bluuebunny/crossref_metadata_2025 huggingface dataset:
Antimicrobial Activities of Essential Oil and Methanol Extract of Teucrium montanum
Authors: Vukovic Nenad , Milosevic Tanja , Sukdolak Slobodan , Solujic Slavica
Published: October 2007

This study was designed to examine the chemical composition of essential oil and the in vitro antimicrobial activities of essential oil and methanol extract of Teucrium montanum. The inhibitory effects of essential oil and methanol extracts of T. montanum were tested against 13 bacterial and three fungal species by using disc‐diffusion method. GC/MS analyses revealed that essential oil contains mainly δ‐cadinene (17.19%), β‐selinene (8.16%) α‐calacorene (4.97%), 1,6‐dimethyl‐4‐(1‐methylethyl)‐naphthalene (4.91%), caryophyllene (4.35%), copaene (4.23%), torreyol (3.91%), 4‐terpineol (3.90%), cadina‐1,4‐diene (3.39%), β‐sesquiphellandrene (3.34%), τ‐cadinol (3.12%) and γ‐curcumene (3.18%). The essential oil has antibacterial as well as antifungal effect.
RAPD Analysis for Determination of Components in Herbal Medicine
Authors: Shinde V. M. , Dhalwal K. , Mahadik K. R. , Joshi K. S. , Patwardhan B. K.
Published: October 2007

In this study, the RAPD (Random Amplified Polymorphic DNA) technique was employed for determination of the components in an Ayurvedic herbal prescription, Rasayana Churna. One‐hundred‐and‐twenty decamer oligonucleotide primers were screened in the RAPD analysis to identify three Ayurvedic medicines, dried stem of Tinospora cordifolia, dried fruit of Emblica officinalis and dried fruit of Tribulus terestris, the Ayurvedic prescription. Primer OPC‐6 simultaneously generated three distinct amplicons, each specific to one component. The marker with 600 bp is specific to Tinospora cordifolia; the marker 500 bp is specific to Emblica officinalis and the remaining marker >1000 bp was present in Tribulus terestris. Presence of three herbal medicines was determined when RAPD reaction with OPC‐6 was performed. The technique was proved to contribute to the identification of components in Ayurvedic herbal preparation and thus helping to serve as a complementary tool for quality control.
Female-biased dispersal and patrilocal kin groups in a mammal with resource-defence polygyny
Authors: Nagy Martina , Heckel Gerald , Voigt Christian C , Mayer Frieder
Published: October 2007

In most mammals, dispersal rates are higher in males than in females. Using behavioural and genetic data of individually marked bats, we show that this general pattern is reversed in the greater sac-winged bat (Saccopteryx bilineata). Dispersal is significantly female biased and male philopatry in combination with rare male immigration causes a patrilineal colony structure. Female dispersal helps avoid father–daughter inbreeding, as male tenure exceeds female age at first breeding in this bat species. Furthermore, our data suggest that females may engage in extra-harem copulations to mate with genetically dissimilar males, and thus avoid their male descendants as mating partners. Acquaintance with the natal colony might facilitate territory takeover since male sac-winged bats queue for harem access. Given the virtual absence of male immigration and the possible lower reproductive success of dispersing males, we argue that enhancing the likelihood of settlement of male descendants could be adaptive despite local mate competition. We conclude that resource defence by males is important in promoting male philopatry, and argue that the potential overlap of male tenure and female first conception is the driving force for females to disperse.
Melatonin for perceived sleep disturbances associated with benzodiazepine withdrawal among patients in methadone maintenance treatment: a double‐blind randomized clinical trial
Authors: Peles Einat , Hetzroni Tal , Bar‐Hamburger Rachel , Adelson Miriam , Schreiber Shaul
Published: October 2007

Aims  To evaluate the effectiveness of melatonin in attenuating sleep difficulties during benzodiazepine (BDZ) withdrawal.

Design  Double‐blind cross‐over control study.

Setting  Methadone maintenance treatment clinic.

Participants  Eighty patients enrolled at a community methadone maintenance clinic recruited to a BDZ withdrawal programme.

Intervention  Melatonin (5 mg/day) or placebo: 6 weeks one arm, 1 week washout, 6 weeks other arm.

Measurements  Urine BDZ; self‐reported Pittsburgh Sleep Quality Index (PSQI) and the Center for Epidemiologic Studies Depression (CES‐D) questionnaires administered at baseline, and at 6, 7 and 13 weeks.

Findings  Sixty‐one patients (77.5% in the ‘melatonin first’ condition and 75% in the ‘placebo first’ condition) completed 6 weeks of treatment, showing a similar BDZ discontinuation rate of 11/31 and 11/30, respectively. PSQI scores were significantly lower (indicating better sleep quality) in the 22 patients who discontinued BDZ (8.9 ± 0.9) than in 39 with urine BDZ (11.2 ± 0.7, P = 0.04). Sleep quality in patients who continued abusing BDZ improved more in the ‘melatonin first’ group than in the ‘placebo first’ group, with no differences in sleep quality improvement in patients who stopped BDZ.

Conclusion  Most improvement in sleep quality was attributed to BDZ discontinuation. Although melatonin did not enhance BDZ discontinuation, it improved sleep quality, especially in patients who did not stop BDZ.
Developing limits for driving under cannabis
Authors: Grotenhermen Franjo , Leson Gero , Berghaus Günter , Drummer Olaf H. , Krüger Hans‐Peter , Longo Marie , Moskowitz Herbert , Perrine Bud , Ramaekers Johannes G. , Smiley Alison , Tunbridge Rob
Published: October 2007

Objective  Development of a rational and enforceable basis for controlling the impact of cannabis use on traffic safety.

