bluuebunny/crossref_metadata_2025_split huggingface dataset:
OTHER-16 DIAGNOSTIC INTERVALS IN BRAIN TUMORS IN IBADAN
Authors: Agboola Oluseyi , Balogun James , Adebayo David 
Published: October 2023

Abstract

INTRODUCTION
The patients’ pathway to a specialist, which impacts on timing of presentation, varies with each healthcare system. This study aims to outline the intervals in the diagnostic pathway of patients with brain tumors and to evaluate the effect of socio-demographic characteristics on these intervals.

MATERIALS AND METHODS
This cross-sectional study was carried out at the University College Hospital, Ibadan. It involved all consenting adults ≥18years with a new radiological diagnosis of brain tumors. The demographic characteristics, the symptom interval (SI), referral interval (RI), the symptom detection to specialist clinic interval (SCI), clinical features were noted. Descriptive statistics were presented and Chi-square test was used for analysis at p &lt;0.05.

RESULTS
There were 159 participants with a mean age of 47.7±13.8 years. The M:F was 1:1.3. 117 (73.6%) completed post secondary education. The median SCI, SI and RI were 730 (210 – 1825) days, 60 (2-365) days and 120 (14-730) days respectively. No socio-demographic characteristics were associated with SCI and SI, but more patients with &gt;3 children had RI within 120 days. Patients with speech impairment tend to have shorter SCI &lt;730days and RI &lt;120days (p=0.01), while patients with hearing impairment have longer SI &gt;60days (p=0.01), and patients with convulsion tend to have a longer RI of ≤4-months (p&lt;0.001). Longer SI and RI resulted in longer SCI (≥730days). However, only about 25% of shorter SI and RI respectively led to shorter SCI (p&lt;0.001).

CONCLUSION
All the diagnostic intervals were long across the socio-demography, only shortened in patients with focal deficits. Multipronged approaches focused particularly on the education of the population, physicians and other healthcare workers will be key to shortening these intervals and improving outcomes.
PAEDIATRIC-07 IMAGING OF PINEAL REGION TUMOURS IN CHILDREN
Authors: Muthee Bernadette 
Published: October 2023

Abstract
Pineal tumors comprise between 3% and 8% of all pediatric brain tumors.
Pineal region tumors can be divided into four categories: Germ cell tumors, pineal cysts, pineal parenchymal tumors, and tumors of the supporting tissues of the pineal gland or adjacent structures (such as pineal gliomas, dermoids, and epidermoids). The most common pineal region tumors are germ cell tumors, most are pure germinomas. Other variants such as nongerminomatous germ cell tumors, mixed germ cell tumors, teratomas, embryonal cell carcinoma, yolk sac tumor, and choriocarcinoma constitute the remainder. Germinomas are hyperdense on CT and enhance homogenously. The typical appearance on CT is a calcified pineal gland surrounded by noncalcified tumor. On MRI, these lesions have homogenous signal isointense to gray matter on all sequences with intense contrast enhancement. These tumors may infiltrate the thalami and midbrain. Spinal dissemination is seen in up to 36% of cases. Pineocytomas are well-differentiated tumors that retain morphologic features of the pineal parenchymal cells. They are slow-growing, circumscribed, but noncapsulated tumors. They are more commonly solid tumors, although cystic variants have been described. Solid tumors are either hypointense or isointense to gray matter and T2-hyperintense. Enhancement is homogenous and calcification is common. Cystic variants are often indistinguishable from pineal cysts. Pineoblastomas are malignant, unencapsulated tumors that resemble embryonal tumors NOS, but are distinct from such tumors in other locations due to their photosensory differentiation. On MRI, these lesions are hypointense to isointense on T1-weighted images and variable low, high, or mixed signal on T2-weighted images. They have lobulated contours and enhance homogenously. They calcify less often than pineocytomas. The “exploded pattern” of calcification with peripheral displacement of pineal gland calcification is considered more typical of pineal parenchymal tumors, differentiating them from germ cell tumors.
SPINAL TUMORS-03 MALIGNANT PHYLLODES TUMOR OF THE BREAST WITH METASTASIS TO THE THORACIC SPINE: A CASE REPORT
Authors: Xavier Rutayisire François , Claire Karekezi 
Published: October 2023

