bluuebunny/crossref_metadata_2025 huggingface dataset:
Kinetic control of staurolite–Al2SiO5 mineral assemblages: Implications for Barrovian and Buchan metamorphism
Authors: Pattison David R. M. , Spear Frank S.
Published: December 2017

The distribution and textural features of staurolite–Al2SiO5 mineral assemblages do not agree with predictions of current equilibrium phase diagrams. In contrast to abundant examples of Barrovian staurolite–kyanite–sillimanite sequences and Buchan‐type staurolite–andalusite–sillimanite sequences, there are few examples of staurolite–sillimanite sequences with neither kyanite nor andalusite anywhere in the sequence, despite the wide (~2.5 kbar) pressure interval in which they are predicted. Textural features of staurolite–kyanite or staurolite–andalusite mineral assemblages commonly imply no reaction relationship between the two minerals, at odds with the predicted first development (in a prograde sense) of kyanite or andalusite at the expense of staurolite in current phase diagrams. In a number of prograde sequences, the incoming of staurolite and either kyanite, in Barrovian sequences, or andalusite, in Buchan‐type sequences, is coincident or nearly so, rather than kyanite or andalusite developing upgrade of a significant staurolite zone as predicted. The width of zones of coexisting staurolite and either kyanite, in Barrovian sequences, or andalusite, in Buchan‐type sequences, is much wider than predicted in equilibrium phase diagrams, and staurolite commonly persists upgrade until its demise in the sillimanite zone. We argue that disequilibrium processes provide the best explanation for these mismatches. We suggest that kyanite (or andalusite) may develop independently and approximately contemporaneously with staurolite by metastable chlorite‐consuming reactions that occur at lower P–T conditions than the thermodynamically predicted staurolite‐to‐kyanite/andalusite reaction, a process that involves only modest overstepping (<15°C) of the stable chlorite‐to‐staurolite reaction and which is favoured, in the case of kyanite, by advantageous nucleation kinetics. If so, the pressure difference between Barrovian kyanite‐bearing sequences and Buchan andalusite‐bearing sequences could be ~1 kbar or less, in better agreement with the natural record. The unusual width of coexistence of staurolite and Al2SiO5 minerals, in particular kyanite and andalusite, can be accounted for by a combination of lack of thermodynamic driving force for conversion of staurolite to kyanite or andalusite, sluggish dissolution of staurolite, and possibly the absence of a fluid phase to catalyse reaction. This study represents an example of how kinetic controls on metamorphic mineral assemblage development have to be considered in regional as well as contact metamorphism.
Sources and Types of Social Support for Physical Activity Perceived by Fifth to Eighth Grade Girls
Authors: Robbins Lorraine B. , Ling Jiying , Dalimonte‐Merckling Danielle M. , Sharma Dhruv B. , Bakhoya Marion , Pfeiffer Karin A.
Published: December 2017

Background

Information is lacking on forms and sources of social support for physical activity (PA) received by adolescent girls during various pubertal stages. Two study purposes were to (a) identify the sources and forms of social support for PA perceived by adolescent girls, and (b) examine associations of pubertal stage and social support with PA.

Methods

A secondary analysis of data from a randomized trial was conducted. Fifth through eighth grade girls (N = 1,519) completed surveys on social support for PA and pubertal stage and wore an accelerometer.

Results

Girls in early‐middle and late‐post puberty most frequently received social support from their mothers. A higher proportion of girls in late‐post puberty, compared to early‐middle puberty, received social support from nonfamily adults (4.2% vs. 3.0%, p = .019). Girls identifying three sources participated in more moderate‐to‐vigorous PA than those having fewer sources (t1,512 = −3.57, p < .001). Various forms of social support, except for encouragement, were positively related to moderate‐to‐vigorous PA. Girls in early‐middle puberty reported greater social support than those in late‐post puberty (t1,512 = 3.99, p < .001). Social support was positively associated with moderate‐to‐vigorous PA, while girls in late‐post puberty had lower moderate‐to‐vigorous PA than those in early‐middle puberty.

Conclusions

Mothers are important sources of social support for PA. Having more than two sources may result in greater PA. Encouraging girls to increase their PA may not be sufficient.

Clinical Relevance

Efforts are needed from health professionals to prevent any decline in social support for PA as girls advance across adolescence.
Usefulness of hemostatic sealants for minimizing ovarian damage during laparoscopic cystectomy for endometriosis
Authors: Choi Chahien , Kim Woo Young , Lee Dong Hee , Lee San Hui
Published: December 2017

Aim

We aimed to evaluate the impact of topical hemostatic sealants and bipolar coagulation during laparoscopic ovarian endometriotic cyst resection on ovarian reserve by comparing the rates of decrease in anti‐Müllerian hormone (AMH).

Methods

A randomized prospective data collection was made on women aged 19–45 years who planned to have laparoscopic ovarian cystectomy at one of two institutions (n = 80), Kangbuk Samsung Hospital, Seoul, Korea or National Health Insurance Service Ilsan Hospital, Goyang, Korea, from January 2014 to April 2016. Patients were randomly divided into two groups treated with either a topical hemostatic sealant or bipolar coagulation for hemostasis. The hemostatic group was randomized to the FloSeal or TachoSil subgroups. Preoperative and 3‐month postoperative AMH levels were checked and the rates of decrease of AMH were compared. All patients enrolled were treated with dienogest (Visanne) for 6–12 months. None were lost to follow‐up at postoperative 3 months, but about one‐third of the patients had been lost to follow‐up by 6–12 months.

