bluuebunny/crossref_metadata_2025 huggingface dataset:
Resistance to fungal pathogens triggered by the Cf9‐Avr9 response in tomato and oilseed rape in the absence of hypersensitive cell death
Authors: Hennin Caroline , Diederichsen Elke , Höfte Monica
Published: March 2003

summary

In tomato and related species, the Cf9 resistance gene induces hypersensitive cell death and activates downstream defence pathways upon recognition of the Avr9 elicitor. We investigated whether the Cf9‐Avr9 response without hypersensitive cell death symptoms increases resistance to several fungi. A low Avr9 dose that does not cause hypersensitive cell death was injected in Cf9 tomato and transgenic Cf9 oilseed rape plants. Subsequently, the injected leaves were infected with different fungal pathogens. The disease development of Botrytis cinerea was delayed in Cf9 tomato when the pathogen was inoculated on, or around, the Avr9 injection site. Disease development of Leptosphaeria maculans and Sclerotinia sclerotiorum was delayed on Cf9 oilseed rape plant parts located around the Avr9 injection site. Disease development of Oidium lycopersicum in Cf9 tomato or Erysiphe polygoni in Cf9 oilseed rape was not restricted on leaves injected with Avr9. The Avr9 injection induced systemic resistance to L. maculans and E. polygoni in Cf9 oilseed rape. F1(Cf9×Avr9) oilseed rape plants, obtained from crosses of transgenic Cf9× transgenic Avr9 oilseed rape, exhibited higher levels of resistance to L. maculans and E. polygoni but not to S. sclerotiorum, than wild‐type plants. F1(Cf9×Avr9) plants treated with benzothiadiazole (BTH) did not show elevated levels of expression of some pathogenesis‐related genes but developed higher levels of resistance to L. maculans than BTH‐treated wild‐type plants. This report demonstrates that the hypersensitive cell death which is associated with the Cf9‐Avr9 response is not required for quantitative disease resistance.
Molecular evidence that Verticillium ablo‐atrum Grp 2 isolates are distinct from V. albo‐atrum Grp 1 and V. tricorpus
Authors: Mahuku George S. , Platt H. W.
Published: March 2003

summary

Verticillium species‐specific primers were used in a polymerase chain reaction to differentiate between Verticillium albo‐atrum groups and V. tricorpus. Amplification with species‐specific primers identified 21 isolates from the 64 V. albo‐atrum isolates tested as Grp2. Genome analysis using RAPDs and restriction fragment length polymorphism (RFLP) of the intergenic (IGS) region of the rDNA showed that V. albo‐atrum Grp2 isolate were genetically distinct from either V. albo‐atrum Grp1 or V. tricorpus, demonstrating a significant differentiation between these species. The sizes of the amplified IGS fragment were different, with Grp1 isolates having a smaller fragment (≈ 2.1 kb) than either Grp2 (≈ 2.3 kb) or V. tricorpus (≈ 2.7 kb). Based on RAPD analysis, the average similarity coefficients between Grp1 and Grp2 were 35% and 34% between Grp2 and V. tricorpus. Multiple correspondence analysis separated the isolates into three major groups corresponding to Grp1, Grp2 and V. tricorpus. Surprisingly, isolates collected from Pisum sativa were distinct from other Grp1 V. albo‐atrum isolates. The observed low levels of genetic similarity, the differences in sizes of IGS fragments, IGS‐RFLP profiles and the RAPD patterns point to the possibility of Grp2 isolates comprising a different species of Verticillium than those occupied by either V. albo‐atrum Grp1 isolates or V. tricorpus.
The need for a standard nomenclature for gene classification (a Nucleotide Function Code) and an automated data‐based tool to assist in understanding the molecular associations in cell signalling in plant–pathogen interactions
Authors: Lyon Gary D. , Newton Adrian C. , Marshall Bruce
Published: March 2003

summary

Despite the adoption of Arabidopsis thaliana as a model plant system and the plethora of molecular information being obtained from its use, it is disappointing that the scientific community has not devised a cell signalling model integrating and visualizing these data. Lack of common systems of nomenclature and the sheer size and complexity of the task inhibit any individual from bringing together the knowledge into a unified structure. There are clearly many aspects of cell biology that are similar, even between plants and animals, that could facilitate development of a generic model. A gene‐coding or nucleotide classification system which is ‘user‐friendly’ would be beneficial to building such a model and enable rapid identification of orthologues of genes from different organisms. Whilst some international projects seek to address the problem of assigning unique numbers to genes, none suggest a nucleotide classification system that provides biological information that is transparent within the code. This paper discusses these issues and identifies the need for a more formal, semi‐automated approach to modelling signal transduction utilizing the strengths of the proposed classification approach. By way of illustration, an example of a possible nucleotide function code is suggested, to demonstrate more clearly the benefits of such a system. Further discussion of this topic will be encouraged on websites ( and ).
Social violence: a case for classification as a sub‐phenomenon of community in the ICNP®
Authors: Coler M. S. , Araújo L. do C. A. , Coêlho A. A. , De Figueiredo T. M. R. M. , Freire M. R. de Melo , Moreira M. E. de Araújo
Published: March 2003

