Analysis of the ethical issues in authorship of collaborative research. Observations inspired by the historical case study of Gerard L. Blaes' (Blasius) claim to sole authorship of 'Anatome medullae spinalis'.

This paper discusses the historical context of collaborative research and authorship disputes, exemplified by the complex relationship between Dutch anatomist and physician Gerard L. Blaes and his East-Central European mentee, Daniel Gödtke, during the study of medulla spinalis. The study employs historical analysis to unravel the dynamics of scholarly collaboration, emphasizing the significance of mentorship in scientific progress and the communal nature of knowledge exchange. This historical analysis is based on primary sources and historical records. It underscores Blaes's strategy to circumvent public confrontations regarding the authorship of the seminal work 'Anatome medullae spinalis, et nervorum inde provenientium' (1666). As a teacher, he facilitated his student's participation in a public disputation to avert public authorship conflicts over the book. This ultimately led to the publication of two distinct versions of 'Anatome medullae spinalis.' The first one was co-authored by the mentor and his mentee, while the latter was solely attributed to the mentor. This historical narrative raises essential questions about attributing individual contributions in medical sciences, echoing concerns still pertinent in contemporary academia. Additionally, it makes visible the power dynamics inherent in faculty-students relationships and the potential repercussions of authorship disputes on scholars' reputations. By drawing parallels between historical and modern authorship dilemmas, this study contributes to ongoing discussions on equitable authorship in scientific research and publishing. It not only highlights a historical precedent for the complex dynamics of mentor-mentee collaborations and authorship disputes but also illuminates how these practices continue to influence contemporary academic and publishing customs.

Clinical Effects of Pulmonary Rehabilitation in Very Old Patients with COPD.

BACKGROUND: Pulmonary rehabilitation (PR) improves physical and mental performance as well as quality of life in patients with chronic obstructive pulmonary disease (COPD). However, data on outcomes in very old patients are insufficient. We analyzed whether the elderly with COPD benefit in a similar way to younger patients from participation in an inpatient PR according to the assessments usually collected. METHODS: Data from 3173 patients with COPD were retrospectively analyzed. Patients were referred to PR at the Zurich RehaZentren, Switzerland, between January 2013 and December 2019. PR was performed 6 days per week with an average duration of 18.85 days. Functional Independence Measurement (FIM), Feeling Thermometer (FT), and 6-Minute Walk Test (6MWT) were recorded on admission and discharge. RESULTS: In all age groups, the 6MWT and FT improved significantly. FIM results also showed a significant increase. The results of the different age groups showed no significant differences in percentage improvements according to the assessments that were considered. CONCLUSIONS: All patient groups with COPD, even the oldest (>85 years), benefited from PR regardless of their age and according to the assessments. Prospective studies are needed to support this hypothesis.

The real Theriac - panacea, poisonous drug or quackery?

ETHNOPHARMACOLOGICAL RELEVANCE: Theriac is considered the most popular cure-all multi-ingredient medicine and has been used for more than two millennia. It has also been used as one of the most important anti-epidemic drugs up to the 19th c., treated as an emergency medicine in case of e.g. bubonic plague. AIM OF THE STUDY: Until now, no reliable information regarding the pharmacological effect of the treacle was available, including its possible toxic or narcotic properties. In order to change the state of knowledge in this matter we have selected the Theriac recipe that had been actually used for producing the treacle in 1630, which was confirmed by the official municipal documents of the time. METHODS: The recipe was written in Latin, with the use of pre-Linnean nomenclature and then apothecary common names, which required translation into the modern scientific language in order to get reliable pharmacological conclusions. The information from historical sources has been compiled with the pharmacological data concerning the most potent compounds, which for the first time made it possible to calculate the amounts of active compounds in the doses taken by then patients. RESULTS: Only two species included in Theriac can be harmful in humans: poppy and sea squill, but in both cases the calculated quantity of morphine and cardiac glycosides, respectively, were below toxic level. There are no indications, both from the historical and pharmacological point of view, for Theriac being toxic or narcotic in patients, when used as prescribed. CONCLUSIONS: As for now, the most probable is that the treacle owed its postulated efficacy in the main indications to the placebo effect. Still, the results should be further confirmed by reconstructing the actual Theriac and subjecting it to modern tests and analyses.

Predictive Value of Cough Frequency in Addition to Aspiration Risk for Increased Risk of Pneumonia in Dysphagic Stroke Survivors: A Clinical Pilot Study.