Results

AMH was significantly decreased in both groups 3 months postoperatively; however, the rate of decrease in the bipolar coagulation group was greater than that in the hemostatic sealant group, 41.9% (interquartile range [IQR], 22.29–65.24) versus 18.1% (IQR, 10.94–29.90), P = 0.007. Between the two hemostatic subgroups, there was no significant difference in AMH decrease rate, 14.95% (IQR, 11.34–21.21) versus 18.1% (IQR 9.76–40.70), P = 0.204.

Conclusion

Hemostatic sealants may be an alternative to bipolar coagulation for preservation of ovarian reserve after laparoscopic ovarian cystectomy for endometriosis.
A Catalyst for Change: Language Socialization and Norm Negotiation in a Transient Multilingual Workplace
Authors: Lønsmann Dorte
Published: December 2017

This case study of a team in an international workplace investigates processes of language socialization in a transient multilingual setting. Using interview and observational data, the analysis shows how social and linguistic norms are negotiated, with the newcomer positioned as a catalyst for changing language practices toward more English, with the ultimate aim of creating a “global mindset” in the organization. Language socialization in a transient multilingual setting is shown to focus on and assign positive value to new linguistic norms that experienced members are socialized into in a process that hinges on new members functioning as tools for management to bring about the desired change. The article shows that while the newcomer is used as a catalyst for increased use of English and for the creation of a “global mindset,” she is at the same time socialized into the existing Danish egalitarian workplace culture. The analysis also highlights the vulnerable position of the catalyst. While her status as an expert English speaker with the right “global mindset” may confer power in an internationalizing workplace, the position of catalyst is also linked with feelings of exclusion.
The Risk of Re‐Institutionalization: Examining Rates of Admission to Long‐Term Care Among Adults with Intellectual and Developmental Disabilities Over Time
Authors: Ouellette‐Kuntz Hélène , Martin Lynn , McKenzie Katherine
Published: December 2017

Despite efforts toward community living for persons with intellectual and developmental disabilities, there is a risk of re‐institutionalization through placement in long‐term care facilities. To examine patterns of admission to long‐term care facilities in Ontario, Canada among adults with intellectual and developmental disabilities across key demographic and clinical variables, a cohort of 50 670 adults with intellectual and developmental disabilities was identified using administrative and clinical health data. Proportions admitted to long‐term care facilities between 2009 and 2013 were compared to proportions in a random sample of the general population. A greater proportion of adults with intellectual and developmental disabilities were admitted to long term care over the 4‐year period (4.5 vs. 0.9%). Mental health and addiction problems as well as frailty were more strongly associated with admission among adults without intellectual and developmental disabilities. The proportion of adults with intellectual and developmental disabilities admitted annually dropped from 1.6% (2009/10) to 1% (2012/13) while it remained stable among those without disabilities (∼0.3%); no change was observed in the proportion of younger adults with intellectual and developmental disabilities. A small proportion of younger adults with intellectual and developmental disabilities continue to be admitted to long‐term care. Research is needed to understand factors which predict admission in this group as well as age‐appropriate alternatives to long‐term care.
Description and analyses of nominal concord (Pt I)
Authors: Norris Mark
Published: December 2017

This paper discusses the current understanding of what has been called nominal concord, whereby modifiers of a noun match certain features of the noun (e.g., gender, number, or case features). Part I discusses the existing understanding of concord, remaining as descriptive as possible. Concord has been argued to involve gender, number, case, and definiteness, and nearly every word class that can be present inside nominal phrases is capable of showing concord. I consider some questions concerning the typology of concord, which is largely uncharted territory. Part II focuses on existing formal analyses of concord. Analyses of ϕ‐feature concord are rather varied, but analyses of case concord more or less converge on the same mechanism. Finally, I consider the insight offered by analyses of cases of mixed concord, where modifiers do not all match each other or the head noun in features or feature values.
Description and analyses of nominal concord (Pt II)
Authors: Norris Mark
Published: December 2017

This paper discusses the current understanding of what has been callednominal concord, whereby modifiers of a noun match certain features of the noun (e.g., gender, number, or case features). Part I discusses existing understanding of concord, remaining as descriptive as possible. Concord has been argued to involve gender, number, case, and definiteness, and nearly every word class that can be present inside nominal phrases is capable of showing concord. I consider some questions concerning the typology of concord, which is largely uncharted territory. Part II focuses on existing formal analyses of concord. Analyses ofϕ‐feature concord are rather varied, but analyses of case concord more or less converge on the same mechanism. Finally, I consider the insight offered by analyses of cases of mixed concord, where modifiers do not all match each other or the head noun in features or feature values.
Monitoring and surveillance for multiple micronutrient supplements in pregnancy
Authors: Mei Zuguo , Jefferds Maria Elena , Namaste Sorrel , Suchdev Parminder S. , Flores‐Ayala Rafael C.
Published: December 2017

