bluuebunny/crossref_metadata_2025_split huggingface dataset:
Close Contact Casting versus Surgery for Initial Treatment of Unstable Ankle Fractures in Older Adults
Authors: Hardman John , Pearse Michael 
Published: June 2024

Abstract
A multicenter randomized controlled study designed to compare outcomes of operative fixation vs. close contact casting in the management of unstable ankle fractures in patients over the age of 60 years; 620 patients were randomly assigned to either treatment modality. The primary outcome was ankle function using the Olerud-Molander Ankle Score, which was equivalent at 6 months (66 for surgery vs. 64.5 for casting; p = 0.75). Quality of life, pain, and range of motion assessments were similarly comparable. A lower rate of perioperative complications and reduced overall theater time were observed in the casting group. Casting was associated with an increased rate of asymptomatic radiographic nonunion and malunion.
Primary Arthroscopic Stabilization for a First-Time Anterior Dislocation of the Shoulder
Authors: Assiotis Angelos , Singh Uppal Harpal 
Published: June 2024

Abstract
The investigators of this level I randomized trial from Edinburgh (Scotland) compare the clinical and functional outcomes of arthroscopic examination and lavage against arthroscopic anatomical repair of the Bankart lesion at two years after the intervention in eighty-four patients with a first-time anterior shoulder dislocation. They assess rates of recurrent instability, functional scores, range of motion, satisfaction, health service costs, and complications. They make a strong case in favor of arthroscopic repair of the Bankart lesion as they demonstrate that the risk of a further dislocation is reduced by 76% in the arthroscopic repair group compared with the lavage group. This study suggested that arthroscopic repair of a primary anterior traumatic shoulder dislocation confers improved functional outcomes and a reduced risk of recurrent instability when compared to arthroscopic lavage. This study helped to establish the significant role of arthroscopic Bankart repair in managing such patients.
Compression Plating versus Intramedullary Nailing for Humeral Shaft Fractures Requiring Operative Fixation
Authors: Morgan Catrin , Singh Kewal , Magnussen Alexander 
Published: June 2024

Abstract
This chapter looks at a study investigating dynamic compression plating (DCP) versus intramedullary nailing (IMN) for unstable humeral shaft fractures. This study includes forty-four patients who were randomized into two groups (i.e., DCP and IMN) with a mean follow-up of 14.3 months. The primary outcomes were function and pain, whereas the secondary outcomes were complications and need for further surgery. No difference in functional outcomes were demonstrated between DCP and IMN. A significantly higher complication and revision rate with IMN was reported. Therefore, in this study, DCP is the preferred treatment for unstable humeral shaft fractures.
Total or Partial Knee Replacement for Treating Medial Compartment Osteoarthritis
Authors: Hamilton Thomas W. , Alvand Abtin 
Published: June 2024

Abstract
The Total or Partial Knee Arthroplasty Trial (TOPKAT) was a pragmatic, multicenter randomized controlled trial designed to assess the clinical and cost effectiveness of total knee replacement (TKR) compared to partial knee replacement (PKR) in patients with medial compartment osteoarthritis (OA) of the knee. Randomizing 531 patients at five years, TOPKAT reported that there was no difference in functional outcomes, health-related quality of life, patient satisfaction, or revision rates between groups; however, TKR was associated with an increase in complications, particularly knee stiffness. Health economic analysis identified PKR to be more cost effective compared to TKR, and based on this the study suggested that PKR should be considered the first choice for patients with late-stage isolated medial compartment OA of the knee.
Timing of Surgical Decompression after Onset of Cauda Equina Syndrome
Authors: Wignadasan Warran , Thavarajah Dushan 
Published: June 2024

Abstract
Cauda equina syndrome (CES) is a rare but significant spinal surgical emergency characterized by a constellation of symptoms produced from compression of the cauda equina. The meta-analysis published by Ahn et al. (2000) aimed to determine the association between timing of surgical decompression and clinical outcomes in patients with compression of the cauda equina from a herniated lumbar disc. A total of forty-two articles met the inclusion criteria. The preoperative and postoperative data collected on 322 patients showed that there was a significant benefit in surgical decompression within forty-eight hours of onset of CES symptoms compared to decompression after forty-eight hours.
Long-Term Outcomes of Reverse Total Shoulder Arthroplasty
Authors: Tang Quen O. , Sugand Kapil , Makki Daoud 
Published: June 2024

