Osteopathic Medicine Research Articles

Judge rules in favor of student

Case name: Bahl v. New York College of Osteopathic Medicine of New York Institute of Technology, No. 2:14‐cv‐04020 (E.D. N.Y. 07/21/23).

Judge rules in favor of student

Case name: Bahl v. New York College of Osteopathic Medicine of New York Institute of Technology, No. 2:14‐cv‐04020 (E.D. N.Y. 07/21/23).

Osteopathic Manipulative Medicine and Its Role in Psychiatry.

This paper reviews the current literature to examine what elements of osteopathic medicine can be used in psychiatry. The aim of this study was to use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to conduct a systematic review of studies describing the efficacy of osteopathic manipulative medicine (OMM) in treating psychiatric problems directly and indirectly. The authors searched the databases PubMed, PsycINFO, and CINAHL (Cumulative Index to Nursing and Allied Health Literature), reviewing peer-reviewed articles from 1980 to April 2023. The literature demonstrates that OMMhas a positive effect on psychiatric symptoms indirectly when treating certain medical conditions, such as chronic pain, fibromyalgia, and irritable bowel syndrome; however, there are many limitations on these studies, and further research is required prior to making firm recommendations. The evidence is lacking for osteopathic manual medicine being used directly to treat psychiatric conditions. This review demonstrates that in some populations, such as individuals with chronic pain, fibromyalgia, and irritable bowel syndrome, OMM could be considered by an osteopathic psychiatrist as an adjunct treatment. More research should be conducted in this area due to the many limitations in the available studiesbut current research suggests that the use of OMM by osteopathic psychiatrists could be beneficial for some patient populations.

Implementing a primary care simulation to improve interprofessional competencies

Learners from six health professions programs (athletic training, nursing, optometry, osteopathic medicine, pharmacy, and physical therapy) participated in a telehealth primary care simulation. The learners’ purpose of the simulated visit was to evaluate and manage a patient experiencing complications of type 2 diabetes, including vision changes, frequent falls, and a foot wound. ObjectivesThe objectives of the activity were to: 1) assess changes in perceived interprofessional abilities in the areas of communication, collaboration, roles and responsibilities, patient/family-centered care, conflict management and resolution, and team functioning, and 2) assess learner perceptions regarding the value of the interprofessional primary care simulation. ActivityLearners were divided into teams with 1–2 learners from each program (8–9 total learners per team) and each team interacted face-to-face in small individual classrooms. Trained faculty served as simulation facilitators in each classroom. Each team conducted a two-phase videoconference encounter with a trained standardized patient and family member. Between the two phases, each team conducted an interprofessional care planning session. Learner evaluation of the exercise used two validated tools, the revised Interprofessional Collaborative Competency Attainment Survey (ICCAS-R), and the modified Simulation Effectiveness Tool (SET-M) to inform the faculty. FindingsPaired t-test values on all 20 items of the ICCAS-R indicated statistically significant results (p < .001), and SET-M results indicated that over 88 % of learners strongly agreed or somewhat agreed with questions pertaining to their satisfaction with the activity. Findings from this activity can be used by other educational institutions to develop a primary care simulation based on the health professions available, thus enhancing interprofessional learning opportunities and overcoming a common barrier of limited clinical sites for interprofessional practice.

FRI023 Increased Fibrosis In White Adipose Tissue Of Male And Female bGH Transgenic Mice Appears Independent Of TGF-β Action

