bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telemedicine for Headache: Welcome to the Virtual World
Authors: Bernstein Carolyn , de Dhaem Olivia Begasse 
Published: March 2023

Abstract
The chapter “Telemedicine for Headache: Welcome to the Virtual World” reviews tips to optimize virtual headache medicine visits. The first step of virtual visits consists in ensuring a conducive, calm, confidential, comfortable, and safe environment for both parties. Identity should be confirmed, consent should be obtained, and rules (such as no recording) should be stated. Providers must make a conscious effort to adapt to telemedicine to build trust, show their presence, and ensure that the virtual setting does not dehumanize the patients’ experiences. Looking at the camera to make virtual eye contact, making pauses, and providing written supporting information for reference can help. Telemedicine is not an excuse to skip the neurological exam; this article provides tips on performing the examination. Further development is necessary regarding vital signs, funduscopic exam, and reflexes.
Primary Stabbing Headache: “Sticking Out the Pain”
Authors: Joshi Shivang , Harrington Carly E. 
Published: March 2023

Abstract
Primary stabbing headache, previously referred to as “ice-pick headache,” is a headache condition that causes short-lived but excruciating pain in the extratrigeminal regions. It is diagnosed through careful patient examination as well as testing to rule out conditions with similar presentation: clinicians should not discredit the importance of a detailed patient history while caring for individuals suffering from headaches. When primary stabbing headache is suspected, clinicians must exclude giant cell arteritis, glaucoma, cluster headache, thunderclap headache, and reversible cerebral vasoconstriction syndrome. Once diagnosis of primary stabbing headache has been established, possible treatment options include long-acting NSAIDs, gabapentin, and botox injections. The aim of this case review is to guide the reader through a complex case study in which a clinician is faced with the challenge of navigating both patient history and diagnostic testing to establish the most appropriate headache diagnosis.
Let’s Talk About Jaw Overuse
Authors: Hernández-Nuño de la Rosa María F. 
Published: March 2023

Abstract
The chapter “Let’s Talk about Jaw Overuse” examines the diagnosis, anatomy and etiology, evaluation and examination, work-up, and management of temporomandibular disorders. Temporomandibular disorders (TMDs) are a heterogeneous group of musculoskeletal conditions that affect the masticatory muscles, the temporomandibular joint, and the associated structures. They have a high prevalence in the general population, particularly in women. The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) describes the 12 most common types, including among them the headache attributed to TMD. The International Classification of Headache Disorders 3rd edition (ICHD-3) is another validated tool for the screening and the diagnosis of headache attributed to TMD. Mandibular parafunctional habits such as bruxism, in some cases secondary to long-standing life stressors, might play a very important role in the precipitation and/or perpetuation of this condition. Thus, it is advised to use a battery of standardized and validated questionnaires for behavioral screening as part of a comprehensive psychosocial assessment when encountering these patients. The management of headache attributed to TMD will require a multidisciplinary approach involving a combination of physical therapy, pharmacotherapy, and an intraoral orthotic device. The treatment plan might also include a referral to a clinical psychologist. For refractory pain, trigger point or even botulinum toxin injection therapy will be used. A comprehensive differential diagnosis should be performed to rule out the presence of giant cell arteritis, a condition that untreated can lead to blindness.
My Right Eye Is On Fire
Authors: de Dhaem Olivia Begasse 
Published: March 2023

