Volume 95, Issue 9

The DRG/OMT [Diagnosis-Related Groups/Osteopathic Manipulative Treatment] Master Matrix is a tabulated guideline for helping osteopathic physicians and hospitals document their unique form of healthcare. The DRG/OMT Master Matrix is a quality management tool designed for osteopathic physician care of hospitalized patients. It furnishes a mechanism for relating various diagnostic entities to probable areas of somatic dysfunction. This matrix and the accompanying patient record aid the physician in recording diagnosis and treatment, thus providing the hospital with documentation of osteopathic patient care's competitive advantage. In a hospital record review, OMT use increased from 5% to 15% of patients after the DRG/OMT Master Matrix was introduced.

Cluster headache is a debilitating neuronal headache with secondary vascular changes and is often accompanied by other characteristic signs and symptoms, such as unilateral rhinorrhea, lacrimation, and conjunctival injection. It primarily affects men, and in many cases, patients have distinguishing facial, body, and psychologic features. Several factors may precipitate cluster headaches, including histamine, nitroglycerin, alcohol, transition from rapid eye movement (REM) to non-REM sleep, circadian periodicity, environmental alterations, and change in the level of physical, emotional, or mental activity. The pathophysiologic features have not been completely elucidated, but the realms of neurobiology, intracranial hemodynamics, endocrinology, and immunology are included. Therapy is prophylactic or abortive (or both). Treatment, possibly with combination regimens, should be tailored to the needs of the individual patient.