Hasil untuk "Osteopathy"

Yang Yang, Ming yan Xu, Yiyun Yang

Introduction: In this case, full-arch implant prosthetic rehabilitation was performed on a Hajdu-Cheney syndrome (HCS) patient. The treatment outcomes were systematically evaluated, including implant stability, occlusal reconstruction functionality, aesthetic restoration, and postoperative quality of life. Case description: This case details the dental implant treatment of a 23-year-old female presenting with progressive tooth mobility and loss. CBCT imaging demonstrated maxillofacial skeletal dysplasia, aberrant trabecular bone architecture, and severe alveolar bone resorption. The patient exhibited maxillofacial and limb deformities, osteoporosis and acro-osteolysis. Given the diagnostic challenges posed by the disease's rarity and complexity, we conducted genetic sequencing on the patient and ultimately confirmed the diagnosis of HCS. Finally, we performed a dental implant procedure on the patient. The maxilla received four implants (Dentium SuperLine®), with six implants placed in the mandible. Final restoration comprised mandibular fixed prostheses and maxillary Locator overdentures. Discussion: Hajdu-Cheney syndrome represents a rare hereditary metabolic osteopathy. Since Hajdu's initial documentation of cases in 1948 and Cheney's identification of familial patterns in 1965, approximately 80 confirmed cases have been reported globally. Notably, Dokou et al. (2005) achieved successful implant placement in an HCS patient without postoperative complications, establishing the preliminary feasibility of such interventions. Conclusion/clinical significance: This case represents the first documented complete oral rehabilitation using eight dental implants in an HCS patient, with all implants demonstrating clinical success and no major complications observed during the follow-up period. The therapeutic protocol provides valuable insights for developing evidence-based implant strategies in this special patient population.

Yang Zhang, Yiwen Zhu, Mengying Li et al.

Abstract Objectives Oxymatrine (OMT), a quinolizidine alkaloid derived from Sophora flavescens Ait., has demonstrated therapeutic potential in type 2 diabetes mellitus (T2DM). This study aimed to investigate its effects on diabetic osteoporosis (DOP) and explore the underlying mechanisms involving gut microbiota and osteogenic regulation. Methods In a rat model of T2DM, intragastric Oxymatrine was used to study trabecular bone repair through bone microstructure and histopathology analyses. Changes in gut microbiota, especially Gram-negative bacteria releasing lipopolysaccharides (LPS), were assessed via 16S rRNA sequencing. miRNA sequencing on LPS-induced rat osteoblasts, with and without Oxymatrine, explored osteoblast proliferation, mineralization, and the miR-539-5p/OGN/Runx2 pathway. Results The administration of OMT resulted in an enhancement of diabetic osteopathy by reversing trabecular bone loss and modifying the composition of gut microbiota, specifically affecting Gram-negative bacteria that release LPS into the bloodstream. miRNA sequencing revealed that miR-539-5p, which was upregulated in LPS-induced ROBs, was downregulated following OMT treatment. Furthermore, OMT was found to promote osteoblast proliferation and mineralization under conditions of LPS exposure and modulate the miR-539-5p/OGN/Runx2 signaling pathway. Conclusions OMT improves diabetic osteoporosis by altering gut microbiota, decreasing LPS release, and enhancing osteoblast growth and differentiation through the miR-539-5p/OGN/Runx2 pathway, suggesting its potential as a treatment.

Maria Teresa Colangelo, Marco Meleti, Stefano Guizzardi et al.

<b>Background:</b> Exosomes, nanoscale extracellular vesicles, play a crucial role in tissue physiology and regeneration. This study uses infometric techniques to explore the structure of exosome-based tissue and bone regeneration research. <b>Methods:</b> We applied BERTopic, an advanced topic modeling algorithm, to a comprehensive corpus of the scientific literature on exosomes and tissue regeneration, identifying key themes such as stem cell studies, tissue healing, and regenerative applications, with orthopedics and dentistry emerging as dominant subfields. To further investigate the ‘ideoscape’, i.e., the conceptual landscape that maps how ideas, methods, and themes are interconnected across the field, we extracted significant concepts from abstracts using GPT 3.5 turbo and created knowledge graphs. <b>Results:</b> Our analysis revealed rapid growth in the field of dental stem cell regeneration, which has outpaced other bone regeneration topics by twofold. This analysis highlighted central themes such as periodontal stem cells and their cellular processes—proliferation, migration, and differentiation—along with their clinical applications. Our approach provided a clear visualization of the field’s intellectual structure, showing how emerging topics are interconnected. Our findings offer a comprehensive view of the evolving trends in exosome-based bone regeneration, revealing not only the most active research areas but also gaps and opportunities for further investigation. <b>Conclusions:</b> This study exemplifies the utility of combining topic modeling with knowledge graph creation to map research trends, offering a flexible and largely automated tool for researchers to explore the vast bodies of literature and guide future research directions.

