Rachel Shmuts, Heather Soled, Shika Patel, D. Abend
{"title":"The Virtues of Osteopathic Manipulative Treatments in Patients with Opioid Use Disorder","authors":"Rachel Shmuts, Heather Soled, Shika Patel, D. Abend","doi":"10.33181/13091","DOIUrl":"https://doi.org/10.33181/13091","url":null,"abstract":"As America continues to face the opioid epidemic, numerous people have made great strides in receiving formal treatment for their opioid use disorder (OUD). This research seeks to examine the effects of providing osteopathic manipulative treatment (OMT) along with traditional OUD pharmacological methods in providing results for patients. By using prior research on OMT techniques, we were able to uncover how effective OMT can be in reducing the time and discomfort associated with seeking opioid recovery. Osteopathic manipulative treatment, in combination with traditional pharmacology, was associated with reduction of somatic pain, higher success with medication-assisted treatment and lower costs. This research also highlights the importance of OMT in the era of COVID-19 social distancing, as well as special considerations when treating those with trauma histories associated with their disorder. We argue the benefit of OMT in combination with pharmacological methods can be successful at reducing the overall burden of prior OUDs.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44650952","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 Use of Osteopathic Manipulative Treatment as a Therapy for Mental Health Disorders: A Review","authors":"Colton A. Kinderknecht, Pamela deWilde","doi":"10.33181/13094","DOIUrl":"https://doi.org/10.33181/13094","url":null,"abstract":"There is historical and modern evidence for the use of osteopathic manipulative treatment (OMT) to treat patients with mental health disorders. The first section of this article examines the historical perspective, focusing intently on the Still-Hildreth Sanatorium. This hospital specialized in the osteopathic treatment of mental illnesses. While it was open, it saw patients with diverse mental disorders and reported exceptional recovery rates. However, some data from this institution were destroyed, so this perspective is incomplete. The second part of this article examines modern osteopathic research into this topic. Although there is some literature supporting the use of OMT for mental disorders, overall, it is underwhelming. Few mental illnesses have been researched, and for those that have been, there are too few studies to reliably assess the outcomes. Moreover, these studies have limited sample sizes, further affecting their credibility. To accurately gauge the benefits of OMT, future work should overcome these limitations.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46935216","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":"Osteopathic Considerations in Pain Management","authors":"Param Dave","doi":"10.33181/13093","DOIUrl":"https://doi.org/10.33181/13093","url":null,"abstract":"Chronic pain is defined as pain that has persisted for greater than 6 months. This type of pain may last longer than 6 months and can continue even after the injury or illness that has caused it has healed or resolved. Pain signals can remain active in the nervous system for weeks to months and even years. Individuals with a chronic pain syndrome can experience severe negative effects on their activities of daily living and their mental well-being. The osteopathic philosophy and osteopathic manipulative treatment (OMT) set the osteopathic physician up to provide a comprehensive treatment plan to manage patients with chronic pain. To direct osteopathic techniques to address pain, it is imperative to understand the anatomy and physiology of the way pain is signaled to the central nervous system. Pain can also be classified into multiple categories based on the origin of the signal, which is essential to decipher to direct therapy. The goal of osteopathic care in chronic pain syndrome is to relieve musculoskeletal somatic dysfunctions and to normalize sympathetic and parasympathetic neural tone. This would create the optimal environment to induce the body’s own self-healing capabilities.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41646668","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}
Kate L. Szymanski, Anu Garg, Megan Sizemore, Lindsey Loutzenhiser