Methods  An international working group of experts on issues related to drug use and traffic safety evaluated evidence from experimental and epidemiological research and discussed potential approaches to developing per se limits for cannabis.

Results  In analogy to alcohol, finite (non‐zero) per se limits for delta‐9‐tetrahydrocannabinol (THC) in blood appear to be the most effective approach to separating drivers who are impaired by cannabis use from those who are no longer under the influence. Limited epidemiological studies indicate that serum concentrations of THC below 10 ng/ml are not associated with an elevated accident risk. A comparison of meta‐analyses of experimental studies on the impairment of driving‐relevant skills by alcohol or cannabis suggests that a THC concentration in the serum of 7–10 ng/ml is correlated with an impairment comparable to that caused by a blood alcohol concentration (BAC) of 0.05%. Thus, a suitable numerical limit for THC in serum may fall in that range.

Conclusions  This analysis offers an empirical basis for a per se limit for THC that allows identification of drivers impaired by cannabis. The limited epidemiological data render this limit preliminary.
The value of calretinin and cytokeratin 5/6 as markers for mesothelioma in cell block preparations of serous effusions
Authors: Shield P. W. , Koivurinne K.
Published: October 2007

Objective:  To determine the value of calretinin and cytokeratin (CK) 5/6 in discriminating mesothelioma from adenocarcinoma in serous effusion specimens.

Methods:  A total of 101 recent, histologically or clinically confirmed malignant effusions with immunostained cell block preparations were reviewed. The cases consisted of 34 mesotheliomas and 67 adenocarcinomas. This included 17 ascitic fluid and 84 pleural fluid samples. The adenocarcinomas included metastatic carcinomas from the breast (12), lung (19), stomach (3), colon (1), pancreas (2), ovary (6) endometrium (1) and 23 histologically confirmed metastases from unknown primary sites. The cases were assessed as negative or positive (>5% of cells stained). The staining pattern was recorded as cytoplasmic, cell membrane, nuclear or cytoplasmic and nuclear staining.

Results:  Calretinin staining was present in 97% (33/34) of the mesothelioma cases with a majority of them showing both cytoplasmic and nuclear staining (29/33). Only 3% (2/67) of adenocarcinomas were positive for calretinin, one being a lung adenocarcinoma and the other an adenocarcinoma of unknown primary site in an ascitic fluid. Cytokeratin 5/6 staining was also present in 33/34 (97%) of mesothelioma cases. Six (9%) adenocarcinomas were positive, including metastases from the lung (1), breast (1), ovary (2) and unknown primary site (2). Four of the six adenocarcinoma cases positive for CK5/6 were in ascitic fluids. No cases of mesothelioma were negative for both calretinin and CK5/6. Only one adenocarcinoma case, (which was from unknown primary site in an ascitic fluid sample), was positive for both markers.

Conclusions:  The results confirm that calretinin and CK 5/6 are useful markers for mesothelioma in effusion specimens. CK5/6 staining may be less useful for peritoneal fluid specimens where metastatic adenocarcinomas may be more likely to express the antigen. Further study of ascitic/peritoneal specimens is warranted. However, positive staining, particularly for both antigens, is highly indicative of a mesothelial origin for cells. The two markers make a useful addition to EMA and the panel of adenocarcinoma markers routinely applied to effusion specimens.
Thyroid FNAC cytology: can we do it better?
Authors: Poller D. N. , Stelow E. B. , Yiangou C.
Published: October 2007

This article reviews recent developments in thyroid fine needle aspiration cytology (FNAC). While thyroid nodules are common, carcinoma is comparatively rare. Although histological assessment is used in most studies as the benchmark, the differential diagnosis on cytology or histology is not always reproducible. The literature shows wide variations in criteria for inadequate thyroid FNAC and study inclusion or exclusion criteria. In‐clinic assessment of specimen adequacy and in‐clinic reporting of thyroid FNAC has become popular although the costs and resource implications of in‐clinic thyroid FNAC assessment and reporting are substantial. Many centres continue to use conventional techniques although liquid‐based cytology and ultrasound‐guided FNAC are gaining in popularity. Standardized categorical systems for FNAC reporting can make results easier to understand for clinicians and give clear indications for therapeutic action. Multidisciplinary case review is also essential, especially when there is diagnostic uncertainty. While currently of limited use, molecular pathology testing holds out some promise for the future.
Modeling the date of leaf appearance in low‐arctic tundra
Authors: DELBART NICOLAS , PICARD GHISLAIN
Published: October 2007

