bluuebunny/crossref_metadata_2025 huggingface dataset:
Atopic dermatitis may be a genetically determined dysmaturation of ectodermal tissue, resulting in disturbed T-lymphocyte maturation. A hypothesis.
Authors: Thestrup-Pedersen K , Ellingsen AR , Olesen AB , Lund M , Kaltoft K.
Published: June 2023

Although atopic dermatitis is a skin disorder, it includes immune deviations such as T-cell accumulation and activation in the skin, resulting in chronic, relapsing eczema. The T-lymphocyte activation in the skin is not accompanied by specific allergies in up to two thirds of the patients. It has been shown that T-cell lines and clones can be established from skin biopsies of patients with atopic dermatitis showing cytokine-dependent, but antigen-independent, continuous growth in vitro. This indicates the existence of skin-homing T-lymphocytes with growth requirements different from those of mature T-lymphocytes in the blood. We suggest that atopic dermatitis is a genetically determined change of ectodermal tissue. The thymic epithelium is derived from the ectoderm, and because of that we hypothesize that the maturation of the T-cell immune system of persons who develop atopic dermatitis is disturbed due to a faulty selection of T-lymphocytes in the thymus. "Dys"-matured T-cells leave the thymus as a consequence of faulty selection and continue their growth in the skin. The cells are eventually eradicated by the immune surveillance conducted by the normal part of the patients' immune system and as a consequence of diminished output of faulty selected T-lymphocytes during maturation. Because of the increased proliferation capacity of the aberrant T-cells, a cytokine imbalance occurs and in some patients this leads to the development of type I allergies due to a skewing of the humoral immune system towards IgE production.
Prevalence of infantile and early childhood eczema in a Japanese population: comparison with the disease frequency examined 20 years ago.
Authors: Sugiura H , Uchiyama M , Omoto M , Sasaki K , Uehara M.
Published: June 2023

To investigate the prevalence of infantile and early childhood eczema in a Japanese population, we clinically inspected the entire bodies of 4-month-old infants (341 cases), 10-month-old infants (339 cases) and 3-year-old children (341 cases). The examination was performed in spring, when exacerbations of infantile and childhood eczema most frequently occur in Japan. Eczema was observed in 30-31% of the infants, and in 20% of the 3-year-old children. The prevalence was almost the same as in similar age groups that we examined 20 years ago.
Acquired unilateral nevoid telangiectasia syndrome.
Authors: Taşkapan O , Harmanyeri Y , Sener O , Aksu A.
Published: June 2023

We describe a man with acquired unilateral nevoid telangiectasia syndrome, in whom no underlying disease, alcohol abuse or physiological conditions causing hormonal changes are demonstrable. To our knowledge, this is the first case of acquired unilateral nevoid telangiectasia syndrome seen in a healthy adult male and not associated with a hyperestrogenaemic state and estrogen receptor abnormality. This case report casts doubt on the commonly held view that unilateral nevoid telangiectasia syndrome is an estrogen-sensitive nevoid anomaly.
Metaplastic bone formation in the subcutaneous nodule of a patient with mixed connective tissue disease.
Authors: Nakagawa S , Tagami H.
Published: June 2023

Cutaneous ossification is a rare phenomenon in collagen diseases, despite the rather frequent occurrence in these diseases of dystrophic calcinosis. We observed metaplastic woven bone formation associated with calcification in biopsy material obtained from a 49-year-old woman suffering from mixed connective tissue disease together with multiple subcutaneous indurations. This is the first case of the presence of metaplastic bone formation in a patient with mixed connective tissue disease.
Comparative nuclear morphometric analysis of aggressive and non-aggressive squamous cell carcinomas of the skin.
Authors: Narvaez D , Kanitakis J , Euvrard S , Schmitt D , Faure M , Claudy A.
Published: June 2023

Squamous cell carcinomas (SCC) are the most frequent tumours complicating organ transplantation. Whereas most SCC can be successfully treated with conventional surgery, other lesions show an aggressive course with recurrence and metastases. We assessed the value of nuclear morphometry in detecting tumours with an ab initio potential for aggressive course. Nuclear perimeter, area, feret X and feret Y were calculated semi-automatically on an image analyzer on histological sections of 15 non-aggressive, 15 aggressive and 6 recurrent SCC developed in seven organ graft recipients. We found statistically significant differences for all the parameters studied between recurrent and initially aggressive SCC, and, to a lesser extent, between non-aggressive and aggressive SCC. These results suggest that some SCC have ab initio a potential for more aggressive evolution
Light and electron microscopic findings in human epidermis reconstructed in vitro upon topical application of liposomal tretinoin.
Authors: Schaller M , Steinle R , Korting HC.
Published: June 2023

The topical application of tretinoin is a well-established approach to the treatment of acne vulgaris. However, induced inflammation, clinically addressed as a "flare-up", is a major drawback. Recently, clinical and experimental investigations have hinted at a better tolerability, with equal efficacy, if the active compound is liposomally encapsulated. Using epidermis reconstructed in vitro, we compared the morphological changes upon topical application of a liposomal form (0.05% and 0.025%) and conventional form (0.05%) light and electron microscopically. After 24 h several remarkable changes of the stratum corneum with all treatment modalities, representing inhibition of keratinisation wanted in acne vulgaris, were seen. When preparations of equal strength, i.e. 0.05%, were compared, the changes representing toxic dermatitis in the epidermis were more marked with the conventional form. Epidermis reconstructed in vitro treated with the liposomal forms showed no significant differences due to either concentration. It is suggested that these changes correspond to the flare-up on clinical grounds. The in vitro findings further corroborate the hypothesis that liposomal encapsulation can increase the benefit/risk ratio of an active compound applied to the skin.
Effect of ketoconazole 2% shampoo on scalp sebum level in patients with seborrhoeic dermatitis.
Authors: Dobrev H , Zissova L.
Published: June 2023

