| For medical practitioners and osteopaths - Osteopathy Journal Articles Catalog. |
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| Managed care: an opportunity for osteopathic physicians Ross-Lee, B. and M. A. Weiser (1994), J Am Osteopath Assoc 94(2): 149-56. Abstract: Managed care plans now enroll 38.6 million persons in the United States, and have increased their enrollment 14-fold in 5 years. The three major health reform proposals before Congress presently make managed care organizations, in one form or another, the linchpin of their reform plans. The authors trace the history of managed care leading to today's spectrum of plans from health maintenance organizations to preferred provider organizations with all their variants. They examine the government and insurance industry records of successes and failures and project the future for managed care with and without government-imposed healthcare reform. They unscramble the "alphabet soup" and detail the problems physicians have encountered in managed care settings. Given the key role of the primary care physician, the authors urge osteopathic physicians to take a proactive role in designing the shift to managed care. By supporting intelligent healthcare reform that brings physicians, hospitals, and insurers together in a practitioner-friendly system, the primary care physician can assume the leadership role in managed care and continue to serve as the patient advocate. |
| Managing back pain in general practice--is osteopathy the new paradigm? Williams, N. (1997), Br J Gen Pract 47(423): 653-5. Abstract: Back pain is a common problem in general practice, and is of enormous economic importance. A recent report urges general practitioners (GPs) to refer early for manual therapies, such as osteopathy. The key concept to understanding osteopathic principles is somatic dysfunction. This is a disorder of function, rather than pathology, of the musculoskeletal and related systems. Its characteristic features are asymmetry of anatomical landmarks, asymmetry of joint movement, tissue texture changes, and tenderness. The scientific basis of the tissue texture changes and tenderness can be explained in terms of the 'facilitated segment', but the cause of movement asymmetry remains elusive. Randomized controlled trials provide some support for the use of osteopathic treatment in acute low back pain. It is proposed that somatic dysfunction is the new paradigm for non-specific back pain. |
| Manipulation, osteopathy, and back pain Dove, C. I. (1979), Lancet 1(8130): 1350. |
| Manipulation; an explanation of osteopathic technique Stoddard, A. (1952), Br J Phys Med 15(7): 160-2. |
| Manipulative therapy in osteopathic management of hypertension Northup, T. L. (1950), J Osteopath (Kirksvill) 57(9): 15-22. |
| Manipulative treatment of carpal tunnel syndrome: biomechanical and osteopathic intervention to increase the length of the transverse carpal ligament Sucher, B. M. and R. N. Hinrichs (1998), J Am Osteopath Assoc 98(12): 679-86. Abstract: To quantify the amount of transverse carpal ligament (TCL) elongation in response to osteopathic manipulation or sustained load bearing (or both), a study involving seven cadaver limbs was conducted. Distances from the trapezium to the hamate (distance A) and from the scaphoid to the pisiform (distance B) were measured in five mounted cadaver limbs during and after the limbs bore the weight (2 newtons N to 4 N) for 2 several-hour periods. A several-hour period occurred between the weight bearing to assess recoil. Distances A and B were measured before and after the limbs were manipulated, according to previously described techniques, as well as with a new maneuver, termed the "guywire" technique. Two dissected limbs also were subjected to further weight bearing, this time increased to 8 N. Greater weight loads produced greater lengthening of the TCL, and recoil after removal of weight loads was slower than recoil after manipulation. Manipulation was more effective than weight loading for increasing distance A (distal canal), but weight loading generally was more effective than manipulation for increasing distance B (proximal canal). The guywire manipulation combined with direct transverse extension appeared to have the greatest impact on lengthening the TCL distally. These results show promise for the effective use of manipulation and load bearing for TCL elongation and nonsurgical relief of pressure on the median nerve in patients with carpal tunnel syndrome. |
