bluuebunny/crossref_metadata_2025_split huggingface dataset:
GENITAL HERPES: AUDIT OF CASES REFERRED BY GENERAL PRACTITIONERS TO A DEPARTMENT OF GENITO‐URINARY MEDICINE
Authors: Scott G R 
Published: April 2023

SUMMARYAn audit was carried out of all cases of genital herpes referred by a general practitioner to a department of genito‐urinary medicine from 1987‐1990. Attention was paid as to whether or not the diagnosis had been made correctly and what drugs, if any, the patient had been prescribed. A total of 196 patients (78 men, 118 women) were eligible for study. GPs correctly diagnosed herpes in 32/78 (41%) of the men. Among the 46 who were not diagnosed, 12 were prescribed antibacterial drugs, three were prescribed antifungal cream, two were prescribed a combination of the above and three received miscellaneous non‐antiviral agents. GPs correctly diagnosed 56/118 (47%) of the women. Sixty‐two women were not diagnosed, of whom 17 were prescribed anti‐bacterial drugs, 21 were prescribed antifungal cream, seven were prescribed a combination of these and six received miscellaneous non‐antiviral agents. GPs appeared to have difficulty in diagnosing genital herpes in these patients, with the result of prescription of inappropriate and expensive medications.
INTRAHEPATIC BILOMAS – A POSSIBLE COMPLICATION OF CHOLECYSTECTOMY?
Authors: Dasgupta T K , Sharma V 
Published: April 2023

SUMMARYBiloma(s) were initially defined as encapsulated extrahepatic collection(s) of bile.1 Subsequently the definition was expanded to include abnormal intrahepatic bile collection(s) located outside bile ducts.2 Most descriptions are of subhepatic or subphrenic collections (extrahepatic bilomas), following surgical procedures involving the biliary system or trauma. We report a case of intrahepatic collections of very large amounts of bile, apparently following cholecystectomy.
HOW SOUND ARE RECOMMENDATIONS FOR LOWERING CHOLESTEROL FOR THE PRIMARY PREVENTION OF CORONARY HEART DISEASE?
Authors: Oliver M F 
Published: April 2023

INTRODUCTIONThe almost unbridled enthusiasm of many ‘health professionals’ in western societies for lowering everyone's blood cholesterol may have arisen from an extraordinary NIH (National Institute of Health) consensus statement1 in 1985 that ‘Reduction of blood cholesterol levels will reduce the rate of coronary heart disease’ (the italics are from the report). It would have been better to use the word ‘might’ instead of ‘will’, to qualify what is meant by ‘the rate of coronary heart disease’ and to indicate situations where the facts do not actually support this view.Subsequently, an expert panel2 on detection, evaluation and treatment of high blood cholesterol in adults (the US National Cholesterol Education Programme) stated that their report provided ‘new guidelines for the treatment of high blood cholesterol in adults 20 years of age and over’. However, these ‘guidelines’ and those of other societies3 have come to be regarded by some as inflexible rules with their full implementation being the best or only way to avoid coronary heart disease (CHD). This position is sometimes supported by simulation models of the likely reduction in CHD incidence which would be expected for a given reduction of blood cholesterol over 20 or 30 years – even though no such study has been made. The involvement of the pharmaceutical industry in cholesterol‐lowering is becoming more and more pervasive and reinforces these views. All of this seems to have led to the development of a unified strategy, which should and must not be questioned or doubted!I propose within the limited space available to examine some of these issues and to suggest that for the primary prevention of CHD some current policies, particularly that of the US NCEP, extrapolate beyond the facts and oversimplify some controversial problems. The place of cholesterol‐lowering in the management of patients with established CHD is not the subject of this paper.
ACE INHIBITION IN THE 1990s
Authors: Maxwell S R J , Kendall M J 
Published: April 2023

SUMMARYAngiotensin‐converting enzyme (ACE) inhibitors are now widely prescribed for the treatment of hypertension and heart failure. Their increasing popularity is based on impressive results from studies of efficacy in clinical situations and the realisation that they may have advantages over conventional treatment. This review will highlight some of the recent advances in our knowledge of the role of ACE inhibitors and will develop a rational approach to prescribing.
AN UNCOMMON BENIGN BREAST TUMOUR – HAMARTOMA
Authors: Thirumavalavan V S , Rufaie A L 
Published: April 2023