One of the reported changes of arctic ecosystems in response to warming climate is the advance of the leaf appearance in spring. Such phenological changes play a role in the structural changes within tundra ecosystem communities. Recently, we developed a model that estimates the leaf appearance date for deciduous trees in taiga. We apply this model to the whole low‐arctic tundra, and we compare the simulated green‐up dates with the green‐up dates obtained from satellite observations and to in situ measurements of deciduous shrub leaf appearance. The model, although calibrated for taiga, performs remarkably well in tundra, with root mean square error ranging between 4 and 8 days for most of the tundra region, the same order as in taiga regions. The results seem to indicate that air temperature is the main factor controlling spring leaf phenology in tundra, just as in taiga, although these results do not permit us to reject soil temperature as the main trigger for leaf appearance in tundra. Because our model performs in tundra as well as in taiga, it can be used across the ecotone, and during a northward migration of the species from the taiga to the low‐arctic region. The leaf appearance model and the satellite observations reveal that leaf appearance has tended to occur earlier by approximately 10 days both in Alaska since 1975, and in west Siberian tundra since 1965.
Low‐dose antigen‐experienced CD4+ T cells display reduced clonal expansion but facilitate an effective memory pool in response to secondary exposure
Authors: Park Seong Ok , Han Young Woo , Aleyas Abi George , George Junu Abi , Yoon Hyun A , Lee John Hwa , Kang Ho Young , Kang Seong Ho , Eo Seong Kug
Published: October 2007

The strength and duration of an antigenic signal at the time of initial stimulation were assumed to affect the development and response of effectors and memory cells to secondary stimulation with the same antigen. To test this assumption, we used T‐cell receptor (TCR)‐transgenic CD4+ T cells that were stimulated in vitro with various antigen doses. The primary effector CD4+ T cells generated in response to low‐dose antigen in vitro exhibited reduced clonal expansion upon secondary antigenic exposure after adoptive transfer to hosts. However, the magnitude of their contraction was much smaller than both those generated by high‐dose antigen stimulation and by naïve CD4+ T cells, resulting in higher numbers of antigen‐specific CD4+ T cells remaining until the memory stage. Moreover, secondary effectors and memory cells developed by secondary antigen exposure were not functionally impaired. In hosts given the low‐dose antigen‐experienced CD4+ T cells, we also observed accelerated recall responses upon injection of antigen‐bearing antigen‐presenting cells. These results suggest that primary TCR stimulation is important for developing optimal effectors during initial antigen exposure to confer long‐lasting memory CD4+ T cells in response to secondary exposure.
Determinants of coronary heart disease risk for women on a low income: literature review
Authors: Hemingway Ann
Published: October 2007

Title.  Determinants of coronary heart disease risk for women on a low income: literature review

Aim.  This paper is a report of a literature review of the determinants of health and health behaviour relevant to coronary heart disease risk for women living on a low income.

Background.  Coronary heart disease is now recognized as the biggest killer of women in both developed and developing countries. As in men, women’s mortality rates for coronary heart disease seem to be directly related to income inequality and social deprivation.

Method.  The Medline, British Nursing Index, CINAHL, Cochrane Library, Psychinfo and Web of Science databases were searched from 1996 to 2006 using the search terms ‘women and CHD risk’, ‘women and health behaviour’, ‘women low income and health behaviour’, ‘women low income and smoking’, ‘women low income and diet’ and ‘women low income and exercise’. In relation to the wider determinants of health ‘women low income and CHD’, ‘women education and CHD’, ‘women employment and CHD’ and ‘women housing and CHD’. Seminal research reports before this period were included if they proved highly influential on later research. A narrative review was conducted.

Findings.  All the wider determinants of health considered had a negative impact on heart disease risk for women living on low incomes. The latter also appears to have a negative impact on health behaviour.

Conclusion.  Although the impact of the wider determinants of health on coronary heart disease risk are well‐understood, their impact on health behaviour (specifically diet, exercise and smoking) is less well‐understood. If effective interventions are to be designed to tackle inequalities in health, then this deficiency needs to be addressed urgently.
Evaluation of three fall‐risk assessment tools in an acute care setting
Authors: Kim Emily Ang Neo , Mordiffi Siti Zubaidah , Bee Wong Hwee , Devi Kamala , Evans David
Published: October 2007

Title.  Evaluation of three fall‐risk assessment tools in an acute care setting

Aim.  This paper is a report of a study to evaluate the validity of three fall‐risk assessment tools to identify patients at high risk for falls.

Background.  Patient falls make up 38% of all adverse events occurring in hospital settings, and may result in physical injury and undesirable emotional and financial outcomes. No single fall‐risk assessment tool has been conclusively validated.

Method.  The Morse Fall Scale, St Thomas Risk Assessment Tool in Falling Elderly Inpatients, and Hendrich II Fall Risk Model were validated in inter‐rater reliability and validity studies in 2003. This included assessment of the probability of disagreement, κ‐values, sensitivity, specificity, positive predictive values and negative predictive values of the assessment tools with the associated 95% CI.

Findings.  One hundred and forty‐four patients were recruited for the inter‐rater reliability study. The probabilities of disagreement were between 2·8% and 9·7%, and 95% CI for all tools ranged from 1·1% to 15·7%. The κ‐values were all higher than 0·80. In the validity study, 5489 patients were recruited to observe 60 falls. The Morse Fall Scale at a cutoff score of 25 and Heindrich II Fall Risk Model at a cutoff score of 5 had strong sensitivity values of 88% and 70%, respectively. However, in comparison with the Morse Fall Scale (specificity = 48·3%), only the Heindrich II Fall Risk Model had a more acceptable level of specificity (61·5%).

