Osteopathy Articles and Abstracts

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Osteopathy Journal Articles



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International recognition of osteopathic medicine
Glassman, J. (1998), J Am Osteopath Assoc 98(11): 596.

Intramuscular ketorolac versus osteopathic manipulative treatment in the management of acute neck pain in the emergency department: a randomized clinical trial
McReynolds, T. M. and B. J. Sheridan (2005), J Am Osteopath Assoc 105(2): 57-68.
Abstract: Ketorolac tromethamine injected intramuscularly (IM) has been shown to be an effective analgesic in treating patients with acute musculoskeletal pain in the emergency department (ED). The authors compare the efficacy of a single dose of IM ketorolac to osteopathic manipulative treatment (OMT) as delivered in the ED for the management of acute neck pain. A randomized clinical trial was conducted in three EDs. A convenience sample of 58 patients with acute neck pain of less than three weeks' duration were enrolled. Subjective measures of pain intensity on an 11-point numerical rating scale were gathered from patients immediately before treatment and one hour afterward. Subjects received either OMT or 30 mg, IM ketorolac. Subjects' perceived pain relief was also recorded at one hour after treatment on a subjective 5-point pain relief scale. Twenty-nine patients received IM ketorolac, and 29 patients received OMT. Although both groups showed a significant reduction in pain intensity, 1.7+/-1.6 (P <.001 95% CI, 1.1-2.3) and 2.8+/-1.7 (P <.001 95% CI, 2.1-3.4), respectively, patients receiving OMT reported a significantly greater decrease in pain intensity (P=.02 95% CI, 0.2-1.9). When comparing pain relief at one hour posttreatment, there was no significant difference between the OMT and ketorolac study groups (P=.10). The authors found that, at one hour posttreatment, OMT is as efficacious as IM ketorolac in providing pain relief and significantly better in reducing pain intensity. The authors conclude that OMT is a reasonable alternative to parenteral nonsteroidal anti-inflammatory medication for patients with acute neck pain in the ED setting.

Intrasubject experimental designs in osteopathic medicine: applications in clinical practice
Keating, J. C., Jr., J. Seville, et al. (1985), J Am Osteopath Assoc 85(3): 192-203.

Introducing the cranial approach in osteopathy and the treatment of infants and mothers
Sullivan, C. (1997), Complement Ther Nurs Midwifery 3(3): 72-6.
Abstract: Osteopathy is one of the most commonly known treatments for lower back pain. However, media coverage is increasingly recognizing the potential of osteopathic care for a wide range of conditions across all age groups. In this article the role of osteopathic care in the treatment of pregnant mothers, the newborn and infants is considered. The aim of this paper is to stimulate further investigation by health care professionals into the potential benefits of osteopathic care for a range of clients. I have avoided lengthy technical aspects, hoping rather to expand on the thinking behind the approach, and welcome correspondence on any aspect of this paper. Unfortunately, there is a lack of good research evidence to data to support many of the claims and assertions made by osteopathy. However, with recent accreditation of the first Osteopathic MSc, a significant accumulation of such data over the next decade is anticipated.

Investigating the role of osteopathic manipulation in the treatment of asthma
Allen, T. W. and G. E. D'Alonzo (1993), J Am Osteopath Assoc 93(6): 654-6, 659.

Investigations of bone turnover in renal osteopathy
Muller, A., G. Stein, et al. (1999), Eur J Med Res 4(2): 78-84.
Abstract: The renal bone disease which develops in chronic renal failure (CRF) is not an uniform disorder. Histomorphometry is accepted to be the best method for characterising the state of disease. The purpose of this study was to evaluate the suitability of pyridinium crosslinks in serum and urine as indicators of bone degradation processes. Patients with CRF had significantly higher Pyridinoline (Pyd) and Deoxypyridinoline (Dpyd) levels in serum and urine compared to normal controls except the urinary excretion in the subgroup of glomerulonephritis. A correlation was found between the serum levels of crosslinks and those of both creatinine and parathormone. The Pyd and Dpyd serum levels in patients under dialysis treatment were significantly higher than those of normal controls. With regard to bone turnover urinary crosslink measurements are of minor importance in CRF. In contrast, serum measurements could be helpful in revealing bone resorption both in patients with CRF and those under dialysis treatment.

