Saccomanni ‘S Test

Saccomanni Bernardino — 2025-12-15

Background
A prospective study was established to assess the sensitivity and specificity of the new Saccomanni (SAC) test for isolated AC pathology, and compare with 4 commonly used clinical tests.

Materials and methods
The Saccomanni (Sac) test is essentially the cross-adduction test, with the addition of attempted elevation against resistance. In a positive test, this results in some pain and the inability of the patient to maintain the arm in the adducted and elevated position against resistance. Fifty-eight patients with isolated AC joint symptoms were assessed in random order with the Saccomanni test and 4 other tests. A corticosteroid and local anaesthetic injection was administered into the AC joint space. The Saccomanni test and 4 other tests were then repeated following the injection. After the injection, a symptom free clinical examination was used as a measure of true positive tests.

Study design
Case series.

Results
The SAC test showed a sensitivity of 98% and specificity is 91.7%. All 4 other tests were less sensitive.

Conclusion
The SAC test is a highly sensitive test in patients presenting with isolated AC related symptoms.

This study is an innovation for clinical tests in the world. The primary aim of this study was to assess the diagnostic sensitivity of my newly described SAC test. From the present study, it can be concluded that the easy-to use SAC is a highly sensitive test to evaluate AC joint pathology, when compared to other standard tests.

Clinical relevance
Level III, Diagnostic Study of Nonconsecutive Patients.

Neurochemistry or Sacred Transformation? A Critical Review of Anna Lembke's Dopamine Nation Through the Lens of Integrative Healing and Spiritual Recovery

Julian Ungar-Sargon — 2025-12-25

Anna Lembke's Dopamine Nation: Finding Balance in the Age of Indulgence (2021) has become a landmark text in contemporary addiction discourse, offering a neurobiological framework centered on dopamine regulation, the pleasure-pain balance, and behavioral strategies for restoration of homeostasis. While Lembke's work provides valuable insights into the neuroscience of compulsive consumption, this critical review argues that her fundamentally reductionist approach—locating addiction primarily in neurochemical imbalance—overlooks essential dimensions of human suffering and healing. Drawing upon my published work on the integration of 12-Step recovery models with classical medicine, the theological dimensions of addiction treatment, and the concept of the transformable 'animal soul' (nefesh habehamit), this essay offers a comparative analysis that illuminates both the strengths and limitations of Dopamine Nation. I propose that authentic healing from addiction requires not merely neurochemical rebalancing but profound ontological transformation—a movement from fragmentation to wholeness that engages spiritual, relational, and meaning-making dimensions of human existence. The analysis demonstrates how Lembke's pleasure-pain seesaw metaphor, while pedagogically useful, ultimately fails to capture the deeper existential and theological dimensions of addictive suffering and recovery. By integrating Kabbalistic concepts of tzimtzum, Hasidic psychology of the dual souls, and contemporary embodied cognition research, this review proposes a more comprehensive framework that honors both neurobiological realities and the irreducible mystery of human transformation.

American Journal of Medical and Clinical Research & Reviews

Saccomanni ‘S Test

Neurochemistry or Sacred Transformation? A Critical Review of Anna Lembke's Dopamine Nation Through the Lens of Integrative Healing and Spiritual Recovery