The World Health Organization (WHO) recommends iron–folic acid (IFA) supplementation during pregnancy to improve maternal and infant health outcomes. Multiple micronutrient (MMN) supplementation in pregnancy has been implemented in select countries and emerging evidence suggests that MMN supplementation in pregnancy may provide additional benefits compared to IFA alone. In 2015, WHO, the United Nations Children's Fund (UNICEF), and the Micronutrient Initiative held a “Technical Consultation on MMN supplements in pregnancy: implementation considerations for successful incorporation into existing programmemes,” which included a call for indicators needed for monitoring, evaluation, and surveillance of MMN supplementation programmes. Currently, global surveillance and monitoring data show that overall IFA supplementation programmes suffer from low coverage and intake adherence, despite inclusion in national policies. Common barriers that limit the effectiveness of IFA—which also apply to MMN programmes—include weak supply chains, low access to antenatal care services, low‐quality behaviour change interventions to support and motivate women, and weak or non‐existent monitoring systems used for programme improvement. The causes of these barriers in a given country need careful review to resolve them. As countries heighten their focus on supplementation during pregnancy, or if they decide to initiate or transition into MMN supplementation, a priority is to identify key monitoring indicators to address these issues and support effective programmes. National and global monitoring and surveillance data on IFA supplementation during pregnancy are primarily derived from cross‐sectional surveys and, on a more routine basis, through health and logistics management information systems. Indicators for IFA supplementation exist; however, the new indicators for MMN supplementation need to be incorporated. We reviewed practice‐based evidence, guided by the WHO/Centers for Disease Control and Prevention logic model for vitamin and mineral interventions in public health programmes, and used existing manuals, published literature, country reports, and the opinion of experts, to identify monitoring, evaluation, and surveillance indicators for MMN supplementation programmes. We also considered cross‐cutting indicators that could be used across programme settings, as well as those specific to common delivery models, such as antenatal care services. We then described mechanisms for collecting these data, including integration within existing government monitoring systems, as well as other existing or proposed systems. Monitoring data needs at all stages of the programme lifecycle were considered, as well as the feasibility and cost of data collection. We also propose revisions to global‐, national‐, and subnational‐surveillance indicators based on these reviews.
Multiple‐micronutrient supplementation: Evidence from large‐scale prenatal programmes on coverage, compliance and impact
Authors: Berti Cristiana , Gaffey Michelle F. , Bhutta Zulfiqar A. , Cetin Irene
Published: December 2017

Micronutrient deficiencies during pregnancy pose important challenges for public‐health, given the potential adverse outcomes not only during pregnancy but across the life‐course. Provision of iron‐folic acid (IFA) supplements is the strategy most commonly practiced and recommended globally. How to successfully implement IFA and multiple micronutrient supplementation interventions among pregnant women and to achieve sustainable/permanent solutions to prenatal micronutrient deficiencies remain unresolved issues in many countries. This paper aims to analyse available experiences of prenatal IFA and multiple micronutrient interventions to distil learning for their effective planning and large‐scale implementation. Relevant articles and programme‐documentation were comprehensively identified from electronic databases, websites of major‐agencies and through hand‐searching of relevant documents. Retrieved documents were screened and potentially relevant reports were critically examined by the authors with the aim of identifying a set of case studies reflecting regional variation, a mix of implementation successes and failures, and a mix of programmes and large‐scale experimental studies. Information on implementation, coverage, compliance, and impact was extracted from reports of large‐scale interventions in Central America, Southeast Asia, South Asia, and Sub‐Saharan Africa. The WHO/CDC Logic‐Model for Micronutrient Interventions in Public Health was used as an organizing framework for analysing and presenting the evidence. Our findings suggest that to successfully implement supplementation interventions and achieve sustainable‐permanent solutions efforts must focus on factors and processes related to quality, cost‐effectiveness, coverage, utilization, demand, outcomes, impacts, and sustainability of programmes including strategic analysis, management, collaborations to pilot a project, and careful monitoring, midcourse corrections, supervision and logistical‐support to gradually scaling it up.
Experimental Pathogenicity ofAphanoascusspp.
Authors: Cano J. , Mayayo E. , Guarro J.
Published: December 2017

Immunodepressed mice were inoculated intraperitonealy with a suspension of conidia and micelia macerate of four species ofAphanoascus (A. keratinophilus, A. fulvescens, A. reticulisporusandA. verrucosus). All produced nodular lesions in the peritoneal cavity, especially in the liver, spleen, diaphragm and peritoneum. The recovery rate of the fungi on phytone‐yeast extract agar after one month varied approximately from 20 to 80% depending on the organs. Sections of these revealed the presence of ascospores and hyphal fragments though only in the centre of the nodules. Fungal elements were not detected in organs which were apparently not affected, nor intravascularly.
Tinea Capitis in The Netherlands (Rotterdam Area)
Authors: van der Willigen A.H. , Oranje A.P. , de Weerdt-van Ameijden S. , Wagenvoort J.H.T.
Published: December 2017

This retrospective study reviews the occurrence and treatment of various forms of tinea capitis at the out‐patient clinic for Dermatology and Pediatric Dermatology of the University Hospital Sophia/Dijkzigt over the period 1977–1988. Tinea capitis was diagnosed in 64 children.Trichophyton violaceumwas the pathogen most frequently isolated, withMicrosporum canisranking second. The potassium hydroxide preparation was positive in 58 % of the cases. Four cases showed a positive potassium hydroxide preparation with a negative culture. Immigrant children from Morocco were the largest group (61 %). A zoophilic dermatophyte was isolated in 15 cases (27 %). A pet animal was the source of infection in 4 cases. The ratio between boys and girls was equal in the patient population studied. In 43 % of the children suffering from tinea capitis the clinical features were mild flaking without hair loss (so called seborrheic dermatitis‐like infection).
Pathogenicity of Trichosporon capitatum for normal and irradiated mice and the efficacy of miconazole on experimental systemic trichosporosis in mice
Authors: Pospíšil J. , Postupa J. , Otčenášek M. , Vejbora O.
Published: December 2017

