Osteopathic manipulative treatment for chronic inflammatory diseases.

Chronic inflammatory diseases (CIDs) are debilitating and potentially lethal illnesses that affect a large proportion of the global population. Osteopathic manipulative treatment (OMT) is a manual therapy technique developed and performed by osteopathic physicians that facilitates the body's innate healing processes. Therefore, OMT may prove a beneficial anti-inflammatory modality useful in the management and treatment of CIDs. This work aims to objectively evaluate the therapeutic benefits of OMT in patients with various CIDs. In this review, a structured literature search was performed. The included studies involving asthma, chronic obstructive pulmonary disease, irritable bowel syndrome, ankylosing spondylitis, and peripheral arterial disease were selected for this work. Various OMT modalities, including lymphatic, still, counterstain, and muscle energy techniques, were utilized. Control treatments included sham techniques, routine care, or no treatment. OMT utilization led to variable patient outcomes in individuals with pathologies linked to CID.

Effect of osteopathic manipulative treatment and Bio-Electro-Magnetic Energy Regulation (BEMER) therapy on generalized musculoskeletal neck pain in adults.

CONTEXT: General neck pain is a prevalent complaint made by patients to their physicians and is often of a suspected musculoskeletal origin. Osteopathic manipulative treatment (OMT) is a form of manual therapy utilized by osteopathic physicians and some allopathic physicians to treat a broad variety of musculoskeletal ailments, including neck pain. Bio-Electro-Magnetic Energy Regulation (BEMER) is an emerging therapeutic modality that deploys a biorhythmically defined stimulus through a pulsed electromagnetic field and has been shown to reduce musculoskeletal pain. Studies on these treatments have independently yielded promising results. Therefore, it is possible that the utility of OMT and BEMER can produce an additive improvement in the treatment of neck pain. OBJECTIVES: The objectives of this study are to investigate the individual and combined effects of OMT and BEMER therapy on neck pain in adults. METHODS: Adults with nonspecific neck pain were recruited for the study. A total of 44 participants met the study inclusion criteria and were randomized into one of four study groups: OMT-only, BEMER-only, OMT+BEMER, or CONTROL (light touch and sham). Forty subjects completed the study, and data for 38 participants were included in our analyses. An OMT and BEMER protocol were specifically designed for this study under the guidance of a licensed osteopathic physician. Participants underwent intervention for a duration of 3 weeks. Data were obtained through baseline and postintervention assessments utilizing three surveys: Neck Disability Index (NDI), Visual Analog Scale (VAS), and Short Form 12-item Health Survey (SF-12, divided into Mental and Physical). One-way analysis of variance (ANOVA) analysis was performed retrospectively on pre- and postintervention absolute means between study groups. Significance was set at p<0.05. RESULTS: One-way ANOVA analysis demonstrated a statistically significant difference in pre- vs. postintervention mean scores between BEMER and CONTROL (p<0.05), BEMER compared to OMT (p<0.005), and BEMER compared to BEMER+OMT (p<0.05), in the NDI. The OMT+BEMER group reported an average reduction in pain on the VAS of 21.3 (±29.3) points, or a 65.0 % reduction of pain. A similarly substantial decrease in pain was reported in the BEMER study group, which showed a 46.2 % reduction in pain from baseline. The OMT and CONTROL study groups only reported a 2.9 and 23.9 % decrease, respectively. The BEMER and OMT+BEMER study groups also demonstrated a reduction in subjective reporting on the NDI, by 53.8 and 26.3 %, respectively. The BEMER study group also achieved the most substantial improvement in mental and physical well-being as reported by the SF-12. CONCLUSIONS: Study arms that incorporated BEMER yielded improvements on the NDI, VAS, and SF-12, indicating benefits to BEMER regarding improved overall functionality in routine daily activities as well as a reduction in nonspecific neck pain. Perceived pain, as demonstrated on the VAS, was seemingly improved in an additive fashion from the BEMER group to the OMT+BEMER group, although the results did not achieve statistical significance. Further study with greater participation could provide additional insight.

Effects of osteopathic manipulative treatment and bio-electromagnetic energy regulation therapy on lower back pain.