Hazel J. Jenkins, Benjamin T. Brown, Mary O’Keeffe et al.

Abstract Background The management of low back pain (LBP) is highly variable and patients often receive management that is not recommended and/or miss out on recommended care. Clinician knowledge and behaviours are strongly influenced by entry-level clinical training and are commonly cited as barriers to implementing evidence-based management. Currently there are no internationally recognised curriculum standards for the teaching of LBP content to ensure graduating clinicians have the appropriate knowledge and competencies to assess and manage LBP. We formed an international interdisciplinary working group to develop curriculum content standards for the teaching of LBP in entry-level clinical training programs. Methods The working group included representatives from 11 countries: 18 academics and clinicians from healthcare professions who deal with the management of LBP (medicine, physiotherapy, chiropractic, osteopathy, pharmacology, and psychology), seven professional organisation representatives (medicine, physiotherapy, chiropractic, spine societies), and one healthcare consumer. A literature review was performed, including database and hand searches of guidelines and accreditation, curricula, and other policy documents, to identify gaps in current LBP teaching and recommended entry-level knowledge and competencies. The steering group (authors) drafted the initial LBP Curriculum Content Standards (LBP-CCS), which were discussed and modified through two review rounds with the working group. Results Sixty-two documents informed the draft standards. The final LBP-CCS consisted of four broad topics covering the epidemiology, biopsychosocial contributors, assessment, and management of LBP. For each topic, key knowledge and competencies to be achieved by the end of entry-level clinical training were described. Conclusion We have developed the LBP-CCS in consultation with an interdisciplinary, international working group. These standards can be used to inform or benchmark the content of curricula related to LBP in new or existing entry-level clinical training programs.

ZHANG Zhenlin, YUE Hua, LI Mei, XIA Weibo

China is now witnessing an accelerated aging process，and active reaction is an important issue that we are facing. Osteoporosis and the resulting fractures are particularly noteworthy. In order to further standardize the diagnosis and treatment of primary osteoporosis, the Osteoporosis and Bone Mineral Disease Branch of the Chinese Medical Association has developed and released the “Guidelines for the Diagnosis and Treatment of Primary Osteoporosis (2022 Version)” based on the epidemiological characteristics and pathogenesis of the Chinese population, which combined high-quality medical research evidence from both domestic and foreign sources. Based on evidence-based medicine evidence, and clinical practice in China, this article will focus on the interpretation of two key clinical issues in the new version of the guidelines, namely “fracture risk stratification and treatment selection” and “treatment course of anti-osteoporosis drugs”. Regarding the risk of fractures, this guideline divides it into high and extremely high fracture risks, cancels the classification of low and medium risks, and for one of the extremely high fracture risk indicators “recent brittle fractures”，defines “recent” as “24 months”.Given that the FRAX model underestimates the fracture risk of Chinese patients, it is proposed to develop a highly operational fracture risk stratification criteria in clinical practice. Regarding drug treatment, patients who use bisphosphonates should be fully evaluated before entering the medication holiday, and regular follow-up is still required. Although the Food and Drug Administration (FDA) of the United States has lifted the warning of osteosarcoma and 24- month treatment limit for terlipide, the user manual of the drug in China still suggests a treatment period of 24 months. This guideline is based on high-quality evidence-based medical evidence both domestically and internationally, and may provide reference and research directions for clinical practice.

Kai Cheng, Ian Curthoys, Hamish MacDougall et al.

