Journal of Osteopathic Medicine最新文献

{"title":"Carpal tunnel dimensions following osteopathic manipulation utilizing dorsal carpal arch muscle energy: a pilot study.","authors":"Lilian Zhan, Juanita Brown, Sharon Gustowski, Patrick Davis, Mario Loomis","doi":"10.1515/jom-2024-0167","DOIUrl":"https://doi.org/10.1515/jom-2024-0167","url":null,"abstract":"<p><strong>Context: </strong>Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. When mild to moderate in severity, nonoperative treatments including osteopathic manipulative treatment (OMT) have been found to be effective. Studies have been carried out to quantify the mechanism of such treatments with cadaver studies, magnetic resonance imaging (MRI), and ultrasound.</p><p><strong>Objectives: </strong>This pilot project investigated the mechanism of a previously undescribed technique of nonoperative carpal tunnel treatment, dorsal carpal arch muscle energy (DCA-ME), which focuses on the dorsal arch (trapezium, trapezoid, capitate, and hamate bones) manipulating the bones to redome the arch, round the tunnel, and increase its volume. Although the actual effectiveness of such manipulation in the treatment of CTS can only be assessed and quantified in patients with the disorder, this initial study was carried out to see if it was feasible for physical changes following DCA-ME to be quantified with ultrasound.</p><p><strong>Methods: </strong>A pilot study of 25 healthy volunteers with no prior history of CTS or related disorders was undertaken to quantify anatomical changes in carpal tunnel dimensions following OMT of the nondominant wrist, utilizing DCA-ME. The subjects were randomly assigned to either the OMT group (n=14) or the control group (n=11). The control group underwent a sham manipulation. Pre- and postultrasound measurements of carpal tunnel dimensions were made. The study employed a two-group, pre-/postmanipulation design to evaluate the anatomical changes resulting from the OMT manipulation compared to those following the control sham manipulation.</p><p><strong>Results: </strong>Comparison of the OMT and control groups revealed a mean increase in carpal tunnel depth from 0.45 mm ± 0.13 mm pre-OMT to 0.48 mm ± 0.13 mm post-OMT (p=0.0146, Cohen's <i>d</i>=0.214, 95 % CI 0.0068 to 0.0517). There was also a mean increase in cross-sectional area from 1.83 mm<sup>2</sup> ± 0.56 mm<sup>2</sup> pre-OMT to 1.98 mm<sup>2</sup> ± 0.59 mm<sup>2</sup> post-OMT (p=0.0058, Cohen's <i>d</i>=0.260, 95 % CI 0.0517 to 0.2490). There was no significant difference in canal width (p=0.5973) or transverse carpal ligament length (p=0.2673) following OMT intervention. The control group, which received the sham procedure, demonstrated no significant differences in the transverse carpal ligament length, carpal tunnel width, depth, or cross-sectional area before and after the sham intervention.</p><p><strong>Conclusions: </strong>Ultrasound measurements at the narrowest section of the carpal tunnel before and after DCA-ME OMT of healthy asymptomatic wrists demonstrated a significant increase in cross-sectional area as well as depth, with no significant change in the length of the transverse carpal ligament, suggesting that the cause of the increased volume is an alteration of dorsal arch shape. A limitation of the study is the small sample siz","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of osteopathic manipulative treatment on chronic rhinosinusitis.","authors":"Marija Rowane, Ashwin Shankar, Supriya Nagireddi, Amanpreet Kalkat, Cheryl Hammes, Eshika Kohli, Meghan Callahan, Robert Hostoffer","doi":"10.1515/jom-2024-0122","DOIUrl":"https://doi.org/10.1515/jom-2024-0122","url":null,"abstract":"<p><strong>Context: </strong>Chronic rhinosinusitis (CRS) is a prevalent inflammatory disease of the paranasal sinuses that may significantly impair quality of life. CRS may also benefit from the application of manual techniques through osteopathic manipulative treatment (OMT), which aims to improve venous and lymphatic circulation, sympathetic and parasympathetic outflow, and cervicothoracic somatic dysfunction.</p><p><strong>Objectives: </strong>This study aimed to assess whether OMT focused on lymphatic drainage of cranial structures can provide immediate, as well as sustained, relief of CRS symptoms.