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Biological significance of piezoelectricity in relation to acupuncture, Hatha Yoga, osteopathic medicine and action of air ions.

Abstract Title: Biological significance of piezoelectricity in relation to acupuncture, Hatha Yoga, osteopathic medicine and action of air ions. Abstract Source: Med Hypotheses. 1977 Jan-Feb;3(1):9-12. PMID: 577004 Abstract Author(s): B Lipinski Abstract: Piezoelectric properties of biological macromolecules such as proteins, nucleic acids and mucopolysaccharides are reviewed in this paper. It is indicated that the structural elements of the human body composed of these piezoelectric substances are capable of transducing a mechanical energy into an electric current. Such a transduction may be brought about by movements of an acupuncture needle, osteopathic manipulations; Hatha Yoga postures or action of negatively charged air irons. It is postulated that electric current induced by stimulation of the specific sites on the surface of human body flows towards the internal organs along the semiconductive channels of biologic macromolecules. Electric current induced either by the piezoelectric transduction or directly applied from an external source may in turn stimulate individual cells in the target organ. Involvement of electrical phenomena in regulatory mechanisms on cellular and molecular levels is discussed. Article Published Date : Jan 01, 1977
Therapeutic Actions Osteopathic Treatment

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The intersection of professionalism and interprofessional care: development and initial testing of the interprofessional professionalism assessment (IPA).

Related Articles The intersection of professionalism and interprofessional care: development and initial testing of the interprofessional professionalism assessment (IPA). J Interprof Care. 2018 Sep 24;:1-14 Authors: Frost JS, Hammer DP, Nunez LM, Adams JL, Chesluk B, Grus C, Harvison N, McGuinn K, Mortensen L, Nishimoto JH, Palatta A, Richmond M, Ross EJ, Tegzes J, Ruffin AL, Bentley JP Abstract Valid assessment of interprofessional education and collaborative practice (IPECP) is challenging. The number of instruments that measure various aspects of IPECP, or in various sites is growing, however. The Interprofessional Professionalism Assessment (IPA) measures observable behaviors of health care professionals-in-training that demonstrate professionalism and collaboration when working with other health care providers in the context of people-centered care. The IPA instrument was created by the Interprofessional Professionalism Collaborative (IPC), a national group representing 12 entry-level health professions and one medical education assessment organization. The instrument was created and evaluated over several years through a comprehensive, multi-phasic process: 1) development of construct and observable behaviors, 2) instrument design, expert review and cognitive interviews, and 3) psychometric testing. The IPA contains 26 items representing six domains of professionalism (altruism and caring, excellence, ethics, respect, communication, accountability), and was tested by 233 preceptors rating health profession learners in the final year of their practical training. These preceptors represented 30 different academic institutions across the U.S., worked in various types of practice sites, and evaluated learners representing 10 different entry-level health professions. Exploratory factor analysis suggested four factors (communication, respect, excellence, altruism and caring) using 21 items with the least amount of missing data, and confirmed, for the most part, a priori expectations. Internal consistency reliability coefficients for the entire instrument and its four subscales were high (all greater than 0.9). Psychometric results demonstrate aspects of the IPA's reliability and validity and its use across multiple health professions and in various practice sites. PMID: 30247940 [PubMed - as supplied by publisher]

Cost-Effectiveness and Budget Impact of Lumacaftor/Ivacaftor in the Treatment of Cystic Fibrosis.

