bluuebunny/crossref_metadata_2025_split huggingface dataset:
The COVID‐19 pandemic and caring masculinity: New prospects or a wasted opportunity?
Authors: Wojnicka Katarzyna , Kubisa Julia 
Published: April 2023

AbstractThe early data regarding gender implications of COVID‐19 suggest that men are more likely to die as an effect of infection while women are those who suffer the social consequences of pandemic as they dominate in care‐oriented professions and bear the consequences of increased caring needs at home. The latter includes caring for children, who, in many (European) countries have been subjected to homeschooling. However, the lockdown resulted in the fact that also men (usually white‐collar workers from middle class) changed their work organization and habits and have started working from home. Some studies suggest that this specific situation results in the increase of involvement of fathers into caring activities at home. Hence, the main goal of our paper is an attempt to answer the question if pandemic opened new opportunities for larger involvement of men in caring activities. The study will locate research outcomes in the context of gender regime in Poland in order to investigate if lockdown, online work and care responsibilities enabled to challenge or to reproduce existing gender relations, with a special focus on masculinities patterns. It will be done by analyzing data from Poland, namely, semi‐structured qualitative interviews collected in two waves – during spring lockdown 2020 and during late autumn and winter 2020/2021 with men and women working online at home and caring for underage children. By doing so, we expect to add more nuanced, crisis‐related theoretical understandings of caring masculinity concept.
Structuring healthcare advance directives: Evidence from Chinese end‐of‐life cancer patients' treatment preferences
Authors: Ye Zi‐Meng , Ma Ben , Maitland Elizabeth , Nicholas Stephen , Wang Jian , Leng An‐Li 
Published: April 2023

AbstractBackgroundPatients' treatment decisions may be influenced by the ways in which treatment options are presented. There is little evidence on how patients with advanced cancer choose preferences for advance directives (ADs) in China. Informed by behavioural economics, we assess whether end‐of‐life (EOL) cancer patients held deep‐seated preferences for their health care and whether default options and order effects influenced their decision‐making.MethodsWe collected data on 179 advanced cancer patients who were randomly assigned to complete one of the four types of ADs: comfort‐oriented care (CC) AD (comfort default AD); a life extension (LE)‐oriented care option (LE default AD); CC (standard CC AD) and LE‐oriented (standard LE AD). Analysis of variance test was used.ResultsIn terms of the general goal of care, 32.6% of patients in the comfort default AD group retained the comfort‐oriented choice, twice as many as in the standard CC group without default options. Order effect was significant in only two individual‐specific palliative care choices. Most patients (65.9%) appointed their children to make EOL care decisions, but patients choosing the CC goal were twice as likely to ask their family members to adhere to their choices than patients who chose the LE goal.ConclusionPatients with advanced cancer did not hold deep‐seated preferences for EOL care. Default options shaped decisions between CC and LE‐oriented care. Order effect only shaped decisions in some specific treatment targets. The structure of ADs matters and influence different treatment outcomes, including the role of palliative care.Patient or Public ContributionBetween August and November 2018, from 640 cancer hospital medical records fitting the selection criteria at a 3A level hospital in Shandong Province, we randomly selected 188 terminal EOL advanced cancer patients using a random generator programme to ensure all eligible patients had an equal chance of selection. Each respondent completes one of the four AD surveys. While respondents might require support in making their healthcare choices, they were informed about the purpose of our research study, and that their survey choices would not affect their actual treatment plan. Patients who did not agree to participate were not surveyed.
Vascular/epithelial changes as late sequelae after recovery from SARS‐COV‐2 infection: an in‐vivo comparative study
Authors: Pezzuto Federica , Lunardi Francesca , Vedovelli Luca , Olteanu Gheorghe E , Fortarezza Francesco , De Pellegrin Alessandro , Melan Luca , Faccioli Eleonora , De Franceschi Elisa , Giraudo Chiara , del Vecchio Claudia , Marinello Serena , Pasello Giulia , Gregori Dario , Navalesi Paolo , Rea Federico , Schiavon Marco , Calabrese Fiorella 
Published: April 2023