The study is intended to illustrate that the nursing phenomenon, Violence, exists as a phenomenon of the aggregate and should thus be classified, under the higher level phenomenon, Community, in the International Classification for Nursing Practice (ICNP®), published by the International Council of Nurses. This proposition was confirmed during a meeting of an international team of psychiatric nurses to plan reality‐based postgraduate modules for the nine countries they represented. Substantiating data, based on the team’s module, Violence, clinical investigation and a review of the literature, evolved from a classroom project in north‐east Brazil. The Master’s Degree nursing students conducted observations and interviews based on identified factors of the phenomenon on children in two municipal day‐care centres in targeted neighbourhoods in João Pessoa, Paraíba, Brazil. Data were gleaned from observations and verbalizations regarding their individual drawings depicting sadness and happiness, from school records and observations of these children by their teachers. The data, evolving from the time‐limited classroom project, are too sparse to be considered valid, but pave the road for further studies. Professional and lay‐literature substantiates the occurrence of violence in the Brazilian society.

Readers can access the entire text of the ICNP® Beta Version by visitinghttp://www.icn.ch/icnpupdate.htm.Other information about the ICNP® and its development can be found athttp://www.icn.ch/icnp.htm.
Building international partnerships
Authors: Zheng X. X. , Hinshaw . S. , Yu . Y. , Guo . F. , Oakley D. J.
Published: March 2003

Health is a global concern. Although nursing is a global profession, most schools of nursing concentrate on teaching health exclusively within the context of their own nation. Sister‐school partnerships that cross national boundaries are one way of extending the learning opportunities of faculties and students. An example of a 5‐year partnership is described and analysed.
Marrying modern health practices and technology with traditional practices: issues for the African continent
Authors: Bruce J. C.
Published: March 2003

One of the main sessions at the 2001 22nd Quadrennial Congress of the International Council of Nurses in Denmark explored the harnessing of modern health technologies for contemporary health care. The session theme of ‘marrying the old and the new’ is particularly important in societies where modern medicine and technology coexist with traditional approaches to health care; in this instance, its coexistence with traditional medicine in African societies. This coexistence has not been easy for many African countries. For some, overt exclusion from health care systems through prohibitive legislation has become the order of the day for traditional practitioners. On the other hand, there has been an increasing interest in traditional practices among modern health practitioners and a willingness to collaborate. Similarly, traditional practitioners are slowly beginning to incorporate aspects of modern medicine into their practice; notably the use of science and technology. This report describes the interface of modern medicine and technologies with traditional approaches to health care. Benefits and concerns raised by genetic, information, solar and environmental technologies at this interface, are discussed. Selected traditions and the challenges these bring to the practice arena, research, education and policy, are presented together with suggestions to reconcile old and new.
The effect of war on children: the children of Europe after World War II
Authors: Shields L. , Bryan B.
Published: March 2003

In war, children are inevitably innocent victims. In the carnage that was World War II, more children were killed or orphaned than at any other time in history. This article gives a brief history of the place of children within the conflagration, then describes the effects of war on the children. We concentrate on postwar life, placing children in the context of the environment in which they were living at the time. Our article outlines the work carried out by relief agencies and how Europe began to rebuild itself, how the children were fed and made healthy, and how, where possible, they were reunited with their families. We report briefly on the physical and psychological damage children suffered, both during the war and in its aftermath. History such as this is relevant to nurses in the 21st century, as it provides insight upon which nursing care for both our present ageing population and for children of the future can be based.
The ICNP's relevance in the US
Authors: Henry Suzanne Bakken , Elfrink Victoria , McNeil Barbara , Warren Judith
Published: March 2003

Efforts to develop an International Classification for Nursing Practice (ICNP) were initiated nearly a decade ago.** To update nurses on progress, below is a critical review of the ICNP using the Computer‐based Patient Record Institute (CPRI) Features Framework and a discussion of its relevance to current US efforts: 1) the activities of the American Nurses' Association (ANA) Steering Committee on Databases To Support Clinical Nursing Practice; 2) implementation of formal approaches for representing nursing concepts and 3) Health Level 7 standards.
Emotion, moral perception, and nursing practice
Authors: Scott P. Anne
Published: March 2003

AbstractMany of the activities of clinical practice happen to, with or upon vulnerable human beings. For this reason numerous nursing authors draw attention to or claim a significant moral domain in clinical practice. A number of nursing authors also discuss the emotional involvement and/or emotional labour which is often experienced in clinical practice. In this article I explore the importance of emotion for moral perception and moral agency. I suggest that an aspect of being a good nurse is having an emotional sensitivity to other human beings (patients), because this emotional sensitivity allows the nurse to perceive more accurately the context and perspective of the patient. It is thus important to the moral agency of the nurse and to morally sensitive clinical practice. As such education of the emotions should be a feature of the moral education of the nurse. A useful conception of the role of educated emotion in the moral life can be discovered in Aristotelian ethics.
The illusion of progress in nursing
Authors: Herdman Elizabeth A.
Published: March 2003

Abstract The notion that history is a record of continuous improvement has come to dominate the Western view of the world. This paper examines how nursing has embraced this ‘Enlightenment project’ and continues to be guided by a faith in ‘history as progress’ despite the fact that its structural position remains one of subordination and struggle. Faith in progress is manifested in nursing historiography and contemporary nursing literature, in the basic tenet of nursing orthodoxy, that professionalization is both inevitable and desirable, in the alignment of nursing with medical science and technology and the belief that Western nursing is the model for nursing world wide. It is argued that this uncritical faith in a continuously improving future has obscured nursing's vision for the future and rendered it powerless in the face of rapid global economic and social change.
Global classification of human facial healthy skin using PLS discriminant analysis and clustering analysis
Authors: Guinot C , Latreille J , Tenenhaus M , Malvy D J‐M
Published: March 2003

