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Tax Burden
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Written by Stanley Greenfield, R.H.U.   
Wednesday, 04 April 2007 12:23

Do you realize that you have a huge potential tax burden sitting in the background right now and it will jump on you when you can least afford such a burden? Well, you do. In fact, most of you have this and you think it is a real plus. On the surface, it appears to be a big tax savings but, when you dig a little deeper, you will see what I have uncovered for you. In fact, it is a potential liability that could cost you and your family over $1,000,000! What is this potential problem called? Believe it or not, but it is a qualified retirement plan. Yes, retirement plans. Pension, profit-sharing, 401-k, SEP, IRA, all of them.

The IRS tells you how much you can put into a qualified retirement plan for yourself, and how much you must put away for your employees, even the ones that don’t deserve it. The IRS decides when that money belongs to the employees and will give it all to them in three to seven years. Now, does that make you happy?

The IRS also decides when you can get to your money. Retire before age sixty and you just gave the IRS 10 percent more of your money. If you touch any of your money prior to age 59½, you must pay taxes on it plus a 10 percent federal penalty. You must also start using your money by age 70½, and you must pull out an amount based on your life expectancy, or you get hit with a 50 percent tax on the amount not distributed. Administrative charges can also be from a few hundred dollars to a few thousand each and every year. Best of all, the IRS changes the rules almost every year just to confuse everyone. Want to hear more? At your death, the estate taxes and fees can eat up as much as 60 percent of your plan. That should make you even happier.

Here is how a qualified plan works. Dr. Greenfield sets up a qualified plan and contributes $15,000 per year for thirty years to age sixty-five. He earns 8 percent on the money and, at age sixty-five, has over $1,800,000. If he take out just 8 percent per year, that is $146,815. He must now pay taxes on that and we will assume that he is in a 30 percent tax bracket, which means he owes the IRS $44,044, leaving him a net retirement income of $102,771. Based on these numbers, how long will it take the IRS to get back all the taxes he saved by having a qualified plan? Dr. Greenfield put in a total of $450,000 ($15,000 per year for 30 years = $450,000). At a 30 percent tax rate, he saves a total of $135,000. Dr. Greenfield is going to pay $44,044 in taxes each year, so the IRS will get back all the taxes he saved in a little over two years! If he lives to age one hundred, the IRS will be smiling with a total tax of $1,541,540! That is a nice "income" for the IRS!


Is there a way to put money aside and not pay all those taxes to the IRS?

 

Yes, there is. It may surprise you but you can do it with a life insurance plan. Yes, I said life insurance: that stuff that everyone has been telling you is a bad investment. With life insurance, the premiums are paid with after-tax dollars, like the Roth IRA. Let’s use the example of the same $15,000 that was going into the qualified plan. At a 30 percent tax bracket, you would need to have $21,430 to end up with the net after taxes of $15,000. The money goes in and, since it is a life insurance policy, you pay no taxes on the growth within the policy. So, if you pay the tax for thirty years at $6,430 per year, the total is $192,900.

Let’s use the same figures that we did for the qualified plan. A doctor is age thirty-five and makes an annual "net after-tax" deposit of $15,000 for thirty years to age sixty-five. We will use the same rate of return of 8 percent.

The qualified plan gave an annual yield of $146,815 before taxes with a net after taxes of $102,771. The insurance plan will yield over $189,000 per year, net, tax-free for life! It beats the qualified plan by $86,229 per year. The policy starts with a death benefit over $1,000,000. By the way, the IRS cannot tell you how much you can or cannot put into this policy for yourself, and it also cannot tell you that you must also put an equal amount away for each and every employee. In fact, they have no say-so when it comes to this plan. Now are you happy?

You can get to this money prior to age 59½ without any tax liability and also structure a stream of cash to cover your retirement needs that is totally sheltered from any income taxes. This plan works just like the Roth IRA, but it gives you the ability to put away a lot more money. In other words, no income taxes to pay on the accumulation, no income taxes or penalties to pay on the withdrawals, and no contributions for employees and no IRS involvement. Are you smiling now?

You should be!

Stanley B. Greenfield has been engaged in the fields of Financial Management and Insurance since 1962. He has been a guest speaker for Educare Financial on numerous occasions. He is a Registered Financial Consultant, and was awarded the designation of RHU, Registered Professional Disability and Health Insurance Underwriter, in 1979, as one of its Charter Members.