</p><p><strong>Methods: </strong>This prospective, single-blinded study (WCG IRB study number: 1359444) was conducted at an allergy/immunology practice. Study participants included 43 adult patients, with a diagnosis of CRS, refractory to conventional medical therapy, with prior exposure to OMT. Patients consented to the study and were assigned by the provider to the OMT group or the control group 50/50. A four-question, 5-point Likert scale survey inquiring about the severity of nasal congestion, postnasal drainage, and facial or sinus pain/pressure, as well as the appreciation of the opportunity for an alternative therapy, was administered prior to the intervention. An OMT sequence was applied by the same osteopathic physician to each OMT group participant in the following order: thoracicinlet release, venous sinus drainage, occipital-atlantal decompression, thoracic paraspinal inhibition, facial sinus pressure, and Galbreath technique. A structural examination involving light touch was applied to the control group participants. The same 5-point Likert scale survey was administered immediately after the intervention. Participants were provided a blank copy of the survey to save and complete 10 days after the intervention. A paired <i>t</i>-test was applied for statistical comparison between the pre- and postsurveys.</p><p><strong>Results: </strong>A total of 43 patients, including 22 patients in the treatment group (51.1 %) and 21 (48.8 %) patients in the control group, consented to and participated in the study, from May 1 to 30, 2024. Study demographics included 76.7 % females (n=33), 23.3 % males (n=10), 97.7 % White (n=42), and they patients had an average age of 54.4 years. Surveys administered before and immediately after the intervention were completed by 100 % of the study participants. All three surveys, including the presurvey and postsurvey completed immediately after and 10 days after the intervention, were completed by 60.5 % of the study participants. The OMT group pre-vs. immediate postsurvey results scored a statistically significant decrease in the severity of nasal congestion (p=0.001), postnasal drainage (p=0.002), and facial or sinus pain or pressure (p=0.0004).</p><p><strong>Conclusions: </strong>Our single-blinded, prospective survey findings suggested that there was a benefit of OMT application for the immediate relief of ","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in osteopathic medical education: a scoping review.","authors":"Katie Hoskins, Molly Montgomery, Abbey Griffith, Hannah Pollard, Debra Orr-Roderick, Darell Schmick, Jeanne Strausman, Sarah Wade, Melinda Robertson, Megan DeArmond","doi":"10.1515/jom-2024-0051","DOIUrl":"https://doi.org/10.1515/jom-2024-0051","url":null,"abstract":"<p><strong>Context: </strong>Following the transition to a single graduate medical education (GME) accreditation system in 2020, leaders at American Association of Colleges of Osteopathic Medicine (AACOM) were interested in learning more about the research being done about osteopathic medical education leading up to that point in time.</p><p><strong>Objectives: </strong>The objective of this scoping review was to identify trends in undergraduate and graduate osteopathic medical education and to determine where this information was being disseminated and the institutions who were creating the content.</p><p><strong>Methods: </strong>Searches were conducted in eight databases: PubMed (National Center for Biotechnology Information [NCBI]), MEDLINE (Ovid), Embase (Elsevier), Cumulative Index to Nursing and Allied Health Literature ([CINAHL], EBSCO), Education Research Complete (EBSCO) OSTMED.DR, Education Resources Information Center ([ERIC], Ovid), and Scopus (Elsevier). Gray literature sources were also identified. All 10 authors were involved in the search. Search terms were identified by utilizing Medical Subject Headings (MeSH), the Yale MeSH Analyzer, and through consultation with an expert searcher. Sources were excluded if they were not in English, were based outside of the United States, did not fit in the date range of being published between 2010 and 2020, and included information on COVID-19. The research team conducted title/abstract screening based on the inclusion and exclusion criteria.</p><p><strong>Results: </strong>A total of 8,083 articles were identified and included through searches, ending in a total of 1,203 articles after full-text screening. Most sources for this osteopathic medical education review were journal articles (n=505) and conference proceedings (n=482). A total of 23 trends were identified, with the top three being residency (n=318), curriculum (n=235), and pedagogy (n=178). None of the other 23 primary trends were above 6.9 %.