The diagnosis of gastroesophageal reflux in hospitalized infants: 1971-1995.
Medical Corps, United States Army, Tripler Army Medical Center, Department of Pediatrics, Honolulu, Hawaii 96859-5000, USA. firstname.lastname@example.org
Gastroesophageal reflux (GER) is being increasingly diagnosed and implicated for a range of pediatric problems. This study examines the diagnostic rate for GER in US Army hospitals between 1971 and 1995. During this 25-year period, 2059 diagnoses of GER were identified, for a 20-fold increase. Both the rate and total number of cases rose significantly in medical centers and community hospitals alike. The increase in GER diagnoses does not necessarily imply an increase in prevalence. It may be the result of an increased awareness of the problem or over diagnosis. However, it may also reflect an increased prevalence of pathologic GER, which is potentially the result of changes in the practice of infant care.
Acute abdominal pain secondary to a urachal cyst abscess.
Department of Family Medicine, University of Mississippi School of Medicine, Tupelo 38801, USA. email@example.com
Primary care physicians often see patients with complaints of acute abdominal pain. The differential diagnosis for the acute abdomen is complex and requires not only precise clinical skills but also a high index of suspicion for a specific disease state. Uncommon disorders must be considered when the signs and symptoms observed are unusual or the pathologic entity suspected is not found on diagnostic workup or during surgery. A urachal cyst abscess, although rare, may have the signs and symptoms of an acute abdomen.
Effect of lymphatic and splenic pump techniques on the antibody response to hepatitis B vaccine: a pilot study.
Jackson KM. Steele TF. Dugan EP. Kukulka G. Blue W. Roberts A.
Department of Structural Biology, West Virginia School of Osteopathic Medicine, Lewisburg 24901, USA. firstname.lastname@example.org
Osteopathic manipulative treatment (OMT) facilitates the movement of lymphatic fluid and may enhance the immunologic response to infection or injected antigen. In this investigation, two groups of volunteers were vaccinated with recombinant hepatitis B vaccine, given at 0, 5, and 25 weeks. The experimental group (n = 20) received OMT (lymphatic and splenic pump) three times per week for 2 weeks after each vaccination. Control subjects (n = 19) received vaccine but no OMT. Resultant serum antibody levels were measured by enzyme immunoassay. Fifty percent of subjects in the treatment group achieved protective antibody titers (> or = 10 mIU/mL) on the 13th week with an average titer of 374 mIU/mL. Only 16% of the control subjects had positive antibody responses, with average titers of 96 mIU/mL. At all time points from week 6 on, the average anti-hepatitis B titer was higher in the treatment group than in the control group. These data suggest an enhanced immunologic response in subjects who received OMT.
Effect of osteopathic manipulative treatment of length of stay for pancreatitis: a randomized pilot study.
Radjieski JM. Lumley MA. Cantieri MS.
Michigan Hospital and Medical Center, Detroit, USA.
There have been few randomized, controlled studies of the effects of osteopathic manipulative treatment (OMT). In this outcomes research study, the authors randomly assigned patients with pancreatitis to receive standard care plus daily OMT for the duration of their hospitalization (n = 6) or to receive only standard care (n = 8). Osteopathic manipulative treatment involved 10 to 20 minutes daily of a standardized protocol, using myofascial release, soft tissue, and strain-counterstrain techniques. Attending physicians were blinded as to group assignment. Results indicated that patients who received OMT averaged significantly fewer days in the hospital before discharge (mean reduction, 3.5 days) than control subjects, although there were no significant differences in time to food intake or in use of pain medications. These findings suggest the possible benefit of OMT in reducing length of stay for patients with pancreatitis.