bluuebunny/crossref_metadata_2025_split huggingface dataset:
Swahili Translation and Validation of the Patient Health Questionnaire-9 Depression Scale in the Kenyan Head and Neck Cancer Patient Population
Authors: Omoro S.A.O. , Fann J. R. , Weymuller E. A. , MacHaria I. M. , Yueh B. 
Published: February 2007

Background: Depression is an important predictor of post therapy quality of life (QOL) in head and neck (H&N) cancer patients. In addition, depression rates may vary among cultures. Objective: As part of a larger cross cultural study on post therapy QOL differences in H&N cancer patients, the goal of this project was to translate a well-validated English language depression scale into Swahili, and then validate this scale in Kenyan H&N cancer patients. Methods, Settings and Subjects: In Part 1 of the study, we translated the Patient Health Questionnaire-9 (PHQ-9) into Swahili, adhering to established International Quality of Life Association (IQOLA) guidelines. In Part 2, we psychometrically validated the newly translated scale using a prospective study of 48 patients at the Kenyatta National Hospital ENT clinic in Nairobi, Kenya. Results: The Swahili PHQ-9 had good test retest reliability (Intraclass correlation coefficient, 0.71) and internal consistency (Cronbach's alpha=0.80). It also had good construct validity, as scores correlated strongly with TNM stage (Chi square=123, p < 0.05), and with the composite and global scores of an H&N cancer specific QOL scale (UW-QOL, r = −0.87, p < 0.05). Conclusion: The Swahili version of the PHQ-9 is a reliable scale in Kenyan H&N cancer patients, and is a valuable tool in screening for and monitoring of depression as a function of QOL in this population.
State Anxiety during Watchful Waiting for Urinary Lithiasis
Authors: Kalaitzi C. , Kalantzis A. , Gravas S. , Georgiadis J. , Christodoulou C. 
Published: February 2007

Objectives: Guidelines on many disorders recommend a variable period of watchful waiting between diagnosis and indicated action. In this study, we assessed stress during the watchful waiting period for urinary lithiasis, a benign disorder treated with minimally invasive procedures, without the pitfall of the emotional burden of a terminal or debilitating disease or fear of impending major surgery and to assess the distress caused by waiting per se. Furthermore, we attempt to identify individual patients at risk of prolonged or debilitating psychological distress. Methods: A total of 112 lithiasis patients with stones ≤5 mm completed the study. State and trait anxiety were assessed both at baseline and after the end of watchful waiting using STAI, and then they were informed of the indicated action for their case. Results: During the 30 days of watchful waiting, patients experienced a significant increase in state anxiety scores, especially if they were male, had high state or trait anxiety scores at baseline, or if they had experienced more than one episode of colicky pain during the waiting period. Conclusion: Clinicians should be more flexible when they face the above group of patients, as far as the duration of watchful waiting period is concerned, because a long waiting sets those patients under significant emotional burden.
Patient Characteristics Associated with Participation in a Practice-Based Study of Depression in Late Life: The Spectrum Study
Authors: Gallo Joseph J. , Bogner Hillary R. , Straton Joseph B. , Margo Katherine , Lesho Pat , Rabins Peter V. , Ford Daniel E. 
Published: February 2007

Objective: An important component of generalizing study results to patients is the extent to which study participants adequately represent individuals targeted for the study. The Spectrum study of depression in older primary care patients was utilized to consider patient characteristics associated with nonparticipation. Method: Interviewers utilized a validated questionnaire to screen adults aged 65 years and older for depression who presented to one of the participating primary care practices in the Baltimore, Maryland area. Screening interviews included information about sociodemographic factors, functioning, health, and attitudes about depression and its treatment in order to compare participants with persons who declined. Results: In all, 2,560 adults aged 65 years and older were screened. Comparison of the characteristics of the patients who were eligible for the study ( n = 773) with patients who participated fully in the in-home evaluation ( n = 355) found that the study sample included proportionately more persons who: 1) were less than 80 years old; 2) completed high school; and 3) reported two or more visits to the practice site within six months of the interview. Among patients who were depressed, no significant differences were found in the characteristics of those who met study eligibility criteria and those who agreed to participate. Conclusions: Persons over the age of 80 years of age or those with less than a high school education may require tailored strategies for recruitment even when approached by a trained interviewer in a primary care doctor's office.
Perceived Barriers to Health Care Access in a Treated Population
Authors: Bauer Mark S. , Williford William O. , McBride Linda , McBride Katherine , Shea Nancy M. 
Published: February 2007