</p><p><strong>Conclusions: </strong>Osteopathic medical education trends from 2010 to 2020 were primarily focused on residency, curriculum, and pedagogy. This information was disseminated evenly between published journal articles and conference presentations, and osteopathic institutions that have existed longer and have established research track records were more likely to publish and share information in this area.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining the effects of social media engagement on surgery residents within the American College of Osteopathic Surgeons.","authors":"Vincent S Alexander, Bebe Eke, Andrew Xu, Ryan Wong, Andrew Greek, Michael Ernst, Hayden Roberts, Ogechukwu Ariwodo, Andrew D Vogel, Bracken Burns, Kristen Conrad-Schnetz","doi":"10.1515/jom-2024-0213","DOIUrl":"https://doi.org/10.1515/jom-2024-0213","url":null,"abstract":"<p><strong>Context: </strong>The widespread adoption of social media has transformed how individuals connect in medicine. This study explores how social media can be utilized as a conduit to connect osteopathic medical students and residents. By examining how these digital connections can support professional development, this study investigates social media's role as a potential foundation for a mentorship program, fostering guidance, support, and career insights for osteopathic medical students within the surgical field.</p><p><strong>Objectives: </strong>This study aimed to evaluate the effectiveness of \"X\" (formerly Twitter) in networking between osteopathic medical students and surgical residents, specifically assessing engagement rates and the potential of social media as a tool for mentorship in the osteopathic surgical community.</p><p><strong>Methods: </strong>The Accreditation Council on Graduate Medical Education (ACGME)-approved surgical programs that the American College of Osteopathic Surgeons (ACOS) represents were identified online. Doctor of Osteopathic Medicine (DO) residents were identified retrospectively through an online search of publicly available data. Residents and programs were searched through X, and account handles were collected. Residents were contacted through X by direct messaging and subsequently directly commented in the initial ACOS Medical Student Section (ACOS-MSS) message. Descriptive statistics along with the chi-square and Fisher's exact statistical tests were utilized for demographic and categorical variable analysis, respectively.</p><p><strong>Results: </strong>There are 1179 DO surgical residents in ACGME programs, with 84.8 % of those being General Surgery residents. Among residents, 75 % of Cardiothoracic (CT) Surgery, 46.4 % of Urology, 28.6 % of Neurosurgery, 17.3 % of General Surgery, and 11.11 % of Plastic Surgery residents have X accounts. Specific surgical subspecialties are more likely to have an X account in comparison to General Surgery, including CT Surgery (odds ratio [OR], 11.13; p=0.02), Urology (OR, 4.13; p<0.0001), and Neurosurgery (OR, 0.842; p=0.047). After multiple attempts, 0 % of Plastic Surgery, 2.9 % of General Surgery, 7.8 % of Urology, 18.8 % of Neurosurgery, and 33.3 % of CT Surgery residents signed up for the mentorship program, totaling 13 residents.</p><p><strong>Conclusions: </strong>The study reveals low social media engagement via X among osteopathic surgical residents, with notable variation across surgical specialties. This limited engagement suggests exploring and refining social media strategies that foster mentorship connections within the osteopathic surgical community. Future studies should examine other social media platforms and alternative engagement approaches to enhance the reach and impact of mentorship initiatives, ultimately supporting osteopathic medical students as they navigate career paths in surgery.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pityriasis lichenoides chronica presenting in skin of color.","authors":"Bailey Cook, Richard Bindernagel, Robert Dazé, Richard Miller","doi":"10.1515/jom-2024-0220","DOIUrl":"https://doi.org/10.1515/jom-2024-0220","url":null,"abstract":"","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a clinician-directed educational program on communicating with patients regarding gun violence at two community urban healthcare centers.","authors":"Erik Langenau, Alexa M Kaminsky, Michael B Roberts","doi":"10.1515/jom-2024-0245","DOIUrl":"https://doi.org/10.1515/jom-2024-0245","url":null,"abstract":"<p><strong>Context: </strong>Gun violence negatively impacts not only victims but also their families and surrounding communities. Resources and counseling services may be available to support families affected by gun violence, but the families and their clinicians may not know about these resources or how to access them.