| Manipulative treatment of carpal tunnel syndrome: biomechanical and osteopathic intervention to increase the length of the transverse carpal ligament: part 2. Effect of sex differences and manipulative "priming" Sucher, B. M., R. N. Hinrichs, et al. (2005), J Am Osteopath Assoc 105(3): 135-43. Abstract: As a theoretical basis for treatment of carpal tunnel syndrome (CTS) and expanding upon part 1 of this study, the authors investigated the effects of static loading (weights) and dynamic loading (osteopathic manipulation OM) on 20 cadaver limbs (10 male, 10 female). This larger study group allowed for comparative analysis of results by sex and reversal of sequencing for testing protocols. In static loading, 10-newton loads were applied to metal pins inserted into carpal bones. In dynamic loading, the OM maneuvers used were those currently used in clinical settings to treat patients with CTS. Transverse carpal ligament (TCL) response was observed by measuring changes in the width of the transverse carpal arch (TCA) with three-dimensional video analysis and precision calipers. Results demonstrated maximal TCL elongation of 13% (3.7 mm) with a residual elongation after recovery of 9% (2.6 mm) from weight loads in the female cadaver limbs, compared to less than 1 mm as noted in part 1, which used lower weight loads and combined results from both sexes. Favorable responses to all interventions were more significant among female cadaver limbs. Higher weight loads also caused more linear translatory motion through the metal pins, resulting in TCA widening equal to 63% of the increases occurring at skin level, compared to only 38% with lower loads. When OM was performed first, it led to greater widening of the TCA and lengthening of the TCL during the weight loading that followed. Both methods hold promise to favorably impact the course of management of CTS, particularly in women. |
| Mark Twain's osteopathic cure Barrett, W. G. (1953), Psychoanal Q 22(4): 539-47. |
| Marketing lessons and retaining the traditional osteopathic internship Broder, D. L. (2001), J Am Osteopath Assoc 101(9): 494, 496. |
| Marketing osteopathic medicine: a case study of Horizon Health Systems Rieder, J. L. (1987), Osteopath Hosp Leadersh 31(4): 13-5. |
| Maternal mortality under osteopathic care: twenty years' experience Orth, H. C., Jr. (1978), J Am Osteopath Assoc 78(1): 53-60. |
| Maternal mortality: report of ten-year study of patients under osteopathic care Bubeck, R. G., Jr., J. G. Matthews, Jr., et al. (1967), J Am Osteopath Assoc 67(4): 379-95. |
| Measurement of changes in blood volume as a result of osteopathic manipulation Eshleman, J., S. Myers, et al. (1971), J Am Osteopath Assoc 70(10): 1073-9. |
| Mechano-electric patterns during craniosacral osteopathic diagnosis and treatment Upledger, J. E. and Z. Karni (1979), J Am Osteopath Assoc 78(11): 782-91. |
| Medicaid reform: an opportunity for the osteopathic medical profession Ross-Lee, B. and M. A. Weiser (1994), J Am Osteopath Assoc 94(3): 233-9. Abstract: Established in 1965 to provide medical care for the impoverished, the Medicaid program has pitted state governments against the federal government, and made adversaries of the providers. The authors examine the legislative history of the program and the rapid growth of expenditures that have led states to cut benefits, tighten eligibility requirements, and slash payments to providers. The call for comprehensive healthcare reform and universal access put Medicaid at the forefront of proposed changes. The osteopathic medical profession, which already provides a quarter of the care in the program, has an opportunity to lead in innovation to promote program efficiencies, and to affirm the profession's commitment to serve vulnerable populations. |
| Medical and osteopathic boards' positions on chaperones during gynecologic examinations Daniel, W. D. (2000), Obstet Gynecol 95(2): 317. |
| Medical and osteopathic boards' positions on chaperones during gynecologic examinations Stagno, S. J., H. Forster, et al. (1999), Obstet Gynecol 94(3): 352-4. Abstract: OBJECTIVE: The objective of this study was to determine whether United States medical or osteopathic boards have opinions, position statements, or policies on chaperone use, and whether any state laws regulate chaperone use. METHODS: United States Medical and Osteopathic Boards were surveyed by mail to determine whether policies, opinions, positions, or laws exist regarding use of chaperones during gynecologic examinations. We sent the survey to executives at 67 state boards, identified by a list from The Federation of State Medical Boards. Our main outcome measure was positive response to the survey questions. RESULTS: Of 67 targeted sites, 61 responded (91%). Fourteen sites (23%) reported having informal or unpublished opinions recommending chaperones. Eleven sites (18%) reported having positions related to chaperones that have been published for their physicians. Four sites (6.5%) reported having policies specifically related to chaperone use. Thirty-two sites (52.5%) reported that they do not have opinions, positions, or policies related to chaperone use. No site reported state laws governing chaperone use. CONCLUSION: Response to our survey showed no concensus among state medical boards on the use of chaperones, leaving doctors and patients to decide for themselves whether they want or need chaperones present during gynecologic examinations. |