Conclusion.  The Heindrich II Fall Risk Model is potentially useful in identifying patients at high risk for falls in acute care facilities.
Assessing the relationship between respiratory acclimation to the cold and photosystem II redox poise in Arabidopsis thaliana
Authors: ARMSTRONG ANNA F. , WARDLAW KRISTEN D. , ATKIN OWEN K.
Published: October 2007

We examined the effect of manipulating photosystem II (PSII) redox poise on respiratory flux in leaves of Arabidopsis thaliana. Measurements were made on wild‐type (WT) plants and npq4 mutant plants deficient in non‐photochemical quenching (NPQ). Two experiments were carried out. In the first experiment, WT and mutant warm‐grown plants were exposed to three different irradiance regimes [75, 150 and 300 µmol photosynthetically active radiation (PAR)], and leaf dark respiration was measured in conjunction with PSII redox poise. In the second experiment, WT and mutant warm‐grown plants were shifted to 5 °C and 75, 150 or 300 µmol PAR, and dark respiration was measured alongside PSII redox poise in cold‐treated and cold‐developed leaves. Despite significant differences in PSII redox poise between genotypes and irradiance treatments, neither genotype nor growth irradiance had any effect upon the rate of respiration in warm‐grown, cold‐treated or cold‐developed leaves. We conclude that changes in PSII redox poise, at least within the range experienced here, have no direct impacts on rates of leaf dark respiration, and that the respiratory cold acclimation response is unrelated to changes in chloroplast redox poise.
PRMT11: a new Arabidopsis MBD7 protein partner with arginine methyltransferase activity
Authors: Scebba Francesca , De Bastiani Morena , Bernacchia Giovanni , Andreucci Andrea , Galli Alvaro , Pitto Letizia
Published: October 2007

Plant methyl‐DNA‐binding proteins (MBDs), discovered by sequence homology to their animal counterparts, have not been well characterized at the physiological and functional levels. In order better to characterize the Arabidopsis AtMBD7 protein, unique in bearing three MBD domains, we used a yeast two‐hybrid system to identify its partners. One of the interacting proteins we cloned is the Arabidopsis arginine methyltransferase 11 (AtPRMT11). Glutathione S‐transferase pull‐down and co‐immunoprecipitation assays confirmed that the two proteins interact with each other and can be co‐isolated. Using GFP fluorescence, we show that both AtMBD7 and AtPRMT11 are present in the nucleus. Further analyses revealed that AtPRMT11 acts as an arginine methyltransferase active on both histones and proteins of cellular extracts. The analysis of a T‐DNA mutant line lacking AtPRMT11 mRNA revealed reduced levels of proteins with asymmetrically dimethylated arginines, suggesting that AtPRMT11, which is highly similar to mammalian PRMT1, is indeed a type I arginine methyltransferase. Further, AtMBD7 is a substrate for AtPRMT11, which post‐translationally modifies the portion of the protein‐containing C‐terminal methylated DNA‐binding domain. These results suggest the existence of a link between DNA methylation and arginine methylation.
Aesthetic problems associated with the cosmetic use of bleaching products
Authors: Ly Fatimata , Soko Anta Soumare , Dione Demba Anta , Niang Suzanne Oumou , Kane Assane , Bocoum Thierno Ibrahima , Dieng Mame Thierno , Ndiaye Bassirou
Published: October 2007

Background and aim  The use of skin bleaching products for cosmetic purposes is a frequent practice (25–96%) in women from sub‐Saharan Africa. The dermatologic complications associated with this practice have been comprehensively reported. The aim of this work was to study the epidemiologic, clinical, and cosmetic aspects of these complications in order to produce better therapeutic guidelines for their management.

Methods  This was a prospective, descriptive study performed over a 6‐month period. All women aged between 15 and 50 years, who consulted a dermatologist (Le Dantec Hospital or Institute of Social Hygiene), experienced a complication associated with artificial depigmentation, and agreed to take part in the study, were included. The data were input and analyzed using Epi info version 6.0.

Results  Eighty‐six female patients were included, with a mean age of 29.34 years (range, 16–49 years). The breakdown by level of education was as follows: primary (48.8%), secondary (18.3%), and higher (8.5%) education. Twenty‐two per cent of our population had not attended school. The mean monthly cost of skin bleaching products was 6.22 euros. The initial skin tone before using skin bleaching products was black in 41.5% of patients, light in 32.9%, and intermediate in 25.6%. The mean duration of exposure was 6.7 ± 5 years (range, 1–30 years). The breakdown by skin bleaching products showed that topical corticosteroids were the most frequently used (78%), followed by hydroquinone (56%), products based on vegetable extracts (31.7%), caustic products (8.5%), and, finally, products of unknown composition (41.4%). Two components or more were frequently combined (86.5%). The aesthetic complications of artificial depigmentation were the reason for consulting a dermatologist in 10 patients (12%). Nineteen types of aesthetic complication were reported in our sample. Hyperpigmentation of the joints was the most frequently found complication (85.4%), followed by striae atrophicae (72%) and skin atrophy (59.8%). The number of aesthetic complications found in the patients varied from one to nine. Patients frequently presented (71.9%) with other complications associated with artificial depigmentation.

Conclusions  Aesthetic complications associated with artificial depigmentation are common, but rarely the reason for consulting a dermatologist. In the absence of suitable therapeutic agents, prevention, based on informing women of the damaging effects of artificial depigmentation, is the only way forward.
Hair loss in children in South‐East Nigeria: common and uncommon cases
Authors: Nnoruka Edith N. , Obiagboso Innocent , Maduechesi Chinyere
Published: October 2007

Background  The cosmetic importance of hair as a unique structure of the scalp is immense, such that once the loss of hair becomes an issue for a child, parents, in most cases, project their own concerns, often expressed as guilt. The clinical presentation of hair loss and scalp disorders in children varies widely, often ranging from subtle to disfiguring forms, and may be acquired or congenital. This variable pattern of hair loss is seen in all regions, possibly based on the ethnic origin of hair types.