Mr. Greenfield also serves as a member of the Board of Directors of the Florida Chiropractic Foundation for Education and Research. You may reach him at This e-mail address is being protected from spambots. You need JavaScript enabled to view it , call 800-585-1555 or visit his website, www.stanleygreenfield.com.

 

 
Frequency and Duration of Care for the Doctor of Chiropractic
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Written by Dwight C. Whynot, D.C.   
Sunday, 04 March 2007 09:37

There has been a lot of news lately regarding the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) and its validity in the chiropractic clinical setting.

I have been anticipating the release of these clinical compass guidelines because I practice and teach evidence-based practice protocols. I was anxiously waiting (hoping) for a set of objective guidelines that would be useful in determining frequency and duration for my patients. Much to my dismay, I have been sorely disappointed at the type of political and biased rhetoric that has been produced thus far. The only thing I can say is, "Nice try, but you can’t pull the wool over the eyes of this profession for your own personal gain by selling out the members of this profession!!!"

With that said we have no other option but to look at the previously published works to guide us in determining what would be a reasonable and sensible case management strategy for frequency and duration of care for our patients.

To determine appropriate levels of frequency and duration of care, we can look at several documents: 1) The Guidelines for the Chiropractic Quality Assurance and Practice Parameters (Mercy), 2) the Council on Chiropractic Practice (CCP) document and 3) Foreman and Croft’s Whiplash Treatment Guidelines.

 

Table 1.

Stages of Care: The Mercy Document (Table II, Pg. 120, Mercy)

Passive Care

 The doctor is doing most of the work
 Acute Intervention
 1. To promote anatomical rest
 2. To diminish muscular spasm
 3. To reduce inflammation
 4. To alleviate pain
 

Active Care

 The doctor and patient are doing the work together
 Remobilization
 1. To increase pain-free ROM
 2. To minimize deconditioning
 Rehabilitation
 1. To restore strength and endurance
 2. To increase physical work capacity
 Life Style Adaptations
 1. To modify social and recreational activity
 2. To diminish work environment risk factors
 3. To adapt psychological factors affecting or altered by the spinal disorder


 

Table 2.
Complicating Factors
Criteria for Expanding & Increasing Treatment Plans (Pg.124, Mercy Doc.)
1) Symptoms present more than eight (8) days a.If the duration of the symptoms were present for more than 8 days, recovery may take 1.5 times longer.
   
2) Four  to seven (4-7) previous episodes  a.If the number of previous episodes is 0 to 3, no anticipated delay in recovery is anticipated.

b.If the number of previous episodes is 4 to 7, recovery time may take up to 1.5 to 2 times longer.
3) Presence of skeletal anomalies a.If there is a skeletal anomaly present, recovery may be increased 1.5 to 2 times longer.

b.If there is structural pathology, recovery may be increased 1.5 to 2 times longer.
4) Presence of severe pain a.If severe pain is present, recovery may take up to 2 times longer.

b.If mild pain is present, no delay on recovery is anticipated.


Determining Frequency and Duration of Care for a Commercial Insurance Patient

 

First, for commercial insurance patients, the doctor can follow the Mercy Guidelines. The Mercy document was designed to conservatively treat low back pain in a reasonable amount of time and focuses on shifting the care to the home or to more radical approaches, such as neurologists and orthopedists. Mercy was neither designed nor mentions frequency and duration of care for neck pain and/or cervical acceleration/deceleration (CAD) injuries. The Mercy document does mention stages of care (see Table 1) and gives recommendations on the frequency and duration of care for each stage. Passive care is for acute intervention and the doctor should be focused on decreasing muscular spasm, inflammation and pain. This particular stage is highlighted by the fact that the doctor is performing most of the work whereas, in active care, the patient and doctor are doing the work together and it is highlighted by an increase in rehabilitation exercises. Each stage can have durations of up to twenty-four visits and the frequency can be three times per week for eight weeks.

These statements are rather significant because insurance companies commonly refuse to pay for more than twelve to fifteen visits or make accusations that the patient should have recovered in four to six weeks. These types of accusations by the insurance companies can’t be proven because they cannot come up with any competing guidelines to confirm these statements.

Although the Mercy document allows for at least forty-eight treatments, the treating chiropractor may receive more visits based on various complicating factors—complicating factors such as those found in Table 2. With a thorough history and objective examination findings, a doctor of chiropractic could realistically treat a patient approximately ninety-six visits.

