Western Medical Literature Research Articles

Revisiting the relationship between traditional East Asian medicine and biomedicine: Incorporating the Western into the Eastern

IntroductionWhether traditional East Asian medicine (TEAM) is compatible with biomedicine remains controversial, with biomedicine research failing to explain key TEAM concepts. This article hypothesizes that reconciliation could be effective if biomedicine assumed that it examines a limited portion of reality, whereas Eastern medicine aims to conceptualize reality in its entirety. Re-discovering elements of Western thought that allow epistemological expansion, such as the notion of a non-material aspect inherent to all phenomena, and its implications for research methodology, can encourage biomedical research to reflect on TEAM. ApproachThe article reviews sources from the Western and Eastern medical literature to explore the above hypothesis. DiscussionThe concept of Qi (氣), inherent in TEAM's interpretive framework, lays the foundations for theoretical compatibility and a practical integrative approach. In TEAM, Qi is the basic fabric from which all things are made; however, holding that all things have a non-material aspect is also deeply rooted in the European religious and philosophical tradition. This article proposes that biomedicine detects the denser part of the Qi spectrum conceived by TEAM. As an illness progresses, parts of Qi that make up the organism become increasingly separated, but biomedicine detects disharmony only when the magnitude reaches a certain level owing to its sensitivity range. ConclusionBoth TEAM and biomedicine consider the patient's complaint as an unquestionable reality that medicine can observe and aims to alleviate. TEAM assumes that traditions distilled over millennia require verification through evidence-based medicine to gain credibility in the West, which owes its success to its skeptical attitude. Meanwhile, biomedicine assumes that some mechanisms that influence health and healing may not be measurable by current biomedical devices. However, this does not mean that these mechanisms cannot be verified, albeit with an emphasis on patients’ subjective experiences. The theoretical compatibility of TEAM and biomedicine creates sufficient legitimacy for their co-existence, and research on their sequential, rather than alternative or complementary, use in healthcare is needed.

Ethical Considerations in Human-Centered AI: Advancing Oncology Chatbots through Large Language Models.

The integration of chatbots in oncology underscores the pressing need for human-centered AI that addresses patient and family concerns with empathy and precision. Human-centered AI emphasizes ethical principles, empathy, and user-centric approaches, ensuring technology aligns with human values and needs. This review critically examines the ethical implications of employing Large Language Models (LLMs) like GPT-3 and GPT-4 in oncology chatbots. It examines how these models replicate human-like language patterns, impacting the design of ethical AI systems. The paper identifies key strategies for ethically developing oncology chatbots, focusing on potential biases arising from extensive datasets and neural networks. Specific datasets, such as those sourced from predominantly Western medical literature and patient interactions, may introduce biases by over-representing certain demographic groups. Moreover, the training methodologies of LLMs, including fine-tuning processes, can exacerbate these biases, leading to outputs that may disproportionately favor affluent or Western populations while neglecting marginalized communities. By providing examples of biased outputs in oncology chatbots, the review highlights the ethical challenges LLMs present and the need for mitigation strategies. The study emphasizes integrating human-centric values into AI to mitigate these biases, ultimately advocating for the development of oncology chatbots that are aligned with ethical principles and capable of serving diverse patient populations equitably.

Realising the potential of faecal microbiota transplant

First reported in Western medical literature in the 1950s, faecal microbiota transplant (FMT) has now come of age as a cost‐effective treatment for recurrent Clostridioides difficile infection. But what do we know about FMT, what are its uses and limitations, and where might microbiome treatments take us in the future?

Modern concepts and biomarkers of blood stasis in cardio- and cerebrovascular diseases from the perspectives of Eastern and Western medicine: a scoping review protocol.