Iron as a possible aggravating factor for osteopathy in itai-itai disease, a disease associated with chronic cadmium intoxication
Noda, M., M. Yasuda, et al. (1991), J Bone Miner Res 6(3): 245-55.
Abstract: Itai-itai disease is thought to be the result of chronic cadmium (Cd) intoxication. We examined 23 autopsy cases of itai-itai disease and 18 cases of sudden death as controls. Urine and blood samples from 10 patients were collected before they died and revealed the presence of severe anemia and renal tubular injuries. Undecalcified sections of iliac bone were stained with Aluminon reagent, and ammonium salt of aurintricarboxylic acid, and Prussian blue reagent in all cases of itai-itai disease. These two reagents reacted at the same mineralization fronts. X-ray microanalysis revealed the presence of iron at mineralization fronts in itai-itai disease. Five patients showed evidence of hemosiderosis in the liver, spleen, and pancreas, probably as a result of post transfusion iron overload. Renal calculi and calcified aortic walls were also stained with Prussian blue reagent in several patients. Neither ferritin nor transferrin were visualized at mineralization fronts in itai-itai disease by immunohistochemical staining. These results suggest that iron is bound to calcium or to calcium phosphate by a physicochemical reaction. A marked osteomalacia was observed in 10 cases of itai-itai disease by histomorphometry. Regression analyses of data from cases of itai-itai disease suggested that an Aluminon-positive metal inhibited mineralization and that renal tubules were injured. Since bone Cd levels were increased in itai-itai disease, it is likely that renal tubules were injured by exposure to Cd. Therefore, stainable bone iron is another possible aggravating factor for osteopathy in itai-itai disease, and a synergistic effect between iron and Cd on mineralization is proposed.

Is a combined allopathic-osteopathic residency in physical medicine and rehabilitation beneficial to a D.O.?
Harris, J. D., W. H. Hoyt, et al. (1972), J Am Osteopath Assoc 71(9): 794-8.

Is methotrexate osteopathy a form of bone idiosyncrasy?
Rozin, A. P. (2003), Ann Rheum Dis 62(11): 1123; author reply 1124.

Is osteopathy going the way of homeopathy?
Myers, R. S. (1963), Mod Hosp 101: 118.

Is osteopathy still a cult?
Covey, G. W. (1954), Conn Med 18(5): 426-9.

Is osteopathy still a cult?
Covey, G. W. (1954), Fed Bull 40(4): 106-12.

Is osteopathy still a cult?
Covey, G. W. (1954), Nebr State Med J 39(4): 130-3.

Is there a psoriatic osteopathy? -- the activity of bone resorption in psoriatics is related to inflammatory joint process
Hein, G., F. Schmidt, et al. (1999), Eur J Med Res 4(5): 187-92.
Abstract: The aim of this study was to examine former own histomorphological results by using biochemical markers of bone collagen catabolism in patients with psoriasis vulgaris and psoriatic arthritis and to compare these results with those from rheumatoid arthritis. - The diagnosis of PsA was made according to the diagnostic criteria of Moll and Wright modified by Bennet. Urine was collected from 99 patients with PsA, 21 patients suffering from PS without articular manifestations, 154 patients with RA fulfilling the ACR criteria of 1987, and 80 healthy controls. Pyridinoline and deoxypyridinoline in urine were analyzed by HPLC, levels of CrP and ESR were estimated using laboratory assessment. - Both crosslinks show a elevated excretion in PsA (particularly in active PsA / aPsA) as well as in RA. PS and Controls show no significant difference in the elimination of crosslinks. The levels of both crosslinks are higher in females than males in all groups. With the exception of Dpyd levels in urine which only show a tendency to correlate with ESR, there are positive correlations between measured crosslink-levels in urine and markers of inflammation. The Pyd/Dpyd ratio displays a significant correlation with ESR. - An increased breakdown of collagen I and II was found only in active forms of psoriatic arthritis and in rheumatoid arthritis. Our biochemical results do not demonstrate a complete agreement with former scintigraphic or histological investigations of other authors and own histomorphological results.

