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This paper reviews five cases of malignant otitis externa treated in Portsmouth between 1979 and 1986. These five patients constitute all the cases seen in the Portsmouth, South East Hampshire, Chichester and South West Sussex area during the period, indicating the condition to be rare. All cases showed a number of features in common: all were elderly (over 55 years); diabetic; the majority (4:1) being male. In all cases Pseudomonus aeruginosa was cultured from pus exuding from the external auditory canal. Each of the five cases was resident in the Chichester and South West Sussex part of the catchment area. Every case presented with otorrhoea and otalgia and all were treated with a combination of topical and intravenous antibiotics plus intensified diabetic control. Two cases followed ear syringing. Neurological complications seen in this series of patients included facial palsy (three cases), fifth nerve palsy, dysphagia, vocal cord palsy, ataxia and Argyll-Robertson pupil. [ABSTRACT FROM AUTHOR]

Rapid environmental change, natural resource overconsumption and increasing concerns about ecological sustainability have led to the development of 'Essential Variables' (EVs). EVs are harmonized data products to inform policy and to enable effective management of natural resources by monitoring global changes. Recent years have seen the instigation of new EVs beyond those established for climate, oceans and biodiversity (ECVs, EOVs and EBVs), including Essential Geodiversity Variables (EGVs). EGVs aim to consistently quantify and monitor heterogeneity of Earth-surface and subsurface abiotic features, including geology, geomorphology, hydrology and pedology. Here we assess the status and future development of EGVs to better incorporate geodiversity into policy and sustainable management of natural resources. Getting EGVs operational requires better consensus on defining geodiversity, investments into a governance structure and open platform for curating the development of EGVs, advances in harmonizing in situ measurements and linking heterogeneous databases, and development of open and accessible computational workflows for global digital mapping using machine-learning techniques. Cross-disciplinary collaboration and partnerships with governmental and private organizations are needed to ensure the successful development and uptake of EGVs across science and policy. This article is part of the Theo Murphy meeting issue 'Geodiversity for science and society'.

Geodiversity - the abiotic heterogeneity of Earth's (sub)surface - is gaining recognition for its ecological links to biodiversity. However, theoretical and conceptual knowledge of geodiversity-trait diversity relationships is currently lacking and can improve understanding of abiotic drivers of community assembly. Here we synthesise the state of knowledge of these relationships. We find that some components of geodiversity (e.g., topographic heterogeneity) elicit strong trait responses, whereas other components (e.g., substrate heterogeneity) have marginal effects in driving trait distributions. However, current knowledge is lacking in key aspects, including geodiversity's effect on trait-specific diversity and intraspecific variation. We call for the explicit inclusion of geodiversity when relating environmental drivers to trait diversity, taking advantage of the increasing availability of trait and geodiversity data., Competing Interests: Declaration of interests There are no conflicts of interest to declare., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

A previously healthy 22-year-old woman presented with acute, unilateral facial and neck swelling, associated with fever and malaise. She was initially treated with intravenous antibiotics; however, CT imaging showed unilateral, synchronous swelling and inflammation of the parotid and submandibular glands, and a PCR swab from the parotid duct was positive for mumps. She was fully immunised and had no contact in the preceding period with anyone diagnosed with mumps. She responded to supportive management and her symptoms resolved over the course of her admission. Unilateral, synchronous swelling and severe inflammation of both the parotid and submandibular glands in mumps is a very unusual presentation, and not one previously reported in the literature., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.)

Pure-tone audiometry was carried out on members of a recently described maternal lineage with sensorineural deafness, harbouring a novel mitochondrial mutation in the gene for tRNA-ser(UCN). This revealed a characteristic pattern of symmetrical bilateral sensorineural hearing losses in each affected individual, predominantly affecting the high-frequencies, but with considerable variability between individuals. No clear correlation was observed between age and severity, but most subjects reported progressive worsening of their condition. Some members of the lineage were found to be heteroplasmic for the tRNA-ser(UCN) mutation. However, the severity of hearing loss was poorly correlated with the representation of the mutant mtDNA, indicating that other, as yet unidentified factors must be involved in the aetiology of this disorder.

We have detected a novel mitochondrial mutation in a maternal pedigree, at least 13 of whose members have sensorineural hearing loss of varying severity, but who exhibit no other pathological features. The mutation, at np 7445, converts the 3' terminal T residue of tRNA-ser(UCN) to a C, and also brings about a silent alteration to the COI stop codon. The mutation destroys an XbaI site, within which a second mutation, at np 7444, has previously been reported in association with Leber's hereditary optic neuropathy. Predominantly mutant mtDNA was found in all 13 family members surveyed, whether or not they are overtly affected by deafness, and some individuals appeared homoplasmic, within the limits of detection. The novel mutation was not found in over 600 normal controls, nor in any of 27 other maternally unrelated individuals with deafness Other mutations found in mitochondrial disorders were also absent from this pedigree.

Acute supraglottic laryngitis and epiglottitis is increasingly recognised in adults. We present a case in which the condition was the presenting feature of acute myeloid leukaemia and in which Branhamella catarrhalis was the causative organism.