bluuebunny/crossref_metadata_2025_split huggingface dataset:
EFFICACY AND TOLERABILITY OF FIXED‐DOSE COMBINATIONS OF TELMISARTAN PLUS HCTZ COMPARED WITH LOSARTAN PLUS HCTZ IN PATIENTS WITH ESSENTIAL HYPERTENSION
Authors: Lacourcière Y , Gil‐Extremera B , Mueller O , Byrne M , Williams L 
Published: April 2023

SUMMARYTelmisartan, an angiotensin II receptor blocker, is an effective once‐daily antihypertensive agent available either alone or in fixed‐dose combination with hydrochlorothiazide (HCTZ). This multicentre, prospective, randomised, open‐label, blinded‐endpoint (PROBE) study assessed the efficacy and safety of six weeks' treatment with telmisartan 40 mg/HCTZ 12.5 mg (n=199) and telmisartan 80 mg/HCTZ 12.5 mg (n=200) versus losartan 50 mg/HCTZ 12.5 mg (n=198) in patients with mild to moderate essential hypertension. During the last six hours of the dosing interval, telmisartan 40 mg/HCTZ 12.5 mg and telmisartan 80 mg/HCTZ 12.5 mg reduced mean ambulatory diastolic blood pressure (DBP) to a greater extent than losartan 50 mg/HCTZ 12.5 mg (treatment differences 1.8 mmHg [p<0.05] and 2.5 mmHg [p<0.001], respectively). Telmisartan 80 mg/HCTZ 12.5 mg also lowered mean 24‐hour DBP by 2.3 mmHg more than losartan 50 mg/HCTZ 12.5 mg (p<0.001). Telmisartan 40 mg/HCTZ 12.5 mg and telmisartan 80 mg/HCTZ 12.5 mg produced greater reductions in ambulatory systolic blood pressure versus losartan 50 mg/HCTZ 12.5 mg of 2.5 mmHg and 3.4 mmHg, respectively, during the last six hours of the dosing interval (p<0.05), and of 2.1 mmHg and 3.4 mmHg, respectively, over the entire 24‐hour dosing interval (p<0.05). All treatments were well tolerated.
SEXUAL ACTIVITY CARDIOLOGICAL SURVEY ON MEMBERS OF THE ISRAEL HEART SOCIETY
Authors: Roth A , Malov N , Survey S 
Published: April 2023

SUMMARYA nationwide telephone survey conducted under the auspices of the Israeli Heart Society examined cardiologists' knowledge of and attitudes towards sexual activity among cardiac patients with concomitant sexual dysfunction. The items covered demography, understanding of relevant mechanisms, drug effects and cardiovascular physiology during sexual activity, suitable interventions and sources of the cardiologists' knowledge. Compliance was excellent (364/379 [96%] responders). Attitudes and knowledge were similar among males and females: 74% underestimated the published frequency of erectile dysfunction in general and among cardiac patients specifically; 90% knew that beta‐blockers cause erectile dysfunction but few responded correctly about other non‐cardiac drugs; 77% try to cope with their patient's problematic sexual function, especially younger cardiologists who tended to be more up to date about it. Israeli cardiologists are motivated to assist these patients but demonstrate a general lack of adequate up to date knowledge on the epidemiological, physiological and pharmacological aspects of the problem.
THE DESIGN OF VENOUS THROMBOEMBOLISM PROPHYLAXIS TRIALS: IS ENOXAPARIN MORE EFFECTIVE THAN FONDAPARINUX?
Authors: Lalourcey L 
Published: April 2023

SUMMARYThe aim of thromboprophylaxis is to minimise the incidence of clinically relevant venous thromboembolism (VTE) but in many trials designed to determine the efficacy of thromboprophylactic agents, asymptomatic VTE is included in the primary endpoint. Since asymptomatic events occur much more frequently than symptomatic events, they dominate the results. Data from trials comparing the thromboprophylactic efficacy of enoxaparin and fondaparinux in orthopaedic surgical patients are used to demonstrate that asymptomatic and symptomatic endpoints may yield different conclusions. There was no difference between these agents in the incidence of symptomatic VTE. Efficacy and safety results of thromboprophylactic studies are affected by other aspects of trial design such as the dose of each agent and the timing of treatment initiation and endpoint assessment. Such factors should be considered when designing clinical trials and evaluating their results.
PALLIATIVE SURGERY FOR ACUTE BOWEL OBSTRUCTION CAUSED BY KAPOSI'S SARCOMA IN A PATIENT WITH AIDS
Authors: Wheeler DW , Baigrie RJ 
Published: April 2023