Abstract
This study is a follow-up from an original report of 191 reverse total shoulder arthroplasties (RTSAs) in 186 patients. A retrospective case-series analysis was performed with at least ten years of follow-up (mean of 150 months). Prosthesis survival, radiographic evaluation, complications, and clinical outcomes were presented. Implant survivorship analysis was performed on a total of 240 prostheses. Eighty-four patients (eighty-seven RTSAs) were available for clinical outcome evaluation, and sixty-four patients (sixty-seven RSTAs) were available for radiographic assessment at final follow-up. The ten-year overall implant survivorship was 93% (revision as endpoint). Scapular notching was evident in 73% of patients. Complications were recorded in forty-seven patients (29%), with ten cases (10%) occurring after two years. The mean absolute and relative Constant scores (± standard deviation) were 55 ±16 points and 86 ±26 points respectively, which were both significant.
Diarrhoea
Authors: McConnell Robert , Connolly Michael , Butterly Leona 
Published: June 2024

Abstract
Diarrhoea is a debilitating problem in patients with advanced cancer. This case presents a patient with advanced cancer who has severe diarrhoea and focuses on the causes and management of diarrhoea in this patient group. Particular attention is given to cancer itself as a cause, as well as side effects of treatments, including chemotherapy, radiotherapy, surgery, and medications. The management of diarrhoea and potential complications will be discussed, looking at the specific management of chemotherapy-associated diarrhoea, bile acid malabsorption, immunotherapy-related diarrhoea using medications such as loperamide, codeine, octreotide as well as medications targeted at the cause of the diarrhoea.
De-escalation from Intensive Therapy Unit
Authors: Longwell Sarah , Wyld Lucy 
Published: June 2024

Abstract
This case discusses some of the key areas for clinicians to consider when providing end-of-life care for patients in intensive therapy unit (ITU). It discusses the importance of supporting early advance care planning (ACP) discussions to ensure all treatments are in line with the patient’s goals of care. It explores the unique challenges this environment poses, from symptom management and organ donation to complex decision-making. It considers the practicalities and legal framework surrounding the withdrawal of ventilation and artificial nutrition and hydration at the end of life. It highlights the importance of a patient-centred approach to end-of-life care and considers the role of the multidisciplinary team and other services, such as the Spiritual Care team, in providing this. It also discusses the role of the Hospital Palliative Care Team (HPCT) in the ITU and future models of integrating palliative care into critical care services.
Community Patient Transferred into Emergency Department/Acute Medical Unit
Authors: Copley Alice , Yardley Sarah 
Published: June 2024

Abstract
This chapter reviews the case of a patient attending the emergency department (ED) with dyspnoea and cough on a background of advanced terminal lung disease, who appears to be in the last weeks of life. He is transferred there by ambulance from a nursing home. The case explores the role of healthcare professionals in symptom assessment, communication, and clinical decision-making throughout the patient’s journey from ambulance attendance at the nursing home to the acute hospital setting and finally discharge to the nursing home for end-of-life care. It reviews principles of symptom control, including oxygen therapy and coordinating the discharge of a dying patient to a nursing home from the ED/acute medical unit. It also analyses why patients in the last phase of life are transferred to hospital and encourages professionals to take a patient-centred and pragmatic approach to investigation and intervention.
Giving Remote Advice to Families and Other Professional Providers
Authors: Qureshi Shaun Peter , Guppy Philippa , Osborne Georgina , Al-Qurainy Rasha 
Published: June 2024

