Medical hypotheses
-
The prevalence of kidney stones is increasing worldwide. Various etiologies may in part explain this observation including increased prevalence of diabetes, obesity and the metabolic syndrome, increased dietary protein and salt content, and decreased dietary dairy products. We hypothesize an additional and novel potential contributor to increasing kidney stone prevalence: migration to urban settings, or urbanization, and resultant exposure of the population to the higher temperatures of urban heat islands (UHIs). ⋯ However, demonstration of a convincing link between urbanization and kidney stones is confounded by many variables simultaneously affected by migration to cities, such as changes in occupation, income, and diet. No data have yet been published supporting this proposed association. We explore the plausibility and limitations of this possible etiology of increasing kidney stone prevalence.
-
The autonomic nervous system and the hypothalamic-pituitary-adrenal axis have been shown to be dysfunctional in a number of chronic pain disorders. Spinal manipulation is a therapeutic technique used by manual therapists, which may have widespread neuro-physiological effects. The autonomic nervous system has been implicated to modulate these effects. ⋯ To substantiate our hypothesis we provide evidence from manual therapy studies, basic science and animal studies. According to the proposed theory, there will be measurable changes in the neuro-endocrinal mechanisms following a thoracic spinal manipulation. This has far-reaching implications for manual therapy practice and research and in the integration of spinal manipulation in the treatment of a wide array of disorders.