CONTEXT: Lower back pain (LBP) is prevalent and is a leading contributor to disease burden worldwide. Osteopathic manipulative treatment (OMT) can alleviate alterations in the body that leads to musculoskeletal disorders such as LBP. Bio-electromagnetic Energy Regulation (BEMER; BEMER International AG), which has also been shown to relieve musculoskeletal pain, is a therapeutic modality that deploys a biorhythmically defined stimulus through a pulsed electromagnetic field (PEMF). Therefore, it is possible that combined OMT and BEMER therapy could reduce low back pain in adults more than the effect of either treatment modality alone. OBJECTIVES: To investigate the individual and combined effects of OMT and BEMER therapy on LBP in adults. METHODS: Employees and students at a medical college were recruited to this study by email. Participants were included if they self-reported chronic LBP of 3 months' duration or longer; participants were excluded if they were experiencing acute LBP of 2 weeks' duration or less, were currently being treated for LBP, were pregnant, or had a known medical history of several conditions. Ultimately, 40 participants were randomly assigned to four treatment groups: an OMT only, BEMER only, OMT+BEMER, or control (light touch and sham). Treatments were given regularly over a 3 week period. Data on LBP and quality of life were gathered through the Visual Analog Scale (VAS), Short Form 12 item (SF-12) health survey, and Oswestry Low Back Pain Questionnaire/Oswestry Disability Index prior to treatment and immediately after the 3 week intervention protocol. One-way analysis of variance (ANOVA) was performed retrospectively and absolute changes for each participant were calculated. Normal distribution and equal variances were confirmed by Shapiro-Wilk test (p>0.05) and Brown-Forsythe, respectively. Significance was set at p<0.05. RESULTS: Despite a lack of statistical significance between groups, subjective reports of pain reported on the VAS showed a substantial mean percentage decrease (50.8%) from baseline in the OMT+BEMER group, compared with a 10.2% decrease in the OMT-only and 9.8% in BEMER-only groups when comparing the difference in VAS ratings from preintervention to postintervention. Participants also reported in quality of life assessed on the Oswestry Low Back Pain Questionnaire/Oswestry Disability Index, with the OMT+BEMER group showing a decrease of 30.3% in score, the most among all groups. The OMT+BEMER group also reported the greatest improvement in score in the physical component of the SF-12, with an increase of 21.8%. CONCLUSIONS: The initial data from this study shows a potential additive effect of combination therapy (OMT and BEMER) for management of LBP, though the results did not achieve statistical significance.

Fast In Situ Image Reconstruction for Proton Radiography.

OBJECTIVE: Proton beam therapy is an emerging modality for cancer treatment that, compared to X-ray radiation therapy, promises to provide better dose delivery to clinical targets with lower doses to normal tissues. Crucial to accurate treatment planning and dose delivery is knowledge of the water equivalent path length (WEPL) of each ray, or pencil beam, from the skin to every point in the target. For protons, this length is estimated from relative stopping power based on X-ray Hounsfield units. Unfortunately, such estimates lead to 3 to 4% uncertainties in the proton range prediction. Therefore, protons in the Bragg peak may overshoot (or undershoot) the desired stopping depth in the target causing tissue damage beyond the target volume. Recent studies indicate that tomographic imaging using protons has the potential to provide directly more accurate measurement of RSPs with significantly lower radiation dose than X-rays. We are currently working on a proton radiography system that promises to provide accurate two-dimensional (2D) images of WEPL values for protons that pass through the body. These will be suitable for positioning and range verification in daily treatments. In this study, we demonstrate that this system is capable of rapidly achieving such accurate images in clinically meaningful times. METHODS: We have developed a software platform to characterize the potential performance of the prototype proton radiography system. We use Geant4 to simulate raw data detected by the device. An especially-written software - pRad - was written to process these data as they are received and uses iterative methods to generate radiographs. The software has been designed to generate a radiograph from a few million protons in under a minute after receiving the first proton from the device. We used a head phantom with known chemical compositions that could be modelled quite accurately in Geant4 simulations of proton radiographs. The radiographs are displayed as pixelated WEPL values displayed on a 2D gray scale image of WEPL values. RESULTS: Rapid radiograph reconstruction of 3D phantoms using simulated proton pencil beams have been achieved with our software platform. On a modest desktop computer with a single central processing unit (CPU) and a single graphics processing unit (GPU), it takes about 11 seconds to reconstruct images using iterative linear algorithms to reconstruct a radiograph from 7.6 million protons. For the radiographic reconstructions of the head phantom described here, the mean WEPL errors, in the proton radiograph using a large majority of the pixels in the complete image were less than 1 mm when compared to images obtained without proton scattering and without detector resolution included. CONCLUSION: We have demonstrated, through computer simulations of proton irradiation of a pediatric head phantom using the newly built pRad detector and image reconstruction software, that high quality proton radiographs can be generated for patient alignment and verification of water equivalent thickness of the patient before each treatment.