Background: For almost a decade, virtual reality (VR) has been employed in otology simulation. The realism and accuracy of traditional three-dimensional (3D) mesh models of the middle ear from clinical CT have suffered because of their low resolution. Although micro-computed tomography (micro-CT) imaging overcomes resolution issues, its usage in virtual reality platforms has been limited due to the high computational requirements. The aim of this study was to optimize a high-resolution 3D human middle ear mesh model suitable for viewing and manipulation in an immersive VR environment using an HTC VIVE VR headset (HTC and Valve Corporation, USA) to enable a seamless middle ear anatomical visualisation viewing experience in VR while preserving anatomical accuracy. Methods: A high-resolution 3D mesh model of the human middle ear was reconstructed using micro-CT data with 28 μm voxel resolution. The models were optimised by tailoring the surface model polygon counts, file size, loading time, and frame rate. Results: The optimized middle ear model and its surrounding structures (polygon counts reduced from 21 million polygons to 2.5 million) could be uploaded and visualised in immersive VR at 82 frames per second with no VR-related motion sickness reported. Conclusion: High-resolution micro-CT data can be visualized in an immersive VR environment after optimisation. To our knowledge, this is the first report on overcoming the translational hurdle in middle ear applications of VR.

Bente L Langdahl

Carreras-Díaz R, Saavedra-Santana P, Gómez de Tejada-Romero MJ et al.

Objetivo: Los estilos de vida y la historia ginecológica parecen influir en el metabolismo mineral óseo. Existen datos contradictorios sobre los posibles efectos de la lactancia materna en el posterior desarrollo de una osteoporosis densitométrica o la aparición de fracturas por fragilidad. El objetivo de este estudio fue valorar dichos efectos. Material y métodos: Estudio observacional, transversal, abierto, realizado en 758 mujeres postmenopáusicas que fueron clasificadas en dos grupos, dependiendo de que hubieran lactado a sus hijos o no. Se recogieron datos sobre estilos de vida, historia ginecológica y fracturas por fragilidad. Se les realizó una analítica general, con función renal, hepática, lípidos, iones, así como marcadores bioquímicos de remodelado óseo, hormona paratiroidea (PTH) y vitamina D (25HCC). Se les determinó la densidad mineral ósea (DMO) en la columna lumbar y en la extremidad proximal del fémur mediante absorciometría dual de rayos X (DXA). Así mismo se les realizó una medición mediante ultrasonografía cuantitativa (QUS) en el calcáneo del pie dominante. Los datos crudos, después de ser comparados por grupos, fueron ajustados aplicando el método de pareamiento por puntuación de propensión o propensity score matching, realizándose una comparación más precisa de las variables estudiadas. Resultados: Los resultados previos a la aplicación del propensity score fueron ajustados por la edad y el índice de masa corporal (IMC), dado que en el estudio basal se apreciaron diferencias significativas en estas variables entre ambos grupos (prevalencia de las fracturas de cadera y la cifosis y en los siguientes parámetros bioquímicos: concretamente ácido úrico, glucosa, HDL-colesterol, triglicéridos y fósforo). Estas diferencias desaparecieron tras realizar el ajuste por las variables que fueron incluidas en el modelo por la regresión logística lineal aplicada. Tras realizar el ajuste con el propensity score matching y con el modelo de regresión lineal finalmente obtenido, no se obtuvo una influencia de la lactancia materna en la densidad mineral ósea, en la prevalencia de osteoporosis densitométrica o en la aparición de fracturas por fragilidad después de la menopausia. Conclusión: La lactancia materna no se asocia a mayores o menores valores de densidad mineral ósea, a la prevalencia de osteoporosis densitométrica ni a la presencia de fracturas por fragilidad.