The authors describe the course of experimental trichosporosis in normal and X‐irradiated ICR mice after i.v. inoculation with Trichosporon capitatum. The irradiated animals were considerably more sensitive to infection than normal animals. The LD50 challenge dose used was by approximately two orders lower (1 × 103c.f.u. ml−1) in irradiated mice than in control animals. The histopathological examination of the internal organs of the infected mice demonstrated that the greatest tissue damage was associated with the kidneys, liver and spleen. However, the infectious agent was also found in the heart, lungs and brain. The degree of impairment of the tissues was dependent on the inoculation dose and on the irradiation status. Miconazole (50 mg kg−1) was administered i.p. immediately after inoculation with Ts. capitatum and resulted in an alteration of infection and prolonged survival time. Miconazole was ineffective when challenge dose were used which produced 100% mortality (1 × 106 and 1 × 104 c.f.u. ml−1 for normal and irradiated mice, respectively). With the use of these doses also the course of infection was nearly identical both in the miconazole‐treated and untreated animals.
Compassionate usage program on fluconazole in Germany: survey on clinical experiences
Authors: Krisch H. , Sarnow Elke
Published: December 2017

Fluconazol ist ein neues Antimykotikum aus der Gruppe der Triazole zur systemischen Behandlung von Pilzinfektionen, verursacht durch Candida oder Cryptococcus.

Von September 1988 his Juni 1990 wurde Fluconazol im Rahmen einer klinischen Prüfung unentgeltlich fur die Behandlung von Patienten zur Verfügung gestellt , die auf die herkömmliche Therapie nicht ansprachen oder bei denen die herkömmliche Therapie durch Nebenwirkungen usw. limitiert war (Compassionate Usage Program).

Insgesamt wurden 1 188 Patienten eingeschlossen, davon 79 mit Cryptococcus‐Meningitis, 665 mit lebensbedrohlichen Candidosen und 444 mit nicht lebensbedrohlichen Candidosen.

Bei einer Zwischenauswertung von 254 Fallen wurden folgende Ergebnisse gefunden : Der Therapieerfolg (Heilung und Besserung) betrug bei Patienten mit Cryptococcus‐Meningitis 43 %, bei den lebensbedrohlichen Candidosen 54 % und bei den nicht lebensbedrohlichen Candidosen 67 %.
Prophylaxis and treatment of fungal infections with fluconazole in bone marrow transplant patients
Authors: Quabeck K. , Müller K.-D. , Beelen D. W. , Dermoumi Heide , Kölbel Margit , Kraft J. , Schaefer U. W.
Published: December 2017

Einunddreißig Patienten , bei denen wegen verschiedener hämatologischer Erkrankungen eine Knochenmarktransplantation durchgelührt wurde, erhielten in einer offenen Studie Fluconazol zur Prophylaxe oder Therapie von Pilzinfektionen. Bei 26 dieser Patienten hatte sich unter einer vorausgegangenen oralen Prophylaxe mit den Polyen‐ Antimykotika Amphotericin B und Nystatin eine Candida‐Infektion entwickelt. Bei 5 der 31 Patienten wurde Fluconazol wegen schlechter Verträglichkeit der Polyen ‐Antimykotika in prophylaktischer Absicht gegeben. Die Substanz wurde oral in einer Dosierung von 100 bzw. 200 mg tfiglich appliziert (n = 29); 2 Patienten erhielten 100 bzw. 400 mg Fluconazol täglich intravenös. Die Medikation wurde für eine mediane Dauer von 52 Tagen (9 bis 546+ Tage) aufrechterhalten. Ein Behandlungserfolg bzw. eine wirksame Prophylaxe von Candida‐Infektionen wurde bei 22/31 Patienten (71 %) erreicht. Bei 3 Patienten (10 %) kam es nach Abklingen der Infektion 14–28 Tage nach Absetzen von Fluconazol zu einer erneuten Besiedlung mit Candida; sechs Patienten hatten persistierende oder welter fortschreitende Candida‐Infektionen. Vier Patienten entwickelten unter Fluconazol Aspergillus‐Infektionen. Ein Anstieg verschiedener Leberenzyme wurde bei 9 Patienten beobachtet and stand bei 3 von ihnen (10 %) vermutlich in einem ursächlichen Zusammenhang mit der Fluconazol‐ Medikation. Ein Patient entwickelte einen Tremor der Hände, der sich nach Absetzen von Fluconazol zurückbildete. Andere unerwünschte Nebenwirkungen traten nicht auf. Nach diesen Ergebnissen scheint Fluconazol eine relativ nebenwirkungsarme und effektive Substanz zur Vorbeugung bzw. Behandlung von oberflächlichen und möglicherweise auch von systemischen Candida‐Infektionen bei schwerstgradig immunsupprimierten Patienten zu sein, während es vermutlich ohne prophylaktischen Wert bei Aspergillus‐Infektionen ist.
Detection of Circulating Galactomannan by Pastorex Aspergillus in Experimental Invasive Aspergillosis
Authors: Van Cutsem J. , Meulemans L. , Van Gerven F. , Stynen D.
Published: December 2017

The performance of Pastorex Aspergillus, a new latex agglutination test for the detection of circulating galactomannan in the serum of patients with invasive aspergillosis, was evaluated in a blind trial in standardized guinea‐pig models of invasive aspergillosis and other invasive mycoses. In these animal models, the invasive nature of the fungal infection was confirmed by re‐isolation of the etiologic agent from the organs of every animal.