AimsWhile there is partial evidence of lung lesions in patients suffering from long COVID there are substantial concerns about lung remodelling sequelae after COVID‐19 pneumonia. The aim of the present retrospective comparative study was to ascertain morphological features in lung samples from patients undergoing tumour resection several months after SARS‐CoV‐2 infection.Methods and resultsThe severity of several lesions with a major focus on the vascular bed was analysed in 2 tumour‐distant lung fragments of 41 cases: 21 SARS‐CoV‐2 (+) lung tumour (LT) patients and 20 SARS‐CoV‐2 (−) LT patients. A systematic evaluation of several lesions was carried out by combining their scores into a grade of I–III. Tissue SARS‐CoV‐2 genomic/subgenomic transcripts were also investigated. Morphological findings were compared with clinical, laboratory and radiological data. SARS‐CoV‐2 (+) LT patients with previous pneumonia showed more severe parenchymal and vascular lesions than those found in SARS‐CoV‐2 (+) LT patients without pneumonia and SARS‐CoV‐2 (−) LT patients, mainly when combined scores were used. SARS‐CoV‐2 viral transcripts were not detected in any sample. SARS‐CoV‐2 (+) LT patients with pneumonia showed a significantly higher radiological global injury score. No other associations were found between morphological lesions and clinical data.ConclusionsTo our knowledge, this is the first study that, after a granular evaluation of tissue parameters, detected several changes in lungs from patients undergoing tumour resection after SARS‐CoV‐2 infection. These lesions, in particular vascular remodelling, could have an important impact overall on the future management of these frail patients.
The impact of COVID‐19 on residents of long‐term care facilities with learning disabilities and/or autism
Authors: Tessier Elise , Webster Harriet , Aziz Nurin Abdul , Flannagan Joe , Zaidi Asad , Charlett Andre , Dabrera Gavin , Lamagni Theresa 
Published: April 2023

AbstractBackgroundThe COVID‐19 pandemic has had disproportionate impact on vulnerable populations including those with learning disabilities. Assessing the incidence and risk of death in such settings can improve the prevention of COVID‐19. We describe individuals who tested positive for SARS‐CoV‐2 while residing in care homes for learning disabilities and/or autism and investigate the risk of death compared with individuals living in their own homes.MethodsSurveillance records for COVID‐19 infections in England from 02 February 2020 to 31 March 2022 were extracted. Data on property type, variant wave, vaccination, hospitalisation and death were derived through data linkage and enrichment. Care home residents with learning disabilities and/or autism and diagnosed with COVID‐19 were identified and analysed, and logistic regression analyses compared the risk of death of individuals living in private residence. We assessed interaction parameters by post‐estimation analyses.ResultsA total of 3501 individuals were identified as diagnosed with SARS‐CoV‐2 whilst living in 632 care home properties for learning disabilities and/or autism. Of the 3686 episodes of infection, 80.4% were part of an outbreak. The crude case fatality rate was 2.6% and 0.6% among care home residents with autism and/or learning disabilities and their counterparts in households, respectively.The post‐estimation analyses found over eight times the odds of death among care home residents in 60 years old compared with their counterparts living in private homes.ConclusionsCare home residents with learning disabilities and/or autism have a greater risk of death from COVID‐19. Optimising guidance to meet their needs is of great importance.
COLD COAGULATION THERAPY IN THE TREATMENT OF HISTOLOGICALLY DIAGNOSED SUBCLINICAL HUMAN PAPILLOMA VIRUS (HPV) INFECTION OF THE CERVIX
Authors: Mohanty K C , Lowe J W 
Published: April 2023

SUMMARYThe efficacy of cold coagulation therapy in the treatment of histologically diagnosed subclinical human papilloma virus (HPV) infection of the cervix, was studied among 65 patients who also had genital warts. This therapy was found to be successful as the failure rate was only 8%. There were no serious side‐effects. The treatment can be administered easily in an out‐patient setting after histological confirmation.This study also showed that if, on the other hand, a subclinical HPV infection is not treated, it may develop into a clinical disease (genital warts) within two years. Therefore long‐term follow‐up of this condition may be necessary in untreated cases.
CORONARY ARTERY SPASM
Authors: Rothman M T , Khan B 
Published: April 2023

INTRODUCTIONIt is now well over 100 years since Latham1 postulated coronary artery spasm as a mechanism for angina pectoris. In 1889, Huchard2 suggested that coronary spasm, superimposed on organic lesions, might explain some aspects of ischaemic heart disease. However, in the 1930s and 40s demonstration of coronary atherosclerosis in pathological specimens led to the concept of obstructive atheroma as the basis for anginal syndromes. In the late 1950s Prinzmetal repopularised Huchard's concept of spasm superimposed on an organic lesion as a basis for angina in some clinical settings (Prinzmetal's variant angina).3 He reported that pain only came on with the subject at rest, or during routine daily activity, rather than with effort. This form of angina is associated with ST segment elevation on the electrocardiogram, rather than with the more usually noted ST depression. Three decades after Prinzmetal described this variant form of angina, there are still doubts about its causation and prevalence.
BLEEDING INTRACRANIAL ANEURYSM? PITUITARY APOPLEXY!
Authors: Oliver R M , Craft T M , Shaw K M 
Published: April 2023