Synopsis

Today’s classifications of healthy skin are predominantly based on a very limited number of skin characteristics, such as skin oiliness or susceptibility to sun exposure. The aim of the present analysis was to set up a global classification of healthy facial skin, using mathematical models. This classification is based on clinical, biophysical skin characteristics and self‐reported information related to the skin, as well as the results of a theoretical skin classification assessed separately for the frontal and the malar zones of the face. In order to maximize the predictive power of the models with a minimum of variables, the Partial Least Square (PLS) discriminant analysis method was used. The resulting PLS components were subjected to clustering analyses to identify the plausible number of clusters and to group the individuals according to their proximities. Using this approach, four PLS components could be constructed and six clusters were found relevant. So, from the 36 hypothetical combinations of the theoretical skin types classification, we tended to a strengthened six classes proposal. Our data suggest that the association of the PLS discriminant analysis and the clustering methods leads to a valid and simple way to classify healthy human skin and represents a potentially useful tool for cosmetic and dermatological research.

Résumé

Les classifications actuelles qui définissent une peau saine sont fondées principalement sur un nombre très limité de caractéristiques cutanées telles que l’aspect gras de la peau ou sa sensibilité au soleil. Cette analyse a pour but d’établir une classification globale de la peau humaine saine du visage à l’aide de modèles mathématiques. Une recherche de typologie a été effectuée à partir des caractéristiques cliniques et biophysiques de la peau du visage des individus tout en tenant compte d’une classification théorique, reflet de l’expertise des dermatologues, appréciée sur les zones frontale et malaire du visage. Pour accroître l’efficacité prédictive des modèles avec un minimum de variables, la méthode d’analyse discriminante PLS (Partial Least Square) a été utilisée. Des méthodes de classification ont été appliquées aux composantes PLS obtenues afin de déterminer le nombre le plus vraisemblable de classes et pour regrouper les sujets selon leurs proximités. Grâce à cette approche, quatre composantes PLS ont pu être construites et six classes se sont avérées pertinentes. Ce travail a abouti à une proposition de classification à six classes plus vraisemblable et acceptable que les 36 combinaisons possibles de la classification théorique proposée. Nos données suggèrent que l’association de l’analyse discriminante PLS aux méthodes de classification permet d’obtenir de façon simple et appropriée une classification de la peau humaine saine et représente un outil potentiel utile dans le domaine de la recherche en cosmétologie et en dermatologie.
A novel sunscreen system based on tocopherol acetate incorporated into solid lipid nanoparticles
Authors: Wissing S. A. , Müller R. H.
Published: March 2003

Synopsis Solid lipid nanoparticles (SLN) have been introduced as a novel carrier system for drugs and cosmetics. It has been found that SLN possess characteristics of physical UV‐blockers on their own, thus offering the possibility of developing a more effective sunscreen system with reduced side‐effects. Incorporation of the chemical sunscreen tocopherol acetate into SLN prevents chemical degradation and increases the UV‐blocking capacity. Aqueous SLN dispersions were produced and incorporated into gels, followed by particle size examination, stability testing upon storage and thermoanalytical examination. Investigation of the UV‐blocking capacity using different in vitro techniques revealed that the SLN dispersions produced in this study are at least twice as effective as their reference emulsions (conventional emulsions with identical lipid content). Placebo SLN even show greater UV‐blocking efficacy than emulsions containing tocopherol acetate as the molecular sunscreen. Incorporation of tocopherol acetate into SLN leads to an overadditive UV‐blocking effect. Furthermore, film formation of SLN on the skin and occlusivity were examined. The obtained data show that incorporation of tocopherol acetate into SLN leads to an improved sunscreen and skin care formulation.
Nudging hair shedding by antidandruff shampoos. A comparison of 1% ketoconazole, 1% piroctone olamine and 1% zinc pyrithione formulations
Authors: Piérard‐Franchimont C. , Goffin V. , Henry F. , Uhoda I. , Braham C. , Piérard G. E.
Published: March 2003

Synopsis

Hair shedding and hair thinning have been reported to be affected by dandruff and seborrhoeic dermatitis. The present study was conducted in 150 men presenting with telogen effluvium related to androgenic alopecia associated with dandruff. They were randomly allocated to three groups receiving each one of the three shampoos in the market containing either 1% ketoconazole (KTZ), 1% piroctone olamine (PTO) or 1% zinc pyrithione (ZPT). Shampoos had to be used 2–3 times a week for 6 months. Hair shedding during shampoo was evaluated semiquantitatively. Hair density on the vertex was evaluated on photographs using a Dermaphot. Trichograms were used for determining the anagen hair percentage and the mean proximal hair shaft diameter using computerized image analysis. The sebum excretion rate (SER, μg cm−2 h−1) was also measured using a Sebumeter®.