Additional Guidelines to Determine the Frequency and Duration of Care for the Commercial Insurance Patient

 

There is another set of guidelines the doctor of chiropractic can utilize to objectively determine the frequency and duration of care for their patients. These guidelines are the CCP Guidelines. CCP Guidelines have been accepted by the National Guideline Clearinghouse (NGC), found on the Internet at http://www.guideline.gov/index.asp. In fact, the CCP Guidelines is the only such chiropractic document listed by NGC. The NGC is a public resource for evidence-based clinical practice guidelines. NGC is sponsored by the Agency for Healthcare Research and Quality (AHRQ) (formerly the Agency for Health Care Policy and Research in partnership with the American Medical Association and the American Association of Health Plans).

It is the position of the Guideline Panel that individual differences in each patient and the unique circumstances of each clinical encounter preclude the formulation of "cookbook" recommendations for frequency and duration of care. The CCP Guidelines states that a chiropractor must adjust a subluxation until all indicators of subluxation are gone. The appropriateness of chiropractic care should be determined by OBJECTIVE indicators of the vertebral subluxation (Chapter 7, Pg 84).

The recommendations from the Panel are that, since the duration of care for correction of a vertebral subluxation is patient specific, frequency of visits should be based upon the reduction and eventual resolution of indicators of the subluxation (Chapter 7, pg. 83).

Determining the Frequency and Duration of Care of a CAD Injured Patient

Firstly, the doctor in CAD injuries (the doctor of chiropractic) needs to be able to determine whether the patient has been injured or not. They must then determine the extent of the injury. After gathering the evidence, the doctor of chiropractic can place the patient into a GRADE that is based on those OBJECTIVE physical findings and the subjective complaints found during the examination process. Foreman and Croft have developed five grades of severity of CAD trauma (Table 3). (Pg. 525, Whiplash Injuries)

In turn, by placing the patient into a category, the physician can then determine the approximate treatment schedule (frequency and duration) for the patient, based on the severity of the injury grade (Table 4). (Pg. 526, Whiplash Injuries 3rd Ed.)

The treatment can be extended based on the number of complicating factors. Croft has developed a list (See Table 5 on page 50) of common factors potentially complicating CAD trauma management. (Pg. 525, Whiplash Injuries)

So, as you can see, there are a number of FAIR and PRACTICAL guidelines that can be used to objectively determine the patient’s frequency and duration of care. If one wants to "update" one’s clinical approach to treating patients for the future, then buy these guidelines and read them and understand what it is going to take to survive in the health insurance realm in the coming years. I did not graduate in the "Mercedes Eighties" where practice was not as time consuming and almost everything that you billed for was paid. I graduated in a time when doctors of ALL professions are being held more accountable for the care they are recommending and performing.

Vince Lombardi once said, "The name of the game is to win, fairly, squarely, by the rules, but to win." I have just given some important rules to practice fairly and squarely by, so that you can win.

 

 

 Table 3.
 Severity of Injury Grades
 1.Grade I: no limitation of range of motion, no ligamentous injury, no neurological symptoms
 2.Grade II: limitation of range of motion, no ligamentous injury, no neurological findings
 3.Grade III: limitation of range of motion, some ligamentous injury, neurological findings present
 4.Grade IV: limitation of range of motion, ligamentous instability, neurological findings present, fracture or disc derangement
 5.Grade V: requires surgical treatment and stabilization

 

 

Table 4.

Frequency & Duration of Care for CAD Injuries

Guidelines for the Frequency and Duration of Care in

Cervical Acceleration/Deceleration Trauma

 


Daily

3X/wk

2X/wk

1X/wk

1X/mo

TDb

TNb

Grade I

1 wk

1-2 wk

2-3 wk

<4 wk

...c

<10 wk

<21

Grade II

1 wk

<4 wk

<4 wk

<4 wk

<4 mo

<29 wk

<33

Grade III

1-2 wk

<10 wk

<10 wk

<10 wk

<6 mo

<56 wk

<76

Grade IV

2-3 wk

<16 wk

< 12 wk

<20 wk

...d

...d

...d

Grade V

Surgical stabilization necessary—chiropractic care is post surgical

 

a Adopted form Croft AC: treatment paradigm for cervical acceleration/deceleration injuries (whiplash). Am Chiro Assoc J Chiro 30(1):41-45, 1993.

b TD indicates treatment duration; TN, treatment total number

c Possible follow-up at 1 month

d May require permanent monthly or p.r.n. treatment

Table 5.