Objective: Health care access may be a significant contributor to health outcome. However, few data exist on perception of barriers by patients in treatment, and attending a clinic visit does not mean that no barriers exist. Understanding barriers for treated populations is particularly important in optimizing care for high vulnerability populations, such as those with mental illness and the elderly. Method: A structured interview, demographic questionnaire, and SF-12 were administered to 324 veterans presenting for primary care or mental health appointments at a Veterans Affairs medical center. Principle components analysis was performed and relationships to vulnerability characteristics were identified. Results: Most interview items showed modest mean levels but high variance. Responses were stable over three to six weeks. As hypothesized, perceived total barriers were greater in participants from several vulnerable populations: those receiving treatment for mental health problems, those with disabilities, and those with worse physical and mental function. Minority participants did not perceive greater barriers. An “inverted-U” relationship with age was found. Principal components analysis assigned 18 items across six clinically meaningful subscales. Participants with mental health treatment perceived greater barriers in three subscales including provider communication. Curvilinear relationships were again seen between subscales and age. Conclusions: Even individuals “in care” perceive barriers. Members of vulnerable populations, particularly those receiving mental health treatment, perceive greater barriers. Data support a multi-dimensional conceptualization of perceived barriers, and different subgroups experience different patterns of barriers.
Individualized Treatment Effects of Oxygen Targets in Mechanically Ventilated Critically Ill Adults
Authors: Buell Kevin G. , Spicer Alexandra B. , Casey Jonathan D. , Seitz Kevin P. , Qian Edward T. , Graham Linck Emma J. , Self Wesley H. , Rice Todd W. , Sinha Pratik , Young Paul J. , Semler Matthew W. , Churpek Matthew M. 
Published: March 2024

ImportanceAmong critically ill adults, randomized trials have not found oxygenation targets to affect outcomes overall. Whether the effects of oxygenation targets differ based on an individual’s characteristics is unknown.ObjectiveTo determine whether an individual’s characteristics modify the effect of lower vs higher peripheral oxygenation-saturation (Spo2) targets on mortality.Design, Setting, and ParticipantsA machine learning model to predict the effect of treatment with a lower vs higher Spo2 target on mortality for individual patients was derived in the Pragmatic Investigation of Optimal Oxygen Targets (PILOT) trial and externally validated in the Intensive Care Unit Randomized Trial Comparing Two Approaches to Oxygen Therapy (ICU-ROX) trial. Critically ill adults received invasive mechanical ventilation in an intensive care unit (ICU) in the United States between July 2018 and August 2021 for PILOT (n = 1682) and in 21 ICUs in Australia and New Zealand between September 2015 and May 2018 for ICU-ROX (n = 965).ExposuresRandomization to a lower vs higher Spo2 target group.Main Outcome and Measure28-Day mortality.ResultsIn the ICU-ROX validation cohort, the predicted effect of treatment with a lower vs higher Spo2 target for individual patients ranged from a 27.2% absolute reduction to a 34.4% absolute increase in 28-day mortality. For example, patients predicted to benefit from a lower Spo2 target had a higher prevalence of acute brain injury, whereas patients predicted to benefit from a higher Spo2 target had a higher prevalence of sepsis and abnormally elevated vital signs. Patients predicted to benefit from a lower Spo2 target experienced lower mortality when randomized to the lower Spo2 group, whereas patients predicted to benefit from a higher Spo2 target experienced lower mortality when randomized to the higher Spo2 group (likelihood ratio test for effect modification P = .02). The use of a Spo2 target predicted to be best for each patient, instead of the randomized Spo2 target, would have reduced the absolute overall mortality by 6.4% (95% CI, 1.9%-10.9%).Conclusion and relevanceOxygenation targets that are individualized using machine learning analyses of randomized trials may reduce mortality for critically ill adults. A prospective trial evaluating the use of individualized oxygenation targets is needed.
Principles of Skin Surgery
Authors: Hussain S. Walayat , Miller Christopher J. , Wang Timothy S. 
Published: March 2024

