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Medicines, Volume 9, Issue 10 (October 2022) – 4 articles

Cover Story (view full-size image): Osteopathic manipulative treatment (OMT) is used in both inpatient and outpatient settings. Evidence suggests that OMT can reduce both patients’ recovery time and financial cost of their acute medical treatment and rehabilitation. Multiple studies from neonatal intensive care units (NICUs) are presented in article that demonstrates that infants treated with OMT recover faster, are discharged earlier, and have lower healthcare costs than their non-OMT-treated counterparts. Osteopathic techniques balancing ligamentous tension and myofascial release can reduce regurgitation, vomiting, milky bilious, or bloody discharge. Therefore, routine incorporation of OMT in the NICU can be of great benefit in infants with multiple disorders. Future OMT research should aim to initiate clinical trial designs that include randomized controlled trials with larger cohorts of infants admitted to the NICU. View this paper
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10 pages, 429 KiB  
Brief Report
Physical Activity in the Elderly and Frailty Syndrome: A Retrospective Study in Primary Care
by Abrar-Ahmad Zulfiqar, Habib Habchi, Perla Habchi, Ibrahima Amadou Dembele and Emmanuel Andres
Medicines 2022, 9(10), 51; https://doi.org/10.3390/medicines9100051 - 11 Oct 2022
Cited by 4 | Viewed by 1625
Abstract
Objectives: Physical activity carries numerous therapeutic benefits, and it is more effective when applied before the onset of symptoms. The objective of this study is to compare the correlation of the evaluation of physical activity carried out using the Ricci and Gagnon test [...] Read more.
Objectives: Physical activity carries numerous therapeutic benefits, and it is more effective when applied before the onset of symptoms. The objective of this study is to compare the correlation of the evaluation of physical activity carried out using the Ricci and Gagnon test and the frailty profile measured by the mSEGA scale in a population of patients consulting in general medicine. Methods: We conducted a retrospective study within a general practitioner clinic in Chaumont and Bologne (Haute-Marne department) during a 3-month period. Patients aged 65 years and up were screened for frailty using the modified SEGA (mSEGA) assessment, and physical activity was measured using the Ricci–Gagnon questionnaire. Results: A total of 44 patients were selected, with a slightly female predominance (59.1%). Of these, 21 patients reported having worked in manual labor. Seven patients were found to be frail using the SEGAm assessment, while 10 (22.73%) patients had an inactive profile according the Ricci–Gagnon score. Malnutrition was detected in six patients (13.64%) using the MNA survey. Frailty as defined by the mSEGA scale had no statistical correlation (p = 0.68) with the Ricci–Gagnon score. A Ricci–Gagnon inactive profile showed statistical correlations with fall indicators (unipedal balance test, p = 0.014) and malnutrition scores using the MNA (p = 0.0057) as well as with the Charlson Comorbidity Index (p = 0.027). Conclusion: A systematic survey of the elderly by a general practitioner implementing a regular and suitable physical activity regimen would allow a better screening of frailty, minimizing its complications. Full article
(This article belongs to the Special Issue Frailty Syndrome in the Elderly: A Real Challenge for Our Society)
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10 pages, 1651 KiB  
Case Report
Management of Salter–Harris Type 1 Fracture Complicated with Osteomyelitis in a Sickle Cell Disease Patient: A Case Report and Review of Literature
by Nnennaya U. Opara, Emmanuella C. Osuala and Ugochinyere I. Nwagbara
Medicines 2022, 9(10), 50; https://doi.org/10.3390/medicines9100050 - 22 Sep 2022
Cited by 2 | Viewed by 2291
Abstract
Salter–Harris fractures may occur due to a single injury or repetitive stress fractures on the extremities. Type I to III fractures are managed medically, while types IV and V, which are rare, are treated surgically. In the pediatric population, Salter–Harris I fractures of [...] Read more.
Salter–Harris fractures may occur due to a single injury or repetitive stress fractures on the extremities. Type I to III fractures are managed medically, while types IV and V, which are rare, are treated surgically. In the pediatric population, Salter–Harris I fractures of the distal tibia are commonly seen, and management of such fractures are well established in the literature. Despite the availability of a wide range of treatment for such fractures, osteonecrosis or avascular necrosis of the proximal femur can subsequently develop. Avascular necrosis is cell death secondary to metabolic disturbances, trauma, adverse effects of certain medications, or sickle cell disease. Avascular necrosis commonly affects the talus, humerus, or tibia in addition to the femoral head. Radiographic images are essential for prompt diagnosis and to minimize negative health outcomes in these patients. However, Salter–Harris I fracture in sickle cell patients can be very challenging due to these patients’ vulnerability to bone infections and sickle cell crisis. In this case report, our patient with a history of sickle cell disease and with a diagnosis of Salter–Harris I fracture was treated with surgical intervention as type V, which is discussed in this article, and responded well to treatment. Thus, this case suggests a new approach to managing Salter–Harris I fractures complicated with osteomyelitis in sickle cell patients. Full article
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14 pages, 1290 KiB  
Review
Osteopathic Manipulative Treatment Decreases Hospital Stay and Healthcare Cost in the Neonatal Intensive Care Unit
by Hannah Roland, Amanda Brown, Amy Rousselot, Natalie Freeman, J. Michael Wieting, Stephen Bergman and Debasis Mondal
Medicines 2022, 9(10), 49; https://doi.org/10.3390/medicines9100049 - 21 Sep 2022
Viewed by 6526
Abstract
Osteopathic manipulative treatment (OMT) is used in both inpatient and outpatient settings. Evidence suggests that OMT can reduce both patients’ recovery time and the financial cost of their acute medical treatment and rehabilitation. Multiple studies from neonatal intensive care units (NICUs) are presented [...] Read more.