BACKGROUND: Post-stroke dysphagia leads to increased risk of aspiration and subsequent higher risk of pneumonia. It is important to not only diagnose post-stroke dysphagia early but also to evaluate the protective mechanism that counteracts aspiration, i.e., primarily cough. The aim of this study was to investigate the predictive value of cough frequency in addition to aspiration risk for pneumonia outcome. METHODS: This was a single-center prospective observational study. Patients with first-ever strokes underwent clinical swallowing evaluation, fibreoptic endoscopic evaluation of swallowing (FEES), and overnight cough recording using LEOSound® (Löwenstein Medical GmbH & Co. KG, Bad Ems, Germany ). Penetration-Aspiration Scale (PAS) ratings and cough frequency measurements were correlated with incidence of pneumonia at discharge. RESULTS: 11 women (37%) and 19 men (63%), mean age 70.3 years (SD ± 10.6), with ischemic stroke and dysphagia were enrolled. Correlation analysis showed statistically significant relationships between pneumonia and PAS (r = 0.521; p < 0.05), hourly cough frequency (r = 0,441; p < 0.05), and categories of cough severity (r = 0.428 p < 0.05), respectively. Logistic regression showed significant predictive effects of PAS (b = 0.687; p = 0.014) and cough frequency (b = 0.239; p = 0.041) for pneumonia outcome. CONCLUSION: Cough frequency in addition to aspiration risk was an independent predictor of pneumonia in dysphagic stroke survivors.

Reassessment of Poststroke Dysphagia in Rehabilitation Facility Results in Reduction in Diet Restrictions.

BACKGROUND: Dysphagia assessment in postacute stroke patients can decrease the incidence of complications like malnutrition, dehydration, and aspiration pneumonia. It also helps to avoid unnecessary diet restrictions. The aim of this study is to verify if regular reassessment of dysphagia would change the diet management of postacute stroke patients in rehabilitation settings. METHODS: This single-center retrospective study included 63 patients referred to an inpatient neurological rehabilitation center between 2018-2019. A standardized clinical swallowing evaluation and Fiberoptic Endoscopic Evaluation of Swallowing (FEES) were performed. Diet level according to Functional Oral Intake Scale (FOIS) was evaluated. As the primary endpoint, the FOIS values based on diagnostic procedures were assessed at hospital discharge, rehabilitation admission, and after FEES. RESULTS: 19 women (30%) and 44 men (70%), with a mean age of 75 y (SD ± 10.08), were enrolled. The intergroup ANOVA revealed significant differences (p < 0.001) between dietary prescriptions in an acute care setting and following clinical and endoscopic reassessment in the rehabilitation center. Diet recommendations changed in 41 of 63 (65%) enrolled patients (p < 0.001). CONCLUSION: Instrumental diagnostic by FEES during the early convalescence period of stroke patients leads to clinically relevant changes to diet restrictions and lower rates of pneumonia. Our findings underline the need for regular and qualitative dysphagia diagnostics in stroke patients participating in neurological rehabilitation.

Natalia Zylberlast-Zand (1883-1942).

The paper presents the life and career of a prominent Polish-Jewish neurologist Natalia Zylberlast-Zand (1883-1942) who perished in the Holocaust. In the inter-war period, she was a prolific author in the area of neurological research and one of the founders of the Association of Polish Female Physicians.

Under the British Roof: The British Contribution to the Development of Hospice and Palliative Care in Poland.

The article focuses on British contribution to the development of palliative and hospice care in Poland in the 1980s and beyond. It is based on archival research in the hospices in Cracow and Poznan and broad-scoped Polish journals' review. The social background of the hospice movement in Poland is described. We explore the role of inspiration and help of Dame Cicely Saunders and other British leaders in the transfer of British hospice philosophy and practice of palliative care to the medical community in Poland. This study demonstrates the importance of institutions for the formal exchange of medical information.

'How well, not how much': The life and career of Maksymilian Rutkowski (1867-1947).

Maksymilian Rutkowski (1867-1947) was a distinguished graduate of the Jagiellonian University and a pioneer in the early days of surgery in interwar Poland. He was a long-standing leader in both clinical and academic surgery. In addition, he played an important role in the founding of the School for Nurses and Healthcare Workers in Cracow supported by the Rockefeller Foundation. Among his best known surgical techniques, one may list the novel procedure of bladder exstrophy, new techniques of gastroenterostomy and plastic restoration of the oesophagus. Although Rutkowski's reputation as a medical figure is well established within Polish medical history, his achievements are hardly recognized by international scholars. Thus, in the absence of adequate historical information on this eminent surgeon, we have researched the main facts about his life and seminal contribution to Polish and international surgery.