The objective of this review is to provide a modern definition and identify potential biomarkers of blood stasis in cardio- and cerebrovascular diseases by mapping, comparing, and combining Eastern and Western concepts. Blood stasis is a pathological concept found in both Eastern and Western medical literature. In traditional East Asian medicine, blood stasis is a differential syndrome characterized by stagnant blood flow in various parts of the body. Similarly, in Western medicine, various diseases, especially cardio- and cerebrovascular diseases, are known to be accompanied by blood stasis. Numerous scientific studies on blood stasis have been conducted over the last decade, and there is a need to synthesize those results. We will use the keywords "blood stasis," "blood stagnation," "blood stagnant," and "blood congestion" in 3 electronic databases: PubMed, Cochrane CENTRAL, and Google Scholar. In addition, we will use the keywords "어혈" and "혈어" in 4 Korean electronic databases (ie, NDSL, OASIS, KISS, and DBpia). Peer-reviewed articles published from 2010 to the present that focus on blood stasis in cardio- and cerebrovascular diseases in human subjects according to the International Classification of Diseases 11 th revision categories BA00-BE2Z, 8B00-8B2Z, 8E64, and 8E65 will be included. Reviews, opinion articles, in vivo, in vitro, and in silico preclinical studies will be excluded. We will follow the frameworks by Arksey and O'Malley and Levac et al. as well as JBI guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. Two reviewers will independently search and screen titles and abstracts followed by full-text screening of eligible studies. If there are discrepancies between the 2 reviewers, a third reviewer will be consulted to make the final decision. We will use descriptive narrative, tabular, and graphical displays, and content analysis to present the results. Open Science Framework https://osf.io/gv4ym.

Aural myiasis in Ancient Rome: Celsus and the ear maggots.

Although today there is extensive scientific literature on aural myiasis, a historical study of the subject has yet to appear. This short article reports the first description of aural myiasis in the Western medical literature. Methods involved: (1) scholarship review of ear diseases within Ancient Greek and Roman medical texts (L'Année philologique); (2) linguistic analysis for text identification through the Library of Latin Texts, the Thesaurus Linguae Latinae and the Loeb Classical Library; and (3) translation of the Latin texts that described cases of aural myiasis with commentary. To our knowledge, the earliest case of aural myiasis in Latin medical literature is reported by the Roman encyclopaedist Celsus (first century CE). In his De Medicina, he describes cases of Wohlfahrtia magnifica maggot infestation of the ear and how to treat affected patients. Despite present advances in otology, we believe that much insight can still be gained from this ancient example of medical history in ear diseases. A more comparative analysis of the subject is to be considered in the future, which will provide more data from different cultures and times.

Serenoa repens (Saw palmetto) for Lower Urinary Tract Symptoms (LUTS): The Evidence for Efficacy and Safety of Lipidosterolic Extracts. Part I

Lower urinary tract symptoms (LUTS) are classically characterized as being related to storage (e.g., frequency, urgency, and nocturia) or flow (e.g., weak stream, intermittency, straining, and incomplete emptying). Conventional prescription medications such as α1-blockers and 5α-reductase inhibitors are used to treat progressive LUTS in men. Due to the adverse events associated with these prescription drugs, many patients with mild-to-moderate LUTS may decide to initiate treatment with non-prescription medications and/or dietary supplements. The lipidosterolic extract of Serenoa repens (LSESr), at a recommended daily dose of 320 mg/day, has been the focus of numerous peer-reviewed studies and review articles concerning the treatment of LUTS, from the first publication in 1983 by Boccafoschi to the most recent publication in 2021 by Russo. Although it seems improbable that the beneficial effect of LSESr reflects a placebo effect given the consistent degree of efficacy comparing various studies published in different countries over a span of almost 40 years, this has been the prevailing impression stemming from essentially three publications in the Western medical literature. In addition, despite publications reporting findings of almost identical efficacy using LUTS endpoints such as the International Prostate Symptom Score (IPSS), the quality of life score (QoL), and the peak urinary flow (Qmax) in comparing LSESr with the α-blocker tamsulosin or the 5α-reductase inhibitor finasteride, and despite the recognized acceptance of the hexane lipidosterolic extract product (Permixon®) as an herbal medicine in Europe showing value in the treatment of LUTS, the use of LSESr remains controversial in the US. Contributing to such an opposing view in the US are the wide variability in quality, composition, and dosage of Serenoa products, the commercial prevalence of dried berry powder supplements, and the lack of awareness of a standardized Serenoa phytotherapy lipidosterolic profile. Can the controversy over the efficacy of LSESr in the context of LUTS be resolved? By understanding the main literature that has led to clinical practice guidelines for Serenoa repens for LUTS in Europe and the US, and by an in-depth analysis of the totality of the clinical literature concerning dose, extraction method, and quality of the Serenoa product used, it should be possible to answer this question. Given the extent of this global analysis, this report is presented in three sections. Part I introduces LUTS. What are the demographics of LUTS? What symptoms are assessed by LUTS, and how do we quantify LUTS? Why would a non-prescription item be a valuable consideration in LUTS treatment versus other treatment options? What is basic information about Serenoa repens, and what defines a standardized LSESr product? What are the published trials that have affected the acceptability of Serenoa repens in the treatment of LUTS? Finally, a major portion of Part I discusses the four major reviews of Serenoa repens versus LUTS that have influenced how it is accepted in the USA, in Europe, and in other parts of the world. Part I, therefore, lays the groundwork and is foundational for the important findings relating to LUTS and Serenoa repens that will be presented as Parts II and III in subsequent review articles.