{"title":"Polypharmacy in the Elderly","authors":"Kate L. Szymanski, Anu Garg, Megan Sizemore, Lindsey Loutzenhiser","doi":"10.33181/13089","DOIUrl":"https://doi.org/10.33181/13089","url":null,"abstract":"Polypharmacy is the regular use of multiple medications and is often seen in older adults and individuals with multiple comorbidities. The commonly accepted definition of polypharmacy is the use of five or more medications by any individual. As patients become more multimorbid, the use of medication therapy increases and in turn raises the risk of polypharmacy. Polypharmacy is often associated with adverse outcomes, including increased mortality, falls, drug interactions, drug reactions, increased length of stay in the hospital, and increased readmission to the hospital after discharge. Patients over the age of 65 are often not included or well represented in drug trials, which can make medical decision-making challenging for evaluation of risk versus benefit in this patient population. There are several important factors to take note of when evaluating patients with polypharmacy.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43115600","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":"Home Blood Glucose Monitoring","authors":"J. Shubrook, Kim M Pfotenhauer","doi":"10.33181/13086","DOIUrl":"https://doi.org/10.33181/13086","url":null,"abstract":"Diabetes affects more than 37 million Americans. More than one-third of American adults (96 million) have prediabetes, so it is anticipated that the prevalence of diabetes will continue to climb in the generation to come. There have been major advances in the options for home glucose monitoring. Home glucose monitoring provides critical information and feedback for patients with diabetes to help them understand how daily activities affect their glucose levels and timely data to assist in behavior reinforcement and modification. Self-monitoring of blood glucose (SMBG) is of great value to those with type 1 diabetes and those with type 2 diabetes on insulin as it reduces HbA1c and rates of hypoglycemia. Currently, there is less support for long-term benefit of SMBG in those with type 2 diabetes not on insulin or insulin secretagogues. Continuous glucose monitoring (CGM) is becoming increasingly available to help manage diabetes. This form of monitoring provides benefits in terms of HbA1c, reduced time and rates of hypoglycemia, and increased time in range for those on insulin. CGM reports now include standardized reporting and target goals that will make widespread use easier to implement. This article will review the current data on home glucose monitoring for those with diabetes.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48999200","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":"COVID-19 Vaccine-Induced Cardiac Concerns","authors":"Bryan Cusack, Puneet Tung, Katie McHale, B. Groh","doi":"10.33181/13088","DOIUrl":"https://doi.org/10.33181/13088","url":null,"abstract":"Myocarditis has been increasingly recognized as a rare complication of COVID-19 mRNA vaccinations, especially in young adolescent males. According to the US Centers for Disease Control and Prevention, the incidence of myocarditis in males 16–29 years of age is approximately 10.7 cases per 100,000. Of those diagnosed with myocarditis, roughly 69% were diagnosed 3–5 days after their second vaccination. Most recent reports have shown clinical presentations consistent with chest pain, elevated cardiac enzymes, ST elevations on ECG, and further echocardiogram or cardiac MRI findings displaying mild to moderate left systolic dysfunction. Although mechanisms in the development of myocarditis are still not clear, a promising hypothesis is that myocarditis is exacerbated by a hyperimmune response to the second dose of the vaccine. Children have a robust immune response to COVID-19, which has been exemplified by increasing cases of multisystem inflammatory syndrome in children. This report will review trends seen in patients with vaccine-induced myocarditis and highlight the benefit to risk assessment of cardiovascular complications associated with COVID-19.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47467288","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":"COVID-19 in Patients with Asthma: Review and Implications for Care of Adult Patients with an Osteopathic Component","authors":"D. Frasca, S. Wolf","doi":"10.33181/13087","DOIUrl":"https://doi.org/10.33181/13087","url":null,"abstract":"Patients with asthma who have COVID-19 typically present with rhinitis, rhinosinusitis, cough, and shortness of breath and rarely with wheezing. Family physicians should consider a patient’s asthma subtype, pertinent medical history, and medications. Maintenance medications, including inhaled corticosteroids (ICS), should be continued for most patients. Whether to start ICS in patients with asthma who have COVID-19 should be considered, as the risks and benefits are unclear, and systemic corticosteroids should be avoided in patients with asthma who have COVID-19 if alternatives exist. Pregnant patients with both asthma and COVID-19 should be comanaged by an obstetrician, with consideration for early induction of labor. Behavioral health topics and osteopathic principles and manipulative techniques should be considered in patients with COVID-19 and asthma. Generalities are challenging to make, but patients with asthma do not seem to have worse outcomes with COVID-19 than patients without asthma.