Ninety‐two plasma samples from 42 animals with invasive aspergillosis were submitted to the test. In 41 of these animals, at least one plasma sample was positive with the latex test (sensitivity 97.6 %), titers ranging from 1/1 to 1/512. In general, antigen titers increased as a function of time, reaching the highest values shortly before death. Guinea‐pigs infected with Penicillium marneffei also yielded positive agglutination reactions but antigen titers were lower (maximal titer 1/8). Plasma samples from animals with invasive candidosis (23), disseminated trichophytosis (11) and cryptococcosis(23) were all negative with the latex test. In 80 guinea‐pigs without fungal infection, 3 false positive results (titers 1/1) were observed, which means a specificity of 96.2 % in this control group.
In Vitro and in Vivo Activity of Antifungal Agents in Combination with Fleroxacin, a New Quinolone
Authors: Polak Annemarie
Published: December 2017

The in vitro and in vivo Interaction of fleroxacin with amphotericin B (Amph B), flucytosine (5‐FC) and azoles against Candida albicans strains was tested. In vitro the interaction between fleroxacin and various antifungals was not dependent on the incubation time. Fleroxacin neither enhances nor antagonizes the in vitro activity of Amph B at high concentration (50–100 µg/ml). Fleroxacin has a synergistic effect with ketoconazole (KETO), but this is not observed with itraconazole (ITRA) or fluconazole (FLU). In no instance antagonism was observed. The activity of 5‐FC was antagonized by fleroxacin being generally reduced by 2–4 dilution steps. In murine candidosis the efficacies of all antifungal drugs were not influenced by addition of 100 mg/kg fleroxacin. Therefore, the effects seen in in vitro tests are most probably not relevant for the clinical use of a combination of fleroxacin with antifungal drugs.
Molecular genetics of pathogenic fungi: some recent developments and perspectives
Authors: Ernst J. F.
Published: December 2017

The diagnosis and the treatment of fungal diseases remains problematic in many cases. Difficulties in diagnosis are due (1) to the ubiquitous presence of fungal pathogens that may lead to false positive test results and (2) to difficulties in the evalution of the aetiological significance of these pathogens. The relatively small number of effective antifungal agents reflects to a large extent on the fact that many aspects of fungal physiology and virulence are not well understood. The methods of molecular genetics provide effective tools for the diagnosis of mycoses and may also contribute to the identification of new targets for antifungals by genetic analyses of fungal virulence. During the last 3 years molecular genetic methods have been developed for the asexual pathogen Candida albicans that may be used for strain identification. This success indicates a general use of molecular genetics for the analysis of fungal pathogenesis.
Malassezia pachydermatis isolation from a scarlet macaw
Authors: Breuer-Strosberg R. , Hochleithner M. , Kuttin E. S.
Published: December 2017

A repeated isolation of Malassezia pachydermatis Weidman from a scarlet macaw is reported. This is the first report of birds infected with this yeast.
Growth of Candida albicans on the stratum corneum of diabetic and non‐diabetic patients
Authors: Rurangirwa A. , Piérard-Franchimont C. , Piérard G. E.
Published: December 2017

We have used a novel approach to in vitro culture of Candida albicans on cyanoacrylate skin surface strippings. It appears that with this model yeasts and hyphae grew on large surfaces of stratum corneum. The area of extension of the fungal growth was larger on stratum corneum taken from diabetic than from non‐diabetic volunteers.
Prophylaxis of fungal infections with itraconazole in immunocompromised cancer patients
Authors: Mühldorfer S. M. , König H. J.
Published: December 2017

During a period of 32 months (August 1986 until April 1989) 108 patients (74 women, 34 men; mean age 53 years) with neoplastic diseases (59 patients with solid tumors, 45 patients with lymphomas, two patients with acute leukaemias, one patient with chronic myelogenous leukaemia, one patient with aplastic anaemia) were studied in the Department of Internal Medicine of the University Erlangen‐Nuremberg. Most were treated with a cytostatic chemotherapy.

In order to prevent a mycotic infection in these immunocompromised patients, itraconazole, a new broad‐spectrum antimycotic drug of the azole group, was given in an oral dosage of 100 mg day−1 (mean duration of prophylactic treatment 24 months).

Localized Candida infections involving the oropharynx and the female genital organs were diagnosed in 16 patients (14.8 %). Candida endophthalmitis occurred in one patient (0.9 %). The serum concentration of Candida antibodies was significantly elevated in one patient (0.9 %) without evidence of fungemia.

Itraconazole had to be discontinued in four cases (3.7 %) due to minor side effects of the drug (nausea, stomach complaints).

Itraconazole appears to be a safe and effective antimycotic drug in long‐term use in neutropenic patients.
The epidemiology of pseudallescheriasis complicating transplantation: Nosocomial and community‐acquired infection
Authors: Patterson T. F. , Andriole V. T. , Zervos M. J. , Therasse D. , Kauffman Carol A.
Published: December 2017

The epidemiology of two cases of pseudallescheriasis in organ transplant patients are described and the disease in that population is reviewed. Disseminated hospital‐acquired infection occurred in a liver transplant recipient and was fatal despite therapy with miconazole. A heart transplant recipient developed localized disease following soil contamination of soft tissue trauma which was cured with surgical resection and miconazole therapy. Itraconazole showed in vitro activity against Pseudallescheria boydii and should be evaluated in pseudallescheriasis. P. boydii infections are important complications of transplantation and should be considered in the differential diagnosis of community‐acquired as well as nosocomial fungal infections in this population.
Sporotrichosis with bilateral lesions. A case report
Authors: Takase T. , Uyeno K.
Published: December 2017