Participant-Driven Health Education Workshops With Men Transitioning From Prison to Community.

As part of a participatory health research project seeking to support men in achieving their health goals during the transition from prison to community, a workshop program was developed and piloted in a Community Residential Facility in British Columbia, Canada. The pilot program was evaluated through feedback surveys at each of the 16 workshops and a focus group interview at the end of the program. Workshops were highly valued by participants and seen as a means for (1) building skills relevant to their health and wellness, (2) working toward changing attitudes and behaviors adopted in prison, and (3) helping others and accepting help from others. Similar programs may be an effective support for men working to achieve their health goals during other transitions (e.g., bereavement, cancer patients, returning soldiers, and veterans).

In vivo study of magnesium plate and screw degradation and bone fracture healing.

Each year, millions of Americans suffer bone fractures, often requiring internal fixation. Current devices, like plates and screws, are made with permanent metals or resorbable polymers. Permanent metals provide strength and biocompatibility, but cause long-term complications and may require removal. Resorbable polymers reduce long-term complications, but are unsuitable for many load-bearing applications. To mitigate complications, degradable magnesium (Mg) alloys are being developed for craniofacial and orthopedic applications. Their combination of strength and degradation make them ideal for bone fixation. Previously, we conducted a pilot study comparing Mg and titanium devices with a rabbit ulna fracture model. We observed Mg device degradation, with uninhibited healing. Interestingly, we observed bone formation around degrading Mg, but not titanium, devices. These results highlighted the potential for these fixation devices. To better assess their efficacy, we conducted a more thorough study assessing 99.9% Mg devices in a similar rabbit ulna fracture model. Device degradation, fracture healing, and bone formation were evaluated using microcomputed tomography, histology and biomechanical tests. We observed device degradation throughout, and calculated a corrosion rate of 0.40±0.04mm/year after 8 weeks. In addition, we observed fracture healing by 8 weeks, and maturation after 16 weeks. In accordance with our pilot study, we observed bone formation surrounding Mg devices, with complete overgrowth by 16 weeks. Bend tests revealed no difference in flexural load of healed ulnae with Mg devices compared to intact ulnae. These data suggest that Mg devices provide stabilization to facilitate healing, while degrading and stimulating new bone formation.

The blood-based glycophorin A (GPA) human in vivo somatic mutation assay.

The glycophorin A assay concurrently detects and quantifies erythrocytes with allele-loss phenotypes at the autosomal locus responsible for the polymorphic MN blood group. It uses a pair of allele-specific monoclonal antibodies and flow cytometry to efficiently analyze a standard population of five million cells. Two distinct variant phenotypes are detected: simple allele loss and allele loss followed by reduplication of the remaining allele; both are consistent with the mechanisms underlying "loss of heterozygosity" at tumor-suppressor genes. The assay is an intermediate biomarker of biological effect in the somatic mutational model of human cancer and has been applied to populations with a known or suspected genotoxic exposure, to patients with hereditary syndromes causing predisposition to cancer (where the assay has been applied diagnostically), and to patients manifesting cancer as a disease endpoint.

Dinuclear and heptanuclear complexes of copper(II) with 7-azaindole ligand: synthesis, characterization, magnetic properties, and biological activity.

Three new complexes of Cu(II) with 7-azaindole have been synthesized and characterized, a dicopper compound, [Cu(C7H5N2)2(H2O)]2·2CH3CN, 1, and two heptacopper compounds [Cu7(C7H5N2)6(µ3-OH)6(µ2-H2O)2(µ2-CH3OH)4](CH3COO)2·2C7H8·6CH3OH, 2, and [Cu7(C7H5N2)5(CH3COO)(µ3-OH)6(µ2-H2O)4(µ2-CH3OH)2](CH3COO)2, 4. The structure of 2 is monoclinic and it crystallizes in the P21/c space group: a=13.475(4)Å; b=12.945(4)Å; c=23.392(7)Å; ß=91.232(6)°. It contains a unique Cu7O12 core in which a central Cu(II) is situated at an inversion center and is bonded to 6 other Cu(II) ions via bridging oxygen atoms from OH(-), H2O, and CH3OH groups. Anionic 7-azaindole ligands bridge between adjacent outer Cu(II) ions and all Cu(II) ions have distorted octahedral coordination geometries. Variable temperature magnetic susceptibility measurements revealed the presence of antiferromagnetic exchange interactions between Cu(II) ions which leads to an S=5/2 ground state at 1.8K. Cytotoxicity and cell proliferation activities of the Cu compounds using human tongue squamous cell carcinoma and normal cells revealed that the compounds stimulated proliferation in both types of cells.