| Medical education in substance abuse: from student to practicing osteopathic physician Wyatt, S. A., W. Vilensky, et al. (2005), J Am Osteopath Assoc 105(6 Suppl 3): S18-25. Abstract: Substance use disorders (SUDs) have had a major impact on the health of the US population during the past decade. Osteopathic physicians have an important role among those who can make a positive impact on this problem. This article reviews the nature of the problem, how the osteopathic medical profession is currently addressing it, and a current strategy for improvement endorsed by the American Osteopathic Academy of Addiction Medicine. Early in 2004, the Office of National Drug Control Policy-backed by the US Surgeon General, the Center for Substance Abuse Treatment, the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, and the National Highway Traffic Safety Administration-has requested improvement in physician education on this health problem. This request culminated in the Office of National Drug Control Policy's establishing the Leadership Conference on Medical Education in Substance Abuse in December 2004. The osteopathic medical profession is represented in this critical review and formulation of recommendations for improving education on substance use disorders for the undergraduate, graduate, and practicing physician. |
| Medical facility brings osteopathic care to Philadelphia International Airport Gehlert, H. R. (1987), Osteopath Hosp Leadersh 31(2): 16-7. |
| Medical historiography: its place in osteopathic medicine. Part I. Early background and significance in medical education Reed, K. and C. R. Perakis (1984), J Am Osteopath Assoc 83(10): 738-40. |
| Medical historiography: its place in osteopathic medicine. Part II. Current status in osteopathic medical curricula and suggestions for consideration Perakis, C. R. and K. Reed (1984), J Am Osteopath Assoc 83(10): 740-4. |
| Medical licensure for osteopathic physicians in Louisiana: why the State Board of Medical Examiners should accept the NBOME Bellemare, N. A. (1995), J La State Med Soc 147(10): 431-4. Abstract: The Louisiana State Board of Medical Examiners does not recognize the examination offered by the National Board of Osteopathic Medical Examiners as a valid pathway to licensure, either directly or by endorsement. The State Board recognizes the United States Medical Licensing Examination (USMLE) as the appropriate examination for direct licensure. For licensure by endorsement, the State Board will license physicians who have passed any of the allopathic national licensing examinations. Osteopathic physicians do not take the USMLE or other allopathic licensing examinations because they test students on allopathic medical education and do not measure osteopathic medical training. Instead, osteopathic medical students take the examination offered by the National Board of Osteopathic Medical Examiners. The National Board of Osteopathic Medical Examiners' test is accepted by every other state and is an appropriate measure of the abilities of osteopathic physicians. |
| Medical staff appointments in public hospitals. III. Professional misconduct and rights of osteopathic physicians Hayt, E. (1956), Hospitals 30(10): 58-64. |
| Medical testimony in an industrial traumatic neurosis case, showing the direct and cross-examinations of the plaintiff's osteopathic physician, and the defendant's neuropsychiatrist, orthopedic surgeon and radiologist Cline, W. B. (1970), Med Trial Tech Q 17(1): 99-136. |
| Medicine and osteopathy Swanberg, H. (1952), Miss Valley Med J 74(2): 61-2. |
| Meeting the challenges of the 'triple threat' makes for a complete osteopathic physician Patterson, M. M. (1999), J Am Osteopath Assoc 99(3): 140-1. |
| Metaphyseal osteopathy (hypertrophic osteodystrophy) in growing dogs. A clinical study Grondalen, J. (1976), J Small Anim Pract 17(11): 721-35. |
| Metaphyseal osteopathy: (hypertrophic osteodystrophy) Rendano, V. T., R. Dueland, et al. (1977), J Small Anim Pract 18(10): 679-82. |