Abstract Disclosure: G. Lach: None. S. Bell: None. J.A. Young: None. E.O. List: None. R. Basu: None. D. Geitgey: None. K.Y. Lee: None. D. Swegan: None. L.J. Caggiano: None. S. Okada: None. J.J. Kopchick: None. D.E. Berryman: None. Fibrosis is a pathological state caused by excess deposition of extracellular matrix proteins, which can disrupt tissue structure and function. Previous work has shown that male bovine growth hormone (bGH) transgenic mice have high levels of circulating growth hormone (GH) and insulin-like growth factor 1 (IGF-1), marked decrease in lifespan, and increased fibrosis in several tissues including white adipose tissue (WAT), which is more pronounced in the subcutaneous (Sc) depot. The current study expanded on these findings, evaluating: 1) WAT fibrosis in female bGH mice, 2) levels of circulating factors implicated in fibrosis, and 3) the role of TGF-β, a central mediator of fibrogenesis, in the development of bGH WAT fibrosis. Our findings confirmed that female bGH mice exhibit increased WAT fibrosis, most prominent in the Sc depot, like male bGH mice, but also significantly increased in the perigonadal depot, unlike male bGH mice. bGH mice of both sexes have elevated circulating levels of several markers of collagen turnover (plasma P1NP, P3NP and ICTP) and FGF21 relative to controls but no genotype-dependent alteration in fibroblast activation protein (FAP). TGF-β and TGF-β signaling in serum or WAT was either unchanged or reduced in male and female bGH mice at both young and mature ages. The treatment of bGH mice with a TGF-β antagonist, pirfenidone, did not attenuate bGH WAT fibrosis. Contrary to the effects of the chronic exposure to excess GH, acute GH treatments in vivo or in vitro did elicit a modest increase in TGF-β signaling. Finally, single nucleus RNA sequencing confirmed no perturbation in TGF-β or its receptor gene expression in any WAT cell population within subcutaneous bGH WAT; however, a striking increase in B lymphocyte infiltration in Sc bGH WAT was observed. Overall, these data suggest that bGH WAT fibrosis is independent of the action of TGF-β and reveals an intriguing shift in immune cells, particularly B cells, in bGH WAT that should be further explored considering the increasing importance of B cell-mediated WAT fibrosis and aging. Acknowledgements:This work was sponsored, in part, by ASPIRE grant funding from Pfizer. This work was also supported by the State of Ohio’s Eminent Scholar Program to J. J. K. that includes a gift from Milton and Lawrence Goll and by the startup funds from the Heritage College of Osteopathic Medicine at Ohio University, Athens, OH. Presentation: Friday, June 16, 2023

The Prevalence of Urinary Tract Infections and Antibiotic Prescription Treatments Across Three Countries: A Retrospective Study Using an Electronic Medical Record.

Introduction The Clinical Rotation Evaluation and Documentation Organizer (CREDO) is an electronic medical record (EMR) system created by the Edward Via College of Osteopathic Medicine (VCOM). International healthcare providers who partner with VCOM can gain access to CREDO and input their patient data.The objective of this study was to determine the frequency of urinary tract infection (UTI) diagnoses and prescription use over a one-year period in three Latin Americancountries. Methods Researchers analyzed the frequency of UTI diagnosis with corresponding prescription recommendations over a 12-month period in three Latin American countries (i.e., Dominican Republic, El Salvador, and Honduras) that utilize the CREDO system. For each month between May 2021 and May 2022, the total number of UTI diagnosis codes and prescription codes were summed, graphed, and analyzed. Results In El Salvador, there were 142 UTIs and 126 corresponding prescriptions written for UTIs reported from May 2021 to May 2022 but diagnoses were not consistent each month. Ciprofloxacin was prescribed most frequently at a rate of 43.7% in El Salvador.In Honduras, there were 68 UTIs and 68 corresponding prescriptions written for the UTIs reported from May 2021 until May 2022 withCiprofloxacin being prescribed most frequently at a rate of 39.7%. Again, diagnosis frequency was not consistent each month. In the Dominican Republic, there were 42 UTIs and 14 corresponding prescriptions written for those UTIs reported, however,data only reflected two months' worth of UTI diagnoses from May 2021 to May 2022. Fosfomycin was prescribed most frequently at a rate of 61.5%. Conclusion: The findings above suggest that there are inconsistent UTI reports throughout the year with a varied use ofantibiotics prescriptions for UTIs. The discovered discrepancies in disease reporting, or lack thereof of reporting, and prescription recommendation suggest inconsistent reporting in CREDO. In the future, focused education or revision on CREDO reporting and uniform coding practices could be implemented to reduce these inconsistencies.

Addressing Global Health Competencies Through a Virtual Elective During the COVID-19 Pandemic

Due to the COVID-19 pandemic, the Global Health Department at Touro University California College of Osteopathic Medicine adapted its curriculum to deliver it virtually for the first time. We enrolled 25 first- and second-year medical students in a Global Health elective of 12 sessions in the Spring of 2021. Students received pre-recorded video lectures and study materials for each session, followed by live interactions with international preceptors. We analyzed the effectiveness of virtual sessions and overall learning outcomes by using 1) a self-proctored multiple-choice quiz administered before and after each session for eight sessions and 2) true-false surveys at the end of each session for ten sessions. Students’ mean score on pre-session quizzes was 56.33% (standard deviation of 1.72%), with individual quiz scores ranging between 42.22% and 79.53%. However, after live interactions via Zoom, students performed significantly better, with a mean score of 89.55% (p &lt;0.001, standard deviation of 1.78%) and individual quiz scores between 69.08% and 100%. When surveyed about their attitudes towards provided topics and study materials and confidence in discussing the topics and their future implications, students’ response was positive, between 95.8% and 99.3%, with an overall survey response rate of 96.7%. We believe that virtual learning provided an effective platform to address global health competencies during the COVID-19 pandemic. It can, therefore, be an effective model for maintaining the engagement of health science students in global health education.