SUMMARYTwo patients who presented with mobile breast lumps which were later diagnosed to be hamartomas are presented, along with a brief review of current literature. These benign lesions are likely to be increasingly diagnosed because of routine mammographic screening and hence clinical awareness is paramount to prevent these lesions from being overtreated.Hamartoma of the breast is a rare benign breast lesion which is unfamiliar to most clinicians. We herein report two examples of such a lesion and review the recent literature. The hamartoma presents as a soft well‐defined lump, causing considerable asymmetry of the breasts.
PARADOXICAL CEREBRAL EMBOLISM ORIGINATING FROM THROMBUS IN TUMOUR VEINS AS PRESENTING MANIFESTATION OF RETROPERITONEAL UPOSARCOMA
Authors: Garrett P J , Mulcahy K , Burden R J , Ng W C , Price P A 
Published: April 2023

SUMMARYThe coincidence of pulmonary and systemic emboli suggests paradoxical embolism. We present the case of a young man in whom a blood clot travelled from the veins in a retroperitoneal liposarcoma via a patent foramen ovalis to the systemic arterial circulation. Young patients with embolic disease but no obvious source of thrombus may have underlying neoplastic disease.Venous thrombosis is a frequent complication of neoplastic disease. Arterial embolism associated with neoplasm is, however, not widely recognised.
GROWTH OF A VASCULAR MALFORMATION INTO A CROSS‐FINGER FLAP
Authors: Warwick D J , Milling M A P 
Published: April 2023

SUMMARYWe describe a vascular malformation which recurred by invading into the previously normal skin of a cross‐finger flap. We suggest a similarity between the progression of a vascular malformation and the neo‐vascularisation of a flap.
ISOLATED SUBGLOTTIC LYMPHOMA: AN INTERESTING CAUSE OF DYSPHONIA
Authors: Yardley M P J , Chui P 
Published: April 2023

SUMMARYIsolated laryngeal lymphomas are exceedingly rare tumours: they tend to be greyish submucosal swellings and to respond well to radiotherapy. A case of subglottic lymphoma is presented, along with a review of previously reported cases of subglottic lymphomas.
VOLATILE SUBSTANCE ABUSE: A BRIEF REPORT
Authors: Langa A 
Published: April 2023

SUMMARYVolatile substance abuse (VSA) is on the increase: the practice is widespread among young people and concern has often been expressed about its potential dangers. It is estimated that in the United Kingdom between 3.5–10% of current adolescents have at least experimented with solvents, and up to 1% of the secondary school population are currently abusers. Adequate assessment of each individual case is essential as this will lead to appropriate therapeutic interventions and rational management of associated problems.
THE OUTCOME OF SURGERY OF ANEURYSMAL SUBARACHNOID HAEMORRHAGE
Authors: Jamjoom A , Jamjoom Z A , Stranjalis G , Cummins B , Torrens M 
Published: April 2023

SUMMARYAneurysmal subarachnoid haemorrhage is a challenging pathology which remains a cause of considerable mortality and morbidity. To demonstrate to general practitioners the results of surgery for this condition a retrospective study of 160 consecutive cases who had undergone aneurysmal surgery was carried out. On admission 57% of cases had a good Hunt and Hess grade (grades I and II) and 43% a poor grade (grades III, IV and V). Twelve per cent of cases had a pre‐existing hypertension and 73% of cases were treated with nimodipine. Angiography was performed from 0 to 73 days (median 3 days) after the bleed. Early surgery (within the first three days after the bleed) was performed in 41% of cases. Twenty‐two per cent of cases rebled before surgery from 1 to 69 days after initial presentation (median seven days). Delayed cerebral ischaemia was diagnosed in 38% of cases, but only 15% of cases had evidence of low density on the CT scan.The outcome was determined at six months using the ‘Glasgow outcome scale’. Fifty‐five per cent of cases made a good recovery (back to normality), 15% a fair recovery (moderately disabled but independent), 15% a poor recovery (severely disabled and dependent), and 15% died. The significant poor prognostic factors were: a poor pre‐operative Hunt and Hess grade, the presence of an intracerebral haematoma or angiographic spasm, evidence of rebleeding and early surgery without treatment with nimodipine. Other factors which did not reach a statistical significance include: age, presence of subarachnoid and intraventricular blood on CT, timing of surgery, history of long‐standing hypertension, intraoperative rupture, and the development of hydrocephalus or delayed ischaemia.
POTASSIUM CHANNEL ACTIVATORS IN THE MANAGEMENT OF ISCHAEMIC HEART DISEASE: A FOCUS ON NICORANDIL
Authors: Purcell H , Fox K 
Published: April 2023