We report on a case of sporotrichosis in which lesions occurred bilaterally on upper limbs at different periods. The patient was an 84‐year‐old farmer living in Tsukuba City, Japan. The first lesion appeared on the left upper arm and remained untreated. The second lesion appeared on the back of the right hand 5 years later. Findings suggesting internal metastasis could not be confirmed in various examinations. We judged that the lesion of the left upper arm was primary and the lesion at the back of the right hand was caused by autoinoculation.
Saperconazole: A selective inhibitor of the cytochrome P‐450‐dependent ergosterol synthesis in Candida albicans, Aspergillus fumigatus and Trichophyton mentagrophytes
Authors: Vanden Bossche H. , Marichal P. , Willemsens G. , Bellens D. , Gorrens J. , Roels I. , Coene M.-C. , Le Jeune L. , Janssen P. A. J.
Published: December 2017

The N‐1‐substituted triazole antifungal, saperconazole, is a potent inhibitor of ergosterol synthesis in Candida albicans, Aspergillus fumigatus and Trichophyton mentagrophytes. Fifty % inhibition is already achieved at nanomolar concentrations. The saperconazole‐induced inhibition of ergosterol synthesis coincides with an accumulation of 14‐methylated sterols, such as 24‐methylenedihydrolanosterol, lanosterol, obtusifoliol, 14α‐methylfecosterol, 14α‐methylergosta‐8,24(28)‐dien‐3,β‐6α‐diol and 14α‐methylergosta‐5,7,22,24(28)‐tetraenol. This indicates that saperconazole interferes with the cytochrome P‐450 (P‐450)‐dependent 14α‐demethylation of lanosterol and/or 24‐methylenedihydrolanosterol. Saperconazole forms stable drug‐P‐450‐complexes by binding via its free triazole nitrogen to the heme iron and via its N‐1 substituent to the apoprotein moiety. The triazole derivative is a highly selective inhibitor of the 14α‐demethylase in fungal cells. It is a poor inhibitor of the 14α‐demethylation of lanosterol in rat and human liver cells. Saperconazole is, at concentrations as high as 10 µM, devoid of effects on the P‐450‐dependent cholesterol side‐chain cleavage and 11β‐hydroxylase, 17,20‐lyase, 21‐hydroxylase and aromatase. Saperconazole does not interfere with the 2α, 6α‐, 6β‐ and 7α‐hydroxylations of testosterone in microsomes from male rat liver. At high concentrations (> 5 µM) an inhibition of the 16β‐+hydroxylations is seen.
Antifungal combination therapy in localized candidosis
Authors: Polak Annemarie
Published: December 2017

A mouse model of localized candidosis in air‐filled subcutaneous cysts imitating thrush has been developed. We have now tested various antifungal combinations in this animal model. Flucytosine (5‐FC) + amphotericin B (Amph B) showed the highest efficacy, a clear additive or even synergistic effect was seen. The combination of 5‐FC + imidazole or triazole derivative was less efficacious, an additive effect was rare. The combination of 5‐FC + Amph B was also tested against Candida albicans strains showing various degrees of 5‐FC‐resistance. A significant reduction in 5‐FC‐resistant mutants was seen after the treatment with the combination.
Oral candidosis in HIV‐infected patients. Prognostic value and correlation with immunological parameters
Authors: Plettenberg A. , Reisinger E. , Lenzner U. , Listemann H. , Ernst M. , Kern P. , Dietrich M. , Meigel W.
Published: December 2017

In a prospective study, 29 patients were observed over a period of 42 weeks for signs of oral candidosis (OC), immunological parameters and other typical AIDS‐related events. Before the study started, no OC was observed in any of the patients. During the observation period, OC was diagnosed in 12 of the 29 patients (41 %). 5 of these 12 patients (42 %) developed full‐blown AIDS during the 42 weeks. In contrast, a progression to AIDS was observed in only 1 of the 17 patients (5.9 %) without OC. The laboratory findings for patients with and without OC showed statistically significant differences for neopterin (23.6 against 14.4 nmol 1−1), CD4 counts (417 against 763/mm3) and CD4/CD8 ratios (0.45 against 0.85). Based on these results, it seems justifiable to consider prophylactic measures such as pentamidine inhalation and/or treatment with zidovudine in HIV‐infected patients with immunodeficiency and occurrence of OC.
A rapid susceptibility testing method for yeasts to 5‐fluorocytosine
Authors: Scheven M.
Published: December 2017

A rapid method of susceptibility testing of yeasts to 5‐fluorocytosine is demonstrated. The method is based on photometric determination of the optical density of yeast suspensions before and after incubation for 4h in the presence of the antifungal. The method was evaluated with 50 Candida strains.
Localized cutaneous cryptococcosis successfully treated with itraconazole. Review of medication in 18 cases reported in Japan
Authors: Sato T. , Koseki S. , Takahashi S. , Maie O.
Published: December 2017

A case of localized cutaneous Cryptococcosis successfully treated with oral Itraconazole is reported. The patient, a 63‐year‐old Japanese housewife, had had an erythematous and partly eroded lesion in the area of her right earlobe for about 10 months. No findings suggesting a primary focus of Cryptococcus infection were found In the lung, central nervous system or other Internal organs. The isolate obtained from the lesion was identified as Cryptococcus neoformans based on the demonstration of encapsulated blastospores and its biological characteristics. The clinical course shifted toward healing in parallel with a decreased serum level of anticryptococcal antibody after initiation of treatment with oral Itraconazole in a dose of 100 mg once daily. The treatment was discontinued after 13 weeks. There were neither subjective nor objective side effects. Furthermore, this paper reviews the medications employed in 18 cases with cutaneous cryptococcosis reported in Japan during the nearly 40‐year period between 1952 and 1989.
Isolation of Cryptococcus neoformans var. neoformans from canine otitis
Authors: Pal M. , Ono K. , Goitsuka R. , Hasegawa A.
Published: December 2017