Twenty patients with scalp seborrhoeic dermatitis were treated twice weekly with ketoconazole 2% shampoo for 4 weeks. Clinical assessment, culture for P. ovale on Dixon broth and lipid measurement at two places were made before treatment and after 2 and 4 weeks. Significant improvement of the severity of seborrhoeic dermatitis (p < 0.001) and negative mycological tests by 19 (95%) of patients were observed. The scalp lipid content remained unaltered in 11 patients with an initial lipid value over 220 micrograms/cm2 but increased in those with lower initial values. This is probably due to the improvement of sebum delivery onto skin surface as a result of the elimination of the follicular occlusion.
Sebum and water content in the skin of aged immobilized patients.
Authors: Aisen E , Shafran A , Gilhar A.
Published: June 2023

In the present study we investigated the sebum content and hydration of the skin in aged immobilized patients. Healthy aged as well as young and aged immobilized patients were evaluated by photometry, using a sebum tester and capacitance meter to detect sebum and hydration, respectively, in various skin areas. Sebum content was significantly higher in the young groups as compared to the aged ones, including those of the immobilized patients. Similar values of water content were observed in the healthy young and aged volunteers. However, surprisingly, a significantly marked decrease was detected in each tested area of the immobilized patients. We may assume that a cascade of events caused by the immobilization status of the patients leads to a significant decrease in water content within the dermis.
Linear steatocystoma multiplex.
Authors: D'Souza P , Joshi A , Gujral S , Ramam M.
Published: June 2023

No abstract available.
Spontaneous photo-onycholysis in a West Indian with type V skin.
Authors: Baran R , Jeanmougin M , Cesarini JP.
Published: June 2023

No abstract available.
Successful interferon treatment for lichen planus associated with chronic active hepatitis due to hepatitis C virus infection.
Authors: Lapidoth M , Arber N , Ben-Amitai D , Hagler J.
Published: June 2023

No abstract available.
Detection of streptococcal class I M protein in psoriasis by confocal immunofluorescent microscopy.
Authors: Talanin NY , Shelley WB , Raeder R , Shelley ED , Boyle MD.
Published: June 2023

Epidemiological evidence implicates Streptococcus pyogenes (group A) infection as a common triggering stimulus for psoriasis. Unequivocal demonstration of streptococcal antigens in psoriatic skin has been difficult due to cross-reactive antigens in both normal human tissue and group A streptococci, which complicate immunohistological analysis. In this study cryostat sections of involved psoriatic skin were stained with monoclonal antibody 111-15504 to group A streptococci. The epitope recognized by this antibody was found to be specific for group A streptococci and is associated with class I M protein. Streptococcal antigens were found in the dermal papillae and epidermis of psoriatic skin lesions of 20 out 38 patients. These findings indicate that specific S. pyogenes antigen, associated with class I M protein, is often present in psoriatic lesions. Such an antigen, originating from focal infection elsewhere could be responsible for T-lymphocyte inflammatory responses triggering the development of psoriatic lesions.
T-cell receptor V beta expression is restricted in dermatitis herpetiformis skin.
Authors: Garioch JJ , Baker BS , Leonard JN , Fry L.
Published: June 2023

An infiltrate of T-cells is found in lesional dermatitis herpetiformis skin, but the role of these cells in the pathogenesis of the skin lesions is unknown. The purpose of this study was to examine T-cell receptor V beta expression in skin biopsies taken from patients with dermatitis herpetiformis. Expression of eleven T-cell receptor V beta families in biopsies obtained from 10 patients was examined by immunoperoxidase staining and compared simultaneously with peripheral blood lymphocytes. Over-representation of V beta 2 (p < 0.02), V beta 5.2/5.3 (p < 0.01) and V beta 5.3 (p < 0.05) was found in lesional dermatitis herpetiformis skin compared with peripheral blood lymphocytes. These results suggest that recognition of an antigen(s) or superantigen is involved in the pathogenesis of dermatitis herpetiformis skin lesions.
A randomized double-blind comparison of the effects on systemic calcium homeostasis of topical calcitriol (3 micrograms/g) and calcipotriol (50 micrograms/g) in the treatment of chronic plaque psoriasis vulgaris.
Authors: Bourke JF , Iqbal SJ , Hutchinson PE.
Published: June 2023