</p><p><strong>Objectives: </strong>The objective of this study was to investigate the impact of a clinician-directed educational program on patient reports of their discussions with their physician regarding gun violence, prevention, and available resources for support and treatment.</p><p><strong>Methods: </strong>This quasi-experimental, cross-sectional, survey-based, quality-improvement study included pre-, mid-, and posttraining surveys administered to patients and clinicians participating in an educational program at two urban healthcare centers in Philadelphia. The educational program included office enhancements (handouts and posters) and lunchtime presentations for clinicians regarding gun violence prevalence, prevention strategies, local support resources, and impacts on mental health for patients and their families. The anonymous patient survey was offered to all patients seen at two urban healthcare centers in Philadelphia during three nonconsecutive weeks over 3 months.</p><p><strong>Results: </strong>Among 542 patients seen over the 3 weeks of survey collection, 428 completed the survey (response rate of 79 %). Sixty-four percent acknowledged being impacted by gun violence including the death of a loved one, witnessing a shooting, or being shot themselves. Over the course of the educational program, patients reported significant increases in (1) awareness of materials related to gun violence in the waiting areas, by 17.2 %, (2) discussions of gun violence with their clinician, by 12.1 %, and (3) discussions of methods to prevent gun injury, by 9.7 %. At the end of the study, 19.3 % of patients reported having discussions with their clinician about gun violence, and 14.3 % discussed strategies to prevent gun injury. Participating clinicians reported high levels of satisfaction and increased confidence when talking to patients about gun violence at the end of the program.</p><p><strong>Conclusions: </strong>Providing clinician-directed education and printed materials increased the frequency with which clinicians discussed gun violence, prevention, and available resources with their patients. Increases were modest, with opportunities for improvement. A holistic and multifaceted approach is required to support families affected by gun violence, including education for clinicians and dissemination of information for families.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent and future trends in osteopathic orthopedic surgery residency match rates following the transition to a single accreditation system.","authors":"Morgan Turnow, Minali Nemani, Nithin Gupta, Hayden Hartman, Taylor Manes, Tyler Williamson, Arianna Gianakos","doi":"10.1515/jom-2024-0117","DOIUrl":"https://doi.org/10.1515/jom-2024-0117","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Context: &lt;/strong&gt;Medical education in the United States has undergone significant changes, specifically within the osteopathic community. In 2020, a merger occurred between the American Osteopathic Association (AOA) and the Accreditation Council for Graduate Medical Education (ACGME), forming a single accreditation system (SAS) for graduate medical education and residency placement, with the purpose to create consistency within graduate medical education and to provide equal opportunities for applicants pursuing all specialties in medicine. However, osteopathic medical students, especially students applying to competitive residencies including orthopedic surgery, have faced challenges, raising concerns about future implications within this field.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The main objective of this study aimed to investigate recent match rate trends in orthopedic surgery within the past 5 years and to forecast match trends for both allopathic and osteopathic students to further analyze the future projection of the orthopedic surgery match.