Abstract
The acquisition of dermatological surgery skills is an integral component of dermatological training. Indeed, the increasing burden of skin cancer has resulted in competence in dermatological surgery being a mandatory requirement for all dermatologists. This chapter provides an overview of the fundamental basics of skin surgery and provides an introduction to more advanced surgical techniques, including Mohs micrographic surgery. This chapter is complemented by high‐quality videos of the surgical techniques discussed and may be accessed via the online version of the textbook.
Principles of Radiotherapy
Authors: Kelly Charles G. , Frew John , Mahtab Najibah 
Published: March 2024

Abstract
Radiotherapy has been used for over a century to treat skin malignancies and still has a curative role to play in a number of different skin pathologies, as well as in adjuvant and palliative settings and where lack of patient fitness or reserve precludes extensive surgery. It is also finding new roles, as in its use in stereotactic radiosurgery for melanoma brain metastases. The potential uses of radiotherapy provide additional options within the multidisciplinary skin cancer team meeting and helps optimise individual skin cancer management plans. Its use is not without morbidities, whose management have also to be considered.
Non‐Syphilitic Bacterial Sexually Transmitted Diseases
Authors: Kinghorn George R. , Gupta Nadi K. 
Published: March 2024

Abstract

Non‐treponemal bacterial sexually transmitted infections, of which gonorrhoea and genital chlamydia are the commonest, have important consequences for maternal and neonatal health worldwide. Transmission is facilitated by their high infectivity and variable periods of asymptomatic carriage. Diagnostic tests have become more sensitive and treatment schedules have recently changed to reflect increasing concerns about antimicrobial resistance. Chancroid has become a sporadic cause of genital ulceration in the UK, usually acquired during travel abroad. Its causative organism,
Haemophilus ducreyi
, is now also recognised in yaws‐like cutaneous lesions in children within isolated communities in tropical countries. Lymphogranuloma venereum has evolved and is now more usually diagnosed as a cause of rectal bleeding resembling inflammatory bowel disease, especially in men who have sex with men, with concomitant HIV infection. Granuloma inguinale has become rare worldwide.
Mycoplasma genitalium
has emerged as another cause of genital tract infection with clinical features similar those of genital chlamydia but where treatment failure is increasing.
Graft‐versus‐host Disease
Authors: Basu Tanya N. 
Published: March 2024

Abstract
Graft‐versus‐host disease is a major complication of allogeneic haematopoietic stem cell transplantation. It is a multiorgan disease process that results from the action of donor‐derived immunocompetent T‐lymphocyte cells against antigens expressed on the cells of the immunocompromised recipient host. The main organs affected are the skin, liver and gastrointestinal tract. Acute, chronic and overlap forms are recognised.
Atopic Eczema
Authors: Ardern‐Jones Michael R. , Flohr Carsten , Reynolds Nick J. 
Published: March 2024

Abstract
Atopic dermatitis is a complex disorder that is highly heritable, but which is strongly influenced by the environment. This chapter reviews the current understanding and describes in detail important concepts in disease pathogenesis in children and adults. Epidemiological understanding, allergy and trigger factors are reviewed. Alongside a comprehensive description of how to optimise topical therapies, phototherapy and the use of classic systemic treatments, we review the most important inflammatory pathways and link these directly to modern therapeutic treatment advances, and the evidence for their effectiveness and safety.
Urticaria
Authors: Grattan Clive E. H. , Sears Alison V. 
Published: March 2024