The three treatments cleared pruritus and dandruff rapidly. At end point, hair density was unchanged, although hair shedding was decreased (KTZ: −17.3%, PTO: −16.5%, ZPT: −10.1%) and the anagen hair percentage was increased (KTZ: 4.9%, PTO: 7.9%, ZPT: 6.8%). The effect on the mean hair shaft diameter was contrasted between the three groups of volunteers (KTZ: 5.4%, PTO: 7.7%, ZPT: −2.2%). In conclusion, telogen effluvium was controlled by KTZ, PTO and ZPT shampoos at 1% concentration. In addition, KTZ and PTO increased the mean hair shaft thickness while discretely decreasing the sebum output at the skin surface.
Low‐fat diets, triglycerides and coronary heart disease risk
Authors: Roche Helen M.
Published: March 2003

Nutritionists are currently debating whether low‐fat high‐carbohydrate diets protect against coronary heart disease (CHD). Traditionally, low‐fat diets were prescribed because they reduce plasma and low density lipoprotein (LDL) cholesterol concentrations. However, there is considerable concern because low‐fat diets also increase plasma triglyceride (TG) and reduce high density lipoprotein (HDL) cholesterol concentrations. Recent prospective epidemiological studies have shown that these are independent risk factors for future CHD risk. It has been proposed that the adverse effects of low‐fat, high‐carbohydrate diets on TG and HDL may counteract or negate the beneficial effect of reducing LDL cholesterol concentrations. Although there is also strong epidemiological evidence that reduced total fat intake is not protective against CHD, high‐fat diets predispose to obesity and insulin resistance, both of which adversely affect TG metabolism. This review presents the evidence in relation to the importance of TG as a risk factor for CHD, and explains the pathophysiology that may underlie the aetiological role of TG metabolism in the pathogenesis and progression of CHD. It also addresses the physiological consequences of advocating low‐fat high‐carbohydrate diets, with particular reference to the effects on lipoprotein metabolism and CHD risk.
An exploration of nutritional knowledge in a sample of Scottish men of low socio‐economic status
Authors: McPherson Kerri E. , Turnbull Jane Dunkeld
Published: March 2003

Summary The government has used health promotion campaigns as a means of improving nutritional knowledge in the Scottish population, in an attempt to encourage healthier eating practices and reduce diet‐related illness. However, mismeasurement of nutritional knowledge and the presence of barriers to behaviour change, such as socio‐economic status, means that the relationship between nutritional knowledge and dietary practice is not a straightforward one. The main findings of the present study are twofold. Firstly, the results emphasise the multidimensionality of the nutritional knowledge construct. Secondly, the results show that educational status is a major facilitator/barrier in the nutritional knowledge–dietary practice relationship.
Dietary assessment for sports dietetics
Authors: Black Alison E.
Published: March 2003

Summary The different techniques for assessing energy and nutrient intakes are described. Work showing that energy intake is frequently underestimated is summarised. The validity of reported energy intake can be evaluated by comparing reported intake with expected energy expenditure. To do this, information on activity patterns must also be obtained.
Neuroendocrine mechanisms regulating food intake and body weight
Authors: McMinn J. E. , Baskin D. G. , Schwartz M. W.
Published: March 2003

In the field of obesity research, two separate lines of study have emerged which explore the mechanism by which food intake is regulated: short‐term control of food intake, and the central regulation of energy balance. The former studies the satiety response during consumption of meals, whereby satiety signalling originating in the gut is transduced into a neural signal that modulates satiety pathways in the brainstem. This review describes a neuroanatomically based model in which leptin and insulin signalling in the hypothalamus governs long‐term regulation of energy balance via mechanisms that are integrated with satiety hormone signalling in the brainstem. The functional outcome of this integration is a cumulative meal‐to‐meal regulation of food intake, that over relatively long intervals serves to maintain stable adipose stores. Our model provides a context within which continued investigation of neuroendocrine mechanisms that control food intake and body weight can be explored, and has potential application to our current understanding of clinical obesity and its treatment.
Iron metabolism and absorption
Authors: Andrews Nancy C.
Published: March 2003

Iron is an essential nutrient for animals living in an oxygen‐rich environment. It greatly enhances the oxygen‐carrying capacity of aqueous solutions as the active center in hemoglobin, facilitating oxygen delivery to tissues. Because it accepts and loses electrons readily, iron confers redox activity on the cytochromes of the respiratory chain and on numerous other enzymes. Yet, its utility is balanced by a risk of toxicity. Free iron catalyzes the formation of free radicals that damage cell membranes, proteins and DNA. To exploit the useful properties of iron, while avoiding its toxicity, most living organisms have developed meticulously regulated mechanisms for iron transport and storage. Specialized proteins sequester extracellular and intracellular iron and mediate transport of iron across cellular membranes. Iron balance is regulated by systemic homeostatic mechanisms that we are only beginning to understand. This review describes our current understanding of iron metabolism in mammals.
HIV‐related morbidity and mortality in patients starting protease inhibitors in very advanced HIV disease (CD4 count of < 50 cells/µL): an analysis of 338 clinical events from a randomized clinical trial*
Authors: Floridia M , Fragola V , Galluzzo CM , Giannini G , Pirillo MF , Andreotti M , Tomino C , Vella for the ISS‐IP1 Study Group S
Published: March 2003

Background

AIDS defining events occur infrequently in the presence of CD4 counts above 200 cells/µL. It is, however, uncertain for most of the AIDS defining conditions whether this threshold can be considered equally safe in patients with a previously very low CD4 nadir.