Primary Care Pracitioner Perspectives on the Role of Primary Care in Dementia Diagnosis and Care

Although the barriers to dementia care in primary care are well characterized, primary care practitioner (PCP) perspectives could be used to support the design of values-aligned dementia care pathways that strengthen the role of primary care. To describe PCP perspectives on their role in dementia diagnosis and care. In this qualitative study, interviews were conducted with 39 PCPs (medical doctors, nurse practitioners, and doctors of osteopathic medicine) in California between March 2020 and November 2022. Results were analyzed using thematic analysis. Overarching themes associated with PCP roles in dementia care. Interviews were conducted with 39 PCPs (25 [64.1%] were female; 16 [41%] were Asian). The majority (36 PCPs [92.3%]) reported that more than half of their patients were insured via MediCal, the California Medicaid program serving low-income individuals. Six themes were identified that convey PCPs' perspectives on their role in dementia care. These themes focused on (1) their role as first point of contact and in the diagnostic workup; (2) the importance of long-term, trusting relationships with patients; (3) the value of understanding patients' life contexts; (4) their work to involve and educate families; (5) their activities around coordinating dementia care; and (6) how the care they want to provide may be limited by systems-level constraints. In this qualitative study of PCP perspectives on their role in dementia care, there was alignment between PCP perspectives about the core values of primary care and their work diagnosing and providing care for people living with dementia. The study also identified a mismatch between these values and the health systems infrastructure for dementia care in their practice environment.

The Effectiveness of a Mobile Health Clinic Delivering Mandatory and Elective Middle School Immunizations: A Descriptive Analysis.

Mobile health clinics serve a unique role in which they can offer affordable and adaptable care to the population they serve. The Edward Via College of Osteopathic Medicine (VCOM) mobile clinics began in 2020 as a partnership with the South Carolina Department of Health and Environmental Control (SCDHEC) to address the low vaccination rates that resulted from the COVID-19 pandemic. This study is a descriptive analysis that examines the number of vaccinations of tetanus, diphtheria, and pertussis (Tdap) and human papillomavirus (HPV) at different locations of administration including pediatrician offices, the novel VCOM mobile vaccination clinic, and the Spartanburg Health Department. The variables of interest and the study endpoints focused on Tdap and HPV vaccinations among students aged 11-12 years old in Spartanburg County according to the type of healthcare delivery location. From April to May of 2021, the VCOM mobile clinic was able to administer 279 Tdap vaccines and 189 HPV vaccines to students at local middle schools, which surpasses the number of vaccines administered at other sites from August 2020 to May 2021 when compared individually for both Tdap and HPV vaccinations. By assessing the total volume of vaccines administered by each group, the VCOM mobile clinic was established as an effective method of delivery and played a crucial role in the vaccination efforts of the Spartanburg community. Mobile medical units should be considered for similar efforts in providing care to resource-limited communities and those with limited access to care.

Uniting a shared history: Bringing osteopathic and evolutionary medicine (back) together

Throughout its history, osteopathic medicine has struggled to define its professional identity and distinguish itself from its allopathic counterpart. In this paper, we suggest that osteopathic medicine has an opportunity to define its unique professional identity by embracing the emerging science of evolutionary medicine. We outline the similarities between osteopathic and evolutionary medicine and highlight their shared history. We further emphasize how aspects of evolutionary medicine align with core osteopathic principles and philosophy. We conclude by suggesting ways in which evolutionary medicine concepts can be incorporated into the osteopathic medical curriculum.

The effectiveness of disinfection protocols in osteopathic family medicine offices.