Abstract
Urticaria is a common illness characterised by itchy weals, angioedema or both. It may be acute (lasting less than 6 weeks) or chronic (lasting 6 weeks or more). Weals and angioedema are characterised by their transient nature and resolve within hours or days without damage. Most acute urticaria is spontaneous and most inducible urticarias are chronic. Several subtypes of inducible urticaria are defined by the provoking stimulus but overlaps between them and spontaneous types occur. The mast cell is central to all types of urticaria and histamine is a major mediator. Allergy may be a cause of acute urticaria but probably never chronic urticaria. Autoimmune and autoallergic aetiologies have been recognised in chronic spontaneous urticaria but the cause remains elusive in many patients and may be multifactorial. Management hinges on identifying a cause or trigger if one can be found, addressing co‐morbidities and optimising pharmacological treatments with antihistamines, omalizumab and other low‐evidence‐based treatments when appropriate to control symptoms. Natural remission can be expected but the illness may be prolonged in some patients.
Adamantiades–Behçet Disease
Authors: Zouboulis Christos C. 
Published: March 2024

Abstract
Adamantiades–Behçet disease (ABD) is a rare, multisystem inflammatory disease of unknown aetiology, classified as a systemic vasculitis and as a neutrophilic dermatosis involving all types and sizes of blood vessels. A genetically determined background with environmental triggering factor(s) are probably involved. A chronic, relapsing, progressive course of oral aphthous ulcers, genital ulcers, skin lesions (papulopustules, erythema nodosum) and iridocyclitis/posterior uveitis is characteristic. ABD is occasionally accompanied by arthritis and vascular, neurological and gastrointestinal manifestations. ABD has a worldwide occurrence with varying prevalence, being endemic in eastern and central Asian and the eastern Mediterranean countries. Characteristic histopathological features of ABD are vasculitis and thrombosis. ABD is not considered contagious. There is no specific mode of Mendelian transmission in ABD. The disease has potentially poor prognosis (especially in males with systemic presenting signs). HLA‐B51 and ERAP‐1 seem to be associated with a more severe prognosis. Immunological mechanisms are considered to play a major role in the pathogenesis of ABD. The disease has currently been classified among the autoinflammatory disorders. The endothelium seems to be the primary target. Diagnosis of ABD is based on clinical signs. The Revised International Criteria for Behçet's Disease provides the most accurate diagnosis. Ophthalmic and neurological sequelae are leading causes of morbidity, followed by severe vascular and gastrointestinal manifestations. Their effects on morbidity may be cumulative. The clinical course of ABD is variable. A multidisciplinary approach in the management of ABD patients is mandatory. The choice of treatment depends on the site and severity of the clinical manifestations of the disease.
Genetic Disorders of Pigmentation
Authors: Morice‐Picard Fanny , Taïeb Alain 
Published: March 2024

Abstract
Differences in skin and hair colour are principally the result of differences in the melanin content of skin. The synthesis of melanin takes place in melanocytes within specialised vesicles known as melanosomes, then distributed to surrounding keratinocytes. Development of skin pigmentation is a complex multistep process that is tightly regulated. Mutations in genes involved in any one of these steps may lead to pigmentary manifestations. Genetic pigmentary disorders provide a way to improve understanding of the development and the regulation of pigmentation.
Chromosomal Disorders
Authors: Rajan Neil , Irvine Alan D. , Mellerio Jemima E. 
Published: March 2024

Abstract
Chromosomal disorders may be due to abnormalities of chromosome number or structure and may involve autosomes or sex chromosomes. Approximately 7.5% of all conceptions have a chromosomal disorder, but most of these are spontaneously aborted, so the birth frequency is 0.6%. Chromosomal abnormalities generally cause multiple congenital malformations. Children with more than one physical abnormality, particularly if developmentally delayed, should undergo chromosomal analysis as part of their investigation. Recent advances for detecting chromosomal aneuploidies leverage the ability of sensitive DNA sequencing technologies to detect fetal (cell free) DNA circulating in the maternal circulation. Invasive diagnostic testing approaches such as chorionic villus sampling or amniocentesis allow access to tissue or amniocytes that can be tested for fetal chromosomal abnormalities. Many chromosomal disorders have cutaneous manifestations. In this chapter we review the cutaneous manifestations of the commonest chromosomal abnormalities.
Inherited Skin Tumour Syndromes
Authors: Rajan Neil , Mellerio Jemima E. , Irvine Alan D. 
Published: March 2024