Aim  To determine the clinical aspects of hair loss based on clinical appearance, age of onset, duration of disease, and associated features, and to provide a guide for the evaluation of acquired hair loss and scalp disorders commonly occurring in childhood in south‐east Nigeria.

Methods  One hundred and thirteen children with hair loss and scalp disorders consulted the University of Nigeria Teaching Hospital Skin Clinic between February 2002 and March 2003. The data collected included age, sex, clinical presentation, associated symptoms, and family history. Laboratory tests [full blood count (FBC), thyroid function test (TFT), antinuclear antibody (ANA), urinalysis], microscopic examination, Wood's light examination, and histology were conducted for further confirmation where necessary.

Results  There were 71 males (62.8%) and 42 females (37.2%), aged between 3 months and 13 years. The presenting symptoms included scaly scalp, itchiness, and anxiety; some patients were asymptomatic. Hair loss and fear were the chief concerns of 89.6% and 51.3% of parents, respectively, who presented with their children. Commonly occurring diagnoses were tinea capitis (62; 54.9%), alopecia areata (43; 38.1%), psoriasis (5; 4.4%), and telogen effluvium (3; 2.7%). Seventeen patients with alopecia areata had atopic dermatitis and three had vitiligo.

Conclusion  Commonly occurring hair loss in children in our region is mainly acquired, and the clinical course is related to the parent's attitude to treatment, particularly for tinea capitis.
Impact of hair relaxers in women in Nakuru, Kenya
Authors: Etemesi Beatrice Amunga
Published: October 2007

Background  The practice of relaxing hair is intended to straighten it, so that it is easy to manage and style, and the result is aesthetically pleasing. We studied the impact of using hair relaxers in women in Nakuru, Kenya.

Methods  A cross‐sectional study was carried out between February and March 2006. The subjects were women and girls aged 15 years and above, living in Nakuru district, Kenya, who had been or were currently using hair relaxers and were willing to participate. Sampling was by the snowball method and data collection by questionnaire. The data were analyzed using Epi‐info 2000.

Results  Two hundred and forty‐two women were recruited into the study. The age range was 15–51 years, with a median of 32 years. The main reasons given for relaxing hair were that it made hair easy to manage and looked “beautiful”. One hundred and thirty‐four women (67%) had problems with the relaxers used (at least once), 75% of whom decided to stop. Half of those who stopped resumed the use of relaxers almost immediately or after a period of time. The problems encountered included hair loss, burns to the scalp, and color change. Surprisingly fake/counterfeit products were not implicated as a cause of the problems experienced, although they are known to be on the market.

Conclusion  Despite the problems encountered, a significant number of Kenyan women in this region have used and continue to use relaxers.
Alopecia in consultations in the dermatology department at Burkina Faso: epidemiologic, clinical, and etiologic aspects
Authors: Traore Adama , Sawadogo Salam , Barro Fatou , Niamba Pascal
Published: October 2007

Background  Hair loss, or alopecia, in a man or woman can have major psychologic repercussions.

Aim  The aim of this study was to describe the epidemiologic, clinical, and etiologic aspects of alopecia in our service.

Materials and Methods  A retrospective study was performed over two years. All patients of both sexes, who consulted a dermatologist for alopecia, were included. Sociodemographic, clinical, and etiologic data were collected.

Results  The prevalence of alopecia is 1.02%. It generally concerns young people who are pupils or students. Hair loss was generally asymptomatic; the onset was often progressive. Alopecia was diffuse in 13.20% of cases. It was noted that 13.20% involved partial alopecia. The scalp was scarred or inflamed in 54.71% of cases.

Tinea (21 cases), Alopecia areata (14 cases), Keloid folliculitis (6 cases), androgenetic alopecia (4 cases), traction alopecia (4 cases) and cosmetic alopecia (2 cases) were the most common etiologies we found in our patients.

Conclusion  This preliminary study shows few epidemiologic, clinic and etiological aspects of the alopecia in Black African.
Acne on pigmented skin
Authors: Poli Florence
Published: October 2007

Acne on pigmented skin occurs in Africans and their descendants, as well as in patients with a skin phototype above IV. Acne is common in Africans and is often the primary reason for consulting a dermatologist. Acne on pigmented skin is principally inflammatory acne. The sequelae in terms of pigmentation are often the main reason for consulting a dermatologist, and take precedence over the acne itself. Research is needed into cosmetic acne and steroid‐induced dermatitis, which are common in users of skin bleaching products.