Abstract
The chapter “My Right Eye Is On Fire” examines the diagnosis, work-up, and management of neuropathic eye pain. The first step to eye pain and photophobia is to determine whether the etiology is central or peripheral. The pain is likely peripheral if monocular, with no red flags on history, no abnormalities on neurological exam, and abates with a topical anesthetic. If there is a concern for a central etiology, further work-up with imaging and possibly lumbar puncture depending on the history and exam findings is warranted. Once established to be peripheral, a thorough ophthalmologic evaluation is necessary. Especially if the Schirmer test is positive, it is important to ask about other rheumatologic, endocrinologic, dermatologic, and autonomic symptoms. Management of neuropathic eye pain includes preservative-free artificial tears, omega-3 rich diet, riboflavin, systemic antidepressants such as amitriptyline or duloxetine, systemic anticonvulsants such as gabapentin, topical immunosuppressants, autologous serum tears. Medical optimization of comorbidities such as migraine, other chronic pain disorders, insomnia, and mood disorders is crucial. FL-41 or grey tinted glasses help with the blue-light sensitivity and photophobia without causing dark adaptation. Topical NSAIDs can also be helpful for acute bouts of eye pain and may help prevent progression to a full-blown migraine. Reversibly, triptans and other migraine acute treatments can also help with the photophobia associated with migraine attacks.
Headache Following a New Medication
Authors: Ostrem Bridget LaMonica 
Published: March 2023

Abstract
The chapter “Headache Following a New Medication” examines how to evaluate and manage and decrease the risk of vision loss due to idiopathic intracranial hypertension (IIH). IIH is a disorder of increased intracranial pressure (ICP) of unclear cause that primarily affects young women of childbearing age. Risk factors include obesity, family history, and certain medications. Patients often present with headaches and visual changes; funduscopic exam typically demonstrates papilledema. By definition, brain imaging cannot reveal an alternative cause for elevated ICP. Management includes large-volume lumbar puncture(s), weight loss, and carbonic anhydrase inhibitors. IIH can lead to persistent headaches and permanent vision loss. Prompt recognition and treatment of this disorder are needed to mitigate these risks.
Is It All About Mass?
Authors: Melnick Kaitlyn , Ghiaseddin Ashley Parham , Orlova Yulia 
Published: March 2023

Abstract
New or changed headache in a patient with abnormal neurological exam should raise the suspicion of space-occupying lesion and requires neuroimaging. Headache is rarely an isolated symptom of brain tumor, and new neurological signs can be usually found on thorough neurological exam that should include fundoscopy. Headache secondary to brain tumor is nonspecific and can present with various phenotypes. It is more common in children, young adults, those with primary headache disorders, large size or infratentorial location of tumor, and midline shift. Mechanisms of acute and chronic headache in patients with brain tumor are reviewed, including headache that changed or emerged after treatment of brain tumor. Treatment strategies of acute and chronic headache in patients with brain tumor are discussed.
Day-in, Day-out
Authors: de Dhaem Olivia Begasse , Bernstein Carolyn 
Published: March 2023

Abstract
The chapter “Day-in, Day-out” discusses the diagnosis and management of medication overuse headache. Medication overuse headache, preferably called medication adaptation headache, is hypothesized to originate from a combination long-term frequency acute medication use and preexisting headache disorder. The frequent acute medication use is thought to cause calcitonin gene-related peptide system–related sensitization of the trigeminal nociceptive process. The treatment mainly focuses on starting or optimizing preventive treatment (both pharmacologic and nonpharmacologic) and keeping track of headache days and medication use. A bridge therapy may be needed when weaning off butalbital- or opiate-containing agents due to initial headache worsening.
Principles of radiotherapy
Authors: Ajithkumar Thankamma 
Published: March 2023

Abstract
This chapter discusses the evolution of cancer and the basic principles of treatment. While DNA damage predominates the radiation-induced cell kill, there are other mechanisms which might influence radiation damage. This chapter also discusses types of radiations and their interaction with tissues, and the fundamental principles of radiotherapy. Radiotherapy cannot distinguish between multiplying cancer and normal cells and therefore results in damage of both cells. However, fractionation of radiotherapy governed by the 5Rs (redistribution of cells, reoxygenation, repair of sublethal damage, repopulation and radiosensitivity) is helpful to maximise tumour kill with acceptable normal tissue toxicities. The concepts of tumour control and normal tissue complication probabilities and clinical application of altered fractionations are also included.
Practical radiotherapy
Authors: Ajithkumar Thankamma 
Published: March 2023