Abstract
This chapter covers three exemplar inherited skin tumour syndromes: neurofibromatosis type 1 (NF1), the tuberous sclerosis complex and familial adenomatous polyposis, as well as providing an overview of inherited tumour syndromes with cutaneous manifestations. NF1, tuberous sclerosis complex and familial adenomatous polyposis have diverse clinical and genetic features and require disease‐specific knowledge for diagnosis, along with targeted interventions and cancer surveillance plans. All three share in common the clinical presentation of multiple benign skin tumours, which are often pathognomonic for these genetic conditions, and a significant risk of cutaneous and non‐cutaneous neoplasia. The chapter reviews the clinical features of these conditions, their genetic bases and diagnostic tests and provide guidance for management of these conditions.
Ulceration Resulting from Disorders of the Veins and Arteries
Authors: Hafner Jürg , Rabe Eberhard 
Published: March 2024

Abstract
This chapter describes the diagnosis and treatment of the four major variants of chronic leg ulcers with a macrovascular origin: venous leg ulcers; mixed venous and arterial leg ulcers; arterial leg ulcers; and Martorell hypertensive ischaemic leg ulcers. The majority of patients with chronic ulcers can be treated effectively and healed. This, however, requires standardised work‐up and treatment planning. The text highlights the hallmarks of vascular leg ulcers and suggests algorithms to successful management.
Disorders of the Lymphatic System
Authors: Mortimer Peter S. , Gordon Kristiana 
Published: March 2024

Abstract
The lymphatic system is the body’s cleansing and recycling service. It removes toxins, waste and recycles fat and fluid. It also forms part of our immune system. The lymphatic system provides all the checks and balances for other body systems. It is the main controller of body fluid balance and it provides immunosurveillance and is responsible for creating immunity. It mobilises fat: impaired lymph drainage results in fat deposition and lymphoedema swelling is as much fat as fluid. It is also important for preventing atherosclerosis. It patrols for cancer cells; if this surveillance fails, cancer progresses. It regulates self‐tolerance, with failure resulting in autoimmune disease.
Dermatoses of the Scalp
Authors: Farrant Paul , Mowbray Megan , Takwale Anita 
Published: March 2024

Abstract
The scalp is a common site for several common inflammatory skin conditions, including seborrhoeic dermatitis and psoriasis. In severe cases these may be associated with hair loss. Inflammation in the dermis may cause secondary hair loss and alterations to the scalp, with thickening, folding and mucinosis. The scalp is a common site for primary skin tumours and secondary metastases. Lastly, the scalp can be associated with localised itch and pain or dysaesthesia. All of these are discussed in this chapter on the dermatoses of the scalp.
Cutaneous Complications of Stomas and Fistulae
Authors: Lyon Calum 
Published: March 2024

Abstract
An abdominal stoma (ostomy) is a surgically created opening from the gastrointestinal or urinary tract onto the skin in order to drain the effluent from that system. This typically involves a collection device worn on the skin, usually held in place by an adhesive material. In theory most dermatoses could affect peristomal skin. In practice the majority fall into one or more of a few predictable groups: irritant reactions including dermatoses exacerbated by trauma, allergic reactions, infections, common generalised inflammatory dermatoses (e.g. psoriasis) and disorders associated with the reason for surgery especially Crohn disease. Treatment strategies involve the avoidance of irritants or allergens where relevant. Topical therapies need to be chosen carefully to minimise greasiness that would interfere with appliance adhesion. For the same reason progression to systemic therapy may be considered earlier for more severe inflammatory dermatoses such as psoriasis or pemphigoid.
Benign Cutaneous Adverse Reactions to Drugs
Authors: Ardern‐Jones M. 
Published: March 2024

Abstract
Adverse reactions to drugs can induce many different pattens of cutaneous inflammation. This chapter focuses on the non‐severe phenotypes including the exanthems, drug‐induced pruritus, eczema and systemic allergic contact dermatitis (including symmetrical drug‐related intertriginous and flexural exanthema, SDRIFE) as well as lichen planus and lichenoid reactions. Additionally, drug‐induced urticaria, angioedema and anaphylaxis are reviewed. Importantly, while evidence‐based lists of common drug causes for each presentation are considered, imputability alone is an unreliable means for clinicians to assess causality. Instead, an approach utilising drug ingestion timeline and careful clinical assessment of differential diagnosis is presented.