Irritable bowel syndrome in China: a review on the epidemiology, diagnosis, and management.

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disease worldwide. Current guidelines of IBS are mostly based on the western populations and expected to vary in different communities. China has a large population and a vast literature is available on IBS. Due to linguistic variations in the literature, the studies are not widely known and their conclusions thus remain largely obscured to the western medical literature. In this article, we reviewed the published literatures on the investigations of IBS epidemiology, diagnosis, and management in the Chinese population and emphasized the different findings gleaned from the western publications. The detailed literature review will benefit understanding of and promote future study on IBS.

Salernitan Medical School or Langobardic Medical School?

Already famous since the high Middle Ages, the Salernitan Medical School reached its whole scientific role between the 11th and 12th century, declining later due to the rising of modern universities. Information on the earliest period of the School is very poor but, starting from the 10th century, we know that Salernitan physicians were widely recognized as researchers and healers. This paper is focused on the heavy role recognized to the Langobards (first) and Normans (later) on development of the Salernitan Medical School. A special role must be recognized to Alfanus I, Gariopontus and Trotula de Ruggiero: they left memories on their enterprises and many manuscripts of great relevance for the development of Middle Ages and Renaissance Medicine. Their multicultural experience dragged the Salernitan School to become the greatest expression of medical science of its age. This role was expressed in the “Regimen Sanitatis Salernitanum” or “Flos Medicinae Salerni”, a book that resumes the highest knowledges on general hygiene, dietetics, physiotherapy, comparative anatomy and surgery. The book had a tremendous success, having more than 300 editions in many languages up to 1846. It was an essential reference for western medical literature up to Renaissance. Furthermore, Langobards took care of health laws, mainly in the Rotari edict, which included laws on medical practice and on the physicians’ role. (www.actabiomedica.it)

Eugene Raikhel. Governing Habits: Treating Alcoholism in the Post-Soviet Clinic. Ithaca, NY: Cornell University Press, 2016

Patterns of alcohol consumption and alcoholism treatment in post-Soviet countries in the critical years after the collapse of the Soviet Union have generated heightened interest in Western medical literature. During the 1990s a team of British and Russian addiction researchers conducted studies on the topic (Fleming, Meyroyan, and Klimova 1994; Fleming 1996; Fleming, Bradbeer, and Green 2001), reflected also in the present study, and the issue continues to be discussed both within and outside Russia (Zaridze et al. 2014; Penina 2018; Tuchina et al. 2018). Whereas these studies treat alcoholism mostly under the auspices of epidemiology or public health, Eugene Raikhel’s interest and research design are clearly anthropological. In this regard, his study is more in the vein of Michele Rivkin-Fish (2003, 2005, 2017), Tomas Matza (2012, 2018), or Michelle Parsons (2014). Text in English DOI: 10.25285/2078-1938-2018-10-3-127-131

