Open Access Published by De Gruyter

Volume 108 Issue 6

Issue of Journal of Osteopathic Medicine

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AOA COMMUNICATIONS (REPRINTS)

Open Access June 1, 2008

OFFICIAL CALL

Peter B. Ajluni, Carl Michael Pesta

Page range: 276-276

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Open Access June 1, 2008

Proposed Amendments to the AOA Bylaws

Page range: 278-280

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EDITORIALS

Open Access June 1, 2008

Saying What You Mean and Meaning What You Say

Felix J. Rogers

Page range: 281-282

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SPECIAL COMMUNICATIONS

Open Access June 1, 2008

Traumatic Neuralgia From Pressure-Point Strikes in the Martial Arts: Results From a Retrospective Online Survey

Michael D. Kelly

Page range: 284-287

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Abstract

Context : Many techniques in Asian martial arts hand-to-hand combat systems emphasize hitting or striking specific sites on the body that correlate with exposed portions of peripheral nerves. Objective : To evaluate the prevalence and clinical effects of this unique sports-related injury. Methods : An anonymous self-administered retrospective 20-question electronic survey was posted on a high-traffic martial arts Web site. Primary outcome measures were demographic and medical history data, including martial arts experience and neuropathic symptoms associated with injury from this form of combat. Risk of symptoms was calculated by dividing the number of individuals with symptoms in each pressure-point area by the number of individuals who were struck in these areas during martial arts training. Results : Of the 651 survey responses received, 605 met inclusion criteria. Neuropathic symptoms were reported by 291 subjects. Most symptoms occurred in individuals aged between 20 and 30 years as well as in individuals with less than 1 year of martial arts training. The majority of respondents with neuropathic symptoms reported a symptom duration of less than 1 year (207 [71%]). Individuals with more than 5 years of combat training experience had a greater risk of chronic symptoms than individuals with less experience. Strikes to pressure points on the back had the greatest risk of inducing neuropathic symptoms. Conclusion : Symptoms of neurapraxia can occur in individuals as a result of practicing martial arts involving strikes on pressure points. Although the majority of symptoms resolve within 1 year, individuals with prolonged exposure to pressure-point strikes may be more likely to have chronic symptoms.

ORIGINAL CONTRIBUTIONS

Open Access June 1, 2008

Improving Clinical Decisions for Women at Risk of Osteoporosis: Dual-Femur Bone Mineral Density Testing

Raymond E. Cole

Page range: 289-295

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Abstract

Context : In bone mineral density (BMD) testing, unilateral hip analysis and lumbar spine measurement have been the clinical standard for diagnosis and treatment classification for postmenopausal women at risk of osteoporosis. Objective : To determine if analysis of the bilateral hip in BMD testing has a clinical effect on diagnosis of osteoporosis and treatment classification of patients. Methods : Dual-femur BMD test results from 313 postmenopausal women (mean age 61.2 years, range 32-90 years) were evaluated using standard BMD reference values for diagnosis and treatment classification. The author compared T scores for right and left femurs at three sites: femoral neck, trochanter, and total femur. Results : When the bilateral hip was considered in BMD testing and compared with unilateral hip results, a clinical change in diagnosis from normal to osteopenia occurred in 5.7% of subjects. In addition, a clinical change in diagnosis from osteopenia to osteoporosis occurred in 3.3% of subjects. A clinical change in treatment classification from “no treatment required” to “treatment required if one or more risk factors are present” occurred in 3% of subjects. A change in treatment classification from “treatment required if one or more risk factors are present” to “treatment required independent of risk factors” happened in 2.4% of subjects. Conclusion : When compared with BMD testing of the unilateral hip, inclusion of the bilateral hip in BMD testing resulted in a change in classification to a more severe diagnosis in a total of 9% of subjects, and to a more aggressive treatment category in a total of 5.4% of subjects. Dual-femur BMD testing may improve diagnosis and treatment classification for postmenopausal women at risk of osteoporosis.

SPECIAL COMMUNICATIONS

Open Access June 1, 2008

Access to State-of-the-Art Healthcare: a Missing Dynamic in Consumer Selection of a Retirement Community

Bridgette L. Perrotta, Augustine L. Perrotta

Page range: 297-305

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Abstract

The top ten retirement destinations in the United States are compared to the State of Michigan with regard to the quality of medical care that can be readily obtained in the event of a medical emergency. Access to care during the following three medical emergencies was analyzed: cardiac arrest, thromboembolic (ischemic) stroke, and severe traumatic injury. In all instances, successful treatment is dependent on timely access to care. The authors report that, when combined with the health status of baby boomers and their migratory trends on retirement, access to tertiary medical care for the treatment of cardiac arrest, certified primary stroke centers, and level I trauma centers is the missing dynamic in the choice of retirement community among today's prospective retirees. They recommend that physicians encourage this patient population to consider such factors when choosing a retirement community.

CASE REPORTS

Open Access June 1, 2008

Solitary Fibrous Pleural Tumor

Lori A. Jenkins, Albert H. O-Yurvati

Page range: 307-309

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Abstract

Solitary fibrous pleural tumors are rare masses of mesenchymal origin that may be mistaken for mesothelioma. A positive staining of vimentin, negative staining of cytoplasmic keratin, and expression of the CD34 antigen can confirm the presence of a solitary fibrous pleural tumor. Although most tumors of this type are benign, they possess a malignant potential and thus should be excised. We report a case of a 63-year-old man who had an inconclusive biopsy of a lung lesion 15 years ago. Further testing after excision revealed a solitary fibrous pleural tumor. A brief discussion of the clinical presentation and incidence of these tumors is included.

Open Access June 1, 2008

Metastatic Penile Squamous Cell Carcinoma to the Retroperitoneum in a Man With Human Papillomavirus Type 45

Benjamin L. Shaw, Michael J. Menolasino

Page range: 310-312

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Abstract

Squamous cell carcinoma of the penis is a rare cancer associated with smoking, genital warts, lack of neonatal circumcision, and human papillomavirus types 16 and 18. Metastasis of this condition is even rarer, occurring primarily in the lungs or liver. The current report describes a case of penile squamous cell carcinoma in an uncircumcised 63-year-old man who smoked cigarettes and who had genital warts and human papillomavirus type 45. Metastasis occurred in the abdominal cavity.

About this journal

The Journal of Osteopathic Medicine, founded in 1901 and known for 119 years as the Journal of the American Osteopathic Association, is the premier scholarly, peer-reviewed publication of the osteopathic medical profession. The mission of JOM is to serve as an international forum for the dissemination of scientific literature that incorporates an integrative, comprehensive, patient-centered approach to clinical care and improving health. JOM conducts double-blind peer review of academic research manuscripts from a wide variety of medical specialties, covering the full spectrum of clinical settings in which osteopathic physicians practice. All submissions are vetted by a distinguished group of Section Editors led by Editor-in-Chief Ross Zafonte, DO, and supported by a full Editorial Board.

JOM publishes original research, narrative and systematic review articles (including meta-analyses), clinical practice descriptions, and a very limited number of case reports, all of which are described fully in our Instructions for Authors. JOM is particularly interested in original scientific research that provides quantitative analysis of and contributes significantly to the evidence base underpinning current practices in osteopathic medicine, including but not limited to neuromusculoskeletal medicine. We also accept research submissions documenting trends and changes in education for osteopathic medical students. The ultimate focus of all material published in JOM is to support, enhance, and advance patient care through evidence.