bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transformation of Galen’s Textual Legacy from Classical to Post-Classical Islamic Medicine: Commentaries on the Hippocratic Aphorisms
Authors: Karimullah Kamran I. 
Published: June 2017

I assess Galen’s (d. ca. 216) textual legacy on Arabic commentaries on the Hippocratic Aphorisms. I show that early authors in this tradition employ exegetical strategies taken from Alexandrian exegetical models. Applying these strategies to the Hippocratic-Galenic text makes Galen’s commentary the primary means for these authors to understand the Aphorisms. By introducing a host of commentary strategies that depart from Alexandrian models, Ibn Abī Ṣādiq’s (d. after 1067) commentary is a watershed moment in the Aphorisms-commentary tradition. Nevertheless, Galen’s commentary remains crucial for Ibn Abī Ṣādiq. These commentary strategies lead him to introduce texts, concepts and classifications that move beyond Galen’s Aphorisms-commentary. Finally, in one of the last texts in this corpus dating to around 1350, Ibn Sīnā’s (d. 1037) Canon of Medicine and Ibn Abī Ṣādiq’s commentary have become major sources for understanding the Aphorisms. Galen’s commentary is used sparingly.
Clinical Assessment of Cognitive Function in Patients with Head and Neck Cancer: Prevalence and Correlates
Authors: Williams Amy M. , Lindholm Jamie , Siddiqui Farzan , Ghanem Tamer A. , Chang Steven S. 
Published: June 2017

ObjectiveIdentify the prevalence and clinical correlates of cognitive impairment in patients presenting for treatment of head and neck cancer (HNC) using brief screening within a multidisciplinary care team.Study DesignA case series with planned data collection of cognitive function, quality of life (QoL), and psychosocial variables.SettingUrban Midwest academic medical center.Subjects and MethodsIn total, 209 consecutive patients with a diagnosis of HNC between August 2015 and September 2016 who had a pretreatment assessment with a clinical health psychologist. At pretreatment assessment, the Montreal Cognitive Assessment (MoCA), a brief screening tool for cognitive function, was administered along with a semistructured interview to gather information on psychiatric symptoms, social support, and substance use. Patient information, including demographics, clinical variables, and psychosocial variables, was extracted via chart review. A subset of patients with HNC completed the Functional Assessment of Cancer Therapy–Head and Neck Cancer at pretreatment assessment and was included in the QoL analyses.ResultsCognitive impairment was associated with current alcohol use, past tobacco use and number of pack years, time in radiotherapy, and adherence to treatment recommendations. Social, emotional, and functional QoL scales were associated with cognitive impairment, including executive function, language, and memory.ConclusionCognitive impairment is common in patients with HNC, and there are important associations between cognitive impairment and psychosocial, QoL, and treatment adherence variables. The results argue for the incorporation of cognitive screening as part of pretreatment assessment for patients, as well as further research into more direct, causal relationships via longitudinal, prospective studies.
Is Pepsin a Reliable Marker of Laryngopharyngeal Reflux? A Systematic Review
Authors: Calvo‐Henríquez Christian , Ruano‐Ravina Alberto , Vaamonde Pedro , Martínez‐Capoccioni Gabriel , Martín‐Martín Carlos 
Published: June 2017

ObjectiveLaryngopharyngeal reflux (LPR) is a common illness of otolaryngology visits. Over the past few years, pepsin has become a promising marker of LPR. The objective of the present research is to analyze the existing literature using pepsin as a diagnostic tool of LPR through a systematic review.Data SourcesPubMed (Medline), Trip Database, Cochrane Library, EMBASE, SUMsearch, and Web of Science.Review MethodsThe outcome assessed was the presence of pepsin in LPR patients. We included articles in which pepsin was studied in LPR patients (clinically suspected or with confirmed diagnosis). Studies with no control group, comparison group, and/or a sample size lower than 20 patients were excluded.ResultsTwelve studies were included. All included studies, with the exception of 2, found statistically significant differences for pepsin in cases compared with healthy controls.ConclusionPepsin might be a reliable marker in LPR patients, although questions remain about optimal timing, location, nature, and threshold values for pepsin testing. Future investigations are necessary to clarify the best method to use pepsin in the diagnostic process of LPR.
A prolonged antibiotic protocol to treat persistent Chlamydophila pneumoniae infection improves the extracranial venous circulation in multiple sclerosis
Authors: Thibault Paul , Attia John , Oldmeadow Chris 
Published: June 2017