An Ayurvedic herb to enhance the intellect and memory- Convolvulus pluricaulis

Shankhpushpi is an indigenous and very significant herb that considered as a gift of nature in Ayurveda. It is a natural medicine which enhances the memory power and rejuvenates the nervous functions, besides, boosts mental development of children. Convolvulus pluricaulis is a perennial, wild herb commonly found on sandy or rocky grounds under xerophytic conditions in northern India, whose every part like flower, root, stem and leaves are used as medicine. It is used alone or is administered along with modern antiepileptic drugs. Little research has been published in the western medical literature regarding this plant. The plant is reported to be a prominent memory improving drug and reduce mental tension. Article includes systematic agricultural production techniques and its medicinal qualities.

When a doctor becomes a patient, the unique expectations and behaviours in a disease: preliminary report

Descriptions and interpretations of cases in which a doctor becomes a patient are rather marginal in the Polish and Western medical literature. Still, analysis of doctors’ behaviours when they become patients themselves seems interesting. The available research results suggest that doctors find it difficult to adopt the role of a patient and very often delay the process of diagnosis and therapy. A substantial number of them treat themselves and have problems with following therapeutic advice. There are particular features which make doctors demanding or even tough when placed in the role of a patient. Doctors often select ‘partners’ in therapy among their colleagues, expect ‘individual therapy’ and ‘special’ treatment (a longer appointment, consultation after regular working hours etc.). The problem of ‘doctors in sickness’ has been addressed by professional organisations. The British General Medical Council suggests that due to potential risk for one’s patients’ and one’s own health, an ill doctor should consult his/her highly qualified colleague and follow the advice. Moreover, he/she is advised to consult a GP who is not a member of their family in order to guarantee independent and objective medical care. Similar solutions have been adopted by medical organisations from other countries.

Clinical practice guidelines of Korean medicine for facial palsy: An evidence-based approach

IntroductionFacial palsy is a common disease, and Korean medicine (KM) is widely used to treat facial palsy in Korea. However, there are no Korean multidisciplinary guidelines for facial palsy; thus, guidelines that are adequate for domestic circumstances are required. MethodsTo establish clinical practice guidelines (CPGs), professional group formation, plans for research progress and the situation regarding CPG development were analysed. Subsequently, data from the Korean and Western medical literature regarding the CPGs for facial palsy were collected and analysed. A draft of the Korean medicine CPGs for facial palsy was then developed. After review and amendment of the guidelines by a review committee, the Korean acupuncture and moxibustion medicine society reviewed and approved the guidelines. ResultsIn total, 24 recommendations were developed for the KM treatment of facial palsy. Six of the recommendations were primarily related to manual acupuncture and treatment methods. The other recommendations were related to electroacupuncture, thread embedding and other acupuncture techniques. ConclusionThe result of this project suggests a methodology to develop CPGs that is suitable for our environment of KM but that it lacks supporting evidence; in turn, this methodology will lead to the production of evidence and recommendations for patient care in actual KM clinical settings.

A tale of the two PEGylated liposomal doxorubicins.

A tale of the two PEGylated liposomal doxorubicins Hunghsueh Chou,1,4 Hao Lin,2,4 Jacqueline M Liu31Department of Obstetrics and Gynecology, Linkou Chang Gung Memorial Hospital, Linkou, Taiwan; 2Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Linkou, Taiwan; 3TTY Oncology Translational Research Center, TTY Biopharm, Taipei, Taiwan; 4Chang Gung University College of Medicine, Linkou, TaiwanWe are writing this letter in response to the article "Outcomes analysis of an alternative formulation of PEGylated liposomal doxorubicin in recurrent epithelial ovarian carcinoma during the drug shortage era" by Berger et al and published in August 2014.1 This paper is one of the earliest reports of the outcome of using Lipodox® available in the Western medical literature.View original paper by Berger et al.