Abstract
This chapter begins with a discussion of the intent of radiotherapy and clinical decision-making. Practical radiotherapy planning and delivery include a series of steps to ensure the highest quality of treatment. After informed consent, patients proceed with imaging for target volume definition in the optimal position with comfortable immobilisation. The concepts of various target volumes and the importance of appropriate windowing of planning CT scan for target and organs at risk delineation are emphasised. It also discusses treatment plan evaluation, modifications during treatment including gap corrections, and care after radiotherapy. There are sections on contouring of organs at risk, normal tissue tolerance, and treatment verification.
Gastrointestinal tumours
Authors: Ajithkumar Thankamma 
Published: March 2023

Abstract
The role of radiotherapy for gastrointestinal cancers depends on the site of the primary tumour and the stage of disease. There is global variation in the management of gastrointestinal cancers. For example, locally advanced operable oesophageal cancers are treated with neoadjuvant chemotherapy followed by surgery in the UK whereas it is treated with neoadjuvant chemo-radiotherapy in Europe and the US. This chapter discusses the clinical and imaging features of cancers occurring in different parts of the gastrointestinal tract, the role of radiotherapy for tumours arising in different sites, and practical details on radiotherapy planning. It also summarizes the evidence underpinning current clinical practice and mentions about global variations in the management.
Oligometastatic and oligoprogressive extracranial disease
Authors: Ajithkumar Thankamma 
Published: March 2023

Abstract
With the advent of modern imaging and frequent surveillance, some patients are shown to have progressive metastatic disease with or without symptoms. Some of these patients with limited sites of metastatic disease are often classified as oligometastatic, though a strict definition does not exist. Recently, there has been an increasing interest in the use of stereotactic ablative radiotherapy for patients with oligometastatic and oligoprogressive diseases. This chapter discusses the imaging features of oligometastatic and oligoprogressive diseases and their radiotherapy management. It also summarizes the evidence underpinning current clinical practice. Readers should be aware that it is an area where clinical practice is rapidly evolving.
Is it a stroke?
Authors: Harwood Rowan H. , Huwez Farhad Umer , Guyler Paul , Alam Sajid , Gaynor Catherine 
Published: March 2023

Abstract
This chapter describes the definition and diagnosis of stroke. Stroke is a type of brain injury triggered by the sudden interruption of blood flow. Diagnosis depends on history, examination, and the results of imaging studies. Stroke physicians must also have a good working knowledge of alternative diagnoses (mimics), and understand underlying pathological mechanisms in order to make investigation logical and systematic.
The first 2 weeks
Authors: Harwood Rowan H. , Huwez Farhad Umer , Guyler Paul , Alam Sajid , Gaynor Catherine 
Published: March 2023

Abstract
This chapter looks at the first weeks of stroke care Different trajectories of recovery, stability or deterioration can be seen, and care should be appropriate to each. The chapter explores neurological problems such as hemiparesis, neglect, aphasia, and emotional lability. It discusses complications, functional problems, co-existing medical problems, neurological deterioration, and pain. The chapter also covers the options for rehabilitation and specialist services.
Making difficult decisions
Authors: Harwood Rowan H. , Huwez Farhad Umer , Guyler Paul , Alam Sajid , Gaynor Catherine 
Published: March 2023

Abstract
This chapter focuses on medical decision-making, which is governed by law, professional regulations, ethics, and culture. It explains the ethical framework of principlism that considers the benefits and burdens of a proposed intervention, and respect for autonomy and justice. Most healthcare interventions require consent or agreement from an appropriate consultee when a patient lacks mental capacity. It describes the options for advanced care planning and some specific examples of difficult decision-making in stroke care.
Hospital discharge
Authors: Harwood Rowan H. , Huwez Farhad Umer , Guyler Paul , Alam Sajid , Gaynor Catherine 
Published: March 2023