Abstract
Malignant phyllodes tumors (MPT) of the breast are rare, and spinal metastasis from these tumors is even rarer. We present a case report of a 37-year-old female with a breast mass, who was diagnosed with malignant MPT after incisional biopsy. The patient underwent a right partial mastectomy, and negative margins were reported. However, two weeks later, the patient presented to the emergency department with severe back pain, paresthesia, and lower limb weakness. Neurosurgery consultation led to a diagnosis of T4 pathological fracture, spinal tumor and spinal cord compression, likely due to metastasis from the breast mass. Chest abdomen and pelvis CT revealed no other lesion except the T4 compression fracture. The patient underwent cord decompression tumor resection, and transpedicular fixation of T3-T5 with T4 vertebroplasty. Histopathological analysis confirmed that it was a metastasis from phyllodes tumor. Our case report highlights the importance of early detection and management of MPT, as well as the need for close follow-up and monitoring of patients with a history of breast masses it also highlights the importance of considering malignant phyllodes tumors as a differential diagnosis for breast masses and the potential for metastasis to the spine.
Interpretation in different age-groups
Authors: Jelliffe Derrick B , Jelliffe E F Patrice , Zerfas Alfred , Neumann Charlotte G 
Published: October 2023

Abstract
Each stage of human life has different nutritional considerations. The preferred methods for assessment vary with the age-groups that are the main concern of the investigation. Different stages of the life-cycle have special physiological nutritional needs (p. 226), susceptibility to infections (p. 139), and cultural benefits or hazards (p. 165). The risk of different forms of malnutrition varies in different age-groups, and, as has been noted elsewhere (p. 14), even certain clinical signs suggestive of nutritional deficiency can be age-specific (p. 226). In addition, the anthropometric effects of protein-energy malnutrition in rapidly growing young children plainly will be different from those in an adult for whom physiological growth has ceased.
How the diagnosis is made
Authors: Baron-Cohen Simon , Bolton Patrick 
Published: October 2023

Abstract
Diagnosis is essential if different conditions are to be clearly distinguished, with a view to both understanding and treating different disorders. Early diagnosis offers the hope that treatment can start before the condition has pushed the child too far off the normal course of development. At present, early diagnosis of autism is still rare; but doctors are currently working towards improving the diagnostic tools to achieve this goal. In this chapter, we describe an assessment format used in Britain, pointing out how autism is distinguished from superficially similar conditions. We also discuss the consequences of diagnosis.
What causes autism?
Authors: Baron-Cohen Simon , Bolton Patrick 
Published: October 2023

Abstract
In the last two chapters we reviewed the way in which a diagnosis is made, and the consequences of receiving the diagnosis. To recap, the diagnosis is made on the basis of three types of behaviour being present: abnormal social behaviour, abnormal communicative behaviour, and the presence of repetitive, unimaginative activities, all being evident in the first few years of life. In this chapter we summarize what is known about the cause or causes of autism that produce these abnormalities of behaviour. At the outset it is important to stress that no clear-cut answer exists on the question of cause; but what is known is discussed below.
Education: what can be done?
Authors: Baron-Cohen Simon , Bolton Patrick 
Published: October 2023

Abstract
It used to be thought that children with autism were in educable, as was mentioned in Chapter 1. In the past such attitudes resulted in children with autism being placed in the back wards of long-stay mental-handicap institutions, and their lack of progress was then taken as proof of their in educability. When such assumptions were questioned in the case of children with mental handicap, and discovered to be wrong, their validity for autism was also challenged. Current evidence suggests that very few, if any, children are in educable-whatever their intellectual level. The overriding principle is that education should be tailored to the individual, and educability is evident in the progress made, whatever its rate. Highly structured teaching programmes have been claimed to produce the greatest gains. There are several reasons why this may be so. First, the social problems in autism are such that, if a teacher is not actively initiating interaction and being directive, a child with autism may simply drift away from social contact into a pursuit of repetitive patterns of behaviour. Such repetitive behaviours, by definition, allow very little learning of new information. Secondly, the highly structured approach starts from the assumption that every task should be broken down into simple and clear steps, with each goal clearly defined. Children with autism seem to take to such a methodical approach. Finally, highly structured teaching may work because children with autism seem to prefer predictability.
Scleroderma
Authors: Silman Alan J , Hochberg Marc C 
Published: October 2023