Validation of the TIMI risk score in Chinese patients presenting to the emergency department with chest pain

The Thrombolysis In Myocardial Infarction (TIMI) risk score is a 7 item tool which has been validated in Western medical literature to help risk stratify chest pain patients. The aim of this study is to establish the relationship between the TIMI risk score and the rate of occurrence of Major Adverse Cardiovascular Events (MACE) within 30 days in Chinese patients presenting to the emergency department (ED) with undifferentiated chest pain. Methods Design - single center prospective observational study of adult Chinese ED patients with undifferentiated chest pain. Setting - University hospital emergency department in Hong Kong with annual census of 140000 patients. Subjects - all adult patients presenting with undifferentiated chest pain. Data, including patient characteristics, medical history and components of the TIMI risk score was collected. All patients were followed up at 30 days, either by review of electronic medical records or telephone interview. MACE was defined as death from any cause; myocardial infarction; troponin elevated acute coronary syndrome or undergoing percutaneous coronary intervention. Rates of MACE at 30 days were examined in relation to TIMI risk score. Results Follow-up at 30 days was completed for a total of 315 patients. There were a further 37 patients who did not give consent to be included in the study. Median age was 69 years and 55% of the participants were male. A MACE occurred in 57 patients (18%). Rates of MACE according to TIMI risk score were: TIMI 0, 3/37 (8%); TIMI 1, 4/79 (5%); TIMI 2, 12/77 (16%); TIMI 3, 15/67 (22%); TIMI 4 13/36 (36%); TIMI 5, 5/14 (36%); TIMI 6, 5/5 (100%); TIMI 7 0/0 (p<0.005). Conclusion Increasing TIMI risk score is strongly associated with risk of MACE in chest pain patients. The TIMI risk score is sensitive enough to identify Chinese patients at high risk of an adverse event but not specific enough to identify patients suitable for early discharge.

Chong Hai Tay and the syndrome which bears his name

Tay’s syndrome, a rare autosomal recessive disorder, characterized by icthyosiform erythroderma, trichothiodystrophy, brittle hair and nails, intellectual impairment, decreased fertility, short stature, progerialike facies and photosensitivity [1-3]. There is no specific treatment for this genetic disorder. However, some authors reported control of ichthyosis in a case of Tay’s syndrome by topical application of tazarotene [3]. This syndrome is reported first by, Dr. Tay Chong Hai in Singapore in the year 1969 [4]. Dr Tay reported it in 2 brothers and a sister, with first-cousin parents of Chinese extraction. One of the children had hypogammaglobulinemia, and one died at age 2 months of intestinal obstruction. Erythroderma was particularly striking at birth. Chong Hai Tay, was born in 1932 (Fig. 1). He is the first Singapore physician to have a disease named for him in the Western medical literature [5]. He authored more than hundred scientific articles. He wrote also poems. He established the National Arthritis Foundation in 1984, and was chairman for 14 years. He is currently in private practice and a consultant physician and rheumatologist at Mt. Elizabeth Hospital, Gleneagles Hospital, Mt. Alvernia Hospital and East Shore Hospital. Dr Tay was the first editor of The Scientific Victorian [5]. Among his many other scientific contributions, he also, reported ten patients who were presenting with acute polyarthritis and hypereosinophilia of unknown causation [6].

Delayed Presentation of the Traumatic Abdominal Wall Hernia; Dilemma in the Management – Review of Literature

Traumatic abdominal wall hernia is a rare entity, and an uncommon type of abdominal wall hernia as far as the etiology is concerned. It is caused by blunt trauma and disrupts the fascial layers, but does not disrupt the elastic skin. In this study, we report the case of a 60-year-old female, diagnosed with traumatic abdominal wall hernia with delayed presentation. In this case, herniation of the bowels was present through the defect in the left iliac region. She was surgically well-managed. During the follow-up of 1year, there was no recurrence. In the Western medical literature, only a few cases have been reported, especially with intra-abdominal injuries. Confusion still exists in the management of such a disease as to whether to treat the condition at an early or later stage.

