JAOA -- Table of Contents (September 2006, 106 [9])

LETTERS:

Postdoctoral Core Competencies in the Predoctoral Curriculum: Julia E. Mcnabb, Jeanne C. Kangas, Dena Higbee, and Becky Dawson
J Am Osteopath Assoc 2006 106:527-528. [Full Text] [PDF]

Interventions Need to Be Consistent With Osteopathic Philosophy: Alex Vasquez
J Am Osteopath Assoc 2006 106:528-529. [Full Text] [PDF]

Editor's Response: Gilbert E. D'Alonzo, Jr
J Am Osteopath Assoc 2006 106:529. [Full Text] [PDF]

Benign Joint Hypermobility Syndrome: Evaluation, Diagnosis, and Management: MAJ Michael R. Simpson
J Am Osteopath Assoc 2006 106:531-536. [Abstract] [Full Text] [PDF]
Benign joint hypermobility syndrome (BJHS) is a connective tissue disorder with a strong genetic component that is characterized by joint pain resulting from a defect in collagen. Its clinical presentation often leads to misdiagnosis in the primary care setting. This overview is intended to prompt primary care physicians to consider BJHS in their differential diagnoses of unexplained joint pain and other neuromusculoskeletal signs in hypermobile patients.

Stretch Reflex and Hoffmann Reflex Responses to Osteopathic Manipulative Treatment in Subjects With Achilles Tendinitis: John N. Howell, Karen S. Cabell, Anthony G. Chila, and David C. Eland
J Am Osteopath Assoc 2006 106:537-545. [Abstract] [Full Text] [PDF]
In a single-blind clinical trial, the authors studied whether OMT reduces the strength of the stretch reflex for patients with Achilles tendinitis (n=16). Pretreatment and posttreatment amplitudes for stretch reflex and H-reflex (Hoffmann reflex) in the triceps surae muscles were measured in OMT subjects as well as in asymptomatic control subjects who received sham manipulative treatment (n=15). Although the H-reflex was not significantly affected by OMT in subjects with Achilles tendinitis, it produced a 23.1% decrease in the amplitude of the stretch reflex of the soleus (P<.05) and a similarly significant response in the lateral and medial heads of the gastrocnemius. Because subjective soreness ratings declined for OMT subjects immediately posttreatment, the authors hypothesize that decreased nociceptor activity may play an additional role in somatic dysfunction, perhaps altering stretch reflex amplitude.

Effect of Counterstrain on Stretch Reflexes, Hoffmann Reflexes, and Clinical Outcomes in Subjects With Plantar Fasciitis: Marisa M. Wynne, Janet M. Burns, David C. Eland, Robert R. Conatser, and John N. Howell
J Am Osteopath Assoc 2006 106:547-556. [Abstract] [Full Text] [PDF]
Based on evidence that the counterstrain technique produces a decrease in the stretch reflex of calf muscles for subjects who have Achilles tendinitis, the authors studied stretch reflex activity and clinical outcomes in adult subjects with plantar fasciitis (N=20). Using a randomized single-blind, crossover, placebo-controlled trial, the authors evaluated laboratory measures and clinical outcomes as assessed by patients through subjective pain ratings. Clinical improvement--accompanied by mechanical, but not electrical, changes in the reflex responses of the calf muscles--occurred in response to treatment. Further study may explore the causative relation between mechanical changes and clinical responses.

Osteopathic Medicine in Transition: Postmortem of the Osteopathic Medical Center of Texas: Peter E. Hilsenrath
J Am Osteopath Assoc 2006 106:558-561. [Abstract] [Full Text] [PDF]
Osteopathic hospitals can benefit greatly from membership in a hospital system, which provides economic efficiency and security. The author discusses the economics of independent osteopathic hospitals vs system affiliation in light of changes in the healthcare system over recent decades. He asserts that, among other factors, the failure of the Osteopathic Medical Center of Texas to capitalize on system affiliation may have contributed to its eventual closing.

A Safety Review of Long-Acting ß₂-Agonists in Patients With Asthma: Nicholas L. Rider and Timothy J. Craig
J Am Osteopath Assoc 2006 106:562-567. [Abstract] [Full Text] [PDF]
The current standard of care for all patients with severe persistent asthma is a long-acting {beta}2-agonist (LABA) combined with a high-dose inhaled corticosteroid (ICS), specifically salmeterol xinafoate in combination with formeterol fumarate inhalation powder. With the substitution of a high-dose ICS for a low-dose ICS, the same treatment regimen is often recommended for patients who have persistent asthma and are older than 5 years. Used together, LABAs and ICSs relax the airway smooth muscle and are indicated for maintenance therapy. This review examines safety concerns related to the use of LABAs as monotherapy. Used alone, LABAs may cause more exacerbations, blunt the effect of rescue medications, and worsen symptoms.

How to Predict USMLE Scores From COMLEX-USA Scores: A Guide for Directors of ACGME-Accredited Residency Programs: Philip C. Slocum and Janet S. Louder
J Am Osteopath Assoc 2006 106:568-569. [Abstract] [Full Text] [PDF]
Graduates of colleges of osteopathic medicine (COMs) frequently apply to residency programs accredited by the Accreditation Council for Graduate Medical Education. The authors evaluate the correlation between student scores on the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA), the examination used to evaluate osteopathic physicians for licensure, and its allopathic equivalent, the United States Medical Licensing Examination (USMLE), for COM students who took both examinations. The correlation between scores on COMLEX-USA Level 1 and USMLE Step 1 was 0.83 (P<.001) and for COMLEX-USA Level 2 and USMLE Step 2 was 0.70 (P<.001). The authors provide a method for estimating USMLE scores based on COMLEX-USA scores.

Computer-Assisted Instruction: A Survey on the Attitudes of Osteopathic Medical Students: Lloyd J. Forman and Sherry C. Pomerantz
J Am Osteopath Assoc 2006 106:571-578. [Abstract] [Full Text] [PDF]
Using the results of a 27-item questionnaire distributed to students at one college of osteopathic medicine, the authors analyzed student attitudes toward information technology in medical education by self-assessed computer literacy levels. Most respondents rated themselves as having intermediate computer skills. Students with advanced computer skills were significantly more in favor of the further integration of medical school curricula and information technology than were students with basic or intermediate skills. The authors conclude that students' opinions of the importance of information technology in medical education seem to be based mainly on their self-assessed computer literacy levels.