Abstract
Hospital discharge requires careful planning. A hospital admission can serve valuable functions, but a person should remain in hospital only when necessary care cannot be delivered elsewhere. This determines when discharge should occur. Many patients rehabilitate better when nursing and rehabilitation are delivered at home. Community support divides into therapeutic services that try to improve a patient’s function, and prosthetic services that make up for things the patient cannot do themselves. The chapter explains the features to consider at the level of the person, their abilities, and their environment when considering fitness for discharge.
Longer-term problems and their management
Authors: Harwood Rowan H. , Huwez Farhad Umer , Guyler Paul , Alam Sajid , Gaynor Catherine 
Published: March 2023

Abstract
This chapter discusses the longer-term problems of stroke patients and their management. Some patients feel abandoned after leaving hospital. Services for stroke patients should identify and address longer-term needs. Some problems that occur early after stroke persist. Issues that emerge following hospital discharge include: difficulty in returning to work, driving, re-establishing interests, hobbies, and civic participation. Aphasia needs specialist long-term management and support that targets impairment, compensation, adjustment, and carer support. Community rehabilitation teams or stroke support workers can help reduce psychological distress.
Retrospective Analysis of the Safety and Efficacy of Fecal Microbiota, Live-jslm (REBYOTATM) Administered Under Enforcement Discretion to Patients With Clostridioides difficile Infection
Authors: Feuerstadt Paul , Harvey Adam , Yoho David S , Garcia-Diaz Julia B , Knapple Whitfield L , Bancke Lindy 
Published: March 2023

Abstract

Background
Fecal microbiota, live-jslm (RBL; REBYOTA™), the first microbiota-based live biotherapeutic approved by the US Food and Drug Administration to prevent recurrent Clostridioides difficile infection (rCDI) in adults, has been evaluated in 5 prospective clinical trials. A retrospective analysis considered the safety and efficacy of RBL administered under US Food and Drug Administration enforcement discretion to patients with rCDI and broad eligibility criteria mimicking real-world practice.

Methods
We retrospectively identified adults with rCDI treated with RBL under enforcement discretion between November 1, 2015, and September 30, 2019, across 5 study sites. CDI diagnosis was based on site-specific practice. The primary safety set (PSS) included all patients who were naïve to previous RBL treatment and had continuously comprehensive medical records for 6 months following treatment.

Results
The primary treatment cohort had 94 patients; the PSS included 64 patients with common comorbidities receiving diverse chronic therapeutics. Most treatment-emergent adverse events were mild to moderate in severity and comparable between comorbidity subgroups and the overall population. There were no serious adverse events related to RBL or the administration procedure. In the PSS, 82.8% of RBL-treated patients responded at 8 weeks, of whom 88.7% had sustained response through 6 months. The number of RBL doses administered had no marked effect on outcome.

Conclusions
Together with prospective clinical trial outcomes, these findings support the efficacy and safety of RBL to prevent rCDI, with diagnostics and comorbidities representative of real-world clinical practice.
Readability of Online Patient Educational Materials in Pediatric Orthopaedics: A Systematic Review
Authors: Hecht Christian J. , Burkhart Robert J. , McNassor Ryan , Mistovich R. Justin 
Published: March 2023

Background:
As most patients and their families utilize online education materials, ensuring that their readability is at or below the recommended reading level of sixth grade is imperative to enhance informed consent, patient involvement, and shared decision-making. We evaluated and compared the readability of online patient education materials (PEMs) about pediatric orthopaedics for academic-sponsored websites and search-engine result websites.

Methods:
Following the PRISMA-P guidelines, we performed a systematic review to answer our study question (PROSPERO registration of the study protocol: CRD42022352323, August 8, 2022). PubMed, EBSCOhost, Medline, and Google Scholar electronic databases were utilized to identify all studies evaluating the readability of pediatric orthopaedic online PEMs between January 1, 2000 and September 9, 2022. We included studies with full-text manuscripts in English addressing the readability of pediatric orthopaedic online patient education materials. We excluded general reviews, papers, case reports, duplicate studies between databases, grey literature, and publications in languages other than English. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) tool for cross-sectional studies.