96 Validation of the TIMI Risk Score in Chinese Patients Presenting to the Emergency Department With Chest Pain

The Thrombolysis In Myocardial Infarction (TIMI) risk score is a 7 item tool which has been validated in Western medical literature to help risk stratify chest pain patients. The aim of this study is to establish the relationship between the TIMI risk score and the rate of occurrence of Major Adverse Cardiovascular Events (MACE) within 30 days in Chinese patients presenting to the emergency department (ED) with undifferentiated chest pain. Design - single center prospective observational study of adult Chinese ED patients with undifferentiated chest pain. Setting - University hospital emergency department in Hong Kong with annual census of 140000 patients. Subjects - all adult patients presenting with undifferentiated chest pain. Data, including patient characteristics, medical history and components of the TIMI risk score was collected. All patients were followed up at 30 days, either by review of electronic medical records or telephone interview. MACE was defined as death from any cause; myocardial infarction; troponin elevated acute coronary syndrome or undergoing percutaneous coronary intervention. Rates of MACE at 30 days were examined in relation to TIMI risk score. Follow-up at 30 days was completed for a total of 315 patients. There were a further 37 patients who did not give consent to be included in the study. Median age was 69 years and 55% of the participants were male. A MACE occurred in 57 patients (18%). Rates of MACE according to TIMI risk score were: TIMI 0, 3/37 (8%); TIMI 1, 4/79 (5%); TIMI 2, 12/77 (16%); TIMI 3, 15/67 (22%); TIMI 4 13/36 (36%); TIMI 5, 5/14 (36%); TIMI 6, 5/5 (100%); TIMI 7 0/0 (p<0.005). Increasing TIMI risk score is strongly associated with risk of MACE in chest pain patients. The TIMI risk score is sensitive enough to identify Chinese patients at high risk of an adverse event but not specific enough to identify patients suitable for early discharge.

Traumatic anterior abdominal wall hernia: A report of three rare cases

Traumatic abdominal wall hernia is a rare condition that can follow any blunt trauma. Associated intra-abdominal injuries are infrequent. In this study, we are reporting three cases, diagnosed as abdominal wall hernia associated with herniation of bowel loops due to blunt trauma. In one case, injury of the herniated bowel was seen. In western medical literature, only few cases have been reported especially with intra-abdominal injuries.

Vascular risk assessment in patients with sickle cell disease

This year marks the 100th year since sickle cell disease (SCD) was first described in Western medical literature by Dr. James B. Herrick, a Chicago physician who published his observations of the irregular shape of a patient’s red blood cells in November 1910.[1][1] The myriad clinical features of

Surgical scalpel used in the treatment of “infantile hydrocephalus” by Al Zahrawi (936–1013 a.d.)

Hydrocephalus is a term derived from the Greek words “hydro” and “cephalus” meaning water and head, respectively; therefore, this condition is generally named as “water on the brain” [5]. It was first described by the ancient Greek physicians Hippocrates (5th century B.C.), the father of medicine, and Galen (130–200 A.D.) as a disease caused by an extraaxial accumulation of water rather than enlargement of the ventricles [3, 5]. For the treatment of hydrocephalic children, surgical evacuation of superficial intracranial fluid was first described by the Muslim surgeon Abu al-Qasim Khalaf ibn al-Abbas Al-Zahrawi (936–1013 A.D.), the father of surgery, known in the western medical literature as Abulcasis or Albucasis (Fig. 1) [3, 4, 6]. He lived and practiced surgery and medicine in the city of Al Zahra, the capital of Al Andalus in the 10th century [4]. He was the personal physician to Abd Al-Rahman III, the Andalusian caliph who built Medinat Al Zahrah, and to his son and successor Al hakam II [4]. Al Zahrawi was the first medical author to provide illustrations of instruments used in surgery [4]. He wrote a total of 30-volume treatise on medicine in which he recommended decompression–trepanation for the treatment of hydrocephalus between the skull and brain tissue over 1,000 years ago [2]. In his book, Al Zahrawi emphasized the importance of a good “physician and patient relationship”, took great care to ensure the safety of his patients, and win their trust irrespective of their social status [4]. Interestingly, it is important to note that he addressed his students as his