SUMMARYPatients with human immunodeficiency virus (HIV) infection or acquired immune deficiency syndrome (AIDS) can present with acute abdominal surgical problems, either with intra‐abdominal opportunistic infection as a result of their immunosuppression, or with associated malignancies. We report a 39‐year‐old man who developed intermittent nausea and vomiting, which was originally thought to be a side‐effect of the chemotherapy he was receiving for facial Kaposi's sarcoma. However, he was found to have intraperitoneal Kaposi's sarcoma causing small bowel obstruction, which was successfully excised at laparotomy. There were no perioperative complications despite AIDS‐related respiratory disease. The patient remained free of abdominal symptoms until his death. HIV infections or AIDS alone should not be contraindications to surgery for such problems, as careful patient selection can yield good results and significantly improve quality of life.
THE IMPORTANCE OF REACHING LIPID TARGETS: STATINS AND THE PREVENTION OF ATHEROSCLEROSIS
Authors: Schwandt P 
Published: April 2023

SUMMARYTo help prevent the development of coronary heart disease (CHD), the European and NCEP guidelines have recommended target cholesterol levels for all individuals. Lifestyle changes are advocated for individuals not achieving these targets. Intervention with lipid‐modifying agents may be required for patients at high risk of a cardiovascular event and statins are generally recognised as first‐line therapy. Unfortunately, large numbers of patients at risk of cardiovascular events are not being treated to the guideline targets. Primary care physicians are in a good position to improve lipid management by assessing risk factors, implementing lipid management strategies, monitoring whether targets are being reached and amending treatment appropriately. Furthermore, by educating and motivating patients, primary care physicians may improve compliance with lifestyle changes and medication. These approaches may help more patients to achieve recommended lipid levels and prevent the development of cardiovascular disease.
DENSE MIDDLE CEREBRAL ARTERY SIGN: A PICTORIAL STUDY
Authors: Nagaratnam N , Nagaratnam K , Ng K 
Published: April 2023

SUMMARYThe hyperdense middle cerebral artery on computed tomography (CT), although a useful sign of middle cerebral artery occlusion, does not presage the events to follow. Because of the wide availability of CT it is useful to illustrate the radiological spectrum of findings following middle cerebral artery occlusion. This is pictorial study of four prototypic patients with hyperdense middle cerebral artery which was the common denominator. There was a marked heterogeniety among the patients in relation to the character of the vascular disturbances, location, extent of ischaemic changes and the final outcome. We emphasise that a single radiological sign should be seen in the context of the entire scan.
POOR UPTAKE OF INFLUENZA VACCINATIONS IN PATIENTS RECEIVING CYTOTOXIC CHEMOTHERAPY
Authors: Ring A , Marx G , Steer C , Prendiville J , Ellis P 
Published: April 2023

SUMMARYThis audit was designed to assess whether existing UK vaccination programmes mean that patients receiving chemotherapy are being vaccinated against influenza. One hundred and ten adult patients receiving chemotherapy at a south London tertiary referral centre were interviewed when they attended for their chemotherapy. Thirty‐six of the 110 (33%) patients had received their influenza vaccination at the time of the study. Vaccination rates were significantly higher in those patients older than 65 years (53% vs 17%, p<0.001), and in those with co‐morbidities (49% vs 25%, p<0.05). The vaccination rate in this at‐risk population is lower than the overall national uptake in those aged 65 and over. Those patients most likely not to receive their influenza vaccination are those who have no indication for vaccination other than the fact they are receiving chemotherapy. Increased awareness of the benefits of influenza vaccine and its safety is needed among general practitioners, patients and oncologists.
POSTPARTUM THYROIDITIS PRESENTING AS A COLD NODULE AND EVOLVING TO GRAVES' DISEASE
Authors: Papi G , Corrado S , Carapezzi C , Corsello SM 
Published: April 2023

SUMMARYWe describe the case of a 30‐year‐old woman who, five months after giving birth, was referred with a solitary nodule in her anterior neck. Laboratory analysis, ultrasonography, pertechnetate (Tc99m) thyroid scan and cytological examination of fine needle aspiration biopsy performed on the nodule led us to diagnose postpartum thyroiditis (PPT). Twenty‐eight months after parturition, overt hyperthyroidism developed, with raised thyroperoxidase and thyroid stimulating hormone receptor antibody titres, diffuse high uptake of Tc99m at thyroid scan, and high vascular flow throughout the gland at Color‐Power imaging. The diagnosis of Graves' disease (GD) was established. The differential diagnosis of thyrotoxicosis in the postpartum period, and the possible aetiological relationships between PPT and GD are discussed. To our knowledge, this is the first published report of a PPT presenting as a cold nodule, and evolving to GD.
CAROTID ARTERY INVASION BY SQUAMOUS CELL CARCINOMA OF THE UPPER AERODIGESTIVE TRACT: THE PREDICTIVE VALUE OF CT IMAGING
Authors: Nix PA , Coatesworth AP 
Published: April 2023