Abstract
Remote consultations and remote advice-giving have become an increasingly embedded part of clinical practice in palliative care, driven by the COVID-19 pandemic. This case details how remote advice and consults can be delivered safely and effectively, explores the opportunities and challenges of telemedicine, and considers its role in developing more versatile palliative care services. There are complexities and challenges in conducting remote consultations, particularly in being able to develop a rapport with patients, which is key in palliative care, though simple strategies can be used to mitigate these. As healthcare providers and professionals become more confident with remote consultations, we are likely to further develop what can be offered remotely, which will be beneficial in enabling palliative care specialists to share their expertise across numerous sites and a wider geographical area. Building on the strong reputation of palliative care for personalized care, remote input should form part of a blended offer for patients and the wider healthcare family.
Dementia
Authors: Tolmie Kirsty , Dening Karen Harrison 
Published: June 2024

Abstract
Dementia is the leading cause of death in the UK and one of the major causes of disability and dependency among older people. The spectrum of symptoms in advanced dementia is comparable to those with cancer, however the symptom burden is often underestimated and patients are disproportionately underserved by specialist palliative care services. This case study explores some of the barriers people with dementia face when trying to access palliative care. It considers the physical as well as the behavioural and psychological symptoms of dementia (BPSD) and how pain is assessed and managed in patients who are unable to communicate their feelings and experiences. It explores prognostic uncertainty in dementia and presents recommendations for care including shared decision-making, avoiding burdensome interventions, spiritual and psychosocial support, and carer involvement.
Symptom Management in Organ Failure
Authors: Lister-Flynn Stephanie , Ainley Stephanie , Murphy Emma 
Published: June 2024

Abstract
This case explores the range of common symptoms experienced by patients with end-westage kidney disease and how these may be treated, including symptoms experienced after dialysis withdrawal. It reviews types of pain likely to be encountered and the use of opioid and non-opioid analgesics; the management of uraemic pruritus, including the evidence base for recommendations; and the psychiatric comorbidities of anxiety and depression in renal failure. It discusses the use of patient-reported outcome measures to identify symptoms and the importance of palliative and supportive care earlier in the disease course. The case includes the consideration of dialysis adequacy for symptom management, and common symptoms experienced following dialysis withdrawal at the end of life.
Rigidity
Authors: Pitsillides Constantina , Wiblin Lou 
Published: June 2024

Abstract
Progressive supranuclear palsy (PSP) is a rapidly progressing neurological condition which may present with a variety of clinical features such as blurred vision, falls, cognitive impairment, altered eye movements, and rigidity. This case reviews the role of dopamine agonists in the management of rigidity, the causes and management of blurred vision and highlights the importance of a multidisciplinary approach when managing patients with PSP. It also discusses cognitive impairment in patients with PSP and the use of Montreal Cognitive Assessment (MoCA). Additionally, this case also highlights key milestones, such as falls, PSP progression, and the role of palliative care services.
Goal Setting and Interdisciplinary Support and Care Planning
Authors: Tiberini Rebecca , Martin Jonathan 
Published: June 2024

Abstract
In this case, the importance of goal-setting and interdisciplinary support and care planning for people with advanced disease is discussed. Drawing on the practice of a hospice interdisciplinary breathlessness clinic, the case highlights issues such as the need to consider ‘concerns’ rather than just ‘problems’. The practice of person-centred goal-setting is explained, and evidence about patient experiences of this within palliative care is provided. Tips are given to help practitioners consider how to orientate their services so that establishing patient goals becomes the central focus for interdisciplinary care teams. Positive risk-taking and parallel planning are highlighted as ways to shift practice to improve the rehabilitative approaches in palliative care. This case includes video content from Lucy, who was known to hospice services due to her advanced chronic obstructive pulmonary disease. Lucy was keen for her experiences to be used in the education of healthcare professionals and the content is freely accessible via YouTube.
Grief and Bereavement
Authors: Chamberlain Charlotte , Selman Lucy 
Published: June 2024