JAMA 100 years ago and osteopathy
Hruby, R. J. (2000), Jama 284(4): 442.

Joint clinical clerkships for osteopathic and allopathic medical students: New England's experience
Tulgan, H., W. J. DeMarco, et al. (2004), J Am Osteopath Assoc 104(5): 212-4.
Abstract: Although combined osteopathic and allopathic medical programs are well established for graduate medical education and continuing medical education, little has been published in the literature about such integration at the undergraduate level. The authors describe the preliminary efforts of a joint clinical clerkship program with students from regional osteopathic and allopathic medical schools at a major community teaching hospital in New England. Osteopathic principles and practice are consistently reinforced, exposing students from both medical backgrounds to them. It is hoped that this pilot program serves as a model for developing similar combined programs throughout the United States.

Kirksville Osteopathic Hospital, the realization of worthy ambitions
Blair, J. T., Jr. (1950), J Osteopath (Kirksvill) 57(7): 18.

Lack of osteopathic component in anxiety supplement
Abend, D. S. (1997), J Am Osteopath Assoc 97(10): 571-2.

Lake Erie College of Osteopathic Medicine's independent study pathway program: an alternative medical school curriculum design
Ferretti, S. M., J. E. Mesina, et al. (2000), J Am Osteopath Assoc 100(11): 713-6.
Abstract: Lake Erie College of Osteopathic Medicine has developed an independent study pathway as an alternative to the traditional medical school curriculum design. Beginning with the 2001-2002 academic year, three equivalent and distinct curriculum pathways will be available to medical students at the Lake Erie College of Osteopathic Medicine: the lecture/discussion pathway, the problem-based learning pathway, and the independent study pathway (ISP). The ISP program will provide flexibility for students during their preclinical years. Using highly structured faculty-developed modules, students in the ISP program will be responsible for their own learning in a self-directed, independent manner, including when, where, what, and how to study. Examinations will be taken when students consider themselves ready. If examinations reveal deficiencies in student preparation, these deficiencies must be remedied before students continue their studies. Faculty will be available, as needed, to assist the students through difficult concepts and material.

Leadership opinions: the future of osteopathic postdoctoral training
Ward, W. D. (1987), J Am Osteopath Assoc 87(11): 735-44.

Learning difficulties of children viewed in the light of the osteopathic concept
Frymann, V. M. (1976), J Am Osteopath Assoc 76(1): 46-61.

Letter: Striated osteopathy in focal dermal hypoplasia
Larregue, M. and M. Duterque (1975), Arch Dermatol 111(10): 1365.

Levine's 'osteopathic hug' for self-administered OPP and OMT
Levine, H. M. (1999), J Am Osteopath Assoc 99(4): 198.

Lifestyle changes associated with osteopathic medical education
Crapse, F. J., Jr., P. M. Hudgins, et al. (1993), J Am Osteopath Assoc 93(10): 1051-4.
Abstract: A written survey of second-year osteopathic medical students at West Virginia School of Osteopathic Medicine was conducted to determine if detrimental lifestyle changes had occurred in the first 15 months of their medical education. Fifty-two (79%) of the 66 students returned the survey. The large majority of the responders (96%) reported a detrimental alteration in at least one area, and 81%, in two or more of the four areas surveyed. Changes in eating patterns were indicated by 79% of responding students. Increases in caffeinated beverage consumption were reported by 71% of respondents, and decreases in activity level, by 78%. Weight gains were indicated by 64% of respondents. Entering students should be advised of the risk that detrimental lifestyle changes may occur during their osteopathic medical education and be encouraged to prevent these harmful changes.