SUMMARYCarotid artery invasion by squamous cell carcinoma of the upper aerodigestive tract is a poor prognostic indicator and a relative indicator of tumour inoperability. A number of imaging modalities are available for detecting such invasion, but, because of its availability, computerised tomography (CT) is the usual modality We have analysed the CT scans of 196 patients referred to the department with an upper aerodigestive tract squamous cell carcinoma. Comparing the scans with the operative findings indicates that CT scans significantly overestimate carotid artery invasion.
INTRATHYROIDAL THYROGLOSSAL DUCT CYST PRESENTING AS A THYROID NODULE
Authors: Roy D , Roy PG , Malik VK , Seenu V 
Published: April 2023

SUMMARYA 50‐year‐old woman presented with a lateral neck swelling, clinically indistinguishable from solitary thyroid nodule. A right hemithyroidectomy was performed and microscopy revealed an intrathyroidal thyroglossal cyst. Intrathyroidal thyroglossal cyst should be considered in the differential diagnosis of a thyroid nodule.
AUTOIMMUNE HEPATITIS TRIGGERED BY BRUCELLA INFECTION OR DOXYCYCLINE OR BOTH
Authors: Selimoglu MA , Ertekin V 
Published: April 2023

SUMMARYAutoimmune hepatitis is a disorder of unknown aetiology in which progressive destruction of the hepatic parenchyma occurs, often progressing to cirrhosis. Hepatitis A, Ebstein‐Barr virus and measles virus have been identified as triggers for autoimmune hepatitis in susceptible individuals. There are also reports about herbal medicine and minocycline. A case with autoimmune hepatitis triggered by Brucella infection or doxycycline, or both, is presented. An 11‐year‐old female patient treated with six weeks of doxycycline and three weeks of streptomycine for brucellosis presented with histologically proven autoimmune hepatitis (AH) and responded to corticosteroid treatment. Since neither brucellosis nor doxcycyline as triggering factors for AH have been described so far, these two entities are discussed and the literature reviewed.
ADENOID CYSTIC CARCINOMA OF THE BREAST
Authors: Kontos M , Fentiman IS 
Published: April 2023

SUMMARYThis study presents a series of eight patients with adenoid cystic carcinoma of the breast, a rare variant of breast cancer with special clinical and radiological characteristics that may lead to clinical misdiagnosis. Diagnosis may be made by core biopsy or fine needle aspiration cytology. Treatment by wide local excision followed by radiotherapy or mastectomy is necessary but axillary dissection can be avoided. Most of these patients have an excellent prognosis. (Int J Clin Pmct 2003; 57(8): 669–672)
PARATHYROID ADENOMA‐RELATED HYPERCALCAEMIA IN BREAST CANCER: A CRITICAL DIAGNOSIS IN CLINICAL ONCOLOGY
Authors: Barutca S , Yurekli Y , Erdogan S , Kadikoylu G , Kacar F 
Published: April 2023

SUMMARYHypercalcaemia in patients with breast cancer is generally due to osteolytic metastases or to the activity of circulating tumour‐derived products. Hyperparathyroidism is one of the most frequent aetiological factors in benign hypercalcaemia, but it is usually not considered in oncology patients. We present a high‐risk early breast cancer case with hypercalcaemia in the 19th postoperative month of follow‐up. The patient had high serum parathyroid hormone (PTH) levels, but ultrasonography was not diagnostic, and the existence of parathyroid adenoma was established by scintigraphy. Histopathological examination revealed chief cell parathyroid adenoma. The patient is still free of cancer recurrence in the 48th month of follow‐up. Hyperparathyroidism should be considered as a possible cause of hypercalcaemia in breast cancer patients, and parathyroid scintigraphy is essential in the initial evaluation of the cases with increased serum calcium and PTH concentrations.
PULMONARY ARTERIOVENOUS MALFORMATION: A RARE, TREATABLE CAUSE OF STROKE IN YOUNG ADULTS
Authors: Retnakaran RR , Faughnan ME , Chan RP , Pugash RA , O'Connor PW , Chow C‐M 
Published: April 2023