Healthcare-associated infections (HAIs) pose a substantial public health threat. Despite significant strides tocurb HAIs in hospital environments, outpatient settings have not received the same degree of attention. Given their emphasis on holistic, patient-centered care, osteopathic family medicine offices are pivotal in both disease prevention and comprehensive patient treatment. The importance of simple yet effective disinfection protocols, such as thorough cleaning between patient appointments, cannot be overstated in these settings because they are integral to minimizing disease transmission. This study aims to assess the effectiveness of the current disinfection protocols in osteopathic family medicine offices. A cross-sectional study evaluating disinfection practices on 18 examination tables in an osteopathic family medicine office was conducted. Two high-touch surfaces (midtorso region and table edge) were examined. Initial swab samples were collected after morning disinfection by Environmental Services, and terminal swab samples were gathered after day's-end disinfection by the medical staff. Adenosine triphosphate (ATP) bioluminescence assays were performed utilizing AccuPoint Advanced HC Reader, which quantified ATP, indicating contamination levels in the samples. The higher the ATP levels found in a sample, the greater the amount of biological contamination. All samplers were handled and tested as per manufacturer's instructions. Apreliminary trial was conducted to confirm the internal validity of ATP bioluminescence measurements. The statistical analysis involved Shapiro-Wilk and Wilcoxon signed-rank tests, with significance set at p<0.05. Cohen's d test was utilized to calculate the effect size, identifying meaningful differences in initial and terminal swab sample relative light units (RLUs). The midtorso region demonstrated an 11.1 % increase in failure rate after terminal disinfection when compared to initial disinfection. A Wilcoxon signed-rank testrevealed a median estimated pathogen level forthemidtorso region that was higher after terminal disinfection (median, 193 RLUs; range, 1-690 RLUs; n=18) compared to initial disinfection (median, 134 RLUs; range,4-946 RLUs; n=18). However, this increase was not statistically significant, p=0.9124, with a small effect size, d=0.04. The edge showed no change in failure rate after terminal disinfection, maintaining a 100 % failure rate both before and after disinfection. However, the Wilcoxon signed-rank test revealed a slight reduction in the median estimated pathogen levels after terminal disinfection (median, 2095 RLUs; range, 891-5,540 RLUs; n=18) compared to before disinfection (median, 2,257 RLUs; range, 932-5,825 RLUs; n=18). However, this reduction wasnot statistically significant, p=0.61, with a small effect size, d=0.12. The findings from this study reveal a substantial disparity in outcomes between the two sample locations, midtorso and edge. The midtorso demonstrated arelatively low failure rate in both initial and terminal swab samples, indicating successful outcomes. In contrast, the edge consistently displayed a 100 % failure rate, emphasizing the need for more care and attention when cleaning the edge of the examination to ensure better outcomes. By prioritizing adequate disinfection protocols, including thorough cleaning between patients, osteopathic family medicine offices can more effectively prevent disease transmission and promote patient safety.

The clinical anatomy fellowship: A participants' perspective.

Kansas City University offers a Clinical Anatomy Fellowship which enrolls nine medical students during each academic year and provides training in research, teaching, and advanced anatomical topics. The Fellows practice as novice educators, working alongside Anatomy faculty to teach medical students in the Gross Anatomy laboratory. However, little has been reported related to Fellowship participation and success outcomes. This survey-based study was designed to explore (1) student motivation(s) for pursuing the Fellowship, (2) benefits of participation, and (3) the perceived impact on residency applications and career success. Three unique populations were surveyed. The most important factors driving application to the Fellowship were a desire to increase competitiveness in the residency application process (Likert mean score 4.7-5.0) and a passion for Anatomy (Likert mean score 4.3-4.7). Taking a year away from the College of Osteopathic Medicine curriculum (Likert mean score 4.4) and delaying clinical exposure (Likert mean score 4.2) were the most important deterrents to application. The most reported benefits after program completion included opportunities to build a strong residency application (44% and 50% of Fellows), conduct research (44% and 45% of Fellows), and participate in teaching (11% and 50% of Fellows). 73% of past Fellows matched into their top specialty of choice. Flexibility in the program allows participants to individualize their Fellowship experience to address their personal goals related to residency applications and careers as future physicians. As the results suggest, the Clinical Anatomy Fellowship benefits Fellows, signaling other medical institutions to consider adopting a similar program.

Impact of the USMLE Step 1 and COMLEX Level 1 transition to Pass/Fail on osteopathic medical student stress levels and board preparation.

