Impact of Osteopathic Manipulative Therapy (OMT) on Morbidity in Pregnant Persons aged 18-39

Background: Rates of maternal morbidity and mortality in the United States continue to rise.1 Pregnant persons are more vulnerable to stress and morbidities associated with the physiological changes of pregnancy. Low back pain and posterior pelvic pain are of high incidence experienced in pregnant persons.2 Prevention strategies are necessary to improve maternal health outcomes in the United States. Some studies have shown that Osteopathic Manipulative Therapy (OMT) can be an effective treatment modality for pregnant patients experiencing somatic pain. These studies, however, are limited and of small sample size. Purpose: To examine the current literature on the impact of OMT on morbidity in pregnant persons. Methods: This literature review research process used JAMA and PubMed as primary databases. A wide variety of search terms were used: morbidity, mortality, epidemiology, persons, pregnancy, pregnancies, Osteopathy, Osteopathic manipulative medicine, therapy, osteopathic physicians, manual. Studies were limited to back pain and pelvic pain experienced by pregnant persons. Results: Current studies show there is medium quality evidence that OMT is effective at treating low back pain and pelvic pain experienced by pregnant persons. These studies, however, are limited and of small sample size. There were no studies that examined the impact of OMT on the mortality of pregnant persons. Conclusion: There is medium quality evidence that OMT may reduce low back pain and pelvic pain in pregnant persons. There is low quality evidence that OMT can reduce low back pain and pelvic pain in post-partum persons.3 More high-quality studies are needed to determine the impact of OMT on morbidities experienced by pregnant persons

Mental Health Outcomes at a Student-Run Free Clinic

In this project we aim to: 1. Assess the outcomes of screening, management, and diagnosis for patients at the Rowan Community Health Center (RCHC). 2. Compare the outcomes of screening, management, and diagnosis between different groups (gender, race, income, insurance status) using validated surveys. 3. There is a need for accessible and affordable primary care in the South Jersey area, which the RCHC is hoping to meet. Hypothesis: The quality of mental health care available to patients at the RCHC is comparable to that at other insured practices

Orthovoltage intraoperative radiation therapy for pancreatic adenocarcinoma

<p>Abstract</p> <p>Purpose</p> <p>To analyze the outcomes of patients from a single institution treated with surgery and orthovoltage intraoperative radiotherapy (IORT) for pancreatic adenocarcinoma.</p> <p>Methods</p> <p>We retrospectively reviewed 23 consecutive patients from 1990-2001 treated with IORT to 23 discrete sites with median and mean follow up of 6.5 and 21 months, respectively. Most tumors were located in the head of the pancreas (83%) and sites irradiated included: tumor bed (57%), vessels (26%), both the tumor bed/vessels (13%) and other (4%). The majority of patients (83%) had IORT at the time of their definitive surgery. Three patients had preoperative chemoradiation (13%). Orthovoltage X-rays (200-250 kVp) were employed via individually sized and beveled cone applicators. Additional mean clinical characteristics include: age 64 (range 41-81); tumor size 4 cm (range 1.4-11); and IORT dose 1106 cGy (range 600-1500). Post-operative external beam radiation (EBRT) or chemotherapy was given to 65% and 76% of the assessable patients, respectively. Outcomes measured were infield control (IFC), loco-regional control (LRC), distant metastasis free survival (DMFS), overall survival (OS) and treatment-related complications.</p> <p>Results</p> <p>Kaplan-Meier (KM) 2-year IFC, LRC, DMFS and OS probabilities for the whole group were 83%, 61%, 26%, and 27%, respectively. Our cohort had three grade 3-5 complications associated with treatment (surgery and IORT).</p> <p>Conclusions</p> <p>Orthovoltage IORT following tumor reductive surgery is reasonably well tolerated and seems to confer in-field control in carefully selected patients. However, distant metastases remain the major problem for patients with pancreatic adenocarcinoma.</p

The Need for Depression and Anxiety Screenings at a Student-Run Clinic

General anxiety and major depressive disorder are common and treatable mental health disorders. The US Preventive Services Task Force provides strong evidence that early screening helps identify depression in primary care settings, promotes intervention and facilitates treatment. Many medical offices use validated screening tools, GAD-7 and PHQ-9, to measure symptom severities and further help guide treatment modalities for patients with anxiety and depression, respectively. The Rowan Community Health Clinic (RCHC) in Lindenwold, NJ is a student-run free clinic that serves patients regardless of patient gender, race, income, or insurance status. This study aims to determine if there is a need to build internal infrastructure at RCHC for depression and anxiety management. This study started in June 2021 and had a total of 25 patients. Patients were administered both the GAD-7 and PHQ-9 for screening and were given various resources and/or referrals depending on their calculated score. Data was stored in Qualtrics and analyzed in SPSS. While this study had a small sample size, it was evident that both anxiety and depression play a role in our patients’ lives despite not seeing any significant data between minimal and moderate-to-severe depression and/or anxiety. With these tools only being able to measure symptom severity, further psychiatric evaluation is also essential to accurately diagnose mental health disorders. Future steps involve increasing sample size as well as comparing data with insured patients at a Family Medicine office. One of RCHC’s goals is to use our preliminary data in order to start a framework and provide accessible mental health services within our student-run clinic

Functional Interaction between Type III-Secreted Protein IncA of Chlamydophila psittaci and Human G3BP1

Chlamydophila (Cp.) psittaci, the causative agent of psittacosis in birds and humans, is the most important zoonotic pathogen of the family Chlamydiaceae. These obligate intracellular bacteria are distinguished by a unique biphasic developmental cycle, which includes proliferation in a membrane-bound compartment termed inclusion. All Chlamydiaceae spp. possess a coding capacity for core components of a Type III secretion apparatus, which mediates specific delivery of anti-host effector proteins either into the chlamydial inclusion membrane or into the cytoplasm of target eukaryotic cells. Here we describe the interaction between Type III-secreted protein IncA of Cp. psittaci and host protein G3BP1 in a yeast two-hybrid system. In GST-pull down and co-immunoprecipitation experiments both in vitro and in vivo interaction between full-length IncA and G3BP1 were shown. Using fluorescence microscopy, the localization of G3BP1 near the inclusion membrane of Cp. psittaci-infected Hep-2 cells was demonstrated. Notably, infection of Hep-2 cells with Cp. psittaci and overexpression of IncA in HEK293 cells led to a decrease in c-Myc protein concentration. This effect could be ascribed to the interaction between IncA and G3BP1 since overexpression of an IncA mutant construct disabled to interact with G3BP1 failed to reduce c-Myc concentration. We hypothesize that lowering the host cell c-Myc protein concentration may be part of a strategy employed by Cp. psittaci to avoid apoptosis and scale down host cell proliferation