The treatment for acne in pigmented skin involves the same medicines as used in acne in white skin. Of the available topical treatments, benzoyl peroxide is particularly effective for the inflammatory component. Retinoids act on both the retentional and inflammatory components of acne and have skin bleaching properties. Tetracyclines are essential on initiation of treatment, regardless of severity. They prevent an inflammatory episode at the onset of acne and rapidly improve the inflammatory component. Minocycline should not be prescribed in African patients. Fatal cases of hypersensitivity have been described, with a particular frequency in this population. Doxycycline is effective, but has photosensitizing properties. Lymecycline is well tolerated. Isotretinoin is indicated for nodular acne. The same precautions for use should be followed as in all cases of acne. The skin bleaching effects are considerable. Photoprotection should generally be imposed, but, in patients with black skin, photoprotective agents are often not applied. The administration of a cosmetic containing a skin bleaching agent combined with a photoprotective agent for application in the morning, instead of hydrating cream, is acceptable to patients, improves compliance, and is effective.
Dermatosis papulosa nigra in Dakar, Senegal
Authors: Niang Suzanne Oumou , Kane Assane , Diallo Moussa , Choutah Flavienne , Dieng Mame Tierno , Ndiaye Bassinou
Published: October 2007

Background  Dermatosis papulosa nigra (DPN) is a benign epithelial tumour, common in the black population. It is a special topographic form of ethnic seborrheic keratosis, which is more common in the white population. Its benign character has meant that very few studies have been performed. In Senegal, no investigation has been carried out to date.

Aim  To determine the epidemiologic and semiological characteristics of DPN, and the aesthetic results of DPN exeresis.

Methods  A prospective study was carried out over a period of 6 months (November 2005 to April 2006) at the Dermatology Department, Le Dantec CHU, Dakar, Senegal. The diagnosis of DPN was clinical. If desired, exeresis of the lesions by fine‐needle or fine‐scissor electrosurgery was carried out, and the results were evaluated over a period of 6 weeks.

Results  Thirty patients were evaluated: 21 women and nine men. The average age was 39.8 years (range, 25–70 years). A family predisposition was found in 93.3% of cases. The average age of onset of the lesions was 22 years, with a progressive increase in size and number. The lesions appeared initially on the face and then spread to all photoexposed areas. The lesions were profuse, numbering between 50 and 100 in 66.6% of cases, and coalesced to form plaques in 26.6%. In other cases, the lesions were papular, pediculate, or wide‐based brown to deep black in colour, and with a keratotic appearance. Eight of the 21 women practiced artificial depigmentation and presented with profuse lesions. Aesthetic problems were found in 60% of patients. When performed, exeresis was satisfactory without scarring in 60% of cases at day 45. Hypochromic scars persisted in four patients who practiced artificial depigmentation and in one who had been treated with carbon dioxide snow.

Conclusion  This study on 30 cases of DPN is the first in Senegal. The classic female predominance, family predisposition, and photodistribution of the lesions were found. The lesions were profuse, with a background of artificial depigmentation. This suggests that the sun may be an etiopathogenic factor. Aesthetic problems are an indication for ablation of the lesions using a method that minimises the risk of scarring. Artificial depigmentation may cause delayed healing and dyschromic scars, as may the application of carbon dioxide snow.
Development and evaluation of a decision aid for patients considering first‐line chemotherapy for metastatic breast cancer
Authors: Chiew Kimberly S. , Shepherd Heather , Vardy Janette , Tattersall Martin H.N. , Butow Phyllis N. , Leighl Natasha B.
Published: October 2007

Objective  Treatment decisions in advanced breast cancer are complex, with enhanced quality of life and survival among important treatment goals. Patients with metastatic breast cancer face the decision of whether or not to have chemotherapy, and many wish to be involved in this decision. We report the development and evaluation of a decision aid (DA) designed to assist patients facing this treatment decision.

Design and sample  Women with metastatic breast cancer (n = 17) and medical oncologists in Australia and Canada (n = 7) were invited to evaluate the DA.

Intervention  A DA was developed for patients with hormone‐resistant metastatic breast cancer considering chemotherapy. The DA presented options of supportive care, with or without chemotherapy. Potential benefits and side effects of different chemotherapy regimens, and evidence‐based prognostic estimates were described, and a values clarification exercise included.

Main outcome measures  Patient questionnaires evaluating information and decision involvement preferences, attitudes toward the DA and oncologist feedback regarding attitudes toward the DA.

Results  Seventeen patients participated; fifteen desired as much information about their illness as possible; sixteen wished to be actively involved in the decision‐making process. The majority rated the DA as highly acceptable, clear and informative, and would recommend it to others facing this treatment decision.

Conclusion  This is the first DA for patients with advanced metastatic breast cancer considering chemotherapy. A randomized trial is underway to evaluate its role in clinical decision‐making.
Allergic sensitization to cat in childhood as major predictor of incident respiratory allergy in young adults
Authors: Schäfer T. , Wölke G. , Ring J. , Wichmann H.‐E. , Heinrich J.
Published: October 2007

Background:  Little is known on the predictive value of sensitization to specific aeroallergens in children with respect to asthma and hay fever incidence in young adulthood. We followed the incidence of asthma and hay fever in children (mean age 11 years) over 9 years, and analyzed the predictive value of sensitization to five common aeroallergens.

Methods:  Three consecutive surveys were conducted in East German school children. Specific IgE antibodies to birch and timothy grass pollen, house dust mite, cat, and cladosporium were measured. In 1207 out of the 2453 children, the 9‐year incidence of asthma and hay fever was assessed by reported doctors’ diagnoses. For sensitization, diagnostic parameters were determined and logistic regression analyses controlled for relevant confounders.