The United States Medical Licensing Examination (USMLE) Step 1 and Comprehensive Osteopathic Medical Licensing Exam (COMLEX) Level 1 transitioned from a numeric scoring system to a Pass/Fail designation in 2022. This transition intended to decrease stress, improve medical student well-being, and encourage residency program directors to emphasize other aspects of residency applications. Pass/Fail score transitions in the undergraduate medical education curriculum have improved medical student psychological well-being and satisfaction; whether these same benefits translate to the board examination period is unknown. The objectives of this study are to assess the impact of USMLE Step 1 and COMLEX Level 1 grade scaletransition on medical student stress, wellness, board preparation decisions, and future residency selection processes. Investigators hypothesized that students under the Pass/Fail designation would experience less stress during the intensive study period leading up to USMLE Step 1 andCOMLEX Level 1 and devote more time to other aspects oftheir residency applications. To examine the impact on osteopathic medical student (OMS) stress and approach to board preparation, two surveys were administered to Rocky Vista University College of Osteopathic Medicine (RVU-COM) students before (Class of 2023) and after (Class of 2024) the transition to a Pass/Fail designation. All students within the RVU-COM Classes of 2023 and 2024 were invited to participate. The Cohen Perceived Stress Scale (PSS-10) was administered at the beginning of the focused board study period in May 2021 and 2022 to the Class of 2023 and 2024, respectively. The investigator-designed Licensing Exam Questionnaire (LEQ), meant to capture board preparation patterns, residency application perspectives, and wellness during examination preparation, was administered immediately after the board examination deadline in July 2021 and 2022 to the Class of2023 and 2024, respectively. Statistical analysis included theuse of independent t tests (numeric variables) and chi-square tests (categorical data). This project was considered exempt from full Institutional Review Board review. Approximately one-third of the Class of 2023 (PSS-10: n=86; LEQ: n=93) and 2024 (PSS-10=89; LEQ: n=92) responded. No difference was detected in mean PSS-10 score, 20.14 (SD=7.3) compared to 19.92 (SD=6.56) for the Class of2023 and 2024 (p=0.84), respectively. The Class of 2023 reported more weeks studying (mean 6.27weeks, SD=0.79) vs.the Class of 2024 (mean 5.44weeks, SD=0.007), p<0.001, more practice examinations taken X 2 (1, n=182)=13.75, p<0.001, and a greater proportion scheduled examinations after June 20 X 2 (1, n=182)=29.01, p<0.001. No difference existed in hours studying per day, sequence of Step 1/Level 1, time between examinations, money spent, or type of study resources utilized. The transition of USMLE Step 1 and COMLEX Level 1 to a Pass/Fail designation did not reduce stress for OMSs at a single, multicampus COM. Respondents, however, altered board preparation practices in meaningful ways. Asstudent behaviors and board-study patterns emerge, these insights must be connected to outcomes in the future.

A Study to Determine the Knowledge, Attitude and Usage of Traditional (AYUSH) Systems of Medicine among the Students Seeking Admission to the Bachelor in Homoeopathic Medicine and Surgery (BHMS) Course - Telangana, India

AYUSH system of medicines consists of seven systems - Ayurveda, Yoga, Naturopathy, Unani, Siddha, Sowa- Rigpa, and Homeopathy.1 Apart from these many other systems like, acupuncture, Chinese medicines, Chiropractic and osteopathic medicine, etc. are included under Complementary and Alternative medicines (CAM). In India, only the above-mentioned. AYUSH systems and educational courses related to these systems are considered under medical stream. AYUSH medicines though are popular among people, the knowledge regarding these systems in medical science and medical course is not evident. Hence this study is aimed to estimate the knowledge, attitude towards, and usage of AYUSH systems of medicine among the students seeking admission to the BHMS course. Materials and Methods: For this observational, cross-section study, a total of 132 students of both sexes, seeking admission to the BHMS course between October 2022 to May 2023, were selected by random sampling. A closed-ended, self-structured online questionnaire was used after validation and approval, to assess the knowledge, attitude towards and usage of the AYUSH system of medicines. Descriptive statistical analysis was done using MS EXCEL. Result: The study revealed that students had good knowledge and positive attitudes towards AYUSH systems. 74% of students had used AYUSH medicines at least once. 84% of students willingly joined the course. The most popular system was Homoeopathy, while no student was aware of Sowa-Rigpa as the system of medicine. Conclusion: This study concludes that the knowledge and attitude among the students seeking admission to the BHMS course, regarding Homoeopathy is good compared to other AYUSH systems. Keywords: Alternative; Complementary; AYUSH; Traditional; Attitude; Knowledge; Usage; BHMS

Integrating physiology into the first two years of a new osteopathic medical school curriculum.