Abstract
Scleroderma is a general term of referring to pathological thickening and tethering of skin. Isolated scleroderma, localized as in morphoea or in linear scleroderma, does not form part of a multisystem disease and will not be considered further in this review. Systemic sclerosis, sometimes prefixed with the term ‘progressive’ is used in the literature to relate to the combination of sclerodermatous skin change and internal organ involvement. However, the current preferred term is scleroderma and for clinical classification purposes it is usefully subdivided into limited and diffuse cutaneous forms (LeRoy et al. 1988). The diffuse form requires skin involvement proximal to the hands and feet, an increased risk of internal organ involvement, and a high frequency of the Sci-70 antibody (topoisomerase-1). By contrast, the limited form, by definition, has skin involvement limited to the extremities, has low risk of internal organ involvement, and a high frequency of the anticentromere antibody (anti-kinetochore). One typical syndrome of limited cutaneous scleroderma is the CREST syndrome. This comprised of calcinosis, Raynauds, esophageal hypomotility, sclerodactyly (see Table 8.1) and telangiectasia. The clinical and serological differences between these two forms are not absolute and, for epidemiological purposes it is more usual and perhaps appropriate to consider scleroderma as a single disease entity.
Drugs
Authors: Morton N S 
Published: October 2023

Abstract
An adverse drug reaction is any drug effect that is not beneficial to the patient. Some reactions depend on the dose of drug given and are an extension of the drug’s properties. This type of reaction is common, for example morphine produces dose-related depression of breathing. Other adverse reactions are not related to the dose given and are unpredictable and relatively rare, for example anaphylactic shock, malignant hyperthermia.
Equipment
Authors: Morton N S 
Published: October 2023

Abstract
Most operating theatres are connected to a back up power generator electricity supply to cover the possibility of failure of the usual mains supply. This generator system is regularly checked but there is the remote chance that it could also fail. In this situation, theatre lighting, monitoring equipment and ventilators may fail. The safest option is to take over ventilation by hand using portable oxygen and a self-inflating bag and try to get a battery powered patient monitor pack attached. The surgery should be stopped until the situation is clarified and then completed if possible as quickly as is safe. The anaesthetist will give specific instructions on how the assistant should help.
Genitourinary Surgery
Authors: Morton N S 
Published: October 2023

Abstract
Patients with renal failure presenting for surgery raise particular problems. Patients are often anaemic and may have significant abnormalities of their body chemistry and fluid compartments. Particular care is required in the patient in renal failure presenting for a surgical procedure to establish vascular access for dialysis as these patients may be in cardiac failure from fluid overload and may have a high serum potassium which predisposes to abnormal heart rhythms. Many drugs used in anaesthesia are excreted from the body via the kidneys and so care is needed with doses of agents such as muscle relaxants and opioids, particularly if given in repeated doses.
Acute Medicine Algorithms
Authors: Singer Mervyn , Webb Andrew R 
Published: October 2023

Abstract
Acute Medicine Algorithms is an essential pocket reference for everyone in the intensive care unit. It takes a unique approach to the management of acutely ill patients - with a straightforward decision-tree format which provides unequivocal guidelines for acute medical conditions. It includes 70 algorithms - either problem orientated or related to specific conditions - together with complementary notes and references. The book provides junior doctors and SHO's in the ITU with an invaluable aid to learning and revising the management of acute medical care and provides experienced physicians with a thought-provoking digest of current practices and procedures. Acute Medicine Algorithms continues the tremendous success of the highly-acclaimed Critical Care Algorithms from the same author team. All those involved in acute medical care will find this book an indispensable clinical tool that will prove an invaluable reference in day-to-day practice and as a revision and discussion text.
Whole-body scintigraphy
Authors: Schaeffer Juergen , Floege, Juergen , Koch Karl M 
Published: October 2023

