Abstract

Transmural inflammation in Crohn’s disease can lead to stricturing of the bowel which may result in an obstruction and perforation of the intestines. Emergent surgery is indicated to amend a perforation but complications, such as edema, can limit a surgeon’s ability to close the abdominal wall. In such a case, the open wounds may heal by secondary intent where new tissue is laid down from the base upwards.

This case report describes a 23-year-old woman completing her Bachelor of Arts in dance with a past medical history of stricturing and inflammatory ileocolonic Crohn’s disease who presented to the osteopathic manipulative medicine (OMM)/Physical Medicine and Rehabilitation (PM&R) clinic for multiple open abdominal wounds and weakness.

To the authors’ knowledge, this is the first case report detailing the benefits of osteopathic manipulative treatment (OMT) to healing open abdominal wounds, increasing flexibility and physical fitness, and improving the mental health of an individual who required prompt rehabilitation to return to the high-level of fitness required to pursue a career as a professional dancer.

Abstract

The prohibition of touch in psychiatry has multiple origins. The most prominent advocate for an interdiction on touch has been Sigmund Freud and the legacy of psychoanalysis. Scientism, dualism, and medicolegal concerns have also promoted a touch taboo in psychiatry. However, it is evident that non-sexual physical touch is vital for human health; studies of touch in children and adults have shown numerous health benefits physically and psychologically. A discussion of ethical principles in light of the use of touch in psychiatry is provided. Several theoretical paradigms do utilize touch in treating patients and are reviewed including the medical model, body-psychotherapies, and osteopathic medicine. The osteopathic philosophy provides a lens through which the osteopathic physician both assesses and provides rational treatment to the patient. In addition to this philosophy, osteopathic physicians are extensively trained in osteopathic manipulative treatment (OMT). Osteopathic physicians have treated patients with psychiatric disorders with OMT and other treatments for nearly 150 years. The unique osteopathic model of care contrasts with the long-standing prohibition of touch with psychiatric patients and thereby provides a rational approach to the use of touch in psychiatry. The reasoned recommendations for osteopathic psychiatrists using touch clinically include consent, context, and competency considerations.

Abstract

Since the advent of Medicare in 1965, the concept of quality of care in medical practice in the United States has been under review, and a revision of ideas and responsibilities to the patient (consumer) has had a major impact on the system of delivery. In little, more than ten years, there have been major changes in the health care system in the United States, with a necessary delineation of the contributions to total health care of followers of two separate and distinct philosophies of medicine that are coexistent and recognized equally by the legislation of the United States. The purpose of this paper is to consider the quality of care rendered by the minority school of medicine through the services of the osteopathic community hospital and possible methods of improving it.