Croft has developed a list of common factors potentially complicating CAD trauma management (Pg. 525, Whiplash Injuries)

Factors Complicating

CAD Trauma Management

1. Advanced age

11. Prior cervical spinal surgery

2. Metabolic disorders

12. Prior lumbar surgery

3. Congenital anomalies

13. Prior vertebral fracture

4. Developmental anomalies

14. Osteoporosis

5. Degenerative disc disease

15. Paget’s disease or other bone diseases

6. Disc protrusion

16. Spinal stenosis

7. Facet arthrosis

17. Paraplegia/ Quadriplegia

8. Rheumatoid arthritis

18. Prior spinal injury

9. Ankylosis spondylitis

19. Spondylosis

10. Scoliosis

 

 


Dr. Dwight C. Whynot is in fulltime practice in Johnson City, Tennessee. Dr. Whynot gives license-renewal lectures on Evidence-Based Chiropractic Practices which are promoted by the EBC Seminars and sponsored by Myo-Logic and Spinal Logic Diagnostics. For questions regarding evidence-based practice procedures, email questions to This e-mail address is being protected from spambots. You need JavaScript enabled to view it . For 6 and 12 hours CCE license renewal lecture dates and locations call Karl Parker Seminars at 1-888-437-5275 or visit www.EBCSeminars.com.

 
The Clinic Of The Future
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Written by Michelle Leblanc   
Thursday, 01 February 2007 16:33

"Michelle Leblanc, a senior Montréal Designer, has been in commercial design for twelve years. Over the years, she has created hundreds of concepts, furniture and design for commercial needs. Now she’s become concerned about many of today’s chiropractic realities and clinics needs.

This has led her to begin envisioning the clinic of the future, based on her personal experience, intuitive sense, reading, and comments heard from doctors all over.

In the following article, Ms. Leblanc shares her vision with respect to a potential model for the office of the future.“As the profession evolves, she predicts, “although purpose, procedures, personal goals, and professionalism will always be at the forefront of service, support will be found in technology, patient education, and research."


 RECEPTION


Trends and Consumer Habits

Time, time, time! It’s becoming more and more precious, so offer people time-saving services:

• Additional professional services under the same roof, such as massage, nutritional counseling, acupuncture, even private medical services, etc.;

• Affiliated products, such as supplements, etc.;

• Workshops and special classes on personal development, yoga, etc.

Create a wellness model in your community. If this is your goal, everything you do must be congruent with your vision. If your clinic cannot house all these extras, then locate in a building where complementary services to your care are offered. People will be asking for them, as the trend is towards wellness and quality of life. The move is toward an integrated health system, so offering these services yourself will put your clinic in a better position.

Economic Factors

Low overhead practices are the future. There will also be a shift in source of income, so envision serving more people, at reasonable rates, keeping in mind that, for some, making this shift may involve redesigning the clinic and adding intelligent technology. If income from adjustment is what you’re relying on most, you’ll be missing the trend. Income from other professional and ancillary products could boost your income by 20%-30%; besides which, everyone wins. Have a product display set up in your reception area (see Reception photo).

Imagine a small, central facility, offering digitized radiology, owned by five doctors practicing in five locations within a five-mile radius. Each clinic sends its patients to the facility for initial and comparative X-rays, providing the doctors with immediate, on-line results. This would only be possible if a centralized, web-based system for chiropractic were used. As well, all the appointment books would be on-line, so this central facility could also take all new patient appointments for each of the clinics...a great way to reduce personal office space and staff, and increase profits.

Design and Architecture

Remember that you are offering more than a service: you’re offering an experience for all the senses. A calm, yet stimulating environment will be very welcome in a society that needs to relax, so adapting the design of your clinic may be important.

Reception

• Lots of light, a water fountain, plants, and appropriate ambience music

• An in-and-out welcome desk (improves traffic and energy flow and enhances privacy)

• Do away with the waiting room. Provide a hospitality area instead, with a wellness info center in the adjusting area (where people wait).

• The perception of ‘‘waiting’’ is lessened when patients are spending this time learning, which is also a part of their care. Display recommended books in the info center, an article-of-the-week on health, chiropractic, healthy food, a recipe-of-the-week, information on supplements, any latest research, and testimonials. Access also this vital information on the computer and then print it out.

Adjusting area

• Provide seats equipped with small computer screens. A fingerprint reading allows patients to access educational information targeting their health condition, as recorded in their electronic patient file. Patients can schedule their next workshop, read about supplementation, exercise or view the clinic’s next promotional event while waiting. If this patient education measure proves to be too costly, I recommend conside ring TV screens.

• Use this space for your workshops.