Calcitriol and calcipotriol are effective treatments for psoriasis, although the two have never been directly compared. We compared the efficacy and toxicity of each agent in 24 patients with moderately extensive chronic plaque psoriasis, who were randomized in double-blind fashion to apply 90 g per week of either calcitriol (3 micrograms/g) ointment or calcipotriol (50 micrograms/g) ointment over an 8-week period. Mean PASI in patients applying calcitriol fell from 13 to 8.8 (p < 0.05) and in patients applying calcipotriol from 14.9 to 4.7 (p < 0.005). The reduction was significantly greater in the calcipotriol-treated group (p < 0.05). There was a small increase in serum ionized calcium in the calcipotriol-treated group (from 1.21 mmol/L to 1.25 mmol/L, p < 0.05) but no effect on calcium homeostasis in the calcitriol group.
Alopecia syphilitica in a prepubertal girl.
Authors: Taniguchi S , Ishii M.
Published: June 2023

No abstract available
Cutaneous adverse reaction to ciprofloxacin: demonstration of specific lymphocyte proliferation and cross-reactivity to ofloxacin in vitro.
Authors: Rönnau AC , Sachs B , Von Schmiedeberg , Hunzelmann N , Ruzicka T , Gleichmann E , Schuppe HC.
Published: June 2023

Ciprofloxacin (CPFX) is a widely used fluoroquinolone antibiotic, inducing cutaneous adverse drug reactions in about 1 to 2% of the treated patients. Conclusive diagnosis of drug allergy, however, still remains a major problem in daily clinical practice. Here, we present 2 patients with drug allergy to CPFX. In both cases the clinical suspicion for CPFX as the causative agent was confirmed in vitro by means of the lymphocyte transformation test, whereas epicutaneous patch tests remained negative. In vivo, a small percentage of the drug is biotransformed to the three major metabolites desethylene-, sulfo- and oxociprofloxacin. Though structurally closely related to their mother compound, these metabolites failed to induce in vitro lymphocyte proliferation in both patients. On the other hand, in vitro crossreactivity to ofloxacin, another fluorinated quinolone, could be demonstrated, which to our knowledge has not previously been reported.
Refractory ulcerative lupus vulgaris associated with CD4 lymphocytopenia, inversion of chromosome 14, primary amenorrhoea and mental retardation.
Authors: Ozarmagan G , Ozgüroglu EZ , Maden MU , Oztürk S.
Published: June 2023

A case of ulcerative lupus vulgaris, confirmed by polymerase chain reaction (PCR) is reported. The initial lesion of our case was a papule on the nose, which progressed during antituberculous treatment and caused cartilage destruction and ectropion. Immunological analysis revealed CD4 lymphocytopenia, and the possibility of idiopathic CD4 lymphocyte deficiency was considered. In addition, the patient had primary amenorrhoea, mental retardation and inversion of chromosome 14. CD4 lymphocytopenia and chromosomal abnormality are the possible causes of antituberculous treatment failure.
Low-frequency ultrasound treatment of chronic venous leg ulcers in an outpatient therapy.
Authors: Peschen M , Weichenthal M , Schöpf E , Vanscheidt W.
Published: June 2023

Low-dose ultrasound seems to be an effective method to enhance wound healing, particularly in chronic venous leg ulcers. The aim of our investigation was to examine the effect of 30 kHz low-dose ultrasound in local treatment of chronic venous leg ulcers, when added to conventional therapy of outpatients. Twenty-four patients with chronic ulcerations of the leg due to chronic venous insufficiency were randomised in placebo-controlled parallel groups in a single-blind clinical study. Patients were randomised to conventional therapy with topical application of hydrocolloid dressings and compression therapy or conventional therapy with additional ultrasound treatment for 12 weeks. The ultrasound treatment consisted of 10 min of footbathing, with application of 30 kHz continuous ultrasound 100 mW/cm2 three times a week. The ulcer area was measured by planimetry, using a millimeter grid before treatment and after 2, 4, 6, 8, 10 and 12 weeks of therapy. The ulcer radius and the daily ulcer radius reduction were calculated. Colour photographs of the ulcers were taken under standard conditions at the same time. After each treatment local findings and side effects were recorded. After 12 weeks of treatment the control group showed a mean decrease of 16.5% in the ulcerated area. In contrast the mean ulcerated area decreased by 55.4% in the ultrasound group (p
Urticaria-like follicular mucinosis in a young female patient.
Authors: Tupker RA , Van der Meer JB , Groote AD , Hartman A , Elema JD , De Jong MC , Starink TM.
Published: June 2023

No Abstract available
Localized crusted scabies in a patient with acquired immunodeficiency syndrome.
Authors: Porras-Luque JI , Valks R , Daudén E , Fernández-Herrera J.
Published: June 2023

No abstract available
Kawasaki syndrome or atypical measles mimicking Kawasaki syndrome?
Authors: Martin L , Goudeau A , Lanotte P , Besnier JM , Lorette G , Vaillant L.
Published: June 2023

No abstract available
Ultraviolet light exposure, pigmentary traits and the development of melanocytic naevi and cutaneous melanoma. A case-control study of the German Central Malignant Melanoma Registry.
Authors: Breitbart M , Garbe C , Büttner P , Weiss J , Soyer HP , Stocker U , Krüger S , Breitbart EW , Weckbecker J , Panizzon R , Bahmer F , Tilgen W , Guggenmoos-Holzmann I , Orfanos CE.
Published: June 2023