Objective Chronic cerebrospinal venous insufficiency (CCSVI) is a condition associated with multiple sclerosis (MS). One mechanism that has been proposed is that the venous obstructions found in MS are due to a chronic persistent venulitis caused by the intra-cellular bacterial parasite, Chlamydophila pneumoniae (Cpn). The objective of the current study is to determine the effect of a combined antibiotic protocol (CAP) on the venous flow in MS patients as measured by a quantitative duplex ultrasound examination (QDUS). Method A non-randomised before-after cohort study was conducted to investigate differences in blood flow volumes pre and 6-months post antibiotic treatment for Cpn infection. Flow volume data were measured by QDUS across affected and unaffected sides from multiple veins segments, including internal jugular vein (IJV) segments J2 and J3, and vertebral vein (VV), as well as global arterial blood flow (GABF). Results 91 patients were included in the study. 64 (70%) were found to have positive Cpn serology. There was a statistically significant post-treatment difference seen for the affected side of Cpn infected patients (mean difference = 56 mL/min, p = 0.02). There was a non-significant increase seen for the affected side of uninfected patients (mean difference = 23 mL/min, p = 0.2). The difference in these effects (34 mL/min) was not statistically significant ( p = 0.3). The mean flow rate decreased in the unaffected side for both infected (−27 mL/min, p = 0.5) and uninfected patients (−69 mL/min, p = 0.01). There was a statistically significant post-treatment increase in GABF for the infected patients (mean difference = 90 mL/min, p = 0.02) and a difference of 76 mL/min for non-infected patients ( p = 0.01). Conclusion A CAP appears to improve the extra-cranial circulation in patients diagnosed with MS. This effect is statistically significant in patients with positive Cpn serology, although patients with negative Cpn serology also show some benefit, betraying a lack of specificity of this effect.
Suicide in primary headaches in 48 countries: A physician-survey based study
Authors: Trejo-Gabriel-Galan Jose Maria , Aicua-Rapún Irene , Cubo-Delgado Esther , Velasco-Bernal Carmen 
Published: June 2017

Aim To investigate the relationship between primary headache types and accomplished or attempted suicide in countries from all world regions. Methods Data were obtained using a questionnaire about suicide due to headache in a face-to-face interview with 203 physicians with expertise in headaches. They came from 48 countries, and from all continents. Results Primary headaches cause one suicide per 1,000,000 population each year (1% of the suicide rate due to all causes). Cluster headache and migraines account for 70–80% of them. Suicide attempts are 10 times more frequent than accomplished suicides. Cluster headache poses more risk than migraine. This risk is not often acknowledged, and is increased if there is previous psychiatric history. More than half of the physicians interviewed think it could be reduced with a more aggressive treatment of headaches. Conclusions Cluster headache and migraine are not always benign, and are the cause of the majority of suicides due to headache.
Effectiveness of Radial Extracorporeal Shock Wave Therapy (rESWT) When Combined With Supervised Exercises in Patients With Subacromial Shoulder Pain: A Double-Masked, Randomized, Sham-Controlled Trial
Authors: Kvalvaag Elisabeth , Brox Jens Ivar , Engebretsen Kaia Beck , Soberg Helene Lundgaard , Juel Niels Gunnar , Bautz-Holter Erik , Sandvik Leiv , Roe Cecilie 
Published: June 2017