Burhan Fatih Koçyiğit, Ahmet Akyol, Serkan Usgu

Fibromyalgia syndrome (FMS) is a chronic rheumatic disease in which pain is predominant and accompanied by fatigue, anxiety, depression, sleep disturbance and cognitive dysfunction. Although there are numerous pharmacological and non-pharmacological therapeutic alternatives, symptom control is frequently problematic. Manual therapy covers manipulating soft tissue and various joints using the hands. It is organized by mapping of soft tissue structures with rhythmically applied pressure to improve physical function, facilitate daily activities, promote rehabilitation procedures and decrease pain.  Massage is generally accepted as an essential component of manual therapy. Stretching and mobilizations are also part of manual therapy. Although numerous beneficial effects of manual therapy and massage on the musculoskeletal system and pain have been proven, the data in FMS patients studies are inconclusive. We hypothesize that manual therapy and massage are beneficial therapeutic options for the control of symptoms of FMS patients. Furthermore, these strategies can be employed in conjunction with well-established and high-evidence therapeutic procedures. Future research should focus on establishing standardized protocols for manual therapy and massage, which is one of the major limitations. To ensure a high level of evidence, research studies with large sample sizes, long follow-up periods and methodologically complete are needed.

Jon Adams, D. Sibbritt, A. Steel et al.

BackgroundLimited information is available regarding the profile and clinical practice characteristics of the osteopathy workforce in Australia. This paper reports such information by analysing data from a nationally-representative sample of Australian osteopaths.MethodsData was obtained from a workforce survey of Australian osteopathy, investigating the characteristics of the practitioner, their practice, clinical management features and perceptions regarding research. The survey questionnaire was distributed to all registered osteopaths across Australia in 2016 as part of the Osteopathy Research and Innovation Network (ORION) project.ResultsA total of 992 Australian osteopaths participated in this study representing a response rate of 49.1%. The average age of the participants was 38.0 years with 58.1% being female and the majority holding a Bachelor or higher degree qualification related to the osteopathy professional. Approximately 80.0% of the osteopaths were practicing in an urban area, with most osteopaths working in multi-practitioner locations, having referral relationships with a range of health care practitioners, managing patients a number of musculoskeletal disorders, and providing multi-model treatment options.ConclusionsA total of 3.9 million patients were estimated to consult with osteopaths every year and an average of approximate 3.0 million hours were spent delivering osteopathy services per year. Further research is required to provide rich, in-depth examination regarding a range of osteopathy workforce issues which will help ensure safe, effective patient care to all receiving and providing treatments as part of the broader Australian health system.

P. Vaucher, Mia Macdonald, D. Carnes

Objectives The aim of this study was to describe osteopathic activity and scope of practice to understand the current and future role of osteopathy in the Swiss healthcare system. Design A questionnaire survey that included a patient record-based retrospective clinical audit. Setting/population Osteopaths with a national diploma (n=1086) were invited by mail to participate in an online survey. Osteopathic assistants (n=84) were identified through their national association. Questionnaire The survey was constructed from previous surveys and tested for face validity with experts, osteopaths and patient representatives. The questionnaires were completed online in English, German and French between April and August 2017. Osteopaths anonymously reported information about themselves, their practice, and the treatment and care for four randomly selected patients they managed in 2016. Results The response rate from the survey was 44.5% (521/1171). Data on osteopathic care were collected for 1144 patients and 3449 consultations. In 2016, osteopaths saw approximately 6.8% of the Swiss population for 1700 000 consultations and an overall estimated cost of 200 million Swiss francs. 76% of patients sought care directly without a referral from another care provider. Few osteopaths (<1%) work in a hospital setting and 46% work in isolation in private practice. Infants (under 2 years old) made up 10% of all patients and 9% of patients were ≥65 years. Patients most commonly sought treatment for musculoskeletal conditions (81%) with the spine being the most frequent location (66%). Treatments also included exercise advice (34.2%) and lifestyle management (35.4%). Fewer than 1 patient out of 10 were referred to another health profession or provider. Conclusions In Switzerland, osteopathic care represents an important first line management for musculoskeletal conditions that alleviates some of the burden of care in the Swiss primary healthcare system.