Abstract
Grief is the emotional process we go through when losing someone or something important to us. It is a natural part of life and not a pathology requiring medical intervention. However, while most grief can be managed within personal social support networks, for up to 10% of people it can become prolonged, leading to anxiety, depression, increased use of medication and hospital admissions. This case describes theoretical models of grief and specific sub-types of grief (anticipatory, disenfranchised). It highlights evidence that tailored interventions (such as individual and group psychotherapy) targeted at those with prolonged grief disorder (PGD) improve outcomes for this population. Health professionals have a responsibility to support those who are recently bereaved or grieving, providing information about grief and signposting to support options. For those with risk factors for or exhibiting signs of PGD, awareness and referring to specialist services is essential to prevent further harm to patients.
Behavior and Psychosocial Functioning after Kidney Transplantation
Authors: Steel Jennifer L. , Cukor Daniel 
Published: June 2024

Abstract
Psychosocial and behavioral factors are considered among the determinants of health and are critical in the development and progression of chronic disease. Psychosocial factors, including anxiety, post-traumatic stress disorder (PTSD), and depression, and behavioral factors, such as diet, physical activity, and substance use, may contribute to the development of end-stage renal disease. These psychosocial and behavioral factors remain important for quality and quantity of life post–renal transplant. While psychosocial factors such as depression, sleep, anxiety, and substance use have been shown to contribute to increased risk of mortality in other chronic diseases, there is a paucity of research linking these factors to post-kidney transplant survival.
Winter's End
Authors: Cohen Lewis 
Published: June 2024

Abstract
Winter’s End: Dementia and Dying Well is constructed around a lengthy and detailed case history layered with the voices of approximately 100 palliative medicine practitioners, legal scholars, bioethicists, social workers, nurses, neurologists, and other authorities, primarily from North America and Europe. Arguably among the worst of all medical afflictions, the dementias slowly destroy one’s personality; take a tremendous emotional, physical, and financial toll on patients and families; and are irreversible and inexorably fatal. This book explores how and when one might prepare to foreshorten life after being diagnosed with a dementing illness while not ignoring the reality that, for most people, such actions are unthinkable and unacceptable.
2
Authors: Cohen Lewis 
Published: June 2024

Abstract
The author recounts the circumstances of how he first met Dan Winter and came to begin a series of interviews that would chronicle, in real-time, how Dan received his diagnosis of dementia, continued living his life, and, ultimately, sought his death. Practical matters surrounding a dementia diagnosis, such as getting personal affairs in order, are explored. The concept of memory is discussed. The reader learns more about Dan’s personal history and how the gathering of such details can provide the context needed to understand an individual’s decision to terminate their life to relieve suffering. A brief description of organizations that assist individuals in dying is included.
6
Authors: Cohen Lewis 
Published: June 2024

Abstract
In this chapter, the reader learns more about Dan’s personal history, particularly his coming out as a gay man and how he met his husband, John Forsgren. As a lead up to Dan’s own story, a general history of the HIV/AIDS epidemic of the 1980s also is discussed. At that time, a great number people with HIV diagnoses perished, and the embedded trauma this caused for members of the LGBTQ population resonates to this day. John’s experiences during the HIV/AIDS epidemic left a lasting impression on him. In this chapter, experts from psycho-oncology and psychiatry explore how John’s testing positive for HIV and his social activism allowed him a unique perspective on end-of-life issues.
25
Authors: Cohen Lewis 
Published: June 2024

Abstract
This chapter begins with a conversation between the author and Dan’s husband. In this discussion, they review the concept of family and friends (particularly a “logical” family that you build yourself) and the impact the AIDS epidemic on end-of-life issues in American society. They discuss how the decision to pursue voluntarily stopping eating and drinking (VSED) instead of a legal drug cocktail may have had a positive impact on Dan’s family. The conversation with John reveals more details about the logistics of VSED and how he’ll be supported. Most importantly, Dan later reveals to me that he is beginning his fast on the following day.
26
Authors: Cohen Lewis 
Published: June 2024