SUMMARYThe treatment of angina pectoris continues to pose challenges. Novel new compounds are a rarity, but the potassium channel activators represent a new class of drugs with novel mechanisms of action. Nicorandil will be the first available potassium channel modulator for treatment of angina, and the following review assesses its clinical potential.
THE MANAGEMENT OF RECTAL BLEEDING
Authors: Jones R , Farthing M , Barnes J , Leicester R 
Published: April 2023

SUMMARYRectal bleeding is a common symptom in the general population;1 it may signal the presence of serious gastrointestinal disease but more frequently is caused by minor and self‐limiting local ano‐rectal conditions. Appropriate and accurate evaluation of rectal bleeding requires an investigative approach which balances an appreciation of the need to provide an adequate explanation for the bleeding against over‐investigation, excessive referral and wasted resources. As doctors of first contact, general practitioners (GPs) are frequently faced with difficult questions concerning the optimum management of rectal bleeding. This paper was prepared as a result of a series of interactive meetings with over 1,000 GPs from throughout the UK, which revealed wide variations in the possession and use of investigative equipment in the surgery, access to secondary care facilities, estimates of the prevalence and potential seriousness of rectal bleeding and the management strategies adopted in response to a series of case histories. We highlight a number of unresolved issues about the roles of GPs and hospital specialists in the management of rectal bleeding and the need for research directed at answering outstanding questions. In addition, a management strategy is proposed which might form the basis for a protocol for care, shared between general practice and the hospital.
GALLSTONE CIRRHOSIS: ARE WE ONLY SEEING THE TIP OF THE ICEBERG?
Authors: Lakshmi M Vijaya , Sridharan G V , Butterworth D 
Published: April 2023

SUMMARYGallstones are common and their incidence increases with age.1 Fifty per cent of these stones are in the common bile duct (CBD) in the elderly.2 Most of them are silent but with time there is an increasing chance of developing symptoms which are more likely to be serious in the elderly.3 Failure to relieve mechanical obstruction of bile flow may lead to secondary biliary cirrhosis.4 It has been estimated that on average secondary biliary cirrhosis develops some seven years after the onset of obstruction from a stricture, four and half years after gallstone obstruction and 10 months after the onset of malignant stricture.5 The characteristic features are the pathological findings of portal‐portal linkages, with a pattern of monolobular cirrhosis and the preservation of normal vascular relationships.6 Secondary biliary cirrhosis may lead to hepatic insufficiency and portal hypertension with the resultant complications, such as bleeding oesophageal varices, hypersplenism with pancytopenia, ascites and encephalopathy. We describe a patient in whom the diagnosis was not suspected until laparotomy and confirmed only at autopsy.
Lattice misorientation at domain boundaries in β‐Ga2O3 single‐crystal substrates observed via synchrotron radiation X‐ray diffraction imaging and X‐ray reticulography
Authors: Yao Yongzhao , Hirano Keiichi , Sasaki Kohei , Kuramata Akito , Sugawara Yoshihiro , Ishikawa Yukari 
Published: April 2023

AbstractTo evaluate the lattice misorientation at domain boundaries (DBs) in β‐Ga2O3, we performed X‐ray diffraction imaging (XRDI), X‐ray reticulography (XRR), and X‐ray topography (XRT) using a synchrotron radiation light source. Four reciprocal lattice vectors (g‐vectors) were applied, and the DBs showed different visibilities in the XRDI maps depending on the g‐vector. By analyzing possible characteristics of the misorientation, the XRDI results suggested that the DB being investigated was associated with a misorientation on the () plane and contained twist and tilt components. The apparent peak change in XRDI caused by the two components was calculated. We further succeeded in separating the tilt and twist components using XRR images in conjunction with simulation. Dislocation arrays at the DBs were observed using XRT, and the average distance between the dislocations in the array was consistent with the misorientation obtained using XRDI and XRR. The distribution of DBs across a wide area was acquired by a combination of XRR images recorded on a charge‐coupled device camera and X‐ray films. The fringe‐patterned XRR on X‐ray films provided a powerful and nondestructive tool to characterize DBs distributed across a large‐diameter wafer with an angular resolution on the order of several arc sec (low 10−5 rad).
First recorded occurrence of the parasitic barnacle (Anelasma squalicola) on a Greenland shark (Somniosus microcephalus) in the Canadian Arctic
Authors: Ste‐Marie Eric , Glenner Henrik , Rees David J. , Hussey Nigel E. 
Published: April 2023