| Methotrexate (MTX) inhibits osteoblastic differentiation in vitro: possible mechanism of MTX osteopathy Uehara, R., Y. Suzuki, et al. (2001), J Rheumatol 28(2): 251-6. Abstract: OBJECTIVE: To clarify the mechanism of impaired bone formation during low dose methotrexate (MTX) therapy. METHODS: The in vitro effects of MTX on the function and differentiation of osteoblastic cells were investigated using (1) a mouse osteogenic cell line (MC3T3-E1) with the capacity to differentiate into osteoblastic or osteocytes, (2) a human osteoblastic osteosarcoma cell line (SaOS-2) with a mature osteoblastic phenotype, and (3) mouse bone marrow stromal cells containing osteoblast precursors. Osteoblast function was assessed by measuring the cellular activity of alkaline phosphatase (ALP) and the mineralization capacity of cultures. RESULTS: MTX suppressed ALP activity dose-dependently in growing MC3T3-E1 cells, but proliferation of these cells was only inhibited by a high concentration of MTX. In contrast, inhibition of ALP activity in MC3T3-E1 cells of mature osteoblastic phenotype was only observed with 10(-8) M and 10(-7) M MTX, and proliferation was not influenced. ALP activity and the proliferation of SaOS-2 cells were not inhibited by MTX, even when growing cells were treated. However, both ALP activity and formation of calcified nodules in bone marrow stromal cell cultures were significantly suppressed by MTX at concentrations between l0(-10) and 10(-7) M. CONCLUSION: These results suggest that MTX suppresses bone formation by inhibiting the differentiation of early osteoblastic cells. |
| Methotrexate osteopathy Rooney, P. (1997), J Rheumatol 24(10): 2051. |
| Methotrexate osteopathy Schwartz, A. M. and J. C. Leonidas (1984), Skeletal Radiol 11(1): 13-6. Abstract: Methotrexate osteopathy is an uncommon complication of long-term oral maintenance therapy for childhood neoplasms, most commonly acute lymphocytic leukemia. It is characterized by severe lower extremity pain and by osteoporosis particularly involving the lower extremities and thick dense provisional zones of calcification and growth arrest lines resembling scurvy. Fractures may occur. The appearance must be distinguished from recurrent or metastatic disease. |
| Methotrexate osteopathy demonstrated by Technetium-99m HDP bone scintigraphy Stevens, H., J. W. Jacobs, et al. (2001), Clin Nucl Med 26(5): 389-91. Abstract: The authors report a case of methotrexate osteopathy as revealed by Tc-99m HDP bone scintigraphy in a patient with rheumatoid arthritis. Methotrexate is used widely in high doses as a chemotherapeutic agent. Lower doses are given in rheumatoid and psoriatric arthritis. Methotrexate affects bone metabolism, resulting in methotrexate osteopathy, characterized by osteoporosis, osseus pain, and even spontaneous (micro)fractures. Radiographic visualization of microfractures is difficult. Tc-99m HDP bone scans have been shown to be very sensitive in the visualization of changes in bone metabolism as a result of methotrexate osteopathy. |
| Methotrexate osteopathy in infants with tumors of the central nervous system Meister, B., I. Gassner, et al. (1994), Med Pediatr Oncol 23(6): 493-6. Abstract: Methotrexate osteopathy, previously reported as a complication of maintenance-therapy for acute lymphoblastic leukemia, is characterized by osteopenia, particularly involving the lower extremities, thick, dense provisional zones of calcification, growth arrest lines, and corner fractures resembling scurvy. In attempts to postpone radiotherapy in infants under three years of age, the multicentric German therapy protocol for childhood central nervous system tumors (HIT-89 protocol) has employed high cumulative methotrexate doses. Here we describe osteopathy in three patients as a toxic side effect after administration of cumulative methotrexate doses of 20 g/m2, 80 g/m2 and 135 g/m2. The high prevalence of this adverse effect in infants with tumors of the central nervous system may be attributed to the long-term therapy with high cumulative methotrexate-doses. Both factors may favor intracellular accumulation of methotrexate and formation of methotrexate-polyglutamates and may be responsible for bone toxicity. Apparently the susceptibility of the rapidly growing skeletal structures of infants under three years of age to this toxic side effect of methotrexate is remarkably high. |