SUMMARYPituitary apoplexy describes the clinical syndrome characterised by headache, visual impairment and ophthalmoplegia caused by sudden enlargement of a pituitary adenoma. This is usually due to extensive tumour infarction or haemorrhage. Pituitary apoplexy is rare, mimics spontaneous intracranial bleeding, and thus may be easily mistaken for acute subarachnoid haemorrhage. Urgent surgical intervention and hormone replacement therapy are required.
SLEEP APNOEA: CAUSES, CONSEQUENCES AND TREATMENT
Authors: Nasser S , Rees P J 
Published: April 2023

SUMMARYAn awakening has taken place over the last 25 years to the science of sleep disorders. Foremost amongst these, both in the medical world and the public eye, has been Sleep Apnoea Syndrome (SAS).The prevalence is thought to be of the order of 1–2%.1,2 Males are eight times more commonly affected than females, although after the menopause the gap narrows considerably. Sleep apnoea occurs in children, usually in relation to large tonsils and adenoids, but in adult life patients usually present between the age of 40 and 60 and the prevalence increases with age. Numerous apnoeas or hypopnoeas during the night's sleep result in disordered sleep architecture and unrefreshing sleep. This is usually accompanied by night‐long snoring which may lead to marital discord and even complaints from neighbours. Symptoms on waking may be a headache and a feeling of not being refreshed by sleep. Sleepiness during the day can interfere with work and social activities and may produce risks to the patient and others if it occurs while operating dangerous machinery or driving.Over a longer time scale SAS results in intellectual and memory deterioration, a higher incidence of ischaemic heart disease, hypertension, polycythemia and pulmonary hypertension. Right heart failure is particularly likely if there is chronic airflow obstruction contributing to a low arterial oxygen level. Asystolic periods and tachyarrhythmias may occur during apnoeic periods. The increased mortality of SAS relates to coronary and cerebrovascular disease and arrhythmias. Sudden death occurs with greater frequency in patients with SAS, mainly at night.3
QUALITY OF SLEEP IN THE MEDICAL DEPARTMENT
Authors: Yinnon A M , Ilan Y , Tadmor B , Altarescu G , Hershko C 
Published: April 2023

SUMMARYThe quality of sleep in 134 patients admitted to two medical departments and an intensive coronary care unit was studied by comparing pre‐ and post‐admission sleeping scores. Four aspects of sleep have been evaluated: duration of sleep; number of awakenings; personal assessment of quality of sleep; and the need for using sleeping pills. Results were expressed in scores ranging from 1 (worst) to 4 (best). A significant reduction in the mean quality of sleep for the entire group was found for all scores employed (P<0.01–P<0.001).Of the 134 patients, 51% had a reduction in post‐admission total sleep score (23 ± 3%, mean ± SE); 31% had no change or mixed trends in the various scores, with a change in total sleep score not exceeding 3 ± 3%; and 18% had an improved total sleep score (16 ± 2%). Of the individual scores, a deterioration was found in the following order of frequency: number of awakenings (37%); personal assessment of quality of sleep (32%); duration of sleep (31%); and the need for using sleeping pills (26%). Of the reasons specified for impaired quality of sleep, the most important were noise made by other patients or by the medical staff (47%), and the patient's own disease (30%).Significant differences in the quality of sleep between the two medical departments located in different hospitals have been encountered (P<0.01). In the department with a greater impairment in sleep score, about twice as many patients were housed per room as in the other department and complaints about noise made by other patients were significantly more common (P<0.05). These findings indicate that the quality of sleep is impaired by hospital admission in the majority of patients and this is attributed mainly to environmental factors. Our findings suggest that increased awareness of the patient's needs for rest and privacy on the part of hospital staff and planners may result in significant improvement in the quality of sleep.
DYSPEPSIA IN THE COMMUNITY: A FOLLOW‐UP STUDY
Authors: Jones R , Lydeard S 
Published: April 2023

