Carls C, Krajacic P. Bridging the Gap: An Osteopathic Primary Care–Centered Approach to Duchenne Muscular Dystrophy. J Am Osteopath Assoc 2017;117(6):377–385. doi: 10.7556/jaoa.2017.076.
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Duchenne muscular dystrophy (DMD) is a deadly and incurable disease typically diagnosed in early childhood. Presently, the delay between a caregiver's initial concern and the primary care physician obtaining creatine kinase levels—the most important screening test—is more than a year. It is imperative to diagnose DMD as soon as possible because early treatment has the potential to double the patient's lifespan. In addition, because of geographic and economic disadvantages, multidisciplinary DMD treatment centers are not readily available to all patients. Therefore, the challenge of early diagnosis and treatment coordination rests with the primary care physician. The present review provides osteopathic primary care physicians with current and relevant information regarding DMD diagnosis and management.
a Assembled using data available on ClinicalTrials.gov and information adapted from TREAT-NMD treatment recommendations.
b Preserve muscle, pulmonary, and cardiac function and prevent scoliosis.
Abbreviations: ACE, angiotensin-converting enzyme; ARB, angiotensin II receptor blockers; FDA, US Food and Drug Administration.
Abbreviations: AOA, American Osteopathic Association; DMD, Duchenne muscular dystrophy; MDA, Muscular Dystrophy Association; MD STARnet, Muscular Dystrophy Surveillance, Tracking and Research network.
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