Morphoea presenting histopathologically as mycosis fungoides: an illustrative series of four cases.

Aims: There have been exceptional reports of morphoea presenting with epidermal changes overlapping histopathologically with cutaneous T cell lymphoma of the mycosis fungoides type (MF). This phenomenon gives rise to an ambiguous clinicopathological scenario in which distinguishing these conditions may be challenging. The aim of this study is to characterise the clinical, histopathological and molecular findings of this phenomenon through a case series.

Systemic acidemia impairs cardiac function in critically Ill patients.

Background: Acidemia, is associated with reduced cardiac function in animals, but no studies showing an effect of acidemia on cardiac function in humans are reported. In the present study, we examined the effect of acidemia on cardiac function assessed with transpulmonary thermodilution technique with integrated pulse contour analysis (Pulse Contour Cardiac Output, PiCCO™) in a large cohort of critically ill patients.

Methods: This was a prospective multicenter observational cross-sectional study of 297 patients from 6 intensive care units in London, England selected from all patients admitted consecutively between May 2018 and March 2019.

Long Term Outcomes of Nasoseptal Perforation Repair With an Anterior Ethmoidal Artery Flap.

Background: Nasoseptal perforation repair is a challenging condition with no standard technique for repair recognized.

Methods: A case series of consecutive patients who underwent nasoseptal perforation repair with an anterior ethmoidal artery flap was conducted. Demographic data, preoperative features of the perforation and postoperative outcomes were analyzed.

Endoscopic Endonasal Transpterygoid Approach to Sphenoid Sinus Lateral Recess Defects.

 Lesions affecting sphenoid sinus lateral recess (SSLR) are difficult to visualize and manipulate through the transnasal routes, especially when the sinus is highly pneumatized. External approaches to this area involve extensive surgery and are associated with significant morbidity. The aims of this study are to present our experience with the endoscopic transpterygoid approach as a method for approaching lesions of the SSLR and to evaluate the outcomes of this procedure.

Ultrasonic Scalpel-Assisted Endoscopic Endonasal Surgery of Infratemporal Fossa: Our First Impressions.

Background: The endoscopic endonasal transpterygoid approach is emerging as a valid option for treating selected tumors in the infratemporal fossa. Compared with traditional open approaches, the endoscopic endonasal approach presents more difficulty in controlling bleeding and less choice in surgical instruments for endoscopic tumor dissection, which is often performed with bipolar forceps or steel dissectors.

Case Description: We describe the use of an ultrasonic scalpel device for performing endoscopic endonasal resection of 2 rare infratemporal fossa tumors (mature teratoma and hemangiopericytoma), which has not been reported in the literature so far.

Assessment of taste functions in allergic rhinitis patients undergoing allergen-specific immunotherapy.

Background: We evaluated taste functions of patients with perennial allergic rhinitis (AR) before and after allergen-specific immunotherapy (AIT).

Methods: The study was designed as a prospective clinical study in our tertiary care hospital. Patients (n = 21) who were diagnosed with perennial AR on the basis of physical examination, skin prick test of at least 3* for HDM allergen and treated with AIT were enrolled in this study.

A novel cognitive stress management technique for acne vulgaris: a short report of a pilot experimental study.

Background: Acne vulgaris (AV) is one of the most common disorders treated by dermatologists and other healthcare providers. Stress is a well-attested contributor to AV pathogenesis. However, to our knowledge, stress management has not yet been performed in AV patients.

Neck Muscle Mass Index as a Predictor of Post-Laryngectomy Wound Complications.

Objective: We investigated the relationship between paravertebral muscle cross-sectional area (PVM CSA) at the third vertebra (C3) level using computerized tomography (CT) neck images and its relationship with complications after total laryngectomy.

Design: Retrospective analysis of 60 advanced laryngeal cancer patients who underwent total laryngectomy was performed. The cross-sectional areas of paravertebral neck muscles using neck CT at C3 level images obtained preoperatively were analyzed.

Aspirin for Evidence-Based Preeclampsia Prevention trial: effect of aspirin on length of stay in the neonatal intensive care unit.

Background: Preeclampsia is a major pregnancy complication with adverse short- and long-term implications for both the mother and baby. Screening for preeclampsia at 11-13 weeks' gestation by a combination of maternal demographic characteristics and medical history with measurements of biomarkers can identify about 75% of women who develop preterm preeclampsia with delivery at <37 weeks' gestation and 90% of those with early preeclampsia at <32 weeks, at a screen-positive rate of 10%. A recent trial (Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-Based Preeclampsia Prevention) has reported that in women identified by first-trimester screening as being at high risk for preeclampsia, use of aspirin (150 mg/d from the first to the third trimester), compared to placebo, reduced the incidence of preterm preeclampsia, which was the primary outcome, by 62% (95% confidence interval, 26-80%) and the incidence of early preeclampsia by 89% (95% confidence interval, 53-97%).