Cryptococcus neoformans was demonstrated in the clinical material of a 15‐year‐old male dog with a history of chronic otitis externa by employing Helianthus annuus seed agar as a selective medium. The examination of the isolate for sexual compatibility on modified Helianthus annuus seed medium revealed that it belonged to Filobasidiella neoformans var. neoformans ‘α’ mating type. In the authors' view, this appears to be the first report of isolation of Cr. neoformans var. neoformans from diseased ear of a dog.
Experimental phaeohyphomycosis
Authors: Pospíšil L. , Buček J. , Moster M. , Synek S.
Published: December 2017

The authors performed an experimental infection of the rabbit eye with Wangiella dermatitidis which had been isolated from the corneal ulcer of a patient. The fungus was inoculated into the front chamber and the vitreous body. The disease showed a trend to spontaneous recovery. The individual phases of the experimental infection were followed by histology and electronmicroscopy, both TEM and SEM. Different stages of development of the polymorphous fungus, as sclerotic bodies, mycelial filaments and yeast‐like cells, could be demonstrated.
Keratomycosis caused by Dichotomophthoropsis nymphaearum
Authors: Wright Elizabeth D. , Clayton Yvonne M. , Howlader A. , Islam Nazrul M. , Husain R.
Published: December 2017

A case of Dichotomophthoropsis nymphaearum, a dematiaceous hyphomycete, is described from Bangladesh. This species has not previously been reported as a human pathogen. Hyphae were observed in Gram stained corneal scrapings and the species was grown from cultured corneal material. Reatment with topical econazole and subconjunctival injections of miconazole was successful in the short term but long‐term outcome could not be determined. The results of sensitivity tests for six antifungal drugs are reported for the isolate.
Comparative evaluation of the Premier™ enzyme immunoassay, micro‐immunodiffusion and complement fixation tests for the detection of Histoplasma capsulatum var. capsulatum antibodies
Authors: Sekhon A. S. , Kaufman L. , Kobayashi G. S. , Moledina N. , Jalbert M. , Notenboom R. H.
Published: December 2017

A total of 178 sera, including 68 from proven cases of histoplasmosis (65 positive for the presence of Histoplasma capsulatum var. capsulatum antibodies and three positive for antigen), 93 from patients with suspected histoplasmosis but with no laboratory evidence of H. capsulatum var. capsulatum infection, 14 from humans with heterologous fungal and non‐fungal infections and three from normal individuals, were tested for IgG H. capsulatum antibodies and M or M and H precipitins by enzyme immunoassay (EIA) (Meridian Diagnostics, Cincinnati, OH, USA) and microimmunodiffusion (MID) respectively. Sixty‐three of the 68 histoplasmosis case sera demonstrated IgG antibody, and 65 of 68 demonstrated the presence of specific precipitins in the MID test. Nine positive case sera, when tested with the Laboratory Branch complement fixation (LBCF) test, reacted positively to whole yeast and histoplasmin antigens (titres 1 : 8 to 1 : 512). Three histoplasmosis case sera repeatedly tested negative for IgG, specific precipitins and complement‐fixing antibodies, whereas they were positive for Histoplasma antigen. Eighteen of 95 sera from patients without evidence of histoplasmosis demonstrated IgG antibody in the EIA only. Among these positive sera, three out of three cases of aspergillosis and three out of five cases of blastomycosis were confirmed. Sera from HIV‐infected and healthy individuals did not show IgG or M and/or H antibodies to H. capsulatum. Ninety‐three sera were negative by both EIA and MID. The EIA for IgG was less sensitive (97%) than MID (100%). The specificity of EIA and MID was 84% and 100% respectively.
Isolation of Cryptococcus neoformans from pigeon (Columba livia) droppings in Mexico City
Authors: Castanón-Olivares L. R. , López-Martínez R.
Published: December 2017

To determine the ecological and epidemiological significance of pigeon excrement in cryptococcosis in Mexico City, 251 samples of pigeon droppings were studied. These were collected from houses, public buildings, churches, parks and pigeon nests. Each sample was suspended 1 : 10 in isotonic saline solution and then cultured in Staib medium. Identification of Cryptococcus neoformans was performed based on the development of brown‐coloured colonies and the presence of encapsulated yeasts. Of 251 samples, 52 (20.7%) were positive for Cr. neoformans. The highest frequency was observed in droppings from public buildings (31.2%), followed by churches (22.0%) and houses (13.3%). No significant differences in isolation frequency were observed between fresh or dried excrement. All isolates obtained were Cr. neoformans var. neoformans. As in other studies on Cr. neoformans from pigeons, performed in other countries, these frequency data are considered ‘normal’. The results, however, accentuate the potential risk of cryptococcosis acquisition, especially now that cryptococcosis frequency is increasing in Mexico, mainly in AIDS patients.
Growth inhibition of pathogenic yeasts by Pseudomonas aeruginosa in vitro: clinical implications in blood cultures
Authors: Grillot R. , Portmann-Coffin V. , Ambroise-Thomas P.
Published: December 2017