Methods

We evaluated in detail all the AIDS defining events observed during a 48‐week clinical trial in 1251 nucleoside reverse transcriptase inhibitor‐experienced patients who started protease inhibitors (PIs) at CD4 counts below 50 cells/µL. The type of event, immunological status at the moment of event and time between start of PI treatment and event occurrence were analysed cumulatively and by event type; event rates were calculated.

Results

Concomitant data on CD4 counts were available for 338 AIDS defining events (81% of total events). Median time between start of treatment with PI and event was 94.5 days and median absolute CD4 value at the occurrence of event was 20 per µL. Only 14 events (in 12 patients) were observed above the threshold of 200 CD4 cells/µL. An analysis of the 67 deaths with concomitantly available CD4 counts (57%) showed a median CD4 count of 10 cells/µL, with only four deaths occurring in the presence of a CD4 count above 100 cells/µL.

Conclusions

Very few clinical AIDS defining conditions were observed in patients who start PIs at very low CD4 counts and with treatment restore absolute values in CD4 counts above 200 cells/µL. This threshold can therefore be considered a clinically effective goal of treatment with respect to occurrence of all AIDS defining conditions in patients starting PIs in very advanced HIV disease.
Ritonavir plus saquinavir versus single protease inhibitor therapy in protease inhibitor‐naive HIV‐infected patients: the Swiss HIV Cohort Study
Authors: Bucher HC , Bichsel M , Taffé P , Furrer H , Telenti A , Hirschel B , Weber R , Bernasconi E , Vernazza P , Minder C , Battegay M ,   for the Swiss HIV Cohort Study
Published: March 2003

Objectives

To compare the response to ritonavir (RTV) plus saquinavir (SQV) with single protease inhibitor (PI) therapies among PI‐naive HIV‐1 infected individuals.

Methods

Response to treatment was analysed according to the intent‐to‐treat principle in a prospective observational cohort study of 177 patients who between May 1995 and March 2000 started a double PI therapy with RTV and SQV (nonboosting dosages) plus at least one nucleoside reverse transcriptase inhibitor (NRTI) and 2214 patients with a single PI therapy plus two NRTIs. We used survival analysis and Cox's proportional hazard regression methods. The primary endpoint was the time to a plasma viral load of < 400 copies/mL. Secondary endpoints were taken as a gain in the CD4 count of >100 cells/μL, and change of initial PI for any reason.

Results

Baseline characteristics in both treatment groups were balanced. Median follow‐up in both groups was 10.4 months. Time to an HIV‐1 viral load of < 400 copies/mL and an increase in the CD4 count of >100 × 106 cells/L was shorter for RTV plus SQV compared with single PI regimens (log rank test for each endpoint P < 0.05). The adjusted hazard ratios of RTV plus SQV compared with single PI regimens were 1.21 (95% confidence interval 0.99–1.47) for achieving an HIV‐1 viral load of < 400 copies/mL, 1.12 (0.88–1.42) for an increase in the CD4 count of > 100 cells/μL, and 0.90 (0.73–1.11) for change of first PI regimen.

Conclusions

Treatment with RTV plus SQV compared with single PI regimens appeared to give similar results for virological or immunological response.
Causes of death among HIV‐infected patients in the era of highly active antiretroviral therapy, Bordeaux, France, 1998–1999
Authors: Bonnet F , Morlat P , Chêne G , Mercié P , Neau D , Chossat I , Decoin M , Djossou F , Beylot J , Dabis F ,   for the Groupe d'Epidémiologie Clinique du SIDA en Aquitaine (GECSA)
Published: March 2003

Objectives

To describe the causes of death in HIV‐infected patients in the era of highly active antiretroviral therapy (HAART).

Method

A retrospective survey conducted in Bordeaux, France. Medical records of all deaths that had occurred in 1998 and 1999 amongst patients followed within the Aquitaine cohort were reviewed by the same physician. Immediate and underlying causes of death were described, taking into account the morbidity at the time of death.

Results

Sixty‐six deaths occurred in 1998, and 41 in 1999. Sixty‐seven per cent of deceased patients were male. Median age at time of death was 43 years (range 25–71), median CD4 was 162 cells/µL (0–957); 28% of patients had a CD4 count > 200 cells/µL and 7% plasma viral load < 500 HIV‐RNA copies/mL. Amongst morbidity present at the time of death, there were 23 bacterial infections, 16 non‐Hodgkin's lymphomas, 16 cirrhoses, 15 non HIV‐related malignancies, 13 central nervous system diseases and 10 myocardiopathies. The main immediate causes of death were: multiple organ failure (21%), coma (18%), septic shock (15%) and acute respiratory failure (14%). Underlying causes of death were AIDS‐defining events (48%), non AIDS HIV‐related infection (3%), hepatitis B‐ or C‐associated cirrhosis (14%), non HIV‐related malignancies (11%), cardiovascular events (10%), suicide and overdose (6%), treatment‐related fatalities (4%), injury (2%) and unknown (2%). Patients dying from AIDS‐related events were more often female, had a lower CD4 count, a higher level of HIV‐RNA, a shorter history of HIV infection and were less often coinfected with hepatitis B and C viruses than those dying from other underlying causes.