The present study firstly aimed at understanding the relationship between sun exposure, pigmentary traits and the history of sunburns. Secondly, the significance of UV-exposure for cutaneous melanoma and for melanocytic naevi was investigated. The case-controlled study comprised 513 patients with primary cutaneous melanoma and 498 controls matched by age and gender. Multivariate logistic regression analysis was used to study melanoma risk factors. The number of common melanocytic naevi was associated with age, gender, the history of sunburns and UV-exposure during holidays (odds-ratio = 1.9
The applicability of clinical scoring systems: SCORAD and PASI in psoriasis and atopic dermatitis.
Authors: Jemec GB , Wulf HC.
Published: June 2023

The lack of standard systems for assessment of disease severity poses a problem for the introduction of rational quality control in dermatology. The scoring systems often involve assessment of the same aspects of disease, and it may therefore be conceivable that one system could potentially be applied to routine clinical work and form the basis of disease quantification in dermatology. This study was undertaken to compare PASI (Psoriasis Area and Severity Index) and SCORAD (SCOring index of Atopic Dermatitis) scoring systems, to assess disease severity in patients with atopic dermatitis and psoriasis. Patients with psoriasis (14) and atopic dermatitis (14) were scored with both systems, and correlation coefficients and multiple regression coefficients were calculated. A significant correlation between SCORAD and PASI was found (rs = 0.66). Correlation coefficients were highest (rs = 0.87) when only atopic patients were studied, and lowest (rs = 0.57) when only psoriatic patients were studied. Assessments of area and erythema are suggested as candidates for a generalised scoring systems for dermatological disease. The results suggest that in spite of the overlap between the two score systems, significant diagnosis-specific differences exist, and neither PASI nor SCORAD is an optimal general dermatological scoring system for disease severity. Additional methodological developments are necessary.
Follicular lymphomatoid papulosis and multiple myeloma.
Authors: Rongioletti F , Basso GI , Sementa A , Gambini C , Rebora A.
Published: June 2023

No Abstract available
Plaque-type blue nevus. Review and an unusual Case.
Authors: Wen SY.
Published: June 2023

A 31-year-old male presented with a 13-15-mm blue-black plaque tumor on his left forearm, which had existed since birth. Histological examination showed a common blue nevus. Its small size and its location are unusual. A review of plaque-type blue nevus is given.
Low doses of low molecular weight heparin in vivo do not inhibit delayed-type hypersensitivity.
Authors: Zachariae CO , Larsen CG , Thomsen PD , Nowak J , Zachariae R , Menné T.
Published: June 2023

No Abstract available
Comparison of the influence of cyclosporine and topical betamethasone-17,21-dipropionate treatment on quality of life in chronic hand eczema.
Authors: Granlund H , Erkko P , Reitamo S.
Published: June 2023

In a randomized, controlled parallel group study we have shown that cyclosporine at 3 mg/kg/day is as effective as topical betamethasone-17,21-dipropionate in the treatment of chronic hand eczema. In this study we compared the influence of these therapies on the quality of life. Forty-one patients were treated with either treatment for 6 weeks, after which patients with failure were switched to the other treatment for another 6 weeks. Quality of life was assessed with the Eczema Disability Index (EDI) at baseline and at the end of both treatment periods. The total EDI score decreased significantly and to the same degree in both groups, i.e. from the mean value of 30.5 to 20.9 in the cyclosporine group and from 27.2 to 18.9 in the betamethasone-17,21-dipropionate group. Irrespective of the dimension of the EDI (daily activity, school/work, personal relationship, leisure, treatment), the difference between the treatment groups at the end of the first treatment period was not significant. In the second part of the study a slight further decrease in total score was observed, but without any difference between the groups. There was a significant correlation between changes in the total EDI score and changes in all the clinical assessments, i.e. disease activity, extent of the disease, itch, sleep disturbances and use of emollients. Though the significant correlation between the total EDI and clinical assessments makes quality of life assessments in hand eczema questionable, the missing correlation between some clinical assessments and dimensions of the EDI suggests that EDI views aspects of the disease not covered by clinical measures.
Asymmetric periflexural exanthem in an adult.
Authors: Corazza M , Virgili A.
Published: June 2023

No Abstract available
Focus on Caustic Acid Substances and Bone Tissue: What Forensic Anthropologists and Pathologists Should Pay Attention To
Authors: Tambuzzi Stefano
Published: June 2023

The interaction between caustic acid substances and a human body is typically observed in forensics as a means of concealment and destruction. In this regard, the literature is sparse, and the few studies that have been conducted have been primarily on animal bones. However, since it has been shown that the complete dissolution of a body in acid is more of a theoretical occurrence than a real one, we sought to focus on this particular aspect and to gather the latest findings from the literature. It has been shown that traces of human teeth and bones can still be effectively detected even after immersion in acidic substances through Scanning Electron Microscopy with Energy-Dispersive X-ray (SEM/EDX) analysis. Furthermore, compact bone has been identified as the best substrate for investigating the human nature of acid-immersed bone remains. Thus, it is necessary for forensic anthropologists (and, of course, pathologists) to be aware of the critical issues involved in approaching a body immersed in acid, as well as the analyses that can be performed to uncover the clues that may lie in microscopic traces that can be easily overlooked.
COVID-19 Vaccine Development: The Need, the Fast-track, and the Concerns
Authors: V Nikhra
Published: June 2023