The interaction between yeasts and bacteria may have clinical implications in polymicrobial septicaemia. The in vitro effect of Pseudomonas aeruginosa on five pathogenic yeast species, Candida albicans, Candida tropicalis, Candida parapsilosis, Candida glabrata and Cyptococcus neoformans, was investigated. Yeast inhibition assays were performed in an aerobic blood culture medium, inoculated with yeast cells (inoculum 1–10 CFU ml −1) and bacterial cells (inoculum 10−107 CFU m1−1). Interactions between P. aeruginosa and yeasts were determined after incubation by enumeration of pure and mixed cultures. Growth of all isolates tested was completely or partially inhibited by P. aeruginosa in blood culture medium, the phenomenon depending on the yeast genus and bacterial inoculum. Suppression of fungal growth was also observed in bacterial culture filtrate. This in vitro antifungal activity may preclude yeast recovery from blood cultures in mixed infections.
Isolation of Candida species from bats in Nigeria
Authors: Oyeka C. A.
Published: December 2017

Eighteen (15%) of 120 Nigerian bats screened for fungal infections yielded yeasts of medical importance from their visceral organs. Candida albicans was the commonest organism recovered from the liver, spleen, kidneys and intestinal contents 1 of 10 out of 40 Glossophaga soricinia bats (nectar‐feeding bats). Candida krusei was recovered from the liver and spleen of 3 out of 50 Molossus maior bats (the tropical house bat). Five out of 30 lesser free‐tailed bats (Rhinopoma hardwickei hardwickei) yielded mixed isolates of Trichosporon cutaneum and Candida spp. from their liver and spleen. Only Glossophaga soricinia showed evidence of infection of the organs. The liver, spleen and kidneys were covered by white patches of yeast colonies.
Incidence, species distribution and antifungal sensitivity pattern of vaginal yeasts in Sri Lankan women
Authors: Perera Jennifer , Clayton Yvonne
Published: December 2017

A total of 432 high vaginal swabs from patients with vulvovaginitis were processed for the presence of yeasts. Candida species were isolated from 40 (32.4%). In comparison, vaginal swabs from 107 normal asymptomatic women yielded only eight (7.3%) isolates (P<0.001). Candida albicans was the commonest species isolated (76%). Other species included C. tropicalis, C. krusei, C. kefrr, C. glabrata and C. guilliermondii. Of the C. albicans isolates, 42.8% showed in vitro resistance to miconazole and 6.6% to econazole. Ninety‐two percent of the isolates were sensitive to the polyenes (nystatin and amphotericin B) and 87% and 74% to clotrimazole and ketaconazole respectively.

Zusammenfassung. Insgesamt 432 Abstriche aus dem oberen Vaginalbereich von Vulvovaginitis‐Patientinnen wurden auf Hefen untersucht. Aus 40 Proben (32.4%) wurden Candida‐Arten isoliert. Bei einer Vergleichsgruppe von 107 asymptomatischen Frauen wurden nur bei acht (7.3%) Hefen isoliert (p<0.001). Candida albicans wurde am häufigsten isoliert (76%). Andere Isolate umfaßten C. tropicalis, C. krusei, C. kefyr, C. glabrata und C. guilliermondii. Von den Isolaten waren 42.8% in vitro resistent gegen Miconazol und 6.6% gegen Econazol. Für die Polyene waren 92% empfindlich und 87% fur Clotrimazol und 74% für Ketoconazol.
Systemic treatment of skin candidosis: a randomized comparison of terbinafine and ketoconazole
Authors: Jung E. G. , Haas P. J. , Bräutigam M. , Weidinger G.
Published: December 2017

Terbinafine is an antimycotic drug which has a much higher in vitro activity against dermatophytes than against yeasts. To investigate the clinical relevance of these in vitro data, 118 patients with cutaneous candidosis were enrolled in a randomized, double‐blind study and allocated to a 4‐week treatment with a daily dose of either 250 mg b.i.d. terbinafine or 200 mg once‐daily ketoconazole. At the final assessment, 3 weeks after cessation of therapy, mycological cure rates (negative culture and negative microscopy) were 82% in the terbinafine group and 73% in the ketoconazole group. Effective treatment with negative mycology and no or minimal signs or symptoms could be achieved in 65% of those who received terbinafine and in 57% of those randomized to ketoconazole. Five per cent and 7% of the patients taking terbinafine and ketoconazole, respectively, complained about adverse events, which were usually mild and did not lead to discontinuation of treatment. In one patient in the ketoconazole group, abnormal liver enzymes were noted at the final laboratory assessment. The results of this study indicate that terbinafine 500 mg daily can be an alternative to ketoconazole when systemic treatment of skin candidosis is required.
Scottish healthcare student's perceptions of an interprofessional ward simulation: An exploratory, descriptive study
Authors: Roberts Fiona E. , Goodhand Kate
Published: December 2017

The most memorable learning occurs during placement. Simulated interprofessional learning is a logical learning opportunity to help healthcare professionals work beyond their professional silos. In this qualitative study, we investigated the perceived learning of students from six health professions (adult nursing, diagnostic radiography, occupational therapy, physiotherapy, dietetics, and pharmacy) from their participation in a 45 min interprofessional ward simulation. Semistructured focus groups were undertaken, and data were analyzed using framework analysis. Two overarching themes were evident, each of which had subthemes: (i) the ward simulation as an interprofessional education opportunity (subthemes: reality of situations and interactions); and (ii) the perceived learning achieved (subthemes: professional roles, priorities, respect, communication, teamwork, and quality of care). The results indicated that a short interprofessional ward simulation, unsupported by additional learning opportunities or directed study, is a useful and engaging interprofessional learning opportunity. Students appear to have learnt important key messages central to the interprofessional education curricula to help develop practitioners who can effectively work together as an interprofessional team, and that this learning is partly due to simulation allowing things to go wrong.