Conclusions

AIDS‐related events are no longer the major causes of death of HIV‐infected patients in the era of HAART. This evolving mortality pattern justifies an adaptation of both the epidemiological surveillance and the clinical monitoring of HIV‐infected patients.
First‐line ritonavir/indinavir 100/800 mg twice daily plus nucleoside reverse transcriptase inhibitors in a German multicentre study: 48‐week results
Authors: Voigt E , Wickesberg A , Wasmuth J‐C , Gute P , Locher L , Salzberger B , Wöhrmann A , Adam A , Weitner L , Rockstroh JK
Published: March 2003

Objectives

To evaluate safety and efficacy of the protease inhibitor combination ritonavir/indinavir 100/800 mg twice daily plus 2–3 nucleoside reverse transcriptase inhibitors (NRTI) in antiretroviral‐naive patients.

Methods

Within this open‐label, uncontrolled multicentre trial, antiretroviral‐naive patients (n = 57) with median baseline HIV‐RNA of 308 000 copies/mL (range 170–3.01 million copies/mL) and median CD4 cell count of 50 cells/μL (range 0–853 cells/μL) were started on 2–3 NRTIs plus ritonavir/indinavir 100/800 mg twice daily. CD4 cell counts and HIV‐RNA were determined at weeks 0, 4, 8, 12, 16, 20, 24 and 48. Statistical analysis was performed on treatment as well as intent‐to‐treat.

Results

Viral load decreased by a median of 3.79 log10 copies/mL (range 2.0–4.60 log10 copies/mL) until week 48. At week 48, 23/57 (40%, intent‐to‐treat) patients showed a viral load ≤ 80 copies/mL. In parallel, median CD4 cell counts increased by a median of 149 cells/μL (range −60–420 cells/μL). Median triglycerides and cholesterol increased from baseline 160 mg/dL (range 33–364 mg/dL) to 218 mg/dL (range 110–527 mg/dL) at week 48 and from 166 mg/dL (range 63–262 mg/dL) to 233 mg/dL (range 95–359 mg/dL), respectively. Twenty‐seven of fifty‐seven patients (47%) discontinued study medication, 19 (33%) due to nephrolithiasis. Two patients changed their antiretroviral regimen after failing virologically.

Conclusion

Ritonavir/indinavir 100/800 mg twice daily appears to be effective up to 48 weeks despite high baseline viraemia and low CD4 cell count in antiretroviral‐naive patients. However, discontinuation due to adverse events, especially nephrotoxicity, is frequent and limits treatment duration. Therefore, extra hydration appears inevitable with this combination.
Virological and immunological profiles among patients with undetectable viral load followed prospectively for 24 months
Authors: Katzenstein TL , Ullum H , Røge BT , Wandall J , Dickmeiss E , Barrington T , Skinhøj P , Gerstoft J
Published: March 2003

Objective

To quantify HIV‐RNA in plasma, in lymphoid tissue and proviral DNA in peripheral blood mononuclear cells and to relate these to immunological markers among patients with plasma viral load counts of ≤ 200 HIV‐RNA copies/mL.

Methods

A prospective study of one hundred and three patients was undertaken with an inclusion criteria of plasma viral load of ≤ 200 copies/mL. The patients had advanced HIV infection; 25% had developed AIDS. Patients were seen every 6 months for a period of 2 years.

Results

The median plasma viral load was < 20 copies/mL with no increase during follow‐up. Thirty‐one per cent had plasma viral load of ≤ 20 copies/mL at all visits, 44% had ≥ 1 measurement with 21–200 and 25% had ≥ 1 sample with plasma HIV‐RNA > 200 copies/mL. Lymphoid tissue viral load was low at enrolment and declined further during follow‐up. Baseline HIV‐DNA and immunoglobulin (IgA) differed significantly between the plasma viral load rebound groups (P < 0.05).

Conclusion

In this cohort, selected solely on the basis of having a plasma viral load of ≤ 200 copies/mL, we found stable or declining viral loads in the measured compartments during 2 years of follow‐up. Baseline HIV‐DNA and IgA levels were higher among patients with less complete virological suppression relative to patients with persistently undetectable plasma HIV‐RNA. Hence, a high cellular level of HIV‐DNA and high plasma IgA may predict subsequent development of low‐grade viraemia.
Photosensitivity associated with treatment with triflusal
Authors: Nagore E , Pérez‐Ferriols A , Sánchez‐Motilla Jm , Serrano G , Aliaga A
Published: March 2003

Background Triflusal is a fluorinated aspirin derivative with antiplatelet properties, which is used in Spain for the management and prevention of thromboembolic disease.

Case report A 91‐year‐old female developed a systemic photosensitivity reaction 15 days after beginning triflusal preventive treatment (300 mg/12 h) for prior transient ischaemic attack. Photobiological study showed an abnormal response to light in areas exposed to ultraviolet B and A radiation, with a photopatch test positive to both triflusal and its main metabolite. These observations suggested a causal relation between triflusal and the clinical findings, as described in previous reports.

Conclusions The few cases reported to date and the clinicopathological features of this case suggested an immunological response as the most likely cause of the reaction.
Incorporation of ceramide 3B in dermatocosmetic emulsions: effect on the transepidermal water loss of sodium lauryl sulphate‐damaged skin
Authors: De Paepe Kristien , Derde Marie‐Paule , Roseeuw Diane , Rogiers Vera
Published: March 2003

Background

In previous work we reported on the efficacy of cosmetic body lotions enriched with skin‐identical lipids to reduce the transepidermal water loss (TEWL) of ageing and sodium lauryl sulphate (SLS)‐damaged skin. The observations made depended on the experimental design and clearly raised the question of the importance of the galenic formulation of skin ceramide‐containing products.