SUMMARYPulmonary arteriovenous malformation (PAVM) predisposes affected patients to a significantly increased risk of stroke. Most commonly, PAVM is seen in patients with hereditary haemorrhagic telangiectasia (HHT), an inherited disorder that can be difficult to diagnose in young people because of variable age‐related penetrance. As such, stroke in the young adult may be the presenting feature of underlying PAVM in a previously undiagnosed patient. The importance of considering this diagnosis in the evaluation of young adults with cryptogenic stroke is underscored by the availability of both sensitive screening and effective treatment for PAVM, from which this at‐risk population can greatly benefit.
EXPLOSION DURING DIATHERMY GASTROTOMY IN A PATIENT WITH CARCINOMA OF THE ANTRUM
Authors: Inan A , Dener C , Demirci S 
Published: April 2023

SUMMARYGas explosion during diathermy gastrotomy is a very rare occurrence. We report on an unusual case of gas explosion during diathermy gastrotomy in a patient with carcinoma of the gastric antrum.
EFFICACY OF POVIDONE‐IODINE IN PREPUTIAL ANTISEPSIS
Authors: Çakmak M , Çaglayan F , Kiliç D , Kaygusuz S , Çakmak A , Ulusoy S , Özlü N , Özlük O 
Published: April 2023

SUMMARYWound infection after a surgical procedure is one of the main problems affecting the success of an operation. The prepuce is used in hypospadias surgery and in tissue defects in reconstructive surgery. The objective of this study is to determine the efficacy of povidone‐iodine and surgical soap in preputial skin preparation. Ninety‐four healthy children were divided into three groups. After obtaining preputial skin swabs, an application of povidone‐iodine 10% was made and skin swabs were obtained after two and five minutes in group 1. An additional application of povidone‐iodine after two minutes was made in group 2 and swabs taken. Group 3 received a local scrub with surgical soap and an application of povidone‐iodine. Results showed that, despite painting with povidone‐iodine and/or local cleaning with surgical soap, it is not possible totally to eradicate the micro‐organisms in the prepuce. Surgical soap decreases the colony count, which can lead to increased effectiveness of povidone‐iodine after painting. We recommend preoperative local cleaning with surgical soap before surgical painting.
SNORING, NOT JUST A SOCIAL NUISANCE
Authors: Jarvis S , Rees PJ 
Published: April 2023

SUMMARYSnoring is a very common source of complaints from partners and neighbours. Snorers themselves are less likely to be affected, unless they have associated daytime sleepiness caused by the sleep disruption from obstructive sleep apnoea. There is increasingly firm evidence that obstructive sleep apnoea is associated with hypertension, cardiovascular, cerebrovascular and metabolic problems such as insulin resistance, even at mild levels which may not cause much daytime somnolence. In addition, the central and obstructive apnoeas found in cardiac failure affect heart muscle function. Treatment of the apnoea improves blood pressure and cardiac function and is likely to have a beneficial effect on mortality. Since obstructive sleep apnoea is common it should be sought by appropriate questioning in these patient groups. The treatments for obstructive sleep apnoea are effective but cumbersome and this remains a challenge if patients do not achieve obvious early benefits such as reduction in sleepiness or breathlessness.
XX MALE: A RARE CAUSE OF SHORT STATURE, INFERTILITY, GYNAECOMASTIA AND CARCINOMA OF THE BREAST
Authors: Hado HSH , Helmy SW , Klemm K , Miller P , Elhadd TA 
Published: April 2023

SUMMARYWe present a case of an XX male with carcinoma of the breast and primary infertility. He was admitted to hospital with recurrent chest pains, but a history of surgery for breast carcinoma, gynaecomastia and the finding of bilaterally atrophied testes, coupled with the fact that he had never fathered children, necessitated further investigations. Chromosomal analysis showed a 46, XX male genotype with a normal X chromosome and an abnormal X chromosome formed by translocation between the short arm of one X chromosome and the Y chromosome. By using fluorescence in situ hybridisation, the patient proved to be SRY positive, the sex‐determining region of the Y chromosome. In this rare genetic abnormality males retain normal phenotype but they are generally of short stature, have gynaecomastia, and may have genital anomalies. They are infertile and at increased risk of developing carcinoma of the breast. This seems to be the first documented case of carcinoma of the breast in an SRY positive XX male. This particular case illustrates the need for all cases of male breast cancer to undergo full endocrinological assessment, especially in the presence of genital anomaly or infertility. (Int J Clin Pract 2003; 57(9): 844–845)
NASOPHARYNGEAL CARCINOMA IN YOUNG PATIENTS
Authors: Lim LHY , Goh CHK , Loong SLE , Khin LW , Balakrishnan A , Wee J 
Published: April 2023