AbstractA solitary Anelasma squalicola specimen was collected from the cloaca of a Greenland shark (Somniosus microcephalus), the first time this association has been recorded. The specimen's identity was confirmed through morphological and genetic assessment (mitochondrial markers: COI and control region). A. squalicola is a species typically associated with deep‐sea lantern sharks (Etmopteridae) and, until the present observation, had never been observed at a sexually mature size in the absence of a mating partner. Given the reported negative effects of this parasite on its hosts, monitoring Greenland sharks for additional cases is recommended.
Successful treatment of submental fat using a non‐focused pulsed ultrasound
Authors: Somji Munir , Solomon Tino 
Published: April 2023

AbstractBackgroundThe prevalence of non‐invasive aesthetic treatments is increasing, with patients demanding easier, safer, and more effective non‐invasive cosmetic procedures. Submental fat is usually addressed using liposuction, which is associated with significant adverse events and a long recovery. Although newer, non‐invasive submental fat treatments are gaining popularity, they are often complex, require frequent injections, or have adverse side effects.AimsAssess the safety and efficacy of vacuum‐assisted acoustic wave technology for treating submental.Patients/MethodsFourteen female patients underwent a total of three weekly 15‐min treatments using ultrasound with a 40 mm bell‐shaped sonotrode. Improvement in submental fat was assessed 3 months after the final treatment using questionnaires for the patients and physicians. Two blinded dermatologists rated each patient using the Clinician‐Reported Submental Fat Rating Scale (CR‐SMFRS) 5‐point scale.ResultsBoth physicians rated a significant improvement in all 14 patients. Furthermore, self‐evaluation of the 14 patients on a 1 to 5 satisfaction scale averaged 2.14, indicating that most patients were somewhat satisfied.ConclusionThis study demonstrates that a three‐treatment course with an acoustic wave ultrasound applicator with 1‐week intervals leads to a significant reduction in submental fat and can be used as a novel, efficient treatment paradigm.
A technical approach for redefinition and volumization of lip area with hyaluronic acid: A case series
Authors: Ribé Natalia 
Published: April 2023

AbstractBackground and AimNon‐surgical procedures using injectable filler products for perioral rejuvenation have emerged and evolved rapidly to become one of the most frequently performed aesthetic treatments. We report a case series describing the administration of two hyaluronic acid‐based dermal fillers (HA filler) with excellent characteristics and formulation using a technique developed by the author.Patient/MethodsWe describe a series of nine female subjects who underwent perioral rejuvenation performed by a single physician in her private clinic. The HA filler (Alaxin® FL or Alaxin® LV) was injected into the lips using the specially developed Clodia technique. Patients were given post‐treatment advice for optimal results. Patient‐ and investigator‐perceived outcomes were rated using the Global Aesthetic Improvement Scale (GAIS) and adverse events (AEs) were collected.ResultsAll subjects described the injection method as painless and well tolerated, as shown by the immediate post‐treatment photographs. Mean GAIS scores for both the patients and the investigator were 4.8/5, indicating significant improvement 12 months after the treatment. No AEs were reported during follow‐up. The HA filler showed a high degree of dermal integration in all subjects, and the investigator reported excellent handling and injection properties.ConclusionPerioral rejuvenation with an HA filler administered using the developed injection technique gave highly satisfactory results in all subjects and was not associated with AEs.
The clinical benefit of a multimodal topical approach to treating skin dyspigmentation
Authors: Draelos Zoe Diana , Diaz Isabel 
Published: April 2023

