURNE INSTITUTE TECHNOLOGY 
Objective: To assess the attitudes of undergraduate chiropractic and osteopathic students at Royal Melbourne Institute of Technology (RMIT) in 1992 on the education they are receiving and on the effectiveness of chiropractic and osteopathic care.
Design: Cross-sectional descriptive survey.
Participants: Undergraduate chiropractic and osteopathic students enrolled at RMIT School of Chiropractic and Osteopathy in 1992.
Results: This study surveyed 272 students, 196 who were chiropractic students and 76 who were osteopathic students from RMIT School of Chiropractic and Osteopathy in Melbourne, Australia. The students that responded represented 73.4% of chiropractic students and 85.4% of osteopathic students currently enrolled in their respective courses. Chiropractic and osteopathic students entered their respective courses from non-chiropractic/non-osteopathic families. More chiropractic students than osteopathic students (1.3:1.0) had their respective course as their first choice when applying for tertiary education. A majority (95.8 chiropractic students and 94.8% osteopathic students) of both groups surveyed were pleased with their choice of course. Students from both disciplines held considerable respect for each other in the care of certain conditions, but did not see the other profession’s care as effective as their own. A greater percentage of osteopathic students believed there was sufficient difference between chiropractic and osteopathy to justify two separate professions (57.6% compared to 97.2%).
Discussion: High quality education is a major aim in our schools and colleges. For this standard to be maintained it requires continual re-evaluation and assessment. Surveys such as this should be performed regularly as a method of evaluating student attitude and how these attitudes change during the course. This would also allow administrators to determine whether they are achieving their academic intentions. An immediate follow up survey asking the same questions is suggested to ascertain whether the same attitudes exist today.
PMCID: PMC2051086  PMID: 17987188
Chiropractic; osteopathic medicine; education; students; attitude
7.  A CASE OF LEPTOMENINGEAL DISEASE PRESENTING AS A LUMBAR NERVE ROOT RADICULOPATHY 
Objective: To discuss a case of leptomenigeal disease mimicking a lower lumbar disc lesion and accompanying neurological deficit.
Clinical Features: A 62 year old male presented with a 3-4 day history of left low back and left posterior thigh pain. The patient had a previous history of non-specific low back pain for approximately 10-25 years, which was relieved in the past by manual therapy. He was also currently being treated by a medical oncologist with chemotherapy for low grade non-Hodgkin's lymphoma, which was considered stable.
Intervention and Outcome: After a favourable initial response to therapy, the patient developed a noticeable left-sided limp. Computed tomography scanning of the lumbar spine and pelvis was then performed, which revealed a mild posterior annular bulging of the intervertebral disc at the L4/5 level. The patient was then treated with axial lumbar spine traction but on review two days later had also developed a left sided facial droop, consistent with a Bell's palsy. A subsequent magnetic resonance imaging scan of the brain and lumbar spine revealed sites of abnormal enhancement of multiple cranial nerves, the cauda equina and the vertebral bodies L1 and L5. The findings were consistent with widespread leptomeningeal disease or leptomenigeal carcinomatosis and unfortunately the patient died as a direct consequence of the disease approximately three weeks after diagnosis.
Conclusion: Although relatively rare, leptomenigeal disease must considered as a differential diagnosis in a patient with a history of carcinoma who presents with low back pain and/or any neurological signs and symptoms.
PMCID: PMC2050809  PMID: 17987161
Non-Hodgkin's lymphoma; leptomeningeal disease/carcinomatosis; radiculopathy; lumbar disc herniation; chiropractic; spinal manipulative therapy
8.  HEALTH PROMOTION IN A PRIMARY HEALTH CARE SETTING 
Primary care practitioners are ideally situated to carry out health promotion activities. Neural tube defects are of a fairly low incidence, but the consequences are tragic. They range from life long physical and often intellectual disabilities, to death at birth. Increased folate intake, either through eating folate rich foods or through supplementation, has been shown to reduce the incidence of neural tube defects in newborns by up to 75%. Encouraging all women of child-bearing age to increase their folate intake could thus prevent a significant number of neural tube defects occurring in the Australian population.
PMCID: PMC2050631  PMID: 17987155
Primary health care; neural tube defects; folate
9.  SOMETIMES THEY MAY BE ZEBRAS: HERPES ZOSTER OF THE L2 SPINAL NERVE 
This case report describes a relatively uncommon presentation of herpes zoster affecting the cutaneous distribution of the L2 spinal nerve. The coexistence of a previous history of leg pain, cortical thickening of the femoral shaft on plain film x-ray examination, and the absence, at the time of examination, of the tell tale rash of herpes zoster provided the clinician with a diagnostic challenge. Furthermore, this case stresses the importance of a thorough neurological and orthopaedic examination as well as careful visual inspection of the painful region.
PMCID: PMC2050615  PMID: 17987138
Herpes zoster; spinal nerves; chiropractic; spinal manipulative therapy.

Results 1-9 (9)