S. Stigliano, A. Waldthaler, E. Martínez-Moneo et al.

Background: Osteopathy is common in patients with chronic pancreatitis (CP), but previous studies carry several limitations. Vitamin K is essential for bone metabolism, but its role in this setting has never been investigated. Our aim is to assess the prevalence of osteoporosis and osteopenia in CP patients, and to investigate the association between osteopathy and CP features and nutritional parameters, especially vitamin D and K levels. Methods: Multicentre cross‐sectional study on CP patients diagnosed according to M‐ANNHEIM criteria. Bone density was evaluated by dual‐energy X‐ray absorptiometry and pancreatic function by faecal elastase. Nutritional evaluation included vitamin D and vitamin K. Differences between patients with or without osteopathy were evaluated. The association between investigated variables and bone density were analysed with logistic regression analysis. Results: In total, 211 CP patients were enrolled at eight Centres (67% men; mean age 60). In total, 18% had advancedmarked CP, 56% suffered from pancreatic exocrine insufficiency and disease aetiology was alcoholic in 43%. Vitamin D and K were deficient in 56% and 32%, respectively. Osteopenia was diagnosed in 42% and osteoporosis in 22%. In the multivariate analysis, female sex (OR 2.78), age (OR 1.07 per year) and higher BMI (OR 0.84) were associated with the presence of osteoporosis. In male patients, the only factor associated with osteoporosis was vitamin K deficiency (OR 4.23). Conclusion: The present data confirm a high rate of osteopathy in CP patients and highlight the relevance of vitamin K deficiency as only factor associated with osteoporosis in male patients for the first time.

Lixia Zhang, Li-li Zheng, Chong Li et al.

Objective: Diabetic osteopathy is a common comorbidity of diabetes mellitus, with skeletal fragility, osteoporosis and bone pain. The aim of our study was to highlight the role of sema3a on osteoblast differentiation of MC3T3-e1 in high-glucose condition and explore its therapeutic effect of diabetic osteopathy in vitro and vivo. Methods: In our study, the expression of osteogenesis-related makers, such as ALP, OCN, OPG, β-catenin and Runx2, were analyzed in MC3T3 osteoblastic cells to explore the effect of sema3a on osteoblast differentiation in high-glucose condition, and as was the staining of ALP and Alizarin Red S. In a diabetic animal model, the expression of serum bone metabolic markers, such as ALP, P1NP, OCN, and β-CTX, were analyzed and micro-CT was used to detect bone architecture, including Tb.N, Tb.Th, Tb.Sp, Tb.Pf, BS/BV, and BV/TV after the treatment of sema3a. Results: High glucose significantly inhibited osteogenic differentiation by decreasing the expression of osteogenesis-related makers, sema3a and its receptor of Nrp-1 in a dose-dependent manner in MC3T3. In high-glucose condition, exogenous sema3a (RPL917Mu01) increased the expression of ALP, OCN, OPG, Runx2, β-catenin, and the positive proportion of ALP and Alizarin Red S staining. In addition, in diabetic animal model, exogenous sema3a could increase bone mass and bone mineral density, and downregulate the expression of ALP, P1NP, OCN, and β-CTX. Conclusion: High glucose suppresses osteogenic differentiation in MC3T3 and sema3a may take part in this process. The application of exogenous sema3a alleviates high glucose-induced inhibition of osteoblast differentiation in diabetic osteopathy.

Kylie Fitzgerald, Tracey Denning, B. Vaughan et al.

BackgroundClinical education forms a substantial component of health professional education. Increased cohorts in Australian osteopathic education have led to consideration of alternatives to traditional placements to ensure adequate clinical exposure and learning opportunities. Simulated learning offers a new avenue for sustainable clinical education. The aim of the study was to explore whether directed observation of simulated scenarios, as part replacement of clinical hours, could provide an equivalent learning experience as measured by performance in an objective structured clinical examination (OSCE).MethodsThe year 3 osteopathy cohort were invited to participate in replacement of 50% of their clinical placement hours with online facilitated, video-based simulation exercises (intervention). Competency was assessed by an OSCE at the end of the teaching period. Inferential statistics were used to explore any differences between the control and intervention groups as a post-test control design.ResultsThe funding model allowed ten learners to participate in the intervention, with sixty-six in the control group. Only one OSCE item was significantly different between groups, that being technique selection (p = 0.038, d = 0.72) in favour of the intervention group, although this may be a type 1 error. Grade point average was moderately positively correlated with the manual therapy technique station total score (r = 0.35, p < 0.01) and a trivial relationship with the treatment reasoning station total score (r = 0.17, p = 0.132).ConclusionsThe current study provides support for further investigation into part replacement of clinical placements with directed observation of simulated scenarios in osteopathy.