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study utilized publicly available data from the National Residency Match Program (NRMP) Main Residency Match data. Data were collected retrospectively from 2020 to 2024 regarding students applying for orthopedic surgery residency. The number of matched Doctor of Osteopathic Medicine (DO) applicants, Doctor of Medicine (MD) applicants, overall applicants, and the proportion of matched applicants being DOs were forecasted over the next 10 years utilizing an Autoregressive Integrated Moving Average (ARIMA) model in SPSS 29.0. This model harvests data from previous instances (number of matched applicants from 2008 to 2024) to develop a close-fit model to predict future values and their respective confidence intervals (CIs). This study incorporated all applicants applying to orthopedic surgery, including international medical graduates (IMGs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There was an increase in the total applicants applying to orthopedic surgery residency positions for both allopathic and osteopathic students. The largest increase in applicants occurred between the 2021 and 2022 application cycles. There was a statistically significant difference in the total number of applicants overall over the 2020-2024 match cycle. The percentage of DOs to match into an orthopedic surgery residency position decreased from 63.28 % in 2020 to 45.70 % in 2024, and there was a statistically significant decline in the match percentage of DOs in orthopedic surgery residency over the 2020-2024 match cycle. Based on the ARIMA model projection utilizing data from 2008 to 2024, there is expected to be an average increase of 14.1 % in the total number of positions offered by 2034, to 1,045 positions total. There is expected to be a moderate increase in the number of matched DO applicants, from 128 in 2024 to 161 in 2034. Utilizing data from 2016 to 2024, there is expected to be","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving vascular access knowledge and assessment skill of hemodialysis staff.","authors":"Kyle Smith, Candace Ayars","doi":"10.1515/jom-2023-0262","DOIUrl":"https://doi.org/10.1515/jom-2023-0262","url":null,"abstract":"<p><strong>Context: </strong>Vascular access malfunction and failure contribute to morbidity and hospitalization in hemodialysis populations. Although controversy still exists over the identification and appropriate management of access malfunction, recognition of sentinel signs during physical examination remains an efficient way to screen for access malfunction. Dialysis staff are on the front line of providing quality care to dialysis patients, often being the first ones who could detect early physical signs of access malfunction.</p><p><strong>Objectives: </strong>The study's purpose is to determine the effect of an advanced vascular access educational module presented to hemodialysis nurses and technicians, focusing on physical examination findings to identify a dialysis access at risk for malfunction.</p><p><strong>Methods: </strong>Utilizing a quasi-experimental pretest and posttest group design with a nonequivalent comparison control group, the effect of an advanced vascular access education module to improve vascular access knowledge and skill in recognition of sentinel signs of access malfunction was studied in a group of hemodialysis nurses (registered nurses [RNs]) and certified patient care technicians (PCTs).</p><p><strong>Results: </strong>Knowledge post-test scores (RN, M=94.44, SD=7.05; PCT, M=90.83, SD=7.93) were significantly higher than pretest scores (RN, M<i>=</i>79.54, SD<i>=</i>12.47; PCT M=80.67, SD<i>=</i>7.99) in the intervention group (p<0.001) but not in the comparison group. There were no statistically significant differences in mean skill scores between dialysis nurses (p=0.38) and PCTs (p=0.826) or between intervention and comparison groups (p=0.332).</p><p><strong>Conclusions: </strong>This study exposes a critical gap in the transition of vascular access knowledge to the practical skill of access assessment. The findings suggest the need for restructuring the clinical training of dialysis nurses and PCTs in vascular access management and care. Newer active learning educational strategies in physical assessment of hemodialysis vascular access should be explored to further support dialysis nurses and PCTs in providing optimal patient care.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stressbusters: a pilot study investigating the effects of OMT on stress management in medical students.","authors":"Robert Valencia, Gowtham Anche, Gabriela Do Rego Barros, Victor Arostegui, Henal Sutaria, Emily McAllister, Mary Banihashem, Mikhail Volokitin","doi":"10.1515/jom-2024-0020","DOIUrl":"10.1515/jom-2024-0020","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Context: &lt;/strong&gt;Medical students report high levels of perceived stress and burnout, especially during the preclinical years. The combination of physical stressors from poor posture, poor sleep quality, and mental stressors from the rigorous curriculum stimulates the sympathetic nervous system (SNS) to secrete cortisol. Previous studies have shown that persistent elevated cortisol levels are associated with negative health outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;We conducted an Institutional Review Board (IRB)-approved study to determine if regular osteopathic manipulative treatments (OMTs) could impact the stress levels of first-year osteopathic medical students (OMSs) at Touro College of Osteopathic Medicine (TouroCOM) Harlem campus by measuring physiologic stress through changes in weekly salivary cortisol levels, perceived emotional and psychological stress levels, and cognitive function.