Abstract
Accurate and early diagnosis of 132-microglobulin amyloidosis (Al32m) is essential for the individual patient in order to rule out other causes of symptoms, and because of potential serious complications of progressive Al32m such as hip fractures. Reliable diagnosis is also important for the understanding of the pathogenesis, and also, it is hoped, for the development of strategies to prevent or at least delay the progression of Al32m.
Description, localization, and progression of β2- microglobulin dialysis-related amyloid deposition
Authors: Athanasou N A 
Published: October 2023

Abstract
Beta2-microglobulin (132m) amyloid deposition is now recognized as one of the most serious complications of long-term haemodialysis. Its most prominent clinical manifestations are the carpal tunnel syndrome, joint swelling, erosive arthropathy, haemarthrosis, and cystic lesions within bone. The pathological features of dialysis amyloid deposition in joints can be related to the radiological and clinical pattern of amyloid arthropathy. Systemic amyloid deposition also occurs in patients on long-term haemodialysis treatment. In both cases, the pathological consequences of dialysis amyloid deposition depend largely on the duration of haemodialysis and the site of amyloid deposition (Table 8.1).
The endometrial vascular bed
Authors: Rogers Peter 
Published: October 2023

Abstract
In searching for a paradigm upon which to base an understanding of the structure and function of the endometrial vascular bed, it is not inappropriate to consider the relative evolutionary histories of both the vascular system and the endometrium. Primitive invertebrate and vertebrate vascular systems first appeared some 500 million years ago. Since that time the vascular system has evolved into a complex organ playing central roles in a number of functions critical to the survival of the organism, including oxygen transport, nutrition, excretion, fluid balance, homeostasis, and immune defence. By contrast, placental mammals and the first primates appeared about 60–70 million years ago, and it is from this time onwards that a functional endometrium has developed.
The role of hysterectomy for menorrhagia
Authors: Petrucco Oswald M 
Published: October 2023

Abstract
Disorders of menstruation resulting in excessive menstrual loss, or menorrhagia, affect up to 20 per cent of otherwise healthy women. At a rate of 20-30 per 1000 these women will seek the help of primary care physicians and when referred to gynaecologists they will represent up to 12 per cent of all gynaecological consultations (Bradlow et al. 1992). The health care costs of abnormal menstruation and associated anaemia, when related to loss of productivity in the work force and home and utilization of medical services, are considerable even before expenditure is considered for investigating and treating this disorder. Medication prescribed for women suffering from menorrhagia for 1993 in England and Wales resulted in 821 700 prescriptions at a cost of £7 176 596. In the same year 128 000 diagnostic procedures and 73 000 hysterectomies were performed for the management of menorrhagia (Nuffield Institute for Health 1995).
Surgical treatment of submucous fibroids
Authors: Donnez Jacques , Nisolle Michelle , Gillerot Stephane , Bassil Salim , Polet Roland , Smets Mireille 
Published: October 2023

Abstract
Dysfunctional uterine bleeding and fibroids are the major reasons for hysterectomy in women over 40 years of age. Since 1985, gonadotrophin releasing hormone (GnRH) agonists have been recognized as a possible medical management for these conditions (Maheux et al. 1985). Nevertheless, because of the bone loss induced by the hypoestrogenic state, this therapy must be considered as either a temporary medical approach before endoscopic surgery, or as a long-term therapy combined with ‘add-back’ therapy (Friedman et al. 1988; Maheux et al. 1991).
Contraceptive steroids and endometrial morphology
Authors: Okon Moses A , Li T C , Dockery Peter 
Published: October 2023

Abstract
The effect of the contraceptive pill on endometrial histology depends on the factors discussed above. The endometrium of women taking combined oral contraceptives may sometimes show early secretory activity in the glands but secretory changes typical of the mid and late luteal phase are lacking. During the last week of the cycle the glands become atrophic, small, and tubular with a lining of flattened cuboidal epithelium.
The prevention and treatment of illness in pregnancy
Authors: White David , Griffiths Frances , O’Neill, Patrick , Jackson Ann 
Published: October 2023