Abstract
This chapter follows the day-to-day, practical details of going through voluntarily stopping eating and drinking (VSED). The chapter discusses how Dan’s family is reacting to his decision to pursue VSED. These include symptom management (e.g., headaches, thirst). Also discussed is how a partner living with someone undergoing VSED handles matters like cooking, eating, and drinking. The reader learns how VSED is progressing for Dan, and the various symptoms he is experiencing. During the first few days, he remains able to walk his dog while accompanied by John, but this becomes impossible as his fatigue increases. Dan urges his family members to honestly tell his mother what is transpiring. He is exceedingly grateful when they comply with his request.
‘Intimacy as method’: Ethnographic reflections on equitable knowledge production in migration research
Authors: Cîrstea Ana-Maria , Pescinski Janina 
Published: June 2024

Abstract
Despite the ongoing ‘reflexive turn’ in migration studies, intimacy continues to be cropped out of methodologies. This article explores how intimacy can enable us to produce knowledge in a way that is grounded in and sensitive to our participants’ lives. We reflect on our experiences of building intimacy during our two respective ethnographic projects. While one project analyses the solidarity practices of citizens and migrants at the Franco–Italian border, the other explores the experiences of a Romanian family in London. Although researching seemingly divergent topics, we find methodological convergences and come together to propose the concept of ‘intimacy as method’. Positionality is central to intimacy, as who we are as early-career female researchers shaped how we built intimate and caring relationships with our participants. Cultivating intimacy, however, also presented challenges, including ethical considerations in how we conduct research, and how we represent our interlocutors and engage them in knowledge production. In sitting with the discomfort which is central to intimacy, we found its analytical potential as it granted us novel insights into our participants’ lives. By reflecting on both the potential and challenges of intimacy, we argue that migration researchers can use ‘intimacy as method’ to conduct more equitable research in migration studies.
Talaromyces marneffei, Coccidioides species, and Paracoccidioides species—a systematic review to inform the World Health Organization priority list of fungal pathogens
Authors: Morris Arthur J , Kim Hannah Yejin , Nield Blake , Dao Aiken , McMullan Brendan , Alastruey-Izquierdo Ana , Colombo Arnaldo Lopes , Heim Jutta , Wahyuningsih Retno , Le Thuy , Chiller Tom M , Forastiero Agustina , Chakrabarti Arunaloke , Harrison Thomas S , Bongomin Felix , Galas Marcelo , Siswanto Siswanto , Dagne Daniel Argaw , Roitberg Felipe , Gigante Valeria , Beardsley Justin , Sati Hatim , Alffenaar Jan-Willem , Morrissey Catherine Orla 
Published: June 2024

Abstract
The World Health Organization, in response to the growing burden of fungal disease, established a process to develop a fungal pathogen priority list. This systematic review aimed to evaluate the epidemiology and impact of infections caused by Talaromyces marneffei, Coccidioides species, and Paracoccidioides species. PubMed and Web of Sciences databases were searched to identify studies published between 1 January 2011 and 23 February 2021 reporting on mortality, complications and sequelae, antifungal susceptibility, preventability, annual incidence, and trends. Overall, 25, 17, and 6 articles were included for T. marneffei, Coccidioides spp. and Paracoccidioides spp., respectively. Mortality rates were high in those with invasive talaromycosis and paracoccidioidomycosis (up to 21% and 22.7%, respectively). Hospitalization was frequent in those with coccidioidomycosis (up to 84%), and while the duration was short (mean/median 3–7 days), readmission was common (38%). Reduced susceptibility to fluconazole and echinocandins was observed for T. marneffei and Coccidioides spp., whereas &gt;88% of T. marneffei isolates had minimum inhibitory concentration values ≤0.015 μg/ml for itraconazole, posaconazole, and voriconazole. Risk factors for mortality in those with talaromycosis included low CD4 counts (odds ratio 2.90 when CD4 count &lt;200 cells/μl compared with 24.26 when CD4 count &lt;50 cells/μl). Outbreaks of coccidioidomycosis and paracoccidioidomycosis were associated with construction work (relative risk 4.4–210.6 and 5.7-times increase, respectively). In the United States of America, cases of coccidioidomycosis increased between 2014 and 2017 (from 8232 to 14 364/year). National and global surveillance as well as more detailed studies to better define sequelae, risk factors, outcomes, global distribution, and trends are required.