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We recruited 10 first-year OMSs who were not currently receiving external OMT outside of weekly coursework; other forms of external stress management, such as yoga or meditation, were not controlled for in this study. Utilizing a random number generator, the 10 student respondents were split into a control group that received no treatment and a treatment group that received 15 min of weekly OMT for 6 weeks. The treatment consisted of condylar decompression, paraspinal inhibition, and supine rib raising, which are techniques that are known to balance the SNS and parasympathetic nervous system (PNS). Cortisol levels were quantified by enzyme-linked immunosorbent assay (ELISA) cortisol immunoassay via salivary samples collected at the beginning of each weekly session, prior to treatment for the treatment group, at the same time of day each week. We also measured participants' weekly subjective perception of stress utilizing the College Student Stress Scale (CSSS) and cognitive function utilizing the Lumosity Performance Index (LPI). We conducted a two-tailed, unpaired &lt;i&gt;t&lt;/i&gt;-test as well as a U test for the cortisol levels, given the smaller sample size and potential for a nonnormal distribution.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A lower cortisol level was correlated to a higher optical density (OD), the logarithmic measure of percent transmission of light through a sample; analysis of our data from the ELISA cortisol immunoassay showed an average weekly change in OD (∆OD) for the treatment group of 0.0215 and an average weekly ∆OD of -0.0044 in the control group. The &lt;i&gt;t&lt;/i&gt;-test showed p=0.0497, and our U test showed a p=0.0317. Both tests indicated a statistically significant decrease across the weekly salivary cortisol levels in the treatment group utilizing a p&lt;0.05. An additional effect-size analysis supported our finding of a significant decrease in weekly cortisol levels in the treatment group, Cohen's &lt;i&gt;d&lt;/i&gt;=1.460. Based on the CSSS responses, there was no significant difference in perceived stress b","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of endometriosis: a call to multidisciplinary approach.","authors":"Jordann-Mishael Duncan, Ritchie Delara, Gina Ranieri, Megan Wasson","doi":"10.1515/jom-2024-0105","DOIUrl":"https://doi.org/10.1515/jom-2024-0105","url":null,"abstract":"<p><p>Endometriosis is defined as the presence of endometrial-like glands and stroma outside of the uterus. There are three types of endometriotic lesions: superficial or peritoneal endometriosis, ovarian endometrioma, and deep infiltrating disease. Endometriosis not only occurs in the pelvis but also can be found in extrapelvic sites such as the gastrointestinal tract, upper abdominal viscera, genitourinary tract, abdominal wall, diaphragm, and thoracic cavity. After thorough history and physical examination is performed, imaging, such as ultrasound or magnetic resonance imaging (MRI), should be obtained if there is high suspicion for deep-infiltrating endometriosis to better assess visceral involvement. Endometriosis can be suspected based on symptoms, physical examination findings, and imaging. However, a definitive diagnosis requires histopathologic confirmation. Treatment options include expectant, medical, and surgical management. Endometriosis is largely a quality-of-life issue, and treatment should be tailored accordingly with empiric medical therapy frequently utilized. Medical management focuses on symptom improvement. Surgical management with excision of endometriosis is preferred over ablation or fulguration of endometriotic lesions. In the case of deep or extrapelvic endometriosis, treatment with a multidisciplinary team with experience in the treatment of advanced-stage endometriosis is essential to minimizing morbidity and increasing long-term success.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}