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46963622","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":"Identifying Multisystem Inflammatory Syndrome in Children After COVID-19 Infection","authors":"Anthony McKeiver, Gautam Desai, W. Cox","doi":"10.33181/13082","DOIUrl":"https://doi.org/10.33181/13082","url":null,"abstract":"Since its discovery, the novel coronavirus disease 2019 (COVID-19) has evolved into a global pandemic that has affected millions. The pediatric population was once thought to be mostly spared from the SARS-CoV-2 virus. However, a severe hyperinflammatory sequela of the virus known as multisystem inflammatory syndrome in children (MIS-C) has since been identified and poses a great risk to pediatric morbidity and mortality. The goal of this manuscript is to clarify and characterize MIS-C as a diagnosis, including current management and future considerations. Methods: A thorough literature search was performed using Google Scholar and PubMed databases for articles published January 2020 through August 2021. Results: A two-tiered diagnostic approach was created for any pediatric patient presenting with fever and an epidemiologic link to SARS-CoV-2. The mean age at time of diagnosis was 9.3 years old, with 56.8% of patients identifying as male and the majority identifying as either Hispanic (36.5%) or Black (35.1%). Common signs and symptoms included fever, cough, tachycardia and tachypnea. Current treatment recommendations included IVIG, glucocorticoids, and aspirin, with the more severe cases needing hospitalization and immune modulator therapy. Discussion: MIS-C is a serious and potentially fatal sequelae after COVID-19 infection in the pediatric population. Much is still unknown regarding the long-term effects of MIS-C. Further emphasis should be placed on identifying definitive treatment and preventative strategies. Osteopathic family physicians are the primary providers for many of the patients who may present with signs and symptoms of MIS-C, and familiarity with the workup and treatment can help improve care.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41421715","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":"Dermoscopy Curriculum in Family Medicine Residency Bridges Gap Between Dermatological Care of Skin Malignancies in Rural, Underserved Medical Communities","authors":"Kirby Smith, Ethan McBrayer","doi":"10.33181/13083","DOIUrl":"https://doi.org/10.33181/13083","url":null,"abstract":"An important aspect of any family medicine resident’s training is the ability to competently diagnose and manage common skin conditions, including differentiating between benign and potentially malignant skin lesions. This is particularly important for residents planning to practice in rural or underserved areas where patients may have limited access to specialty dermatologists due to barriers related to their social determinants of health. The authors believe that training family medicine residents in the effective use of dermoscopy can improve the accuracy with which they are able to differentiate between benign and malignant skin lesions, and thereby reduce the need for unnecessary and burdensome referrals to dermatology specialists. Use of the triage amalgamated dermoscopic algorithm (TADA) as part of a family medicine residency’s dermatology curriculum is a simple and effective way to train residents in the use of dermoscopy, and could prove to be an important part of how FM GME programs produce a primary care workforce with the knowledge and skills required to care for the healthcare needs of rural and underserved patient populations.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45595093","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":"Leveraging Primary Care, Public Health and Social Context During the COVID-19 Response Within a University Setting: Considerations for the Osteopathic Family Physician","authors":"Anne Jones, Kanad Mukherjee, Todd Schachter","doi":"10.33181/13084","DOIUrl":"https://doi.org/10.33181/13084","url":null,"abstract":"The COVID-19 pandemic placed a spotlight on both the successes and the needs across the spectrum of the healthcare system. The trusting, enduring relationships developed within the primary care setting served as an important foundation on which to build response strategies throughout the pandemic. Early detection and testing, implementation of telehealth, delivery of continuous comprehensive care, and vaccine education and administration are all key areas where primary care and public health systems successfully served patients and community. Emerging national research from the COVID-19 pandemic experience has also demonstrated the reduction in COVID-19 infection and death rates through the synergy between primary care, public health and social factors, emphasizing once again the critical role these services play and the importance of developing integration strategies for the future. In particular, the COVID-19 experience within the university setting served as a key example of this integration and synergy in action. As osteopathic family physicians, these experiences can serve as lessons learned toward embracing the opportunity afforded by our unique training, expertise and commitment to the osteopathic philosophy.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42929072","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}