Advance Articles

Official Call: 2021 Annual Business Meeting of the American Osteopathic Association

Thomas L. Ely, DO; Ray L. Morrison, DO; and David L. Broder, DO
This is the Official Call for the 2021 Annual Business Meeting of the Board of Trustees and Annual House of Delegates (HOD) of the American Osteopathic Association (AOA) to be held July 12–18, 2021.
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Editorial

Working against bias: double blind peer review at Journal of Osteopathic Medicine

Ross D. Zafonte, DO, and Melissa B. Schmidt, M.Ed.
In this Editorial, JOM’s Editor in Chief and Director discuss the intricacies of peer review at the Journal, including the recent transition to a double blind model.
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NMM/OMT

Cost comparison of osteopathic manipulative treatment for patients with chronic low back pain

Danielle Cooley, DO; James Bailey, DO; and Richard Jermyn, DO
Chronic low back pain (cLBP) is the second leading cause of disability in the United States, with significant physical and financial implications. Development of a multifaceted treatment plan that is cost effective and optimizes patients’ ability to function on a daily basis requires data; among the needed data points is a cost comparison of osteopathic manipulative treatment vs standard care for patients with cLBP. To that end, the authors conducted a prospective, observational study of 146 patients over 4 months with either standard care or standard care plus osteopathic manipulative treatment, quantifying patients’ pain scale responses as well as cost data for all associated interventions during the study period.
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NMM/OMT

Osteopathic Cranial Manipulative Medicine and the Blood Brain Barrier: A Mechanistic Approach to Alzheimer Prevention

Michael McAree, OMS II; Alexis Dunn, OMS II; Jared Furtado, OMS II; Clinton Timmerman, OMS II; Zachary Winchell, OMS II; Radhika Rani, OMS II; Jennifer Farah, OMS II; and Lauren J. Crispino, OMS II
In this narrative literature review, the authors identify relationships between Alzheimer disease and blood brain barrier (BBB) breakdown, the response of the BBB to increased cerebral blood flow and shear stress, and the impact of osteopathic cranial manipulative medicine on cerebrovascular hemodynamics.
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Medical Education

Longitudinal Assessment of Medical Student Emotional Intelligence Over Preclinical Training

Linda S. Mintle, MSW, PhD; Clark F. Greer, MA, PhD; and Lauren E. Russo, OMS II
Emotional intelligence (EI) is critical for physician leadership. Researchers assessed the EI of medical students throughout their preclinical years to identify core competencies of emotional intelligence that could be enhanced.
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Obstetrics/Gynecology

United States internet searches for “infertility” following COVID-19 vaccine misinformation

Nicholas B. Sajjadi, BS; William Nowlin, BS; Ross Nowlin, BS; David Wenger, BS; John Martin Beal, DO; Matt Vassar, PhD; and Micah Hartwell, PhD
Following a December 2020 petition to withhold emergency use authorization of the BNT162b2 messenger ribonucleic acid vaccine for coronavirus disease 2019 (COVID-19) manufactured by BioNTech and Pfizer, misinformation claiming that COVID-19 vaccines cause female infertility began circulating on social media. The authors evaluated Google Trends data to quantify the potential influence that misinformation may have had on public perception and medical decision-making among pregnant patients or those seeking to become pregnant.
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Musculoskeletal Medicine and Pain

Evidence based management of sports related concussion

Brent Pickett, DO; Jeffrey R. Bytomski, DO; and Ross D. Zafonte, DO
In this brief Commentary, the authors write an update on research published previously in the Journal, giving a summary of the current recommendations for nuanced diagnosis and management of sports related concussion.
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Medical Education

Meaningful use of COMSAE Phase 1 in preparation for COMLEX-USA Level 1

Xiaolin Wang, PhD; Hotaka Maeda, PhD; Brandon Craig, PhD; Tsung-Hsun Tsai, PhD; Jeanne M. Sandella, DO; and Marie Fleury, DO, MBA
To investigate how the COMSAE Phase 1 examination was used by candidates and how completing Phase 1 impacted their performance on the COMLEX-USA Level 1 examination, the authors assessed Level 1 data from 7,120 first time candidates who took the 2018-2019 COMSAE administration between May 2018 and April 2019, counting the frequency of the unique Phase 1 forms taken by the candidates and calculating the correlations between first attempt Phase 1 scores and the number of Phase 1 forms taken as well as Level 1 scores and Phase 1 scores.
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NMM/OMT

Osteopathic manipulative medicine in the management of headaches associated with postconcussion syndrome

Dmitry Esterov; Alphonsa Thomas; and Kyle Weiss
Previous studies have demonstrated the effectiveness of osteopathic manipulative treatment (OMT) for various headache types, with limited evidence of its use for headaches related to mild traumatic brain injury (MTBI). To evaluate the efficacy of OMT for headaches in patients with postconcussion syndrome (PCS) - defined as symptom persistence for longer than 3 months after MTBI – the authors performed a pilot study of 26 patients (13 in an OMT group and 13 in a control group), comparing headache scores on a Visual Analog Scale or Headache Impact Test (HIT-6) at baseline, posttreatment, and 4 to 6 week follow up.
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Innovations