Living anatomy: an anatomic basis for the osteopathic concept
Isaacson, P. R. (1980), J Am Osteopath Assoc 79(12): 745-59.

Long-term CaCO3 treatment of chronic hemodialysis patients: an attempt to prevent aluminum osteopathy
Matsubara, M., H. Unagami, et al. (1988), ASAIO Trans 34(3): 168-71.
Abstract: Long-term CaCO3 treatment of chronic hemodialysis patients was studied. Single doses of CaCO3 were given to 25 patients, 23 of whom had been receiving Al(OH)3 before the study. When predialysis serum calcium (Ca) rose to greater than 5.5 mEq/L, CaCO3 was reduced and Al(OH)3 was administered again. Eighteen months later, serum phosphate (P) was well controlled, and predialysis serum P was less than 6.5 mg/dl in 14 patients given CaCO3 alone. Alkaline phosphatase (ALP) levels significantly decreased, and serum aluminum was remarkably lowered in patients who had discontinued Al(OH)3. In patients who resumed Al(OH)3, ALP levels rose after Al(OH)3 administration. Although levels of c-PTH did not change in CaCO3 treated patients, six patients with poor control of serum P before the study showed a significant decrease in c-PTH. These data indicate that CaCO3 is an effective P binder that stops the progression of silent osteopathy, presumably caused by oral intake of Al(OH)3, and may ameliorate these changes. However, further effort will be necessary to develop means to control serum Ca, because long-term use of CaCO3 induced hypercalcemia in half the patients.

Long-term, low-dose, cadmium-induced nephropathy with renal osteopathy in ovariectomized rats
Li, J. P., T. Akiba, et al. (1997), J Toxicol Sci 22(3): 185-98.
Abstract: To establish an animal model of chronic cadmium nephropathy and osteopathy, we intraperitoneally administered 0.228 mg CdCl2 (Cd) or normal saline (NS) to 52 female Sprague-Dawley (S.D.) rats 3 times a week for 16 months following ovariectomy (OV) or sham surgery (Sham), dividing the animals into three experimental groups (OV-Cd, Sham-Cd and OV-NS). Two groups of male S.D. rats were also administered Cd or NS (22 animals; Male-Cd and Male-NS). Cd-administered rats gained significantly less body weight than NS rats after 16 months of experiments with no signs of emaciation. Serum creatinine levels and Cd contents in the kidney had significantly increased in the Cd-administered rats. OV-Cd rats showed significant decreases in PTH levels and increases in calcium contents in the kidney and other organs. Kidneys of Cd-administered rats showed atrophy, dilatation, and interstitial fibrosis of tubules. Sclerosis and collapse of the glomeruli were observed in the Cd groups with no proliferation in mesangial cells or matrix. The Haversian canal system of the Cd-administered rats disappeared and was replaced by a large quantity of degenerated, necrotic, and restorative tissues. Bone histomorphometric parameters showed that osteoid volume and osteoid surface had significantly increased in the Male-Cd group. In contrast, decreases in bone mass and increases in fibrous tissue were found to be more prominent in the OV-Cd group. Our results have demonstrated for the first time that long-term, low-dose CdCl2 administration to ovariectomized S.D. rats is capable of inducing irreversible nephropathy with osteopathy exhibiting pathological and bone histomorphometric characteristics that are very similar to those of Itai-Itai disease.

Looking at the whole. Osteopathic health care in Michigan
Peters, B. (1997), Mich Health Hosp 33(3): 14-6.

Louisa Burns Memorial Lecture 1981: Planning, developing, and conducting osteopathic clinical research
Kelso, A. F. (1981), J Am Osteopath Assoc 80(11): 744-8.

Louisa Burns memorial lecture: biomechanics and osteopathic manipulative treatment
Soutas-Little, R. W. (1983), J Am Osteopath Assoc 83(1): 63-5.

Louisa Burns memorial lecture: measurement in medicine--the osteopathic perspective
Kimberly, P. E. (1985), J Am Osteopath Assoc 85(9): 595-8.