Objectives

The aim of the present work was to study the different galenic forms in which ceramide 3B (0.2% w/v) can be incorporated into common o/w emulsions. In addition, we investigated whether supplementation of skin care products with ceramide 3B enriched with penetration enhancers and coemulsifiers could exert a beneficial effect on barrier function, done by measuring their effects on the TEWL of SLS‐induced scaly skin.

Results

We found that the technique of incorporating ceramide 3B into the o/w emulsions was important for their final stability. However, no additional positive effect on the TEWL values of SLS‐damaged skin could be observed when the efficacy of the ceramide‐containing emulsions was compared with that of proper controls.

Conclusions

Although suitable galenic formulas were developed, no positive effect on TEWL could be observed when ceramide 3B was added in a final concentration of 0.2% (w/v) to different o/w emulsions and applied to SLS‐damaged skin.
Superficial white onychomycosis in a 3‐year‐old human immunodeficiency virus‐infected child
Authors: Peña‐Penabad C , García‐Silva J , Almagro M , Del Pozo J , Fonseca E
Published: March 2003

Background

Superficial white onychomycosis is exceptional in children, although a few anecdotal cases have been reported in the literature. On the other hand, superficial white onychomycosis and proximal subungual onychomycosis, while unusual in the general population, often appear in adult human immunodeficiency virus (HIV)‐infected persons.

Case report

A 3‐year‐old girl with vertically acquired HIV‐1 infection presented superficial white onychomycosis involving the second, third, fourth and fifth toes of her left foot, caused by Trichophyton rubrum. She was treated with topical amorolfine once a week, with a good response within 4 weeks.

Conclusions

We report a case of superficial white onychomycosis associated with HIV infection in a 3‐year‐old girl. To our knowledge, this type of onychomycosis has not been previously reported in HIV‐infected prepubertal children.
Recurrent intravascular papillary endothelial hyperplasia developing from a pyogenic granuloma
Authors: İnalöz HS , Patel G , Knight AG
Published: March 2003

Intravascular papillary endothelial hyperplasia (IPEH) is a rare benign vascular tumour. Many histological features are similar to those of low‐grade angiosarcoma, a common, but more serious condition. Clinical and histological differentiation is important to avoid overtreatment of this benign condition. We report on a 34‐year‐old woman who developed recurrent IPEH at the site of a previously excised pyogenic granuloma.
Imiquimod 5% cream is an acceptable treatment option for external anogenital warts in uncircumcised males
Authors: Maw RD , Kinghorn GR , Bowman CA , Goh BT , Nayagam AT , Nathan M
Published: March 2003

Objectives To determine the safety and efficacy of imiquimod (Aldara™) 5% cream in the treatment of prepuce‐associated warts in uncircumcised males.

Methods An open‐label study in six UK medical centres with 35 uncircumcised males with prepuce‐associated warts treated with imiquimod 5% cream three times per week for up to 16 weeks. Other anogenital warts were also treated.

Results Three times weekly application of imiquimod was found to be safe, with erythema as the most commonly reported local skin reaction. Forty per cent of patients had complete clearance of anogenital warts within 16 weeks.

Conclusions Imiquimod cream at a dosing regimen of three times per week, is effective and has an acceptable safety profile in the treatment of prepuce associated warts and other external anogenital warts in uncircumcised males.
Treatment of vitiligo by topical calcipotriol
Authors: Chiavérini C , Passeron T , Ortonne JP
Published: March 2003

Objective Evaluation of the efficiency of topical calcipotriol monotherapy in vitiligo.

Materials and methods This was a prospective, right/left comparative, open study at the Dermatology Department at the University Hospital in Nice, France. Twenty‐four patients with localized or generalized vitiligo with symmetrical lesions were included. The main outcome measure was the evaluation of the percentage of repigmentation in treated target lesions and untreated control lesions for each patient.

Results and conclusions Topical calcipotriol in monotherapy is not an effective treatment of vitiligo.
Polymorphous light eruption
Authors: Stratigos AJ , Antoniou C , Katsambas AD
Published: March 2003

Polymorphous light eruption (PLE) is a common idiopathic photosensitivity disorder with an estimated prevalence of 10–20%. It is characterized by an intermittent skin reaction to ultraviolet (UV) radiation exposure, consisting of non‐scarring pruritic erythematous papules, vesicles or plaques that develop on light‐exposed skin. Despite the different morphology in different individuals, the eruption tends to have a monomorphous presentation in any single subject. The histopathological features of PLE are distinct and comprise a perivascular lymphocytic infiltrate in the dermis, subepidermal oedema and variable epidermal changes. The pathogenesis of PLE is not well known, but findings suggest that it is a delayed‐type hypersensitivity reaction to one or more UV‐modified cutaneous antigens. The principal action of PLE is mainly in the UVA region, although some subjects exhibit sensitivity to UVB alone or to both UVA and UVB radiation at the same time. Preventive measures in PLE include the regular use of photoprotective methods combined with graduated exposures to natural sunlight. The induction of immune tolerance by phototherapy and photochemotherapy are useful prophylactic methods in moderate to severe cases. The role of systemic agents in the management of PLE is under investigation. This article reviews the epidemiological, pathogenetic and clinical aspects of PLE and discusses recent advances in the diagnostic approach and management of this condition.
Collodion baby: a follow‐up study of 17 cases
Authors: Van Gysel D , Lijnen RLP , Moekti SS , De Laat PCJ , Oranje AP
Published: March 2003