SUMMARYNasopharyngeal carcinoma (NPC) is rare in under 20‐year‐olds. Early diagnosis greatly improves survival. A retrospective review of 12 young NPC patients (seven males, five females, mean age 16 years) was performed to identify differing patient and tumour characteristics from adult NPC. Seventy‐five per cent presented with neck lumps and 25% with headache. None had a family history of NPC or epistaxis. One patient had early stage NPC, and 11 had late stage NPC. Three late stage patients who received chemoradiotherapy had better clinical outcomes than six late stage patients receiving only radiotherapy. There were six deaths, five bony recurrences and one postnasal space recurrence. The 11 late stage patients' five‐year actuarial survival was only 29%. Headache is an important symptom for young NPC. Late stage presentation and distant recurrences are also more common, supporting an increased role of chemotherapy.
EFFICACY AND SAFETY OF BRIMONIDINE, DORZOLAMIDE AND LATANOPROST AS ADJUNCTIVE THERAPY IN PRIMARY OPEN ANGLE GLAUCOMA
Authors: Sodhi PK , Pandey RM , Ratan SK 
Published: April 2023

SUMMARYA double‐blind, randomised, controlled trial was carried out to evaluate the efficacy and safety of brimonidine, dorzolamide and latanoprost as an adjunctive therapy in patients with primary open angle glaucoma (POAG). A total of 200 males and 72 females with POAG uncontrolled with previous glaucoma therapy were randomly allocated to receive topical brimonidine 0.2% b.d. (n=90), topical dorzolamide 2% b.d. (n=91) or topical latanoprost 0.005% o.d. (n=91). One year post treatment, the mean percentage reduction in intraocular pressure (IOP) between the three groups was statistically significant (p<0.0001). In an intergroup comparison of efficacy, there was a statistically significant difference between the brimonidine and dorzolamide groups (p=0.018) and between the dorzolamide and latanoprost groups (p=0.76) but the efficacy of brimonidine was not significantly higher than latanoprost in the brimonidine and latanoprost groups (p=0.002). Patients experiencing mild to severe side‐effects were statistically similar in the three groups. On an inter‐drug comparison of side‐effects, we found no statistically significant difference in the brimonidine and latanoprost groups (p=0.25); and the brimonidine and dorzolamide groups (p=0.067), while the number of side‐effects with latanoprost was significantly higher in the dorzolamide and latanoprost groups (p<0.003). All three drugs caused a significant reduction in the mean IOP from pretreatment values. The brimonidine group had a higher number of patients experiencing severe side‐effects necessitating alteration of therapy.
TESTIS‐SPARING SURGERY FOR BENIGN AND MALIGNANT TESTICULAR TUMOURS
Authors: Chandak P , Shah A , Taghizadeh A , Tiptaft R , Dasgupta P 
Published: April 2023

SUMMARYWe report the technique of testis‐sparing surgery in three young men with testicular tumours, two of which were found to be benign (Leydig cell tumour and benign teratoma) and one malignant (seminoma) on frozen section and final pathological evaluation. The principles of clamping the spermatic cord with a soft bowel clamp, testicular cooling with ice slush, tumour enucleation with clear margins, meticulous haemostasis and frozen section analysis were followed. Testicular preservation was successful in the patients with benign disease. The patient with seminoma was found to have a separate nodule of invasive, poorly differentiated seminoma in the residual testis, which had not been detected on preoperative ultrasound scanning. As a result he was converted to radical orchidectomy.
HYPERTRIGLYCERIDAEMIA AND NK CELL LYMPHOMA
Authors: Suryanarayanan S , Wierzbicki AS , Carr R , Ritter JM 
Published: April 2023

SUMMARYThis case report describes a patient who presented with pyrexia of unknown origin allied with hypertriglyceridaemia (16.2 mmol/l) but not hypercholesterolemia (4.1 mmol/l). Investigations identified the cause of the pyrexia as an adult T‐cell lymphoma of natural killer cell phenotype (CD3[+], CD7[+], anti‐TCR alpha/beta[+], CD8[+], CD56[+]). Hypertriglyceridaemia has been reported with non‐Hodgkins lymphoma, and an animal model suggests that antilipoprotein lipase antibodies may be made as an immunological response to the tumour. Lymphomas should be considered as part of the differential diagnosis in type IV‐V hyperlipidaemia.