Augmentation of immune response to vaccinations through osteopathic manipulative treatment: a study of procedure

CONTEXT

Anecdotal evidence suggested that osteopathic manipulative treatment (OMT) may have imparted survivability to patients in osteopathic hospitals during the 1918 influenza pandemic. In addition, previous OMT research publications throughout the past century have shown evidence of increased lymphatic movement, resulting in improved immunologic function qualitatively and quantitatively.

OBJECTIVES

The following is a description of a proposed protocol to evaluate OMT effects on antibody generation in the peripheral circulation in response to a vaccine and its possible use in the augmentation of various vaccines. This protocol will serve as a template for OMT vaccination studies, and by adhering to the gold standard of randomized controlled trials (RCTs), future studies utilizing this outline may contribute to the much-needed advancement of the scientific literature in this field.

METHODS

This manuscript intends to describe a protocol that will demonstrate increased antibody titers to a vaccine through OMT utilized in previous historical studies. Confirmation data will follow this manuscript validating the protocol. Study participants will be divided into groups with and without OMT with lymphatic pumps. Each group will receive the corresponding vaccine and have antibody titers measured against the specific vaccine pathogen drawn at determined intervals.

RESULTS

These results will be statistically evaluated. Our demonstration of a rational scientific OMT vaccine antibody augmentation will serve as the standard for such investigation that will be reported in the future. These vaccines could include COVID-19 mRNA, influenza, shingles, rabies, and various others. The antibody response to vaccines is the resulting conclusion of its administration. Osteopathic manipulative medicine (OMM) lymphatic pumps have, in the past through anecdotal reports and smaller pilot studies, shown effectiveness on peripheral immune augmentation to vaccines.

CONCLUSIONS

This described protocol will be the template for more extensive scientific studies supporting osteopathic medicine's benefit on vaccine response. The initial vaccine studies will include the COVID-19 mRNA, influenza, shingles, and rabies vaccines.

Quality assurance in Guy's Hospital accident and emergency department

This paper describes the development of a comprehensive, practical audit by the medical staff at the Accident and Emergency Department at Guy's Hospital. The audit has enabled a comprehensive systematic review of clinical care and its documentation. The results shows that audit of Accident Emergency medicine is possible when channelled by proforma. Junior doctors in this specialty exercise great autonomy, and the audit highlights their need for proper training and guidance from senior medical staff in the review of major and minor cases.

Subcutaneous and muscle blood flow during dopamine infusion in man

Subcutaneous fat tissue and skeletal-muscle blood flow was measured in six male volunteers using the local 133Xe-washout method. Measurements were obtained before and during intravenous dopamine infusion in non-pressor (1 microgram kg-1 min-1) and pressor infusion rates (3-6 micrograms kg-1 min-1). During non-pressor infusion rate the systolic and diastolic arterial pressure and heart rate remained unchanged. When pressor dose dopamine was infused the systolic and mean arterial pressures increased significantly, whereas the diastolic pressure and the heart rate were left unchanged. The blood flow increased progressively from control values in both subcutis (control: 2.9 +/- 0.2, non-pressor: 5.0 +/- 1.6, pressor: 9.1 +/- 0.4 ml min-1 100 g-1, mean +/- SEM) and in skeletal muscle (control: 1.2 +/- 0.2, non-pressor: 1.5 +/- 0.2, pressor: 1.9 +/- 0.4 ml min-1 100 g-1, mean +/- SEM) and was significantly different from baseline values at any dopamine infusion rate. Side-effects were observed only at pressor dose infusion. It is concluded that dopamine in humans seems to possess vasodilatoric properties in subcutaneous fat tissue, and in skeletal muscles.

Are preadmission general practitioner telephone calls of value? A study in communication

During a 34-day study period, general practitioners spoke to the medical registrar in 115 out of 196 acute adult medical referrals made to the A & E department, Wellington Hospital. One hundred and fifty-eight of these cases were admitted along with 131 self-referred acute adult medical patients. Verbal communication was preferred by the majority of general practitioners and medical registrars concerning acute referral and was considered to be useful in assessing the patient. Preliminary telephone referral to the medical registrar by general practitioners made no difference to the time which these patients spent in A & E awaiting admission when compared to self-referred patients.

Preliminary experience with mammography. Reliability of mammography in patients with a palpable tumour of the breast

Radiologists with very limited practical experience in mammography initially achieved a low PVpos (0.50) and a high PVneg (0.95) in blind mammography of 80 patients with 85 excised and histologically examined breast tumours. After having read films from approximately 2500 patients the initial films were blindly reevaluated. PVneg was unchanged, whereas PVpos was elevated significantly (0.80). The intraobserver variation was 11.5 per cent. The actual interobserver variation was 3.2 per cent. These findings indicate that the reliability of blind mammography in patients with palpable tumours of the breast is considerable, also in case of only limited mammographic experience.