B. Bordoni, B. Morabito, M. Simonelli

The application of cranial osteopathic manipulative medicine (OMM) is always controversial in the literature. Primary respiration related to the movement of spheno-basilar synchondrosis in the adult goes against the knowledge of complete ossification that occurs at this articulation after the pubertal phase. The idea that the operator's hands can communicate with the meninges is difficult to accept. The anatomy shows us that the fascial system involves the meninges and that from the microcellular point of view there are no layers that divide one tissue from another. The backing of new sciences, such as quantum physics, suggest that cranial palpation allows the osteopath to come into contact with the meninges. Recent scientific evidence shows that meningeal afferents can affect extracranial areas and that the pericranial musculature itself is able to influence these afferents. The article highlights some reflections in support of cranial osteopathy, based on scientific information that could help the osteopath to improve clinical work.

Albin Guillaud, Nelly Darbois, Richard Monvoisin et al.

BackgroundIn 2010, the World Health Organization published benchmarks for training in osteopathy in which osteopathic visceral techniques are included. The purpose of this study was to identify and critically appraise the scientific literature concerning the reliability of diagnosis and the clinical efficacy of techniques used in visceral osteopathy.MethodsDatabases MEDLINE, OSTMED.DR, the Cochrane Library, Osteopathic Research Web, Google Scholar, Journal of American Osteopathic Association (JAOA) website, International Journal of Osteopathic Medicine (IJOM) website, and the catalog of Académie d’ostéopathie de France website were searched through December 2017. Only inter-rater reliability studies including at least two raters or the intra-rater reliability studies including at least two assessments by the same rater were included. For efficacy studies, only randomized-controlled-trials (RCT) or crossover studies on unhealthy subjects (any condition, duration and outcome) were included. Risk of bias was determined using a modified version of the quality appraisal tool for studies of diagnostic reliability (QAREL) in reliability studies. For the efficacy studies, the Cochrane risk of bias tool was used to assess their methodological design. Two authors performed data extraction and analysis.ResultsEight reliability studies and six efficacy studies were included. The analysis of reliability studies shows that the diagnostic techniques used in visceral osteopathy are unreliable. Regarding efficacy studies, the least biased study shows no significant difference for the main outcome. The main risks of bias found in the included studies were due to the absence of blinding of the examiners, an unsuitable statistical method or an absence of primary study outcome.ConclusionsThe results of the systematic review lead us to conclude that well-conducted and sound evidence on the reliability and the efficacy of techniques in visceral osteopathy is absent.Trial registrationThe review is registered PROSPERO 12th of December 2016. Registration number is CRD4201605286.

N. Sergueef

B. Vaughan, C. Burns, Lauren Burridge et al.

Abstract Objective The aim of the study was to evaluate patient satisfaction with, and perception of their, osteopathy treatment. A secondary aim was to evaluate the measurement properties of a short patient satisfaction questionnaire in an osteopathy patient population. Design Questionnaire study. Patients completed a brief demographic questionnaire, patient satisfaction questionnaire and perception of treatment questionnaire at the conclusion of their osteopathy consultation. Setting Osteopathy student-led teaching clinic (Melbourne, Australia). Main outcome measures Two questionnaires: 1) Short Assessment of Patient Satisfaction (SAPS); and, 2) the Patient Perception Measure – Osteopathy (PPM-O). Results Complete data were available for 68 patients. Mean age was 36 years and over half were female. Participants' median satisfaction with life (SWL) was 4 on a 0–5 scale. The SAPS did not satisfy the requirements of a Mokken scale nor was it unidimensional in this population. The reliability estimations for the PPM-O subscales were acceptable (>0.80). Both age and SWL were positively correlated with effect of treatment as measured on the SAPS. Age, gender and previous osteopathy treatment did not relate to SAPS responses. The PPM-O Education and Effectiveness subscale was positively correlated with the SAPS items related to treatment effect, appointment duration and overall satisfaction with care. Conclusions Patients in the present study were largely satisfied with treatment and positive about their perception of the osteopathy treatment provided. Further testing of the SAPS to evaluate if it is suitable for use as a measure of satisfaction with osteopathy care or testing of an alternative measure is required.

Paola Sciomachen, C. Arienti, A. Bergna et al.

C. Gesslbauer, N. Vavti, M. Keilani et al.