Related Articles Cost-Effectiveness and Budget Impact of Lumacaftor/Ivacaftor in the Treatment of Cystic Fibrosis. J Manag Care Spec Pharm. 2018 Oct;24(10):987-997 Authors: Vadagam P, Kamal KM, Covvey JR, Giannetti V, Mukherjee K Abstract BACKGROUND: Cystic fibrosis (CF) is a chronic, progressive, genetic disease affecting more than 30,000 people in the United States and 70,000 people globally. The goals of treatment are to slow disease progression, reduce pulmonary exacerbations, relieve chronic symptoms, and improve the patient's quality of life. Lumacaftor/ivacaftor is a new therapy for CF that has demonstrated good clinical outcomes, including improved absolute percentage predicted forced expiratory volume in 1 second (FEV1%). However, given the high cost of therapy, there is a need to evaluate the overall value of lumacaftor/ivacaftor in CF management. OBJECTIVES: To (a) conduct a cost-effectiveness analysis (CEA) of lumacaftor/ivacaftor to understand the overall effectiveness of the drug compared with its costs and (b) conduct a budget impact analysis (BIA) to understand the potential financial effect of introducing a new drug in a health plan. METHODS: Two static decision models were developed using Microsoft Excel to evaluate the cost-effectiveness and budget impact of lumacaftor/ivacaftor over a 1-year time frame from a payer perspective. Model inputs included drug costs (wholesale acquisition costs), drug monitoring schedules (package inserts), drug monitoring costs (Centers for Medicare & Medicaid physician fee schedule and published literature), FEV1% predicted and pulmonary exacerbation values (clinical trials), and cost to treat pulmonary exacerbations (published literature). The outcomes in the CEA included total cost of therapy; average cost-effectiveness ratio (ACER), defined as cost per FEV1% predicted; and incremental cost-effectiveness ratio (ICER), defined as the difference in the ratio of cost per FEV1% predicted of lumacaftor/ivacaftor and placebo. Outcomes in the BIA included total budget impact; cost per member per month (PMPM), defined as total budget impact per hypothetical plan population; and cost per treated member per month (PTMPM), defined as total budget impact per target CF population. All costs were adjusted to 2016 dollars, and one-way sensitivity analyses were conducted to test the model robustness given uncertainty in model inputs and study assumptions. RESULTS: The annual cost of therapy per patient for lumacaftor/ivacaftor was $379,780. The ACER for lumacaftor/ivacaftor was $151,912, while the ICER for lumacaftor/ivacaftor compared with placebo was $95,016 per FEV1% predicted. The annual total budget impact due to the inclusion of lumacaftor/ivacaftor on the health plan formulary was $266,046. The PMPM cost was $0.02 and the PTMPM cost was $6.21. CONCLUSIONS: In patients with CF, lumacaftor/ivacaftor has demonstrated better clinical effectiveness compared with placebo alongside an increased drug acquisition cost. However, the therapy may be a viable alternative to existing standard therapy over a short time horizon. Health care payers, both private and public, need to evaluate the cost-effectiveness and the financial effect when considering expansion of new drug coverage in CF management. DISCLOSURES: No outside funding supported this study. Covvey and Kamal have received research funding from Novartis Pharmaceuticals. Covvey, Giannetti, and Kamal have received research funding from the College of Psychiatric and Neurologic Pharmacists. Kamal serves as a consultant to the Lynx Group (Cranbury, NJ) and Manticore Consulting Group (Scottsdale, AZ). Mukherjee has nothing to disclose. A related poster abstract was presented at the AMCP Managed Care & Specialty Pharmacy Annual Meeting; March 27-30, 2017; Denver, CO. PMID: 30247102 [PubMed - in process]

Efficacy of platelet transfusion in the management of acute subdural hematoma.