Osteopathic manipulative treatment (OMT) is used in both inpatient and outpatient settings. Evidence suggests that OMT can reduce both patients’ recovery time and the financial cost of their acute medical treatment and rehabilitation. Multiple studies from neonatal intensive care units (NICUs) are presented in this article that demonstrate infants treated with OMT recover faster, are discharged earlier, and have lower healthcare costs than their non-OMT-treated counterparts. Data clearly show that adjunctive OMT facilitates feeding coordination in newborns, such as latching, suckling, swallowing, and breathing, and increases long-term weight gain and maintenance, which reduces hospital length of stay (LOS). Osteopathic techniques, such as soft tissue manipulation, balanced ligamentous tension, myofascial release, and osteopathic cranial manipulation (OCM), can reduce regurgitation, vomiting, milky bilious, or bloody discharge and decrease the need for constipation treatment. OMT can also be effective in reducing the complications of pneumonia in premature babies. Studies show the use of OCM and lymphatic pump technique (LPT) reduces the occurrence of both aspiration and environmentally acquired pneumonia, resulting in significantly lower morbidity and mortality in infants. Based on published findings, it is determined that OMT is clinically effective, cost efficient, a less invasive alternative to surgery, and a less toxic choice to pharmacologic drugs. Therefore, routine incorporation of OMT in the NICU can be of great benefit in infants with multiple disorders. Future OMT research should aim to initiate clinical trial designs that include randomized controlled trials with larger cohorts of infants admitted to the NICU. Furthermore, a streamlined and concerted effort to elucidate the underlying molecular mechanisms associated with the beneficial effects of OMT will aid in understanding the significant value of incorporating OMT into optimal patient care. Full article
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9 pages, 309 KiB  
Brief Report
Association of Frailty Status with Risk of Fall among Hospitalized Elderly Patients: A Cross-Sectional Study in an Acute Geriatric Unit
by Abrar-Ahmad Zulfiqar, Perla Habchi, Ibrahima Amadou Dembele and Emmanuel Andres
Medicines 2022, 9(10), 48; https://doi.org/10.3390/medicines9100048 - 20 Sep 2022
Viewed by 1539
Abstract
Introduction: The objective was to study the association of frailty status in hospitalized elderly patients with risk of fall in an acute geriatric unit and to characterize elderly “fallers” using a comprehensive gerontological assessment. Patients and Methods: A cross-sectional study was conducted in [...] Read more.
Introduction: The objective was to study the association of frailty status in hospitalized elderly patients with risk of fall in an acute geriatric unit and to characterize elderly “fallers” using a comprehensive gerontological assessment. Patients and Methods: A cross-sectional study was conducted in patients over 65 years of age and hospitalized in an acute geriatric unit. This work was carried out in the Acute Geriatric Medicine Unit, Saint-Julien Hospital, Center Hospitalier Universitaire de Rouen from 1 June 2016 to 15 August 2016. Results: 172 patients were included during the collection period, with a female predominance of 115 patients (66.9%). The average age of the sample was 79.37 years old (65–85). The average CHARLSON score was 6.93 (3–16). Patients came from home in 81.4% of cases (i.e., 140 patients), and from a nursing home in 18.6% of cases (i.e., 32 patients). The risk of falling, as assessed by the Monopodal Support Test, returned as abnormal for 127 patients. In our series, there was a statistically strong link between the risk of falling and the presence of a dementia pathology (p = 0.009), the presence of a vitamin D deficiency (p = 0.03), the presence of frailty, as assessed by the three scales (modified SEGA scale, Fried scale and CFS/7 (<0.001), a high comorbidity score (p = 0.04), and a disturbed autonomy assessment according to IADL (p = 1.02 × 10−5) and according to ADL (p = 6.4 × 10−8). There was a statistically strong link between the risk of falling and the occurrence of death (p = 0.01). Conclusion: The consequences of the fall in terms of morbidity and mortality and the frequency of this event with advancing age and its impact on the quality of life as well as on health expenditure justify a systematic identification of the risk of falling in the elderly population. It is therefore important to have sensitive, specific, and reproducible tools available for identifying elderly people at high risk of falling. Full article
(This article belongs to the Special Issue Frailty Syndrome in the Elderly: A Real Challenge for Our Society)
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