Results:
Our initial search yielded 196 candidate publications. Of these, 11 studies met inclusion criteria. These included a total of 893 PEMs assessed for readability between January 2001 to December 2021. The mean JBI score was 7.3±1.1. Each of the seven studies assessing PEMs from academic-sponsored sources reported mean readability scores of at least an eighth-grade level. Among the 5 studies assessing the readability of PEMs accessed through search engines, 3 studies reported ninth-grade reading level whereas the other 2 reported 10th-grade. Academic and search-engine website readability scores remained constant between 2001 and 2021.

Conclusions:
Our analysis showed poor readability scores for both academic-sponsored website PEMs and those accessed through search engines. In addition, the readability scores remained constant between 2001 and 2021, indicating that revisions to orthopaedic online PEMs are needed. Supplementation with visuals should be included to educate patients with lower health literacy.

Level of Evidence:
III.
Risk Factors for Multisystem Inflammatory Syndrome in Children: A Case-control Investigation
Authors: Zambrano Laura D. , Wu Michael J. , Martin Lora , Malloch Lacy , Chen Sabrina , Newhams Margaret M. , Kucukak Suden , Son Mary Beth , Sanders Cameron , Patterson Kayla , Halasa Natasha , Fitzgerald Julie C. , Leroue Matthew K. , Hall Mark , Irby Katherine , Rowan Courtney M. , Wellnitz Kari , Sahni Leila C. , Loftis Laura , Bradford Tamara T. , Staat Mary , Babbitt Christopher , Carroll Christopher L. , Pannaraj Pia S. , Kong Michele , Schuster Jennifer E. , Chou Janet , Patel Manish M. , Randolph Adrienne G. , Campbell Angela P. , Hobbs Charlotte V. 
Published: March 2023

Background:
In a 2020 pilot case-control study using medical records, we reported that non-Hispanic Black children were more likely to develop multisystem inflammatory syndrome in children (MIS-C) after adjustment for sociodemographic factors and underlying medical conditions. Using structured interviews, we investigated patient, household, and community factors underlying MIS-C likelihood.

Methods:
MIS-C case patients hospitalized in 2021 across 14 US pediatric hospitals were matched by age and site to outpatient controls testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within 3 months of the admission date. Caregiver interviews queried race/ethnicity, medical history, and household and potential community exposures 1 month before MIS-C hospitalization (case-patients) or after SARS-CoV-2 infection (controls). We calculated adjusted odds ratios (aOR) using mixed-effects multivariable logistic regression.

Results:
Among 275 case patients and 496 controls, race/ethnicity, social vulnerability and patient or family history of autoimmune/rheumatologic disease were not associated with MIS-C. In previously healthy children, MIS-C was associated with a history of hospitalization for an infection [aOR: 4.8; 95% confidence interval (CI): 2.1–11.0]. Household crowding (aOR: 1.7; 95% CI: 1.2–2.6), large event attendance (aOR: 1.7; 95% CI: 1.3–2.1), school attendance with limited masking (aOR: 2.6; 95% CI: 1.1–6.6), public transit use (aOR: 1.8; 95% CI: 1.4–2.4) and co-resident testing positive for SARS-CoV-2 (aOR: 2.2; 95% CI: 1.3–3.7) were associated with increased MIS-C likelihood, with risk increasing with the number of these factors.

Conclusions:
From caregiver interviews, we clarify household and community exposures associated with MIS-C; however, we did not confirm prior associations between sociodemographic factors and MIS-C.
Cryptococcal Necrotizing Fasciitis in a Patient With Sarcoidosis
Authors: Killblane Tiffany , Milsap Dominique , Vetos Develyn , Grantham David C. , Hagan Margaret 
Published: March 2023

Abstract
Necrotizing fasciitis, a severe soft tissue infection that rapidly destroys the fascial layer through necrosis and inflammation, is often caused by Streptococcus pyogenes, gram-negative bacteria, Clostridium, and, rarely, fungal organisms. We present a case of necrotizing fasciitis caused by Cryptococcus neoformans in a patient with sarcoidosis on oral prednisone therapy.