Band 108, Heft 2

Context: Physicians typically combine the use of palpation and objective measures, as evidence-based medicine dictates, to improve patient diagnosis and care. Practitioners also use palpatory examination in manual medicine to diagnose musculoskeletal impairment; however, there are no commonly accepted objective measures to complement palpatory findings. Objective: To evaluate coupled vertebral motion as a parameter to complement palpatory findings from a standard clinical diagnostic test of cervical function. Methods: Two examiners performed a blind screening of volunteer subjects for the presence of palpable symmetry or asymmetry in motions of the head and neck. In cases of interexaminer agreement, subjects then participated in kinematic assessment of cervical motion patterns. Neck angles were recorded, plotted, and evaluated for amounts of vertebral coupling. Results: Interexaminer agreement was reached with 18 of the 34 subjects screened. Seven subjects with symmetric responses constituted the control group. Experimental subjects consisted of an asymmetric-asymptomatic (pain-free) group (n=6) and an asymmetric-symptomatic (pain) group (n=5). Control subjects exhibited the smallest average linear slope (–0.32) for the least amount of coupled motion. The average linear slopes for asymmetric subjects was –0.42 (asymptomatic) and –0.50 (symptomatic). Data analysis revealed that statistically significant differences among groups will be detected with a larger sample size. Conclusions: Objective, kinematic parameters can be generated, measured, and evaluated relative to palpatory findings of musculoskeletal impairment by identifying trends in ratios of cervical lateral flexion and axial rotation.

The majority of cervical cancers result when the human papillomavirus (HPV) is transmitted from a man to a woman during vaginal intercourse. Several factors, including vaginal intercourse at an early age or with multiple sex partners, place women at increased risk for infection with HPV. It is important for physicians to be aware of these risk factors and to screen for them in all of their female patients. It is also important for physicians to be familiar with the new HPV vaccinations that are becoming available, such as Gardasil, which in June 2006 became the first vaccine approved by the US Food and Drug Administration to protect patients against cervical cancer. The widespread use of routine HPV screening and cervical cancer vaccines can be expected to decrease the incidence of new HPV infection and cervical cancer worldwide.

Background : In 1934, Yale Castlio, DO, and Louise Ferris-Swift, DO, published the results of a within-subjects experiment on direct splenic stimulation in patients with acute infectious disease (N=100). Their results, which used rudimentary statistical analyses, are still cited as evidence that osteopathic manipulative treatment augments immunity. Objective : To retest the validity of Castlio and Ferris-Swift's conclusions by applying contemporary statistical methods to their raw data. Methods : Castlio and Ferris-Swift's original 1934 data were not normally distributed and sample sizes were small. Therefore, the authors of the present study reanalyzed the data using several nonparametric statistical methods: Wilcoxon signed rank, Friedman, and Kruskal-Wallis tests. Results : Contemporary statistical analysis confirms a modest posttreatment increase in leukocytes, a decrease in erythrocytes, a decrease in the Arneth index, and an increase in reticulocytes after the application of direct splenic stimulation for patients diagnosed with acute infectious disease. Contemporary reanalysis also confirms statistically significant posttreatment changes in the immune function tests. Findings were less conclusive for the leukocyte differential cell counts and for the effect of varying the number of splenic compressions. Conclusions : Analysis of Castlio and Ferris-Swift's 1934 data using contemporary statistical methods supports many of their original conclusions. However, faults in study design common to that era limit the article's applicability for modern researchers. Additional research on splenic pump techniques using contemporary study designs and statistical methods is recommended.