Background: Subacromial shoulder pain is a common complaint, and radial extracorporeal shock wave therapy (rESWT) is increasingly used to treat this condition. Although many therapists use rESWT in combination with supervised exercises, no studies have evaluated the additional effect of rESWT with supervised exercises for subacromial shoulder pain. Purpose: To assess whether rESWT is more effective than sham rESWT when combined with supervised exercises for improving pain and function in patients with subacromial shoulder pain. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Patients between 25 and 70 years of age with subacromial shoulder pain with and without calcification in the rotator cuff lasting at least 3 months were assessed for eligibility; 143 patients were recruited. Participants were allocated (1:1) by computer-generated randomization in blocks of 20 to receive either rESWT or sham rESWT in addition to supervised exercises. The rESWT and sham rESWT were performed once a week with additional supervised exercises once a week for the first 4 weeks. The following 8 weeks, the patients received supervised exercises twice a week. The primary outcome was change in the Shoulder Pain and Disability Index (SPADI) after 24 weeks. Patients and outcome assessors were masked to group assignment. Results: At 24 weeks, participants in both the sham group and the rESWT group had improved ( P < .001) in SPADI score compared with baseline (−23.9 points [SD, 23.8 points] and −23.3 points [SD, 25.0 points], respectively), but there were no differences between the groups (mean difference 0.7; 95% CI, −6.9 to 8.3; P = .76). Prespecified subgroup analysis of patients with calcification in rotator cuff showed that the rESWT group had a greater improvement in SPADI score after 24 weeks (mean difference −12.8; 95% CI, −24.8 to −0.8; P = .018). Conclusion: Radial ESWT offered no additional benefit to supervised exercises in the treatment of subacromial shoulder pain after 24 weeks, except in the subgroup of patients with calcification in the rotator cuff. Registration: NCT01441830 ( ClinicalTrials.gov identifier).
Potential conflicts in midwifery practice regarding conscientious objection to abortions in Scotland
Authors: Fleming Valerie , Robb Yvonne 
Published: June 2017

Background: This study was developed as a result of a court case involving conflicts between midwives’ professional practice and their faith when caring for women undergoing abortions in Scotland. Research questions: What are practising Roman Catholics’ perspectives of potential conflicts between midwives’ professional practice in Scotland with regard to involvement in abortions and their faith? How relevant is the ‘conscience clause’ to midwifery practice today? and What are participants’ understandings of Canon 1398 in relation to midwifery practice? Research design: The theoretical underpinning of this study was Gadamer’s hermeneutic out of which the method developed by Fleming et al. involving a five-stage approach was utilised. Participants and research context: The research was conducted in the south of Scotland. A purposive sampling method was used. Eight participants who were practising Roman Catholics familiar with the subject of conscientious objection who were either midwives, lawyers (civil, canon or both) or priests contributed. Ethical considerations: The major ethical issues related to respect for autonomy, maintaining confidentiality and obtaining voluntary informed consent. Parish priests agreed to act as gatekeepers to prospective participants. All legal requirements were addressed regarding data collection and storage. Approval was given by the ethics committee of the university with which one of the researchers were associated. Findings: Three key themes provide an understanding of the situation in which midwives find themselves when considering the care for a woman admitted for an abortion: competing legal systems, competing views of conscience and limits of participation. Conclusion: Clear guidelines for practice should be developed by a multi-professional and consumer group based on an update of the abortion law to reflect the change from a surgical to medical procedure. Clarification of Canon 1398 in relation to what is and is not participation in the procurement of abortion would be of benefit to midwives with a conscientious objection.
Pharmacological management of acute severe behavioural disturbance: a survey of current protocols
Authors: O’Connor Nick , Corish John 
Published: June 2017