Related Articles Efficacy of platelet transfusion in the management of acute subdural hematoma. Clin Neurol Neurosurg. 2018 Sep 13;174:163-166 Authors: Ogunlade J, Wiginton JG, Ghanchi H, Al-Atrache Z, Wacker M, Menoni R, Miulli D Abstract OBJECTIVE: Oral Antithrombotic Therapy has become a well documented predisposing risk factor in the development of traumatic intracranial hemorrhage. Currently, a reversal protocol for antiplatelet therapy remains ill-defined in the management of non-surgical traumatic subdural hematoma and there is no evidence to suggest a clear benefit of platelet transfusion to mitigate the effect of antiplatelet agents. This study aims to establish parameters in which platelet transfusion would be of benefit in patients with non-surgical traumatic subdural hematoma with preinjury antiplatelet therapy. PATIENTS AND METHODS: This study is a retrospective chart review of patents from 2015 to 2018 at two Level II trauma centers identifying consecutive patients with non-surgical acute traumatic subdural hematomas. Patients with use of aspirin and/or clopidogrel were categorized into subgroups based on transfusion of platelets for antiplatelet reversal therapy, and were compared to a control group. The primary outcome measure was the presence of subdural hematoma expansion. RESULTS: A total of 72 patients met the criteria for inclusion in this study. The average age of the cohort was 75.4 with a median of 77.5. There were 40 males and 32 females. Chi-square analysis was performed which demonstrated statistical significance for difference between the aspirin and clopidogrel group for percent of hematoma expansion (p = 0.0284). Patients on antiplatelet therapy (n = 36) were grouped together and compared to patients without antiplatelet therapy (n = 36), this demonstrated that the transfusion of platelets for patients on antiplatelet agents (n = 19/36) still resulted in a significant hematoma expansion in (n = 7/19, 36.8%) compared to patients not on antiplatelet therapy (n = 3/36, 8.3%) (p = 0.0001). CONCLUSION: The results of this study suggest that patients with non-surgical traumatic subdural hematomas on presentation are less likely to expand, however the risk of expansion is greater when the patient is on antiplatelet therapy. There is no clear benefit in the use of platelet transfusion as a reversal agent to mitigate the effects of antiplatelet therapy in the setting of non-surgical traumatic subdural hematomas. PMID: 30245434 [PubMed - as supplied by publisher]

Ellagic Acid Alleviates Hepatic Oxidative Stress and Insulin Resistance in Diabetic Female Rats.

Related Articles Ellagic Acid Alleviates Hepatic Oxidative Stress and Insulin Resistance in Diabetic Female Rats. Nutrients. 2018 Apr 25;10(5): Authors: Polce SA, Burke C, França LM, Kramer B, de Andrade Paes AM, Carrillo-Sepulveda MA Abstract Non-alcoholic fatty liver disease (NAFLD) affects more than 70% of patients with type 2 diabetes mellitus (T2DM) and has become one of the most common metabolic liver diseases worldwide. To date, treatments specifically targeting NAFLD do not exist. Oxidative stress and insulin resistance have been implicated in the pathogenesis of NAFLD in diabetes. Accordingly, the goal of this present study was to determine whether Ellagic acid (EA), a natural antioxidant polyphenol found in berries and nuts, mitigates hepatic oxidative stress and insulin resistance in T2DM rats, and thus alleviates NAFLD. Using adult female Goto Kakizaki (GK) rats, a non-obese and spontaneous model of T2DM, we found that EA treatment significantly lowered fasting blood glucose and reduced insulin resistance, as shown by a 21.8% reduction in the homeostasis model assessment index of insulin resistance (HOMA-IR), while triglyceride and total cholesterol levels remained unchanged. Increased hepatic lipid accumulation and oxidative stress present in diabetic GK rats was markedly reduced with EA treatment. This effect was associated with a downregulation of the NADPH oxidase subunit, p47-phox, and overexpression of NF-E2-related factor-2 (NRF2). Moreover, EA was able to decrease the hepatic expression of hypoxia-inducible factor (HIF-α), a transcription factor linked to hypoxia and hepatic steatosis. We further showed that EA treatment activated an insulin signaling pathway in the liver, as evidenced by increased levels of phosphorylated Akt (Ser 473). In conclusion, our results demonstrate that EA diminishes blood glucose levels and potently suppress NAFLD in diabetic rats via mechanisms that involve reductions in p47-phox and HIF-α, upregulation of NRF2 and enhancement of the Akt signaling pathway in the liver. Together, these results reveal that EA improves hepatic insulin sensitivity and lipid metabolism as a result of its antioxidant effects. This implies an anti-diabetic effect of EA with beneficial effects for the treatment of hepatic complications in T2DM. PMID: 29693586 [PubMed - indexed for MEDLINE]


Related Articles StatPearls Book. 2018 01 Authors: Abstract Isotretinoin is an oral prescription medication that affects sebaceous glands and is used in the treatment of severe acne. The drug was approved by the US Food and Drug Administration (FDA) in 1982 for the treatment of severe, resistant, nodular acne that is unresponsive to conventional therapy including systemic antibiotics. PMID: 30247824