Seventeen cases of collodion baby are reported. Clinical aspects, complications, treatment, final outcome and family history were studied. We did not observe any clinical features in the collodion baby that could serve as a clue in predicting the final diagnosis. Infections were observed in nine, hypothermia in five and hypernatraemic dehydration in four cases. Skin infection mainly occurred in babies treated with emollients (petrolatum, lanolin and cetomacrogolis cream were used). We therefore recommend treating the collodion baby in a humidified incubator, if necessary with intravenous rehydration, but not to use emollients. The final outcome of these study patients was erythrodermic autosomal recessive lamellar ichthyosis in seven cases (41%), non‐erythrodermic autosomal recessive lamellar ichthyosis in three cases (18%), Sjögren–Larsson in one case (6%), epidermolytic hyperkeratosis in one case (6%), acute neonatal variant of Gaucher disease in one case (6%) and normal skin in four cases (24%).
Efficacy of erbium YAG laser‐assisted autologous epidermal grafting in vitiligo
Authors: Pai GS , Vinod V , Joshi A
Published: March 2003

Background Of the various modalities of therapy available for the treatment of vitiligo, a combination of psoralen + ultraviolet A (PUVA) with autologous epidermal grafting appears to offer the best results. The erbium YAG laser can be used to prepare the recipient site in both punch grafting and suction blister grafting.

Methods In this study 29 subjects, 26 with localized and three with generalized stable vitiligo, had received pregrafting PUVA and underwent further PUVA starting 2 weeks after surgery until maximal pigmentation was achieved. The erbium YAG laser was used on 16 subjects; the recipient site for punch grafting was prepared with laser and minigrafts harvested by manual punch were placed into the prepared sites. For suction blister grafting, the site was dermabraded with a laser and the harvested blister roof (created using suction apparatus) was transplanted on to the site.

Results More than two‐thirds (68.75%) of the subjects who were punch grafted using a laser showed repigmentation of more than 75%, but only one‐half of those who underwent conventional punch grafting showed a similar response. All subjects with laser‐assisted suction blister grafting showed a good response, compared with only 60% of those who underwent conventional suction blister grafting.

Conclusions The results obtained with laser‐assisted grafting are more satisfactory than those achieved with conventional grafting techniques. We found that the repigmentation zones are larger (up to 9 mm in the former vs. 3 mm in the latter) and cobblestoning does not occur with laser‐assisted grafting. Also, the procedure is precise, relatively atraumatic and can be performed rapidly even when covering vast areas.
Sebaceus naevi: a clinicopathologic study
Authors: Muñoz‐Pérez MA , García‐Hernandez MJ , Ríos JJ , Camacho F
Published: March 2003

Objective To analyse sebaceus naevus (SN) incidence, associated malignancies, and developmental defects in a retrospective study.

Methods We retrospectively analysed all cases of SN excised in our Department over a 20‐year period. All cases of epidermal naevus syndrome (Schimmelpenning syndrome) associated with SN were recorded, as well as all patients with histological changes suggesting degeneration of the initial SN.

Result A total 226 patients with SN were included in the study. Stage II was the most common (65%), and the parietal area was the most common location of SN (42%), with only 7% located in non‐scalp areas. Syringocystadenoma papilliferum and trichoblastoma were the most common tumours arising on SN. We only found five patients with basal cell carcinoma arising on previous SN. Epidermal naevus syndrome associated with SN was diagnosed in 16 patients, and this was the most common neurocutaneous association.

Conclusion The incidence of malignancy arising on SN was very low, indicating that prophylactic surgery of NS in children is not recommendable. Developmental defects should be investigated in order to evidence possible epidermal naevus syndrome associated with SN.
Comparative biochemistry of human skin: glycosaminoglycans from different body sites in normal subjects and in patients with localized scleroderma
Authors: Passos CO , Werneck CC , Onofre GR , Pagani EA , Filgueira AL , Silva L‐CF
Published: March 2003

Objectives The aim of this investigation is to compare the relative proportions of disaccharides of chondroitinase‐digestible glycosaminoglycans (GAGs) among the different body sites in control human skin and in the skin lesions of patients with localized scleroderma.

Methods The disaccharide relative proportions were determined using high‐performance liquid chromatography (HPLC).

Results ΔDi‐4S, the main disaccharide unit of dermatan sulphate (DS), was the major skin GAG disaccharide (∼70% of the total) in control skin among all different body sites studied here. In scleroderma there was an increase in the relative proportion of both ΔDi‐HA, the main disaccharide unit of hyaluronic acid (HA), and ΔDi‐diSB (α‐ΔUA(2SO4)‐1→3‐GalNAc(4SO4)), derived from DS, and a decrease in ΔDi‐4S, as compared with the uninvolved skin or the site‐matched control skin.

Conclusion DS is the major GAG species in normal skin from different body sites. In addition, our results suggest a decrease and also a structural change in DS and an increase in the proportion of HA in scleroderma skin.