Scrambler therapy for incident pain in bone metastases

Lauren E. Berninger, DO, and Thomas J. Smith, MD
The authors present the case of a 69 year old man with shoulder destruction due to bone metastases who was able to use his arm for normal activities without pain after three sessions of scrambler therapy, a noninvasive form of electrical neuromodulation that requires further study.
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NMM/OMT

Perceptions of nonopioid treatment for pain in a homeless population

Kristina A. Fraser, OMS IV; Harvard Nguyen, OMS IV; Suhhyun Kim, OMS III; Flora Park, OMS III; Joshua Bernal, OMS IV; Alexa D. Westberg, OMS IV; and Alan Podawiltz, DO
The authors collected voluntary responses from 200 residents at the True Worth Place Homeless Shelter in Fort Worth, Texas – where the University of North Texas Health Science Center (UNTHSC) offers a Homeless Outreach through Medical Education (HOME) Clinic – to assess the past and current use of complementary and alternative treatments for chronic pain among people experiencing homelessness, as well as their awareness and perception of osteopathic manipulative treatment (OMT) as a complementary treatment.
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Musculoskeletal Medicine and Pain

The enigmatic fascia: eosinophilic fasciitis

Jonathan A. Aun, DO; Rachel S. Knox, DO; and Jared E. Roberts, MD
This case report highlights the potentially underrecognized subtype of unilateral eosinophilic fasciitis (EF) in a 28 year old man. With fewer than 300 reported encounters to date, EF is a rare disease that eludes clinicians by presenting as a scleroderma like syndrome. As EF remains a clinical diagnosis, biopsy results may be nonspecific, and the disease can easily be misdiagnosed (or missed entirely) if a full thickness biopsy is not reviewed by a dermatopathologist. The authors also emphasize the importance of internationally accepted diagnostic criteria, of which at least two different sets exist.
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Medical Education

The flipped classroom: a novel approach to physical examination skills for osteopathic medical students

Sahar Amin Bhai, OMS II, and Brian Poustinchian, DO
In this cohort study, the authors compared cumulative grades, objective structural clinical examination performance, and practical exam performance from 201 first year osteopathic medical students in the class of 2022, who had taken a physical exam skills (PES) course traditionally, with 203 from the class of 2023, who were taught using a “flipped classroom” approach, where precoursework is completed by students at home to encourage foundational instruction before class.
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Cardiopulmonary Medicine

Development of atrial fibrillation following trauma increases short term risk of cardiovascular events

Sean P. Nassoiy, DO; Robert H. Blackwell, MD; McKenzie Brown, MD; Anai N. Kothari, MD; Timothy P. Plackett, DO, MPH; Paul C. Kuo, MD, MBA; and Joseph A. Posluszny, MD
In this study of 15,424 trauma patients identified through the Healthcare Cost and Utilization Project State Inpatient Databases for California and Florida, the authors assessed the effect of newly developed atrial fibrillation on cardiovascular events such as myocardial infarction and cerebrovascular accident during the patients’ acute index hospitalization period.
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Medical Education

Efficacy of implementing intermittent STOP THE BLEED reviews on long term retention of hemorrhage control skills of first year medical students

Enkhtsogt Sainbayar, OMS II; Nathan Holt, III, OMS II; Amber Jacobson, OMS II; Shalini Bhatia, MS; and Christina Weaver, DO
Using pretraining and posttraining surveys, the authors investigated whether intermittent reviews after initial STOP THE BLEED® training – a single day didactive course used by some medical schools to teach students how to identify and stop life threatening bleeds – improved students’ retention and confidence in hemorrhage control.
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Behavioral Health

Predictors of emotional wellbeing in osteopathic medical students in a COVID-19 world

Robin Jacobs, PhD, MSW, MS, MPH; Michelle Lanspa, MBA; Michael Kane, PhD, LCSW, MDiv; and Joshua Caballero, PharmD, BCPP, FCCP
In this study, the authors report the results of an anonymous survey answered by 335 osteopathic medical students to assess their resilience, coping, health behaviors, and emotional wellbeing during the onset of the COVID-19 pandemic.
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NMM/OMT

Characteristics and treatment of geriatric patients in an osteopathic neuromusculoskeletal medicine clinic

Alicia A. King, DO, MPH; Jayme Cox, BS, OMS III; Shalini Bhatia, MS; and Karen T. Snider, DO
To provide descriptive data addressing the dearth of research on the presenting conditions, treatments, and response to osteopathic manipulative treatment (OMT) in the geriatric population, the authors retrospectively reviewed the charts of 9155 patients over 60 years of age who were managed with OMT at a single outpatient clinic between July 1, 2016, and June 30, 2019.
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Musculoskeletal Medicine and Pain

Manual treatment for kidney mobility and symptoms in women with nonspecific low back pain and urinary infections