The integrated curriculum is a hot topic in curriculum reform in undergraduate medical education; however, there are varying definitions of the term, and resources guiding the integration of specific disciplines throughout the first 2years of undergraduate medical education in a learner-centered curriculum are limited. Our first class matriculated into our osteopathic medical school in 2017, and since then we have developed and implemented a learner-centered, integrated curriculum that begins on day one for our learners. This paper will discuss our experience with the development and implementation of the University of the Incarnate Word School of Osteopathic Medicine (UIWSOM) curriculum with specific emphasis on how we incorporate physiology into it.

A.T. Still, School of Osteopathic Medicine - Volume 1 Issue 1, August 2023 Full Issue

A.T. Still, School of Osteopathic Medicine - Volume 1 Issue 1, August 2023 Full Issue

The Role of Medical Education in Community Hospital Sustainability: A Case for Increasing Models of Integration

U.S. hospitals are facing unprecedented margin compression and experiencing ongoing staffing issues, not only with nursing and ancillary services but with physicians as well. Looming physician shortages add to the vulnerabilities of acute care facilities to maintain normal operations. The traditional model of physician recruitment and retention may be inadequate to fill gaps, and novel approaches are needed. Vertical integration of medical education into health systems ecosystems may provide benefit to future stability. A recent uptick in proposed (and accredited) medical schools in the United States, particularly in Osteopathic Medicine, has seen many of these schools collaborating with community hospitals to provide the clinical training experiences required. Early reflection on this rapid growth (at least in one region) suggests that nascent physician education and training programs can have a significant synergy with community health/hospital systems that have not had such programming heretofore. Criticisms of such patterns are also addressed with a discussion of rebuttals and potential solutions. Hospitals that currently do not have medical education programs should consider the benefits of collaborating with medical education programs and seek to integrate their mission with local and regional providers of such programming.

Practice of Peritoneal Adhesions in Osteopathic Medicine: Part 2.

Peritoneal adhesions are an unwanted and frequent event following abdominal surgery, with a response rate that can reach 100%. The adhesions can be symptomatic, becoming a source of pain and discomfort for the patient, or asymptomatic, with possible chronic or acute visceral dysfunction. The article reviews what the diagnostic strategies are and discusses what could be the causes that lead to chronic pain in the presence of adhesions. The text reports the knowledge of the literature on the manual treatment of adhesions and illustrates possible symptoms that are not easily recognized by the clinician. To conclude, the article proposes osteopathic manual approaches derived from clinical experience and from what has been explained about the formation of peritoneal adhesions. Research must make further efforts to identify not only the causes triggering the formation of peritoneal neogenesis but also seek the most appropriate non-invasive treatments to help the patient.

Peritoneal Adhesions in Osteopathic Medicine: Theory, Part 1.

Peritoneal adhesions form as a result of trauma to the abdomen, injuries resulting from surgery, and infections. These tissutal neoformations are innervated and vascularized, and with lymphatic vessels, adherence becomes a new and independent structure, capable of negatively influencing visceral functions. Adherent neogenesis can be asymptomatic or can be a source of pain, limiting the patient's quality of life. Although adhesiolysis remains the elective approach to eliminate adhesions, this therapeutic route prepares the peritoneal anatomical area to recur. The article reviews information on adhesion formation and peritoneal anatomy, probable subjective predispositions, and pathways that carry nociception. The text aims to be a theoretical basis for making new treatment suggestions for non-invasive osteopathic medicine, through a second part will be discussed in another article.

A Challenging Case of Scleroderma: Diagnosis, Treatment, and Management

Scleroderma is a relatively rare autoimmune disorder that causes progressive hardening, tightening, and scarring of the skin, as well as internal organ involvement. This case study presents a 56-year-old African American female with diffuse cutaneous scleroderma who has had recurrent complications since 2017, including earaches and fingertip infections. The patient’s medical history, clinical course, diagnosis, and treatment options, including NSAIDs, low-dose corticosteroids, and methotrexate, are discussed. Osteopathic manipulative medicine is explored as a potential symptomatic treatment for scleroderma. Early diagnosis and chronic management for scleroderma patients are emphasized to avoid severe complications such as pulmonary hypertension, which can lead to cor pulmonale and right-sided heart failure. Further research is needed on prophylactic treatments for scleroderma complications and the potential link between multiple autoimmune disorders and increased susceptibility to scleroderma. This case study provides medical professionals with a better understanding of scleroderma and the available treatment options to improve patient quality of life.