SUMMARYWe have repeated a population‐based survey of the pattern and prevalence of dyspeptic symptoms in 2460 subjects two years after the original survey, in order to document the changes in dyspeptic symptoms and consultation behaviour.A validated postal questionnaire was sent to 2460 subjects randomly selected in ten‐year age bands from the lists of eight general practitioners working in the south of England. A total of 1417 individuals (58%) responded to both questionnaires. The overall six month prevalence of dyspepsia was unchanged (38%), but while 74% of dyspeptic patients were still getting symptoms, 13% became symptom‐free each year. Over half of those who had reported dyspepsia before, but not at the time of, the first survey had experienced recurrence of their symptoms. In the two‐year study period 113 individuals experienced dyspepsia for the first time, giving an annual incidence of 11.5%. One in four patients consulted their general practitioner, and 75% of those who had not consulted in the first survey still had not done so two years later. Resolution of symptoms appeared independent of consulting behaviour. Peptic ulcers were identified in 14 patients, mostly those with new dyspepsia, during the study period.
QUININE‐INDUCED CUTANEOUS VASCULITIS
Authors: Price E J , Bevan J S , Rees A 
Published: April 2023

SUMMARYWe report a 60‐year‐old woman who developed severe cutaneous vasculitis three weeks after commencing quinine sulphate (300 mg at night) for nocturnal cramps. The patient died despite immunosuppressive treatment with prednisolone and cyclophosphamide. We review three previous cases and conclude that cutaneous vasculitis is a rare but life‐threatening complication of treatment with this widely‐prescribed drug.Quinine sulphate is prescribed frequently for nocturnal cramps, although its efficacy is unsupported by stringently controlled clinical trials. Adverse reactions to the drug are unusual. We describe a 60‐year‐old woman with fatal cutaneous vasculitis related to quinine treatment.
APPARENT ELEVATION OF SERUM CK‐MB NOT DUE TO ACUTE MYOCARDIAL INFARCTION
Authors: Dickey W , Carson C A , Andrews W J , Crowe P F 
Published: April 2023

SUMMARYAn increased serum level of the MB isoenzyme of creatine kinase (CK‐MB) is a useful marker for acute myocardial infarction. Although described extensively in clinical chemistry literature, there is little information in standard medical references about false positives for this test. We report two cases where high levels of measured CK‐MB activity were in fact due to another form of CK, associated with internal malignancy.
CYCLICAL BREAST PAIN — SOME OBSERVATIONS AND THE DIFFICULTIES IN TREATMENT
Authors: McFayden I J , Forrest A P M F , Chetty U , Raab G 
Published: April 2023

SUMMARYThis paper describes a retrospective study of the clinical aspects and treatment of 566 women with cyclical breast pain over a seven‐year period. Figures for the effectiveness of simple treatments including some homeopathic drugs are reported. The article concludes that reassurance is the fundamental treatment. Good responses are obtained from simple and safe drugs (oil of evening primrose, vitamin B6) with minimal side‐effects. The use of stronger hormone drugs such as tamoxifen and danazol was only necessary in a small proportion of patients and resulted in a higher incidence of side‐effects.
NICOTINAMIDE TREATMENT IN SUBJECTS AT HIGH RISK OF DEVELOPING IDDM IMPROVES INSULIN SECRETION
Authors: Manna R , Migliore A , Martin L S , Ferrara E , Ponte E , Marietti G , Scuderi F , Cristiano G , Ghirlanda G , Gambassi G 
Published: April 2023

SUMMARYNicotinamide (NCT) has been shown to be effective in preventing the onset of type 1 diabetes mellitus (IDDM) in mice with non‐obese diabetic (NOD) and beta cell damage, mediated by the diabetogenic agents including streptozotocin. NCT therapy in man has been shown to have a beneficial effect on the remission phase of IDDM, and its use is safe. In this open pilot trial we therefore studied the effect of oral NCT administration on insulin secretion rate and islet‐cell antibody (ICA) titres in IDDM high risk subjects. NCT (25 mg/10 kg bw) was administered in 6/13 high risk patients identified by a family screening programme. Those subjects tested after eight months without treatment showed a decreasing secretion in comparison to onset baseline (56,1 ± 37.8 versus 35,5 ± 12.2), whereas the treated subjects showed an increasing insulin secretion after treatment (26 ± 10 versus 50.2 ± 26.6), in spite of ICA persistence. Statistical analysis shows an increased insulin secretion in the treated group versus the untreated group (χ2= 3.899, P= 0.048). No side‐effects were observed. We conclude that NCT may repair beta‐cell function in high risk subjects too if damage is not too severe; furthermore, the effect seems not to be mediated by an immune mechanism.
AN UNUSUAL PRESENTATION OF POLYMYALGIA RHEUMATICA WITH SEVERE MUSCLE WEAKNESS
Authors: Radhamanohar M 
Published: April 2023