Francesca Lo Basso, PT; Alessandra Pilzer, PT; Giulio Ferrero, MD; Francesco Fiz, PhD; Emanuele Fabbro, MD; Daniele Oliva, PT; Clizia Cazzarolli, MSc(PT); and Andrea Turrina, PT
Since recent studies have suggested a connection between low back pain (LBP) and urinary tract infections (UTI), the authors reviewed the charts of 20 selected patients with nonspecific LBP who were treated at a single physical therapy center to assess whether manual treatment relieved UTI and reduced pain through improvement in kidney mobility.
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Musculoskeletal Medicine and Pain

Impact of COVID-19 on utilization of nonpharmacological and pharmacological treatments for chronic low back pain and clinical outcomes

John C. Licciardone, DO, MS, MBA
In this pre-post study of 476 participants enrolled in a pain registry, the author measured changes in utilization of nonpharmacological and pharmacological treatments for chronic low back pain and related outcomes during the COVID-19 pandemic to help quantify how the pandemic has impacted the delivery of health care services throughout the United States.
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Clinical Image

May–Thurner syndrome with left iliofemoral deep venous thrombosis

Nathan C. Ellis, MD; Matthew T. McCarthy, DO; and Dhimitri A. Nikolla, DO
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Clinical Image

Acute fracture of extensive Achilles tendon calcific tendinopathy

Daniel Sullivan, OMS III; and McKennan Thurston, MD
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Cardiopulmonary Medicine

Abnormal vascular physiology in the lower extremities as a risk factor for ischemic stroke and mortality

Shubhang K. Bhatt, BS; Andrew S. Tseng, MD; Christine Firth, MD; Marlene Girardo, MS; Daniel Sykora, BA; Mina Abdelmalek, MD; F. David Fortuin, MD; Paul Wennberg, MD; David Liedl, RN; and Fadi E. Shamoun, MD
In this retrospective chart review of 39,834 patients, the authors evaluated the risk of incident ischemic stroke and mortality along the spectrum of low and elevated ankle brachial index measurement, since there is a known association between acute ischemic stroke and peripheral artery disease, which affects up to 25% of patients 55 years or older.
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Musculoskeletal Medicine and Pain

An analysis of Google Trends following athletic injuries by high profile NBA players during the 2019 NBA finals

Jay C. Thompson, DO; Christopher M. Price, DO; Jake X. Checketts, DO; Chad Hanson, DO; Trevor Torgerson, BS; Micah Hartwell, PhD; and Matt B. Vassar, PhD
In this article, the authors evaluate search traffic information to assess public interest following athletic injuries in high profile National Basketball Association players, with an eye toward identifying an ideal time period after prominent injury during which sports medicine providers could offer patient education to increase awareness.
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NMM/OMT

A mixed treatment comparison of selected osteopathic techniques used to treat acute nonspecific low back pain: a proof of concept and plan for further research

James W. Price, DO, MPH
The author used a systematic review and Bayesian network metaanalysis to perform a mixed treatment comparison to assess the results of 5 previous randomized controlled trials documenting the outcomes of osteopathic manipulative treatment techniques used to treat acute, nonspecific low back pain in 430 total patients.
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General

An uncommon cause of headache and dizziness after cruise travel: case report of Mal De Debarquement syndrome

Kwasi K. Ampomah, DO, MPH; Brian C. Clark, PhD; William D. Arnold, MD; and Daniel Burwell, DO
In this case report, the authors describe a unique case of a severe headache in a 46 year old woman as a major presenting symptom of Mal de Debarquement syndrome, also known as disembarkment syndrome, which is a benign neurological condition characterized by a feeling of rocking, bobbing, or swaying, usually after exposure passive motion as from being on a cruise, long drives, turbulent air travel, or trains.
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Pediatrics

Healthier together: a pilot study on the implementation of a novel family centered pediatric obesity prevention program

Madeline Bach, OMS IV; Sonia Shenoi, OMS I; Kathleen Winger, OMS III; and Tami Hendriksz, DO
In this article, the authors describe the Project Healthy Attitudes Produces Positive Youth (HAPPY) pilot program, conducted after school at a public elementary school campus in Solano County, California. From April 2018 to May 2018, first-year medical students from Touro University-California served as “family navigators,” guiding participants through a specially designed 5-week curriculum of didactic lessons, cooking demonstrations, and physical exercises designed for pediatric obesity prevention.
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NMM/OMT

Effects of osteopathic manipulative treatment and bioelectromagnetic energy regulation therapy on lower back pain

Kyle Auger, OMS IV; Gregory Shedlock, OMS IV; Kasey Coutinho, OMS IV; Nicole E. Myers, DO, MS; and Santiago Lorenzo, PhD, MS, MS
In this study of 40 patients, the authors compared the individual and combined effects of osteopathic manipulative treatment and Bio-Electro-Magnetic-Energy-Regulation (BEMER) therapy - which has also been shown to relieve musculoskeletal pain by deploying biorhythmically defined stimulus through a pulsed electromagnetic field – for managing low back pain in adults.
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Medical Education

Organizational behavior among academic medical school faculty

Carl Hoegerl, DO, MSc
In this personal Commentary, the author discusses some of the major factors affecting osteopathic physicians who practice in an academic setting, including fragmentation, professionalism, burnout, and gender.
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