Objectives: The investigators reviewed protocols for the pharmacological management of acute severe behavioural disturbance (ASBD) used in Australasian psychiatric settings. Relevant literature was also examined, with a focus on Australian research. Methods: All Fellows of the RANZCP were emailed on two occasions in 2014 requesting a copy of the guidelines for pharmacological management of the ASBD patient used in their workplace. A literature search was also undertaken. Results: Thirty-six pharmacological management protocols for the ASBD patient were received. Twenty-six of these referred to patients aged 18–65 years and were selected for analysis. A number of recent publications provided new evidence in relation to the safe and effective management of patients with ASBD. Conclusions: ASBD is a heterogeneous, transnosological set of presentations requiring careful assessment and rational clinical decision making. Treatment protocols arising from an evolving evidence base provide safe and effective pathways for the majority of patients. However, sound clinical knowledge and a careful assessment of each presentation is required to enable the clinician to tailor treatment individually.
Through a Kaleidoscope: Dimensions of Scholarly Practice
Authors: Lombardozzi Catherine , Tyler Jo A. 
Published: June 2017

The Problem In contemporary work environments, a professional’s learning and development is often encouraged “in the flow of work”; there is an expectation that people will develop knowledge and skill while doing the day to day work of the organization. In considering how one might develop scholarly practice capabilities, therefore, professionals need to look to ways in which they can deliberately begin to incorporate scholarly practices into their standard processes. The Solution The purpose of this article is to provide guidance on everyday scholarly practice so that practitioners might hone their skills through daily work activities. We outline the dimensions of everyday practice and then describe the scholarly practice behaviors and activities that come into play in each dimension of practice. The Stakeholders By offering a more detailed version for scholarly practice in their daily work, this article provides a practical approach to enacting scholarly practice in daily activities that will benefit both practitioners and their managers.
Dabigatran following acute transient ischemic attack and minor stroke II (DATAS II)
Authors: Ng Kuan H , Sharma Mukul , Benavente Oscar , Gioia Laura , Field Thalia S , Hill Michael D , Coutts Shelagh B , Butcher Kenneth ,   for the DATAS-2 Investigators
Published: June 2017

Rationale Patients with transient ischemic attack or minor stroke are at high risk of early recurrent cerebrovascular events. Anticoagulation with heparin or warfarin acutely after ischemic stroke is at least as efficacious as aspirin for preventing recurrent events but is associated with an increased risk of clinical worsening due to hemorrhagic transformation. Aim and hypothesis We aim to demonstrate the safety of early anticoagulation with dabigatran, an oral direct thrombin inhibitor, in acute cerebrovascular syndrome patients. The primary hypothesis is that symptomatic hemorrhagic transformation rates in dabigatran and aspirin-treated patients will be similar. Sample size estimates At least 136 participants in two groups required to demonstrate an absolute between-group difference in the rate of hemorrhagic transformation of 5.6% with 80% power, assuming alpha = 5%. Methods and design A randomized, multicenter open-label clinical trial (NCT02295826). Three-hundred participants with a transient ischemic attack/ischemic stroke (National Institutes of Health Stroke Scale ≤ 9) will undergo magnetic resonance imaging within 72 h of symptom onset and will be randomized to aspirin 81 mg daily or dabigatran 150 mg twice daily for 30 days. Participants undergo repeat magnetic resonance imaging at 30 days and clinical assessment to 90 days. Study outcomes The primary outcome is the symptomatic hemorrhagic transformation rate. Secondary outcomes include recurrent stroke and new ischemic lesions on repeat magnetic resonance imaging. Discussion This study will determine the safety of early anticoagulation with dabigatran in patients with acute transient ischemic attack/ischemic stroke and will inform the design of a phase III randomized trial aimed at demonstrating reduced recurrent early ischemic events after acute transient ischemic attack/stroke.
Ultrasound-guided injections for supraspinatus tendinopathy: corticosteroid versus glucose prolotherapy – a randomized controlled clinical trial
Authors: Cole Brandi , Lam Patrick , Hackett Lisa , Murrell George A. C. 
Published: June 2017