Results:  A total of 176/78 incident hay fever/asthma cases occurred equaling a cumulative incidence of 1.93/0.86% per year. Incident asthma was associated with previous sensitization to cat [risk ratio (RR) 3.49, 1.57–7.74] and grass pollen (RR 1.79, 1.01–3.19), whereas incident hay fever was associated with each allergen, with grass pollen (RR 6.00, 4.04–8.90) and cat (RR 5.36, 2.87–9.99) exhibiting the strongest associations. When mutually adjusting for all allergens, sensitization to cat remained significantly associated with asthma and hay fever. The latter was also associated with sensitization to grass pollen. The highest positive predictive values for asthma and hay fever were obtained for cat sensitization (10/49 = 20.4% and 23/49 = 46.9%).

Conclusions:  Childhood sensitization to cat and grass pollen predicts the incidence of asthma and hay fever in young adulthood. The predictive capacity differs by allergen and manifestation of atopy.
Natural rubber latex and chestnut allergy: cross‐reactivity or co‐sensitization?
Authors: Raulf‐Heimsoth M. , Kespohl S. , Crespo J. F. , Rodriguez J. , Feliu A. , Brüning Th. , Rihs H. P.
Published: October 2007

Background:  Chestnut and natural rubber latex (NRL) allergy are often associated in the latex‐fruit syndrome.

Aim of the study:  To establish whether the concurrent NRL and chestnut IgE antibody reactivity are the results of co‐sensitization or cross‐reactivity.

Methods:  Sera from 19 patients with chestnut‐ and NRL‐specific IgE were selected and tested for reactivity with recombinant (r) latex allergens. Cross‐reactivity was explored by IgE‐inhibition experiments using chestnut or NRL allergens as solid phase on ImmunoCAP.

Results:  IgE‐antibodies were detected to rHev b 6.01 (prohevein) in 58% of the sera, to rHev b 5 in 32%, to rHev b 12 in four of 13 sera, to rHev b 7.02 and rHev b 11 in four, and to rHev b 1 in two of 19 sera. rHev b 8‐IgE antibodies were found in nine sera (47%), whereas six displayed mono‐sensitization to rHev b 8 with regard to our test panel. Three of 16 sera showed IgE to cross‐reactive carbohydrate determinants. In most sera recognizing rHev b 5 and/or rHev b 6.01 as major allergens the IgE‐reactivity to NRL remained unaffected by chestnut extract and chestnut‐IgE remained unaffected by NRL extract. Conversely, in sera with rHev b 8 as dominant allergen IgE‐binding to NRL was nearly completely inhibited by chestnut and vice versa. IgE‐binding to rHev b 8 was abolished by chestnut extract.

Conclusions:  Although patients have concomitant IgE antibody reactivity to chestnut and NRL, cross‐reactivity could be demonstrated mainly in those patients with IgE to Hev b 8 (profilin) from NRL.
Infrequent milk consumption plus being overweight may have great risk for asthma in girls
Authors: Mai X.‐M. , Becker A. B. , Sellers E. A. C. , Liem J. J. , Kozyrskyj A. L.
Published: October 2007

Background:  Inadequate milk consumption and being overweight are each associated with asthma symptoms in children. Milk consumption has been inversely related to childhood overweight. Thus, being overweight may be a pathway or a confounder in milk–asthma relationship. A combination of both factors may be associated with greater risk of asthma than one factor alone.

Methods:  This study included 246 children with allergist‐diagnosed asthma and 477 nonasthmatic controls at the age of 8–10 years. Information on milk consumption during the last 12 months was obtained from questionnaires. Being overweight was defined as body mass index ≥85th percentile. Being overweight as a possible pathway or confounder was formally tested. The odds ratio (OR) for combined infrequent milk consumption and being overweight in asthmatic vs nonasthmatic children was determined in multivariate logistic regression analyses.

Results:  There was a significant interaction between milk consumption and sex of the child in relation to asthma. Asthma was significantly associated with infrequent milk consumption in girls (crude OR 2.11, 95% CI 1.05–4.24) but not in boys. The asthma–milk relation in girls was neither mediated by being overweight (pmediation tests = 0.27) nor was the relationship confounded by being overweight (a 9% change in coefficient). Asthmatic girls had 3.6 times increased odds of having combination of infrequent milk consumption and being overweight than nonasthmatic girls (adjusted OR 3.64, 95% CI 1.18–11.24). Asthma was not associated with either factor or with absence of the other in girls.

Conclusion:  Infrequent milk consumption plus being overweight may have great risk for asthma in girls.
Specific oral tolerance induction in food allergy in children: efficacy and clinical patterns of reaction
Authors: Staden U. , Rolinck‐Werninghaus C. , Brewe F. , Wahn U. , Niggemann B. , Beyer K.
Published: October 2007

Background:  Specific oral tolerance induction (SOTI) seems to be a promising treatment of food allergy. Specific oral tolerance induction and elimination diet were compared with respect to efficacy rate and patterns of clinical reaction.

Methods:  Children with challenge proven immunoglobulin E (IgE)‐mediated cow’s milk (CM) allergy or hen’s egg (HE) allergy were randomly assigned to SOTI or elimination diet as a control group. Specific oral tolerance induction treatment was performed at home on a daily basis according to a study protocol with fresh CM or lyophilized HE protein. Re‐evaluation of clinically relevant food allergy was performed by food challenge after a median of 21 months. Children in the SOTI group received a secondary elimination diet for 2 months prior to follow‐up challenge to evaluate persistence of induced oral tolerance.