Abstract
The invitation to contribute a chapter with the above title came as something of a surprise. We have worked together in a primary health care team for the last eight years providing general medical and maternity care with access to GP intrapartum care in a nearby GP/consultant delivery suite, but apart from AJ, who is a midwife, we have no special interest in maternity care. Having said that, the practice has been involved in education and research for many years, with one former partner responsible for numerous publications, including an audit of maternity care spanning 26 years (Marsh and Channing 1985a; 1985b; 1989).
New born babies and how to treat them
Authors: Watkin Sara , Henson Cath 
Published: October 2023

Abstract
Ninety-three per cent of newborn babies are born at term and of these between 95% and 99% are in good condition. They require no resuscitation and have no abnormalities on routine baby check and biochemical screening. Caring for the newborn demands the skills and expertise of working in partnership with parents.
Introduction
Authors: Lindesay J , Morris J C 
Published: October 2023

Abstract
Specialist services for patients with memory disorders have a relatively short history and have tended to develop separately from other provision for people with dementia, such as psychogeriatric services. One increasingly popular service model, the memory clinic, has its origins in the United States, where they were first established in the mid-1970s with the aim of providing an outpatient diagnostic, treatment, and advice service for individuals with milder forms of dementia. Their genesis was to a great extent a response to the unmet needs of families of dementing individuals, who were frustrated by the apparent reluctance of many physicians to diagnose dementia in patients who lacked insight into their cognitive difficulties and who appeared superficially normal by virtue of preserved social skills and competence for basic activities of daily living. Despite this interest in dementia, they were called ‘memory clinics’ in order to focus attention on memory impairment as an important early sign of the disorder, and to get around the problem that dementia was often not recognized by the patients’ doctors. It was also thought that the idea of a ‘dementia clinic’ would be unattractive and stigmatizing, and might discourage referrals (Fraser 1992). These clinics enabled interested and experienced specialists from various disciplines to collaborate in the diagnosis, management, and research into what, at that time, was an under-appreciated group of disorders. In the two decades since the first clinics were set up, their numbers have steadily grown in the United States and elsewhere; a survey carried out in 1993 in the British Isles identified 20 memory clinics active at that time (Wright and Lindesay 1995). The experience of these specialist memory disorders services has contributed significantly to the greater awareness of the problems associated with mild dementia, and so to the development of community-based services for patients and caregivers. These services have also been important in combating therapeutic nihilism and in promoting the concept of dementia (notably Alzheimer’s disease) as a treatable disorder.
Extensor tendons 1 —mallet finger
Authors: Wilson G R , Nee P A , Watson J S , Harrison R K 
Published: October 2023

Abstract
Make sure that the PIPJ is free to move in the splint. Skin care is difficult to maintain. Make sure that the patient does not remove the splint and bend the finger. The splint can be removed to wash and dry the finger, but the finger must be supported on a flat surface while the splint is off.
Extensor tendons 2 —division of extensor tendon over proximal phalanx (boutonniere deformity)
Authors: Wilson G R , Nee P A , Watson J S , Harrison R K 
Published: October 2023

Abstract
Commonly missed injury. Tell patient to return if finger starts to flex at the PIPJ and he cannot straighten it fully. Then refer to hand clinic. May be an open or a closed injury causing a division of the central slip of the extensor tendon: Closed injury, following a sudden forced flexionrugby injury Open injury-knife/glass.
Intercarpal ligament disruption: lunate dislocation and scapho-lunate dissociation
Authors: Wilson G R , Nee P A , Watson J S , Harrison R K 
Published: October 2023

Abstract
Pain and swelling are often severe, X-rays may look relatively normal. Median nerve may be involved by direct contusion or later swelling. May need acute decompression of the median nerve. Look for concomitant injuries from this high-energy trauma-CMC dislocation, radio/ulnar dislocation, elbow dislocation, radial head fracture.