SUMMARYAn 83‐year‐old woman suddenly developed profound weakness of proximal and distal muscles in both upper limbs. Electromyography revealed abnormal changes but serum creatine kinase was normal. The weakness responded dramatically to steroid therapy. These unusual features of polymyalgia rheumatica are discussed.
THE ROLE OF EARLY SURGERY FOLLOWING MYOCARDIAL INFARCTION
Authors:   European Coronary Surgery Bypass Group, Lorimer A R , Karlsson T , Varnauskas E 
Published: April 2023

SUMMARYThis co‐operative study was a prospective randomised study to evaluate the role of coronary bypass surgery following acute myocardial infarction. The criterion for entry was an early positive exercise tolerance test. All patients who satisfied the clinical criteria of acute myocardial infarction but who were excluded had information on survival obtained after two years. A total of 4658 patients were assessed, with 3334 (71 %) having a modified exercise test. This test was positive in 728 patients, of whom 598 then underwent coronary angiography. Three hundred and forty‐eight patients were randomised (surgery 168, continuing medical treatment 180).At two years the survival in the medical group was 96% and in the surgical group was 93%. At five years the corresponding figures were 88% and 91%. Sub group analyses in terms of age, ejection fraction and extent of vessel disease failed to show any significant differences between those randomised to medicine or surgery. A positive exercise test early after infarction does help to delineate those more likely to require intervention, but a negative exercise test is not an indication for complacency.
RANDOMISED CROSS‐OVER COMPARISON OF FIVE INHALER SYSTEMS FOR BRONCHODILATOR THERAPY
Authors: Harvey J , Williams J G 
Published: April 2023

SUMMARYThe pharmacological efficacy of β‐2 agonists such as bronchodilators is well established, yet many patients fail to obtain optimum benefit from conventional metered‐dose inhalers. This is usually because of difficulty in achieving adequate co‐ordination between activation of the aerosol and inhalation.1 To some extent this problem can be alleviated by detailed personal instruction and re‐instruction, but the medical or paramedical staff needed to do this may be unavailable and in any case their time is expensive.To increase the benefit obtained from bronchodilators, therefore, pharmaceutical companies have produced a variety of devices, eg, large‐volume (750 ml) spacers (Nebuhaler, Volumatic) which enclose a cloud of aerosol, obviating the need for actuation‐inhalation co‐ordination, and breath actuated dry‐power inhalers with (Rotahaler, Diskhaler) or without (Turbohaler) carrier powders. Subsequent compliance with treatment is dependent upon the acceptability of the inhaler device to the patient.
THE INCOMPETENT CERVIX — A REVIEW
Authors: Edozien L C 
Published: April 2023

SUMMARYRepeated midtrimester pregnancy loss due to incompetence of the cervical os has long been recognised as a treatable condition, but the aetiology, diagnosis and management of this condition remain controversial. Some women have clinically obvious cervical incompetence and may benefit from a cerclage operation, but criteria for early diagnosis are not universally agreed upon. Universal agreement on the aetiology and diagnostic criteria is a prerequisite for determining which women may benefit from surgical management.
VARIANT ANGINA IN THYROTOXICOSIS
Authors: Phull P S , Collins C E , Norell M S , THOMAS D J B 
Published: April 2023

SUMMARYThyrotoxicosis may exacerbate angina pectoris in patients with coronary artery disease but angina also occurs in thyrotoxic patients with normal coronary arteries. Four female severely thyrotoxic patients presented with apparent angina pectoris as a manifestation of their thyrotoxicosis. Two of them had transiently abnormal ECGs during pain. Treatment for thyrotoxicosis immediately stopped the chest pain, which did not recur. All patients had negative exercise ECGs, and one had a normal coronary angiogram.The possible mechanisms to explain this phenomenon are discussed. Coronary artery spasm has been demonstrated in thyrotoxic patients previously and may explain the features in these patients. An alternative hypothesis is that myocardial metabolism is fundamentally changed by thyrotoxicosis. We would recommend that thyroid function assessment should be considered in young female patients with atypical angina.