| Methotrexate osteopathy in long-term, low-dose methotrexate treatment for psoriasis and rheumatoid arthritis Zonneveld, I. M., W. K. Bakker, et al. (1996), Arch Dermatol 132(2): 184-7. Abstract: BACKGROUND: In dermatology and rheumatology, methotrexate is frequently prescribed in low dosages per week; in oncology, high dosages per week are prescribed. Methotrexate osteopathy was first reported in children with leukemia treated with high doses of methotrexate. In animal studies, low doses of methotrexate proved to have an adverse effect on bone metabolism, especially on osteoblast activity. OBSERVATIONS: Methotrexate osteopathy is a relatively unknown complication of low-dose methotrexate treatment. We describe three patients treated with low-dose oral methotrexate in whom signs and symptoms were present that were similar to those found in children treated with high doses of methotrexate. All three patients had a triad of severe pain localized in the distal tibiae, osteoporosis, and compression fractures of the distal tibia, which could be identified with radiographs, technetium Tc 99m scanning, and magnetic resonance imaging. CONCLUSIONS: Methotrexate osteopathy can occur in patients treated with low doses of methotrexate, even over a short period of time. As pain is localized in the distal tibia, it is easily misdiagnosed as psoriatic arthritis of the ankle, but the diagnosis can be correctly made by careful investigation and use of imaging techniques. The only therapy is withdrawal of methotrexate. It is important that more physicians become aware of this side effect of methotrexate therapy, which can occur along with arthritic symptoms. |
| Methotrexate osteopathy in patients with osteosarcoma Ecklund, K., T. Laor, et al. (1997), Radiology 202(2): 543-7. Abstract: PURPOSE: To determine the frequency of osteopathy in patients treated with high-dose, short-term, intravenous methotrexate for osteosarcoma and whether this complication varies with patient age and methotrexate dose. MATERIALS AND METHODS: Radiographs and available scintigrams of 87 patients with osteosarcoma who received high-dose methotrexate were reviewed retrospectively for severe osteopenia, dense zones of provisional calcification, insufficiency fractures, and involvement of multiple bones. At least three of these radiographic abnormalities were required for the diagnosis of osteopathy. Patients with bone metastases were excluded. RESULTS: Eight patients (cumulative dose, 60-144 g/m2) exhibited adverse skeletal findings similar to those described in children with leukemia who received low-dose maintenance methotrexate. Images showed severe osteopenia (n = 8), dense zones of provisional calcification (n = 8), multiple bone involvement (n = 6), and insufficiency fractures (n = 6). Most commonly affected sites were the distal tibia (n = 7), distal radius and proximal humerus (n = 3), and calcaneus and public ramus (n = 2). The affected patients were significantly younger (mean age, 9.2 years; P <.001) than the 79 unaffected patients (mean age, 14.9 years). CONCLUSION: Osteopathy occurs in approximately 9% of children who receive high-dose methotrexate for osteosarcoma and is substantially more likely to occur in younger patients. The complication rate was not directly dose dependent. |
| Methotrexate osteopathy in rheumatic disease Preston, S. J., T. Diamond, et al. (1993), Ann Rheum Dis 52(8): 582-5. Abstract: OBJECTIVE--To determine whether two adults with stress fractures receiving low weekly doses of methotrexate had methotrexate osteopathy. CASE REPORTS--Two adult patients developed features consistent with methotrexate osteopathy while receiving low weekly doses of methotrexate. METHODS--Iliac crest biopsy samples were taken and bone histomorphometry carried out. RESULTS--Symptoms resolved when the methotrexate was discontinued. Bone histology showed changes consistent with osteoblast inhibition by methotrexate. CONCLUSIONS--When given in low doses for prolonged periods, methotrexate may have adverse effects on bone, particularly in post-menopausal women. |
| Methotrexate osteopathy, does it exist? Maenaut, K., R. Westhovens, et al. (1996), J Rheumatol 23(12): 2156-9. Abstract: We describe 2 postmenopausal women with rheumatoid arthritis (RA). They developed fractures during their treatment with weekly low dose methotrexate (MTX). The adverse effect of longterm low dose regimens of MTX on bone metabolism has been described as "methotrexate osteopathy," an analogy of the syndrome known in pediatric oncology. MTX may be an additional risk factor for osteoporosis and fractures in RA. This therapy should be relatively contraindicated in patients with multiple risk factors for osteoporosis. |
| Michigan's osteopathic physicians and continuing education Kotre, J. N., F. C. Mann, et al. (1972), J Am Osteopath Assoc 71(11): 982-94. |
| Midwifery. Osteopathy during pregnancy Montague, K. (1985), Nurs Mirror 161(5): 26-8. |
| Missouri campaign completes cycle in osteopathic progress fund activity Chapman, L. F. (1951), J Osteopath (Kirksvill) 58(12): 24-5. |