Volume 100, Issue 12

While osteopathic manipulative treatment (OMT) is thought to be beneficial for patients with pneumonia, there have been few clinical trials--especially in the elderly. The authors' pilot study suggested that duration of intravenous antibiotic use and length of hospital stay were promising measures of outcome. Therefore, a larger randomized controlled study was conducted. Elderly patients hospitalized with acute pneumonia were recruited and randomly placed into two groups: 28 in the treatment group and 30 in the control group. The treatment group received a standardized OMT protocol, while the control group received a light touch protocol. There was no statistical difference between groups for age, sex, or simplified acute physiology scores. The treatment group had a significantly shorter duration of intravenous antibiotic treatment and a shorter hospital stay.

Minor depression is defined as a mood disturbance of at least 2 weeks' duration, with between two and five symptoms of depression, including depressed mood, diminished interest, weight change, sleep disturbance, psychomotor changes, fatigue, feelings of worthlessness, poor concentration, and recurrent thoughts of death. Patients with this condition may have fewer vegetative symptoms (appetite, diurnal mood variation) and more subjective symptoms (self-blame, worry, irritability, lethargy). Minor depressive disorder is more prevalent in primary care than major depressive disorder. Failure to adequately treat this condition may have far-reaching impact on the health, functional status, quality of life, and cost of care for patients who have it. The notion that minor depression requires minor treatment is misleading. Cognitive-behavioral modes of therapy and selective serotonin reuptake inhibitor antidepressants have demonstrated efficacy for primary care patients who have minor depression.

Ipsilateral pulmonary edema may occur in a lung that has been rapidly reinflated after a period of collapse. The syndrome of re-expansion pulmonary edema is associated with variable degrees of hypotension and hypoxemia. In its extreme form, it may result in cardiac arrest and death. The initial cause of uninflated pulmonary parenchyma described with re-expansion pulmonary edema has typically been either a large undrained pleural effusion or a pneumothorax. The authors describe a patient in whom re-expansion pulmonary edema developed when inadvertent puncture of large emphysematous bullae released previously atelectatic lung.

This article describes the results of a survey from graduate pharmacy students who completed a neurology/psychiatry course taught by a pharmacist and an osteopathic physician via the Internet. Seventeen practicing pharmacists completed the 11-week course, and thirteen students completed the survey provided at the end of the course. Results indicated that students were pleased with the course. Mean evaluation scores ranged from 4.31 to 4.77 on a five-point scale. Additionally, students indicated that the collaboration of medicine and pharmacy provided an educational model that should be duplicated for future courses.