Background Subacromial corticosteroid injections are frequently performed for pain associated with supraspinatus tendinopathy. Glucose prolotherapy has been used clinically for multiple tendinopathies and is hypothesized to be an alternate injection therapy for supraspinatus tendinopathy. Methods A prospective, randomized, double blinded clinical trial was conducted. Thirty-six patients with supraspinatus tendinopathy were randomized into two groups: 17 received an ultrasound-guided injection of glucose into the tendinopathic parts of the supraspinatus tendon and 19 received an ultrasound-guided injection of corticosteroid into the subacromial bursa. Primary outcome was level of pain with overhead activities at 3 months. Secondary outcome measures included level and frequency of pain and function, shoulder range of motion, impingement tests, strength and tendon changes on ultrasound. Results Level of pain with overhead activities was significantly reduced at the 3-month follow-up in the prolotherapy group and at the 6-month follow-up for both the prolotherapy and corticosteroid groups. There were no significant differences between the groups at any time point. Conclusions Both glucose prolotherapy and corticosteroid were generally well tolerated; however, glucose prolotherapy offered no additional benefit over subacromial corticosteroid injection for supraspinatus tendinopathy.
Tinnitus after administration of sublingual immunotherapy
Authors: Juel Jacob 
Published: June 2017

Background/objectives: Sublingual immunotherapy was first described in 1986. Since then, its use has been increased as an alternative to subcutaneously administered immunotherapy in the treatment of allergic rhinitis. The most common side effects are of oropharyngeal and gastrointestinal in nature, for example, itching, swelling, irritation, ulceration of the oropharynx and nausea, abdominal pain, diarrhoea, and vomiting. More severe side effects are dominated by systemic and respiratory tract manifestations. Results: In this clinical case, the author reports a right-sided transient tinnitus lasting for 48 h after administration of sublingual immunotherapy for house dust mite in allergic rhinitis. Conclusions: This case provide important insights for clinical practice, as tinnitus has not been previously reported as a side effect of sublingual immunotherapy with house dust mite allergens.
A bronchoscopic approach to benign subglottic stenosis
Authors: Raman Tuhina , Chatterjee Kshitij , Alzghoul Bashar N , Innabi Ayoub A , Tulunay Ozlem , Bartter Thaddeus , Meena Nikhil K 
Published: June 2017

Objectives: Subglottic stenosis is an abnormal narrowing of the tracheal lumen at the level of subglottis (the area in between the vocal cords and the cricoid cartilage). It can cause significant symptoms due to severe attenuation of airflow. We describe our experience in alleviating symptoms by addressing the stenosis using fibreoptic bronchoscopic methods. Methods: We report all concurrent cases performed between September 2015 and July 2016. We use a combination of balloon dilation, electro-surgery knife to dilate and incise stenotic segments followed by steroid injection to modulate healing. Results: We treated 10 patients in the study period, 8 of which were women. A total of 39 procedures were performed on these patients during this period. Gastro-esophageal reflux was the most common comorbidity associated with stenosis. The majority of the patients required more than 2 therapeutic procedures, but none required more than 4 procedures. There were no complications. Conclusion: Tracheal stenosis and in particular subglottic stenosis is a recurrent process and its management requires extensive collaboration amongst treating specialties. Our technique of steroid injection after dilation of the stenosis was effective in symptom control and decreased the number of repeat procedures.
Small intestinal peripheral nerve sheath tumour in a cat
Authors: Ribas Ariadna , Miller Rachel , Rasotto Roberta 
Published: June 2017

Case summary A 5-year-old female spayed Chinchilla cat presented with a 4 week history of weight loss and inappetence. A thorough clinical investigation confirmed the presence of a distal jejunal mass. Histopathological and immunohistochemical analysis was consistent with a small intestinal peripheral nerve sheath tumour. Relevance and novel information To the best of our knowledge, this is the first reported case of a small intestinal peripheral nerve sheath tumour in a cat. This case report demonstrates the use of immunohistochemistry in differentiating this entity from other mesenchymal neoplasms. The veterinary literature available in this field is very limited and this report adds a new differential diagnosis to feline patients presenting with an intestinal mass.