The Nemesis-SARS-CoV-2 Pandemic: Leaving in its wake millions of infections, accompanied by an immense magnitude of morbidity and multitude of mortality, and an unfathomable economic toll, the COVID-19 pandemic has led to a global impact. A vaccine is urgently needed to prevent the disease, thwart the complications and avert deaths resulting from transmission of the infection. The Hubris-Vaccine Development: While most of the platforms of vaccine candidates have focused on the spike (S) protein and its variants as the primary antigen of COVID 19 infection, various techniques involved include nucleic acid technologies (RNA and DNA), non-replicating viral vectors, peptides, recombinant proteins, live attenuated viruses, and inactivated viruses. There are novel vaccine technologies being developed for COVID 19 using next-generation strategies for precision and flexibility for antigen manipulation on SARS-CoV-2 infection mechanisms. The Elpis-Updates and Prospects: There were nine different technology platforms under research and development to create an effective vaccine against COVID 19. Although there are no licensed vaccines against COVID-19 yet, there are various potential vaccine candidates under development and advanced clinical trials. Out of them, few having undergone phase III clinical trials, may soon be available for use among the high-risk groups following emergency use authorization. Conclusion-Hopes and Concerns: The hope of benefiting from the vaccine to the extent that it may be the only way to tide over and control the COVID-19 pandemic is accompanied by the likely fear of adverse effects and opposition in public for COVID-19 vaccination, including the vaccine hesitancy. Further, there is concern among scientific circles that vaccine may have opposite of the desired effect by causing antibody-dependent disease enhancement.
Relating the SARS-CoV-2 Spike Protein to Infectivity, Pathogenicity, and Immunogenicity in COVID-19
Authors: V Nikhra
Published: June 2023

Introduction: SARS-CoV-2 Life Cycle: The disease which reportedly began in Chinese city Wuhan in November-December 2019 manifesting as severe respiratory illness, soon spread to various parts of the world, and was named COVID-19, and declared a pandemic by WHO. The life cycle of SARS-CoV-2 begins with membrane fusion mediated by Spike (S) protein binding to the ACE2 receptors. Following viral entry and release of genome into the host cell cytoplasm there occurs replication and transcription to generate viral structural and non-structural proteins. Finally, VLPs are produced and the mature virions are released from the host cell. Immunogenicity of the Spike Protein: The S protein is considered the main antigenic component among structural proteins of SARS-CoV-2 and responsible for inducing the host immune response. The neutralising antibodies (nAbs) targeting the S protein are produced and may confer a protective immunity against the viral infection. Further, the role of the S protein in infectivity also makes it an important tool for diagnostic antigen-based testing and vaccine development. The S-specific antibodies, memory B and circulating TFH cells are consistently elicited following SARS-CoV-2 infection, and COVID-19 vaccine shots in clinical trials. The Emerging SARS-CoV-2 Variants: The early genomic variations in SARS-CoV-2 have gone almost unnoticed having lacked an impact on disease transmission or its clinical course. Some of the recently discovered mutations, however, have impact on transmissibility, infectivity, or immune response. One such mutation is the D614G variant, which has increased in prevalence to currently become the dominant variant world-over. Another, relatively new variant, named VUI-202012/01 or B.1.1.7 has acquired 17 genomic alterations and carries the risk of enhanced infectivity. Further, its potential impact on vaccine efficacy is a worrisome issue. Conclusion: The Unmet Challenges: COVID-19 as a disease and SARS-CoV-2 as its causative organism, continue to remain an enigma. While we continue to explore the agent factors, disease transmission dynamics, pathogenesis and clinical spectrum of the disease, and therapeutic modalities, the grievous nature of the disease has led to emergency authorizations for COVID-19 vaccines in various countries. Further, the virus may continue to persist and afflict for years to come, as future course of the disease is linked to certain unknown factors like effects of seasonality on virus transmission and unpredictable nature of immune response to the disease.
Utility of Peri-Operative Chest Radiographs Prior to Elective Cardiac Valve Replacement Surgery: A Retrospective Cohort Study
Authors: Wees Matthew Van
Published: June 2023

Purpose: Peri-operative chest radiographs (POCXR) are routinely ordered prior to elective valve replacement but there is currently no data to support this practice. We postulated that surgical management was not altered due to these radiographs. Method: The medical records of patients 18 years and over admitted to our institution between 2020 and 2015 for isolated valve replacement surgery were inspected to determine if their management was changed (delayed surgery, new pathology not known etc) due to a POCXR, along with demographic data, chest radiograph findings and other imaging modality data. Results: 208 patients fit the inclusion criteria; all had POCXR. No patients had alteration to surgical timing or procedure based on the POCXR findings. We did find that 4 patients had alterations due to CT findings. 102 patients had CT and POCXR, with 88 patients having a CXR on the same day as or post CT scan. 11 patients had CT findings that warranted further investigation, which was not the case with CXR findings. 4 patients had surgical management altered due to CT scan findings. Conclusions: Our study demonstrated no utility for pre-operative CXR in elective valve replacement surgery. It is noteworthy that CT scanning did change surgical management and further altered medical management in 15 patients. This warrants further investigation.
Chronic Hypersensitivity Pneumonia. What the Clinical Radiologist Participating in a Multidisciplinary Meet Needs to Know
Authors: Gothi Rajesh
Published: June 2023