ASPRE trial: incidence of preterm pre-eclampsia in patients fulfilling ACOG and NICE criteria according to risk by FMF algorithm.

Objective: To report the incidence of preterm pre-eclampsia (PE) in women who are screen positive according to the criteria of the National Institute for Health and Care Excellence (NICE) and the American College of Obstetricians and Gynecologists (ACOG), and compare the incidence with that in those who are screen positive or screen negative by The Fetal Medicine Foundation (FMF) algorithm.

Methods: This was a secondary analysis of data from the ASPRE study. The study population consisted of women with singleton pregnancy who underwent prospective screening for preterm PE by means of the FMF algorithm, which combines maternal factors and biomarkers at 11-13 weeks' gestation.

Aspirin for Evidence-Based Preeclampsia Prevention trial: effect of aspirin in prevention of preterm preeclampsia in subgroups of women according to their characteristics and medical and obstetrical history.

Background: The Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-Based Preeclampsia Prevention trial demonstrated that in women who were at high risk for preterm preeclampsia with delivery at <37 weeks' gestation identified by screening by means of an algorithm that combines maternal factors and biomarkers at 11-13 weeks' gestation, aspirin administration from 11 to 14 until 36 weeks' gestation was associated with a significant reduction in the incidence of preterm preeclampsia (odds ratio 0.38; 95% confidence interval, 0.20 to 0.

Fifteen-minute consultation: Monogenic forms of diabetes with onset after age 6 months.

Monogenic forms of diabetes (historically known as Maturity Onset Diabetes of the Young (MODY)) are caused by single gene mutations inherited in an autosomal dominant fashion that result in reduced pancreatic beta cell function. Children with these forms of diabetes may be misdiagnosed as having type 1 or 2 diabetes, which has important implications for treatment, genetic counselling, screening of family members and prognosis. Useful tools now exist to aid in their diagnosis and management.

Dedicated Barrett's surveillance sessions managed by trained endoscopists improve dysplasia detection rate.

 Barrett's esophagus (BE)-associated dysplasia is an important marker for risk of progression to esophageal adenocarcinoma (EAC) and an indication for endoscopic therapy. However, BE surveillance technique is variable. The aim of this study was to assess the effect of dedicated BE surveillance lists on dysplasia detection rate (DDR).

Multicenter screening for pre-eclampsia by maternal factors and biomarkers at 11-13 weeks' gestation: comparison with NICE guidelines and ACOG recommendations.

Objective: To compare the performance of screening for pre-eclampsia (PE) based on risk factors from medical history, as recommended by NICE and ACOG, with the method proposed by The Fetal Medicine Foundation (FMF), which uses Bayes' theorem to combine the a-priori risk from maternal factors, derived by a multivariable logistic model, with the results of various combinations of biophysical and biochemical measurements.

Methods: This was a prospective multicenter study of screening for PE in 8775 singleton pregnancies at 11-13 weeks' gestation. A previously published FMF algorithm was used for the calculation of patient-specific risk of PE in each individual.

Hair Follicle Miniaturization in a Woolly Hair Nevus: A Novel "Root" Perspective for a Mosaic Hair Disorder.

Woolly hair nevus is a mosaic disorder characterized by unruly, tightly curled hair in a circumscribed area of the scalp. This condition may be associated with epidermal nevi. We describe an 11-year-old boy who initially presented with multiple patches of woolly hair and with epidermal nevi on his left cheek and back.

A new diagnosis of acute myeloid leukaemia complicated by peripancreatic tuberculous lymphadenitis.

A 29-year-old woman presented with neutropenic sepsis and was found to have a new diagnosis of acute myeloid leukaemia. Following initiation of induction chemotherapy the patient became increasingly unwell with ongoing sepsis despite broad-spectrum antibiotic treatment. An extensive septic screen failed to identify a source, other than the finding of a peripancreatic mass on imaging.

Computed tomography coronary angiography: Is radiation a concern for the gold standard test for anomalous coronary arteries?

Multi-detector computed tomography is now an established modality for the investigation of coronary artery disease.1,2^ 64-Slice multi-detector computed tomography is the standard requirement by the British society of cardiac imaging and can image the whole heart in four heart beats. The 320 slice multi-detector computed tomography can image the heart in one heart beat, but both technologies depend on B-blockers to slow the patient's heart rate to 60 beats per minute to ensure excellent image quality and low radiation dose.

Paediatric case of a large gastric rupture after a blunt abdominal trauma: Report of a case in a District General Hospital.

Introduction: Isolated gastric rupture after blunt abdominal trauma is rare. In current literature gastric rupture from blunt abdominal trauma ranges between 0.02% and 1.