Adjusting rooms

• In open-concept areas with many tables, a single, portable touch screen station, guided by a ceiling rail track, will reduce equipment costs.

• In closed rooms, use a rotating touch screen in the wall between two rooms.

• In a T-bar system, have the screen in between on a rotating stand.

Patient flow

• In medium and high volume clinics, patient flow must be automated. For increased patient confidentiality, the appointment book is linked to the educational TV system, using pictures and special sounds to avoid calling out names.

Technology

Everything on the web! Five years from now, any office not using the power of a web-based office management system will be years behind. Yes! A completely paperless office: patient files and automatic documentation, office administration, on-line claim forms and reports, X-rays and imaging, marketing and more. Imagine having access to any aspect of your office, from anywhere.

The patient station, allows patients to enter the subjective part of the SOAP notes on a touch screen. This saves the doctor’s time and is great for record keeping.

Integration of every aspect of a clinic is vital. Information centralization, security and confidentiality is the direction to move in. Cumulating statistics on millions of patients, without taking up time and team effort, is the key.

New technology will mean important reductions in equipment costs, as only one computer will be necessary. All areas of the clinic will have stations connected to one computer at the reception area, and the internet.

You can enhance the power of a web-based system to promote your services to employees in companies, or those doing screenings. You simply need an internet connection.

More Technology

Many DC’s believe the profession will have a clearer, more distinct position in the health care system by focusing on neurophysiology beyond symptom-based approaches, as many others are doing. It’s all about neurology!

Chiropractic offices will be equipped with hi-tech tools, such as surface EMG, thermogram, postural analysis, pulse wave analyzer, algometry, and visual field. The challenge in the future will be to collect the findings, using a centralized platform.

Imagine walking room-to-room with a wireless scanner for heat readings. Imagine the value of a database containing information on a million patients, all undergoing some of these exams.

Substantiating your objective findings will definitely help you in clinical decision making, and will also act as a bridge towards a wellness model.


Michelle Leblanc is presently working with many clinics to create different models respecting different types of practices and budgets. She may be contacted at This e-mail address is being protected from spambots. You need JavaScript enabled to view it or at 1-514-831-9959 to talk about your clinic project and customize it for your needs.

 
Can We Affect Cortical Asymmetries?
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Written by Randy Beck, B.Sc., D.C., Ph.D.   
Thursday, 01 February 2007 16:28

Welcome back to the continuing series of discussions on functional neurology. In this section we will discuss the concept of cerebral asymmetry as well as consider some of the functional systems utilized by the cortex to regulate the rest of the neuraxis. In the next section we will start to explore how we can look for cortical asymmetries in our patients utilizing some simple physical examination procedures.

Cerebral Asymmetry (Hemisphericity)

The study of brain asymmetry or hemisphericity has a long history in the behavioral and biomedical sciences but is probably one of the most controversial concepts in functional neurology today.  The fact that the human brain is asymmetric has been fairly well established in the literature (Falk, et al., 1991; Steinmetz, et al., 1991). The exact relationship between this asymmetric design and the functional control exerted by each hemisphere remains controversial.

The concept of hemispheric asymmetry or lateralization involves the assumption that the two hemispheres of the brain control different asymmetric aspects of a diverse array of functions and that the hemispheres can function at two different levels of activation. The level at which each hemisphere functions is dependant on the central integrative state of each hemisphere, which is determined, to a large extent, by the afferent stimulation it receives from the periphery as well as nutrient and oxygen supply.  Afferent stimulation is gated through the brainstem and thalamus, both of which are asymmetric structures themselves, and indirectly modulated by their respective ipsilateral cortices.1

Traditionally the concepts of hemisphericity were only applied to the processing of language and visuospatial stimuli. Today, the concept of hemisphericity has developed into a more elaborate theory that involves cortical asymmetric modulation of such diverse constructs as approach versus withdrawal behavior, maintenance versus interruption of ongoing activity, tonic versus phasic aspects of behavior, positive versus negative emotional valence, asymmetric control of the autonomic nervous system, and asymmetric modulation of sensory perception, as well as cognitive, attentional, learning and emotional processes.2

The cortical hemispheres are not the only right and left sided structures. The thalamus, amygdala, hippocampus, caudate, basal ganglia, substantia nigra, red nucleus, the cerebellum, brainstem nuclei and peripheral nervous system all exist as bilateral structures with the potential for asymmetric function.  Hemisphericity can result in dysfunction of major systems of the body, including the spine. Some spinal signs of hemisphericity include:

•    Subluxation
•    Spinal stiffness—increased extensor tone
•    Spondylosis
•    Intrinsic spinal weakness—decreased postural tone
•    Decreased A-P curves in cervical and lumbar spine
•    Increased A-P curves in thoracic spine
•    Increased postural sway in sagittal or coronal planes
•    Pelvic floor weakness

Fundamental Functional Projection Systems

In order to apply the neurophysiological concepts that we have discussed thus far in a clinical setting we must gain an understanding of some of the basic fundamental functional projection systems utilized by the cortex to modulate activity in wide ranging areas of the neuraxis.  About 90 percent of the output axons of the cortex are involved in modulation of the neuraxis. About 10 percent of the cortical output axons of the cortex are involved in motor control and form the corticospinal tracts.  Of the 90 percent output dedicated to neuraxis modulation, about 10 percent projects bilaterally to the reticular formation of the mesencephalon (MRF) and 90 percent projects ipsilaterally to the reticular formation of the pons and medulla or pontomedullary reticular formation (PMRF). (Fig.1)

The cortical projections to both the MRF and the PMRF are excitatory in nature. The neurons in the MRF project bilaterally to excite neurons in the intermediolateral (IML) cell columns located between T1 and L2 spinal cord levels in the grey matter of the spinal cord.3

Some neurons in the PMRF project bilaterally to inhibit the neurons in the intermediolateral (IML) cell columns located between T1 and L2 spinal cord levels in the grey matter of the spinal cord, however the majority of the fibers remain ipsilateral.3 These neurons in the IML form the presynaptic output neurons of the sympathetic nervous system.

Neurons in the IML project to inhibit neurons in the sacral spinal cord regions that form the output neurons of the parasympathetic nervous system.  Following the stimulus flow through the functional system, we can see that high cortical output results in high PMRF output which results in strong inhibition of the IML which, in turn, results in disinhibition of the sacral parasympathetic output. The bilateral excitatory output of the MRF is over-shadowed by the powerful stimulus from the cortex to the PMRF.

To further illustrate the impact that an asymmetric cortical output (hemisphericity) could potentially have clinically, consider the effects of an asymmetric cortical output on the activity levels of the sympathetic and parasympathetic system on each side of the body. Autonomic asymmetries are an important indicator of cortical asymmetry, as this reflects on fuel delivery to the brain (sympathetic system) and the integrity of excitatory and inhibitory influences on sympathetic and parasympathetic function throughout the rest of the body.

The PMRF has other modulatory effects in addition to modulation of the IML neurons. All of the modulatory interactions of the PMRF have clinical relevance and also include:

1)    Inhibition of pain ipsilaterally,
2)    Inhibition of the inhibitory interneurons which project to ventral horn cells (VHC’s) ipsilaterally, which acts to facilitate muscle tone. This is another example of inhibition of inhibition in the neuraxis as discussed above.
3)    Inhibition of the ipsilateral anterior muscles above T6 and the posterior muscles below T6.

References
1.  Savic, I. Pauli, S. Thorell, J.O. Blomqvist, G. Invivo demonstration of altered benzodiazepine receptor density in patients with generalized epilepsy. J.Neurol. Neurosurg. Psychiatry: 57;797-784, 1994.
2.  Davidson, R.J. and Hugdahl, K. Brain Asymmetry. Bradford, MIT press, Cambridge and London.1995.
3.  Nyberg-Hansen, R. Sites and mode of termination of reticulospinal fibers in the cat. An experimental study with silver impregnation methods. J. Comp. Neurol. 124,74-100. 1965.

 
Dietary supplement to the next level
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Written by Pharmanex   
Friday, 29 December 2006 00:48

Lifepak® nano is a nutritional anti-aging program formulated to nourish and protect cells, tissues, and organs in the body with the specific purpose of guarding against the ravages of aging. Lifepak® nano offers the highest bioavailability with a first-ever nanotechnology process and advanced levels of key anti-aging nutrients in a comprehensive formula available exclusively through Pharmanex.* Taking this product will increase your anti-oxidant score or they will refund your money.

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• Superior bioavailability with CR-6 LipoNutrients™ enhances uptake from the gut into the bloodstream and body for maximum anti-aging benefits*
• Advanced anti-aging formula helps protect the body with key nutrients, such as NanoCoQ10™ and nano carotenoids*
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• Offers superior DNA protection against damaging free radical attacks by providing the body with important antioxidants and phytonutrients such as alpha-lipoic acid and catechins*
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*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.

 
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