Chronic hypersensitivity pneumonia (CHP) is a diffuse interstitial lung disease, brought about by an inflammatory response to various known and unknown antigens. It affects the small airways, its surrounding parenchyma and interstitium. It can manifest either as a fibrosing or non-fibrosing diffuse lung disease. The fibrotic pattern is irreversible, hence if not recognized early, it embarks on a downhill course. The pattern and anatomical distribution of fibrosis shows some differences from other fibrosing disorders. Features resembling sarcoidosis, fibrosing NSIP or UIP may be seen towards the end stage, making distinction difficult. Clinical evaluation and perusal of previous records helps suggest the diagnosis and assess its progress. In this review article, an attempt will be made to understand the disease in order to enable the radiologist add value in a multidisciplinary discussion (MDD).
Spontaneous Rupture of the Fornix Following an Obstructive Distal Lithiasis of the Ureterovesical Junction: A Case Report and Literature Review
Authors: Déogratias Nzambimana
Published: June 2023

Spontaneous rupture of the fornix is a rare urological pathology. The urinary tract obstruction is the most frequent etiology. We report here a case with short review of spontaneous rupture of the fornix due to distal lithiasis of the left ureter. The patient was 26 years old, with no particular pathological medical or surgical history, admitted for sudden and intense left low back pain, suffered from the past five days and increasing in intensity with onset of fever. The patient consulted a general practitioner on local clinic where an infectious assessment was requested before the prescription of anti-inflammatory and board spectrum antibiotic to decapitate a probable urinary tract infection. The pain did not disappear under the treatment. The decision was then to refer the patient for urology specialized care. Spontaneous rupture of the fornix is rare but must always be taken into account in the differential diagnosis of pathologies occurring in a febrile patient or presenting with an acute abdomen after episodes of acute low back pain. The often non-specific clinical symptoms will regress after the rupture except in certain cases like ours. The diagnosis is guided by the interrogation, suspected on ultrasound, and confirmed by computed tomography. With a low pressure system by urinary diversion and antibiotic treatment in some cases, the result is excellent. Endoscopic drainage for a better urinary diversion contributes to a good evolution of the patients.
Symptomatic Os Vesalianum Pedis in Young Adult: A Case Report
Authors: Husain Zahra SM
Published: June 2023

Os vesalianum pedis is a rare accessory foot ossicle, which is located proximal to the base of the fifth metatarsal bone. This anatomic variant is usually asymptomatic and detected incidentally on routine foot radiographs. However, it can be an infrequent cause of lateral foot pain and rarely become symptomatic following traumatic injuries to the ankle or foot. To date, there are few reported cases of symptomatic os vesalianum pedis described in the literature and most of them were treated surgically. We report a case of symptomatic os vesalianum pedis in a young adult female, which was misdiagnosed initially and managed conservatively with physiotherapy. Patient’s symptoms regressed completely after a few sessions of physiotherapy and didn’t require surgical intervention. We intended to publish this case to increase the awareness of this rare entity among radiologists and clinicians.
Atypical Unilateral Sacral Stress Fracture in a Marathon Runner
Authors: KSV Abhinetri
Published: June 2023

Stress fractures are common overuse injuries in athletic population. They contribute to 15-20% of all cases in a sports medicine clinic [1,2]. These injuries occurs when a normal bone is exposed to excessive, repetitive forces leading to altered bone homeostasis with predominant osteoclastic function with osseous breakdown leading to micro fractures in the bone which may progress to a frank fracture line in the setting of continued exposure[3].
Teaching Ergonomic Training Skills to Reduce the Fall Risk in an Elderly Patient - A Case Study
Authors: B Linder
Published: June 2023

Background: Ergonomics is a study in the efficiency of movement. This can be an important tool when examining a patient to determine what a root cause of a patient’s dysfunction is. And then, what can be done to resolve that dysfunction. Accepting a patient’s medical diagnosis, age, or self-report as to what their problem is, may not be the best measure of a patient’s loss of function. This is especially true when the clinician may be biased against a patient due to their advanced age. Case Description: The following is a case report of a 68-year-old man named ‘Casey’ (not his real name), who was diagnosed with vertigo and with shoulder pain due to arthritis. Casey had fallen several times in the recent past and his physician had advised him to stop playing sports to protect him from injury. The shoulder evaluation was revealing for loss of motion and weakness. However, Casey’s balance and coordination skills were primarily intact. There did not seem an obvious cause for a history of falling. On taking Casey out to the parking lot, he could easily field, catch, and throw a ball without difficulty. It was noted that Casey was left handed and further noted that he had recently started playing third base. As a left handed player, Casey needed to pivot almost 180 degrees every time he threw the ball to first base. This was a difficult movement pattern for Casey, and he lost his balance every time he had to field a ball, pivot 180 degrees and throw the ball to ‘first base’. It was likely that Casey did not have as much of a problem with vertigo as he did with learning an efficient movement pattern that would allow him to play third base as a left handed player. Casey was seen 5 times in physical therapy and was taught lower extremity movement patterns so he could safely throw a ball to first base without losing his balance. Casey accomplished this very quickly, which then let us focus on his limitations in shoulder pain and weakness, which also recovered quickly. Discussion: A Medical Diagnosis will usually offer an incomplete description of the patient. The Physical Therapist needs to be mindful in studying the patient’s movement, which will be helpful in revealing a root cause of a patient’s loss of function. This is especially true in the elderly, who we expect to have limited abilities.
How do Vehicle Automated Features Help or Hurt Driving Performance?
Authors: SM Easa
Published: June 2023