An oral developmental neurotoxicity study of decabromodiphenyl ether (DecaBDE) in rats.

BACKGROUND: Decabromodiphenyl ether (DecaBDE; CASRN 1163-19-5) is a flame retardant used in a variety of manufactured products. A single oral dose of 20.1 mg/kg administered to mice on postnatal day 3 has been reported to alter motor activity at 2, 4, and 6 months of age. METHODS: To further evaluate these results, a developmental neurotoxicity study was conducted in the most commonly used species for studies of this type, the rat, according to international validated testing guidelines and Good Laboratory Practice Standards. DecaBDE was administered orally via gavage in corn oil to dams from gestation day 6 to weaning at doses of 0, 1, 10, 100, or 1,000 mg/kg/day. Standard measures of growth, development, and neurological endpoints were evaluated in the offspring. Motor activity was assessed at 2 months of age. Additional motor activity assessments were conducted at 4 and 6 months of age. Neuropathology and morphometry evaluations of the offspring were performed at weaning and adulthood. RESULTS: No treatment-related neurobehavioral changes were observed in detailed clinical observations, startle response, or learning and memory tests. No test substance-related changes were noted in motor activity assessments performed at 2, 4, or 6 months of age. Finally, no treatment-related neuropathological or morphometric alterations were found. CONCLUSIONS: Under the conditions of this study, the no-observed-adverse-effect level for developmental neurotoxicity of DecaBDE was 1,000 mg/kg/day, the highest dose tested.

Effects of dose, administration route, and/or vehicle on decabromodiphenyl ether concentrations in plasma of maternal, fetal, and neonatal rats and in milk of maternal rats.

The effects of route and vehicle on blood and milk levels of decabromodiphenyl ether (DecaBDE; CASRN 1163-19-5) were investigated in the rat to assist in the design and conduct of a developmental neurotoxicity study. Blood plasma and/or milk concentrations were determined in dams, fetuses, and/or nursing pups after repeated DecaBDE administration by gavage throughout gestation or gestation and lactation using corn oil (CO) or soyaphospholipon/Lutrol F 127-water (SPL) as the vehicle. The impact of vehicle on plasma levels was also investigated in pups derived from naive dams after a single postnatal dose. This study reports for the first time fetal and neonatal plasma concentrations concurrent with those of maternal plasma and/or milk. Higher concentrations of DecaBDE were achieved in plasma and in milk with CO than with SPL. Furthermore, pups derived from dams treated with only SPL were lower in body weight, compared with those from dams treated with either CO, CO and DecaBDE, or SPL and DecaBDE. The study further shows that exposure to DecaBDE is relatively consistent across the dose range of 100 to 1000 mg/(kg · day) when administered in CO.

Variations in muscle activation levels during traditional latissimus dorsi weight training exercises: An experimental study.

BACKGROUND: Exercise beliefs abound regarding variations in strength training techniques on muscle activation levels yet little research has validated these ideas. The purpose of the study is to determine muscle activation level, expressed as a percent of a normalization contraction, of the latissimus dorsi, biceps brachii and middle trapezius/rhomboids muscle groups during a series of different exercise tasks. METHODS: The average muscle activity during four tasks; wide grip pulldown, reverse grip pull down [RGP], seated row with retracted scapula, and seated rows with non-retracted scapulae was quantified during two 10 second isometric portions of the four exercises. A repeated measures ANOVA with post-hoc Tukey test was used to determine the influence of exercise type on muscle activity for each muscle. RESULTS & DISCUSSION: No exercise type influenced biceps brachii activity. The highest latissimus dorsi to biceps ratio of activation occurred during the wide grip pulldown and the seated row. Highest levels of myoelectric activity in the middle trapezius/rhomboid muscle group occurred during the seated row. Actively retracting the scapula did not influence middle trapezius/rhomboid activity. CONCLUSION: Variations in latissimus dorsi exercises are capable of producing small changes in the myoelectric activity of the primary movers.