AbstractBackgroundThe recent removal of hydroquinone from the over‐the‐counter market has created a need for modern skin lightening formulations. An effective pigment lightening formulation must be non‐irritating to prevent skin darkening from post‐inflammatory hyperpigmentation, penetration enhanced to reach the epidermal/dermal junction, contain anti‐inflammatory ingredients, and address multiple mechanisms of pigment production.ObjectiveThe objective of this research was to demonstrate the efficacy of a topical multimodal pigment lightening preparation containing tranexamic acid, niacinamide, and licorice.MethodsFifty female subjects 18+ years of all Fitzpatrick skin types with mild to moderate facial dyspigmentation were enrolled. Subjects were provided with the study product for twice daily use on the entire face and an SPF50 sunscreen with evaluations occurring at Week 4, Week 8, Week 12, and Week 16.The investigator used a face map to identify a pigmented target site on the face for dermaspectrophotometer (DSP) measurement. The dermatologist investigator completed a baseline facial efficacy and tolerability assessment. The subjects completed a tolerability assessment.Results48/50 subjects completed the study without tolerability issues. The DSP readings demonstrated a statistically significant reduction in target spot pigmentation at Week 16. The investigator assessed a 37% decrease in pigment intensity, a 31% decrease in pigment extent, a 30% decrease in pigment homogeneity, a 45% improvement in brightness, a 42% improvement in clarity, and a 32% improvement in overall facial skin dyspigmentation at Week 16.ConclusionThe combination of penetration enhanced tranexamic acid, niacinamide, and licorice was effective in inducing facial pigment lightening.
Species distribution and antifungal susceptibility of clinical Aspergillus isolates: A multicentre study in Taiwan, 2016–2020
Authors: Wang Hsuan‐Chen , Hsieh Ming‐I , Choi Pui‐Ching , Wu Wan‐Lin , Wu Chi‐Jung ,   the TSARM Hospitals
Published: April 2023

AbstractBackgroundEpidemiological knowledge is important to guide antifungal therapy.ObjectiveThis multicentre study aimed to investigate the species distribution and antifungal susceptibility of Aspergillus isolates in Taiwan.MethodFour hundred and ninety‐two clinical Aspergillus isolates, collected during 2016–2020, were identified by calmodulin sequencing and tested for antifungal susceptibility using CLSI M38‐A3. The Cyp51A sequences of azole‐resistant Aspergillus fumigatus and Aspergillus flavus isolates were analysed.ResultsThis collection comprised 30 species from eight Aspergillus sections—Flavi (33.5%), Nigri (26.0%), Fumigati (24.2%), Terrei (10.0%), Nidulantes (5.1%), Circumdati (0.8%), Restricti (0.2%) and Aspergillus (0.2%). Sections Fumigati, Flavi and Terrei were primarily represented by A. fumigatus (99.2%), A. flavus (95.8%) and A. terreus (100%), respectively. Section Nigri comprised nine species, mostly A. welwitschiae (60.2%), A. niger (12.5%), A. brunneoviolaceus (10.9%) and A. tubingensis (10.2%). A. fumigatus (39.6%) and A. flavus (26.4%) predominated among 53 isolates from lower respiratory samples, whereas section Nigri species (46.2%) and A. terreus (29.2%) predominated among 65 isolates from ear samples. Reduced susceptibility to amphotericin B (minimal inhibitory concentration (MIC) > 1 μg/mL) was noted in A. flavus (7.0%), A. terreus (6.1%), A. nidulans and section Circumdati (A. flocculosus, A. subramanianii and A. westerdijkiae) isolates. Acquired azole resistance was observed in seven A. fumigatus (5.9%), all of which carried TR34/L98H or TR34/L98H/S297T/F495I mutation, and three A. flavus (1.9%), one of which carried G441S mutation. Reduced susceptibility to itraconazole (MIC >1 μg/mL) was noted in 55.5% of section Nigri isolates, mainly in A. welwitschiae, A. niger and A. tubingensis, whereas A. brunneoviolaceus, A. aculeatinus and A. japonicus were hypersusceptible to azoles. Anidulafungin was active against all isolates except for one isolate.ConclusionsThis study depicted the molecular epidemiology and species‐specific characteristics of Aspergillus in Taiwan, which aids in appropriate antifungal therapy and underlines the need of speciation and susceptibility testing of disease‐causing Aspergillus.