Results:  At follow‐up challenge, nine of 25 children (36%) showed permanent tolerance in the SOTI group, three of 25 (12%) were tolerant with regular intake and four of 25 (16%) were partial responders. In the control group, seven of 20 children (35%) were tolerant. Allergen‐specific immunoglobulin E decreased significantly both in children who developed natural tolerance during the elimination diet (P < 0.05) and in those with SOTI (P < 0.001).

Conclusions:  Specific oral tolerance induction seems a valid treatment option for patients with persistent food allergy. Indications may be given if avoidance cannot be guaranteed or for those who are eager to eat the food in question. Advantages of SOTI are the increased threshold dose for allergic reactions and the substantially reduced risk of severe allergic reactions after inadvertent ingestion of the allergen. However, careful monitoring during SOTI is mandatory.
Oat sensitization in children with atopic dermatitis: prevalence, risks and associated factors
Authors: Boussault P. , Léauté‐Labrèze C. , Saubusse E. , Maurice‐Tison S. , Perromat M. , Roul S. , Sarrat A. , Taïeb A. , Boralevi F.
Published: October 2007

Background:  Topical treatments of atopic dermatitis (AD) may be responsible for cutaneous allergies. Percutaneous sensitization to oat used in emollients/moisturizers has already been reported. Our objectives were to measure the prevalence of oat sensitization in AD children, to assess its relevance, and to look at related parameters.

Methods:  We recruited prospectively children with AD referred for allergy testing between June 2001 and December 2004. Atopy patch tests (APT) and skin prick tests (SPT) to oat proteins (1%, 3% and 5%) and to the European standard series were performed followed by oral food challenge (OFC) and repeated open application test (ROAT) in the oat‐sensitized group.

Results:  About 302 children were enrolled. Oat APT and SPT were positive in 14.6% and 19.2% of cases, respectively. Children under 2 years of age were more likely to have positive APT. In oat‐sensitized children, OFC and ROAT were positive in 15.6% (five of 32) and 28% (seven of 25) of cases, respectively. Thirty‐two percentage of oat cream users had oat‐positive atopy patch test (APT) vs 0% in the nonusers group.

Conclusions:  Oat sensitization in AD children seen for allergy testing is higher than expected. It may be the result of repeated applications of cosmetics with oats on a predisposed impaired epidermal barrier. We suggest avoiding topical‐containing oat proteins in infants with AD.
Pediatric Transplant Rating Instrument – A scale for the pretransplant psychiatric evaluation of pediatric organ transplant recipients
Authors: Fung Ernest , Shaw Richard J.
Published: October 2007

Abstract: Although the majority of pediatric solid organ transplant centers in the United States employ psychosocial criteria to assess the suitability of potential transplant candidates, there are no standardized pretransplant psychosocial assessment measures. Assessment scales that have been developed were designed for adult transplant recipients and are not suitable for use in the pediatric population. The P‐TRI was developed to address this gap in the pediatric pretransplant psychosocial evaluation. It is intended to identify areas of psychosocial vulnerability that may be associated with poor treatment adherence and to facilitate the development of informed and focused psychosocial interventions for pediatric patients before and after transplant surgery. Items on the rating instrument were generated based on a review of the major correlates of treatment adherence in the pediatric population. Data are currently being collected for further reliability and validity analyses.
Ins and outs of inferior vena cava filters in patients with venous thromboembolism: the experience at Monash Medical Centre and review of the published reports
Authors: Seshadri T. , Tran H. , Lau K. K. , Tan B. , Gan T. E.
Published: October 2007

Background:  Inferior vena cava (IVC) filters are an alternative management strategy to anticoagulation in patients with venous thromboembolism (VTE). However, an IVC filter has its own inherent risks and complications and may not be the best management strategy. The aims of this study were to evaluate our institution’s practice of permanent Vena Tech (B. Braun Medical S.A., Boulogne, France) and retrievable Gunther Tulip (William Cook Europe, Bjaeverskov) IVC filters and to review the available published reports.

Methods:  Retrospective single centre audit from the medical record.

Results:  Eighty‐three and 42 patients had a VT and GT filter inserted, respectively. Median age was 57 years for VT and 63 years for GT. The majority (75% for VT and 83% for GT) was inserted for acute VTE and contraindication to anticoagulation. Both filters were efficacious at preventing pulmonary embolism (PE) and there was a low rate of recurrent deep venous thrombosis in both groups. Insertion‐related complications were low in both groups. Of the GT filters (n = 42), 16 were deemed an ongoing requirement, and thus, removal was not planned. In a further six patients, there was insufficient documentation as to why removal was not planned. Removal was attempted in 19 patients and was successful in 11. Failure of removal was as a result of clot in the filter (n = 7) or inability to snare it (n = 1).

Conclusions:  Both the permanent and retrievable filters are efficacious at preventing PE and are associated with a low complication rate. Planned removal of the GT filter may not be possible in a significant proportion of cases.
The use of dexmedetomidine during laryngoscopy, bronchoscopy, and tracheal extubation following tracheal reconstruction
Authors: SEYBOLD JEANNIE L. , RAMAMURTHI RADHAMANGALAM J. , HAMMER GREGORY B.
Published: October 2007

We report the use of dexmedetomidine for laryngoscopy, rigid bronchoscopy, and tracheal extubation in the operating room in two children who had undergone tracheal reconstruction 1 week previously. Dexmedetomidine in combination with propofol provided appropriately deep anesthesia during these brief but stimulating procedures without cardiovascular or respiratory depression.