Low agreement of findings in neuromusculoskeletal examinations by a group of osteopathic physicians using their own procedures
McConnell, D. G., M. C. Beal, et al. (1980), J Am Osteopath Assoc 79(7): 441-50.

Low dose methotrexate osteopathy in a patient with polyarticular juvenile idiopathic arthritis
Quinn, M. A., M. J. Green, et al. (2003), Ann Rheum Dis 62(11): 1123-4; author reply 1124.

Low dose methotrexate osteopathy in a patient with polyarticular juvenile idiopathic arthritis
Rudler, M., J. Pouchot, et al. (2003), Ann Rheum Dis 62(6): 588-9.

Lower extremity problems in children. An osteopathic approach
Pratt, W. A. (1950), J Am Osteopath Assoc 50(3): 166-8.

Making a difference: the osteopathic approach lecture series
Danto, J. B. and T. R. Kavieff (1999), J Am Osteopath Assoc 99(3): 168-72.
Abstract: The Osteopathic Approach Lecture Series (Osteopathic AppLeS) was created in response to both the current need in the osteopathic medical profession for a distinctive osteopathic identity and lack of readily available information regarding an osteopathic approach. The series consisted of 16 lectures given to interns, externs, residents, and attendings at a community-based osteopathic hospital during a 10-month time span which emphasized and inculcated an osteopathic approach to patients with a variety of illnesses. Emphasis was placed on osteopathic manipulative treatment training throughout the series. Data were collected at individual presentations using a survey of participants and studied retrospectively. The results of the surveys indicated that using this type of presentation series may substantially increase confidence and knowledge in an osteopathic approach and osteopathic manipulative treatment skills.

Making sense of federal GME reforms: the impact on osteopathic medicine
Meyer, C. T. (1995), J Am Osteopath Assoc 95(4): 261-6.
Abstract: Physician workforce issues, particularly the generalist/specialist mix, surfaced as a major component of the healthcare reform debate in the last Congress. Both of the major bills before the Congress at the end of the session would have legislated reforms in graduate medical education designed to control the cost, mix, and supply of physician manpower. This article examines the graduate medical education reform measures proposed in the Gephardt (House) and Mitchell (Senate) bills and identifies elements of agreement. Discussion focuses on the potential for reforms that could be enacted in the new Congress, with a look at the implications for the osteopathic medical profession. A second article, to appear in next month's issue, will focus on recommendations for secondary reforms to prepare osteopathic medical institutions for the changing graduate medical education environment. Such a changing environment requires comprehensive reevaluation in all of the institutions of osteopathic medicine--the colleges, the hospitals, and the American Osteopathic Association.

Man the unit; an osteopathic philosophy
Thomas, R. B. (1952), J Am Osteopath Assoc 52(3): 155-9.

Man, the challenge to osteopathy, yesterday, today, and tomorrow
Allen, P. V. (1956), J Am Osteopath Assoc 56(2): 103-7.

Managed care education in osteopathic medical schools: development of a fourth-year predoctoral healthcare management clerkship
Riley, C., M. Adelman, et al. (2000), J Am Osteopath Assoc 100(11): 716-22.
Abstract: This article describes the current managed care curricula in osteopathic medical schools and summarizes the development and implementation of a healthcare management clerkship for fourth-year osteopathic medical students at Ohio University College of Osteopathic Medicine. Results of a survey of the 19 osteopathic medical schools indicated that only three schools currently have a stand-alone, managed care elective. No schools have required managed care courses, clerkships, or rotations. The remaining osteopathic medical schools have incorporated managed care-related topics into courses in their schools' curricula. To produce physicians fully competent to succeed in the 21st century's managed healthcare environment, medical schools need to affiliate with managed care organizations, integrate more managed care components into their curricula, and develop required or elective stand-alone managed care courses and clerkships. This article describes content to be integrated in a predoctoral managed care clerkship, including goals and objectives. It also describes the components and learning activities of Ohio University College of Osteopathic Medicine's Healthcare Management Clerkship.


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