It is anticipated that vehicles having automated features of Level 0 to Level 5 will coexist in the future. However, many people are unsure what role, if any, human drivers will play at these levels. How do these automated features affect drivers' performances? This article attempts to answer this question by reviewing critical information from human-automation system characteristics of vehicles with specific automated features (AV). Essential facts about the differences in functional features between human drivers and systems and automated features at various levels were clarified and summarized, including their characteristics, roles, and technical AV structures. Finally, drivers’ performances at all automation levels were discussed. This review provides the insight needed to understand how the automated features affect drivers' performances and to what extent. The results indicate that drivers’ performance does not improve as the automated level upgrades. Compared with no automation, active-safety and high automation can achieve lower workload and better driving performances for drivers. In contrast, driver assistance and partial/conditional automation impose more increased workloads and unstable (even risky) driving performance.
Pushing and Pulling Tasks: Practical Techniques and Criteria for Measuring and Interpreting Detected Forces Using Digital Versus Traditional Analog Dynamometers. Suggestions for Implementing Standards
Authors: D Colombini
Published: June 2023

Objectives: The main objectives of the paper is to compare the measurement of forces during pushing/pulling tasks using digital and analog dynamometers, showing the advantages of the first device and to propose guidelines for measurement interpretation with special attention to practitioners needs. Methods: The paper includes procedures for comparing the reproducibility of analog and digital dynamometers and for determining relationships between measured forces and subjective evaluations using Borg CR-10 Scale. Results: Examples are presented of measurements carried out with digital dynamometers using the original methodology, illustrating advantages and limits. Inter/intra-observer validation tests confirm the advantages of digital over analog dynamometers. Comparisons between measured data and subjective force ratings are presented and confirm good correlations. Conclusion: The results confirm that digital dynamometers, using proposed original methodology, generate more accurate information than analog. The methodology may be useful for future revision of ISO Standard. Open issues are underscored to stimulate additional research.
Management of Indeterminate Thyroid Biopsies, 9-Year Experience in Mexico
Authors: Miracle Lopez Sigfrido
Published: June 2023

Thyroid nodules are selected for Fine Needle Aspiration Biopsy (FNAB) based on suspicious ultrasonographic characteristics. When thyroid nodule fine-needle aspiration (FNAB) cytologic results show follicular lesion of undetermined significance or atypia of undetermined significance (FLUS/AUS, Bethesda III) or follicular neoplasm (Bethesda IV), the results are often called indeterminate. We present the results in the follow-up of indeterminate (Bethesda III and IV) cytologies in thyroid nodules, from April 2013 to August 2022, in our research center in the State of Mexico.
Initial Experience of Endoscopic & Robotic Thyroid Surgery in India
Authors: Chand Gyan
Published: June 2023

The First case of endoscopic thyroid surgery and scar less thyroid surgery was reported in India in 2007 and 2015. The first robotic thyroid surgery was reported in India in 2017. The various approaches has been practice in India including the trans- axillary approach, bilateral Breast and axillary approach, trans-vestibular approach and posterior auricular approach. The most popular approach is trans-axillary approach in India. The Indian doctor do not pioneer in remote access approaches for thyroid surgery however the popularities and acceptance of endoscopic and robotic thyroid surgery have been increasing in India. Majorities of publications showed that the remote access thyroid surgery is safe and effective procedure, have long learning curve that can be overcome by training with excellent cosmetic outcome.
The Psychobehavioral Responses of Pregnant Women towards the COVID-19 Pandemic
Authors: Azman Aqwa
Published: June 2023

Psychological distress during pregnancy can have adverse effects on both maternal and fetal wellbeing. It is a well-known fact that it increases risk of preterm deliveries and low birth weight babies. The objective of this study is to determine the psychological responses of pregnant women towards the COVID-19 outbreak, by assessing the degree of stress, anxiety, and depression among these pregnant women. This study is a cross-sectional study, utilizing a five-part questionnaire exploring patients’ sociodemographic background, level of knowledge and psychological impact of the COVID-19 pandemic utilizing the Depression Anxiety Stress Scale (DASS-21). In addition, the study also aims to evaluate the rate of vaccination among pregnant women attending antenatal care in our center. Respondents are recruited from the Antenatal Clinic, Patient Assessment Center (PAC), and maternity wards of the University Malaya Medical Center, Malaysia. The result shows that the percentage of pregnant mothers with significant psychological distress is low at 1%, further scrutiny showed that the level of anxiety as a result of the COVID-19 pandemic is substantial, whereby half of them reported an abnormal score, 5.4 % and 7.9 % of them reported to be having severe and extremely severe levels of anxiety respectively. Risk factors for anxiety include higher education level, being a first time mothers and having significant complications in the current pregnancy. Good stress management, family support and vaccination may have resulted in a lower degree of stress among pregnant women; however the level of anxiety is significantly higher. The result should help maternity care providers to strategize and implement appropriate screening and interventions to prevent significant deterioration in maternal mental health which subsequently could translate into poor pregnancy and fetal related outcomes.
Gender Bias in Psychoanalysis – An Alternative Thinking
Authors: Amorim Patricia Mafra de
Published: June 2023

Under the risk of being surpassed by newer methods or being accused of using unsubstantiated techniques, it seems urgent to rethink some psychoanalytic central concepts that have not aged well. Considering that, this paper – part of a larger theoretical investigation on psychoanalysis conception of femininity – will try to offer another perspective to explain female sexuality in its own terms. This shift is helpful not only to understand women’s sexuality, but it also opens a path to the comprehension of diverse sexualities that aren’t part of the usual standard psychoanalysis works with. So, to rethink femininity in metapsychological terms we went back to the psychoanalytical myth of origins suggested by the Hungarian psychoanalyst Sándor Ferenczi to understand if there were misconceptions – conscious or unconsciously made - that led to the narrowing in psychoanalysis ability to describe sexualities that are not heterosexual and masculine. To demonstrate that we departed from some clinical material to discuss the revealing concepts Ferenczi left us, the context in which they were developed and how they can be alternatives to some rigid phallocentric interpretations historically transmitted inside psychoanalysis. These considerations help us understand contemporary conflicts that emerge from the clash of a patriarchal society, based on consumerism and technological development that begins to face its limits. The intrapsychic and interpersonal conflicts of a given time tend to take on cultural dimensions and express them in singular ways.
The Flagellate Transition- Serous Carcinoma Ovary
Authors: Bajaj Anubha
Published: June 2023

Serous ovarian tumours are engendered from Mullerian epithelium and denominate a segment of surface epithelial-stromal ovarian tumours. Serous ovarian carcinoma is classified as low grade tumefaction comprising of benign, borderline and low grade malignant lesions and high grade neoplasms. Staging of serous carcinoma of ovary is appropriately achieved with American Joint Committee on Cancer (AJCC), International Federation of Obstetrics and Gynaecology (FIGO) and Tumour, Node, Metastasis(TNM) staging. Surgical resection is an optimal and curative mode of therapy.
PENINGKATAN KREATIVITAS MENGGUNAKAN MODEL PROJECT BASED LEARNING MATA PELAJARAN IPAS KONTEKS MERDEKA BELAJAR KELAS 4 SEKOLAH DASAR
Authors: Hidayati Sofiatul , Restian Arina
Published: June 2023

Penelitian ini bertujuan untuk mengetahui peningkatan kreativitas peserta didik kelas IV UPT Satuan Pendidikan SDN Sentul 3 Kota Blitar konteks merdeka belajar. Dimulai dari observasi yang dilakukan di kelas IV menunjukkan rendahnya kreativitas peserta didik dalam pembelajaran. Jenis penelitian yang digunakan yaitu Penelitian Tindakan Kelas (PTK). Subjek dalam penelitian ini yaitu 28 peserta didik kelas IV UPT Satuan Pendidikan SDN Sentul 3 Kota Blitar. Teknik pengumpulan data yang digunakan meliputi: 1) Observasi melalui pada saat pembelajaran. 2) Pemberian tes kreativitas sesuai dengan rubrik Greinstein. 3) Dokumentasi untuk menunjukan kegiatan yang dilakukan selama penelitian. Teknik analisis data yang digunakan dalam penelitian ini yaitu deskriptif kuantitatif dan kualitatif. Hasil penelitian menunjukkan bahwa presentase kreativitas yang dimulai dari tahap pra siklus sampai dengan siklus 2. Pada tahap pra siklus rata-rata kreativitas peserta didik dalam satu kelas yaitu 26%. Pada siklus 1 di pertemuan 1 diketahui presentase kreativitas peserta didik sebanyak 60% pada siklus 1 pertemuan 2 yaitu 70% Dan siklus 2 pertemuan 1 sebanyak 80% dan siklus 2 pertemuan 2 yaitu 86%. Dari penelitian ini dapat disimpulkan bahwa penggunaan Model project based learning konteks merdeka belajar dapat meningkatkan kreativitas peserta didik kelas IV Sekolah Dasar pada mata pelajaran IPAS
Speech Acts in Text Dialogues: An Analysis of English Textbook Merdeka Belajar for Junior High School
Authors: Fitriani Fitriani , Hidayat Didin Nuruddin , Husna Nida , Alek Alek
Published: June 2023

This study aims to investigate the types of speech acts and their functions contained in the dialogues of the English textbook titled "English in Mind Second Edition Students' Book Starter Grade VII," which was composed based on the implementation of Kurikulum Merdeka Belajar. The study employed a descriptive qualitative research approach, utilizing text dialogues from the English textbook as the primary data source. The speech acts in the dialogues were analyzed based on Searle's (1976) speech act framework. The results indicate a total of 161 speech acts (utterances) across all dialogues in the textbook. The distribution of speech acts is as follows: assertive accounted for 29.2% (47 instances), directive accounted for 24.8% (40 instances), commissive accounted for 9.9% (16 instances), expressive accounted for 35.4% (57 instances), and declaration accounted for 0.6% (1 instance). While the textbook demonstrates good representation of speech acts within Searle's framework, it should be noted that certain functions of speech act types, specifically commissive and declarative speech acts, were not consistently present in all dialogues. Based on these findings, this study suggests that textbook designers and material developers strive to authentically incorporate various functions of speech act types, ensuring authentic interactions and natural language usage. By doing so, they can enhance EFL learners' performances and interactions using speech acts. Please note that this revised version is based on the feedback and suggestions provided earlier. It aims to address the structural and grammatical aspects and provide a clearer representation of the information presented in the abstract