bluuebunny/crossref_metadata_2025 huggingface dataset:
SECULAR CHARITY, SACRED POVERTY: PICTURING THE POOR IN RENAISSANCE VENICE
Authors: NICHOLS TOM
Published: June 2007

The poor were depicted with increasing frequency and prominence in Venetian art of the sixteenth century. This new level of visualization within the fictive space of representation indirectly reflects contemporary attempts to exclude poveri and other undesirables from the actual space of the city. Increased state involvement in poor relief stimulated a new iconography of secular charity featuring almsgiving by patrician officials, presented in an hierarchical manner that pointedly departs from the more communal depictions in paintings commissioned by the city's non‐noble scuole. But it was in religious painting for the city's churches and monasteries that the visual imagery of poverty was most dramatically improved, with reference both to sacred and devotional texts stressing poverty as a sacred value and to formal models from antique and High Renaissance art. The povero increasingly appeared as an idealized human archetype whose suffering and humility associated him directly with Christ. The article concludes by arguing that the symbolization of the poor as significant sacred actors in visual art was an aspect of their repression and exclusion in the social domain.
UTOPIA LOST: ALLEGORY, RUINS AND PIETER BRUEGEL'S TOWERS OF BABEL
Authors: MORRA JOANNE
Published: June 2007

Beginning with the ubiquity with which art history discusses Pieter Bruegel the Elder's work as allegorical – and the Tower of Babel paintings are no exception – I offer a reassessment of this by contributing to the ongoing debates within Breugel studies on methodology, and, until now, outside of them, on Walter Benjamin's theory of allegory. Through a close reading of the paintings, the art historical literature on the paintings, and a philosophical interpretation of the Tower of Babel narrative, I intervene in the methodological debates by proposing an alternative conception of the dialectical aspects of Bruegel's paintings. I then suggest how an understanding of the dialectical character of the paintings, and a necessarily overdetermined hermeneutics of them, can add to our knowledge of Bruegel's work, and put pressure on our comprehension of Benjamin's writings on allegory and ruins.
You Stab My Back, I'll Stab Yours: Management Experience and Perceptions of Organization Political Behaviour
Authors: Buchanan David A.
Published: June 2007

This paper reports the findings of a survey of 250 British managers, exploring their experience and perceptions of organization politics. Political behaviour appeared to be common. Most managers viewed political behaviour as ethical and necessary, and aspects of organizational effectiveness, change, resourcing and reputation were attributed to political tactics, although 80% had no training in this area. Tactics experienced frequently included networking, using ‘key players’ to support initiatives, making friends with power brokers, bending the rules, and self‐promotion. Tactics experienced as rare, but not unknown, included misinformation, spreading rumours, and keeping ‘dirt files’ for blackmail. A consistent pattern of responses concerning willingness to engage in politics, the need to act ruthlessly and the appropriateness of reciprocity when faced with political behaviour implies an attitude of ‘you stab my back, I'll stab yours’. Findings are discussed using an ‘antecedents–behaviours–consequences’ framework of perceived organization politics to guide research.
The Price Chameleons Pay: Self‐monitoring, Boundary Spanning and Role Conflict in the Workplace*
Authors: Mehra Ajay , Schenkel Mark T.
Published: June 2007

The vast majority of research on self‐monitoring in the workplace focuses on the benefits that accrue to chameleon‐like high self‐monitors (relative to true‐to‐themselves low self‐monitors). In this study, we depart from the mainstream by focusing on a potential liability of being a high self‐monitor: high levels of experienced role conflict. We hypothesize that high self‐monitors tend to choose work situations that, although consistent with the expression of their characteristic personality, inherently involve greater role conflict (i.e. competing role expectations from different role senders). Data collected from a 116‐member high‐tech firm showed support for this mediation hypothesis: relative to low self‐monitors, high self‐monitors tended to experience greater role conflict in work organizations because high self‐monitors were more likely to occupy boundary spanning positions. To help draw a more realistic and balanced portrait of self‐monitoring in the workplace, we call for more theoretically grounded research on the price chameleons pay.
A Note on Return on Foreign Assets and Foreign Presence for UK Multinationals*
Authors: Rugman Alan , Yip George , Jayaratne Saliya
Published: June 2007

Within the context of the international business literature on multinationality and performance we develop new data on the foreign presence and performance of large UK multinational enterprises (MNEs). There are 32 UK MNEs for which we can obtain data on both their degree of multinationality (measured by the ratio of foreign to total (F/T) sales) and their performance. Here, in addition to the traditional overall performance of the firm, shown as return on total assets, we use new data on the return on foreign assets (ROFA). We conduct analytical work to show the positioning of the UK MNEs in the ROFA and F/T sales space and provide regression results showing a linear relationship between multinationality and performance, using the new ROFA metric.
Determinants of Relationship Quality in Importer–Exporter Relationships
Authors: Skarmeas Dionysis , Robson Matthew J.
Published: June 2007

Despite significant evidence pointing to the key role of relationship quality in solidifying commercial relationships, limited attention has been paid to its determinants in an international context. In an attempt to fill this research gap, our study examines the impact of asset specificity, role performance and cultural sensitivity on the quality of the relationships between importers and their foreign suppliers. It is based on a mailed survey involving 292 importing firms. Relationship quality is presented as a higher‐order concept that results in lower conflict and greater trust, commitment and satisfaction. The results indicate that asset specificity, role performance and cultural sensitivity play a significant positive role in building sound relationship quality. Several managerial implications are extracted from the study, as well as suggestions for future research.
Exploring the Career Capital Impact of International Assignments within Distinct Organizational Contexts
Authors: Dickmann Michael , Doherty Noeleen
Published: June 2007

The existing expatriation literature concentrates on what individuals need to perform in an international assignment (IA) but neglects what they gain from their foreign work experience. Using a dual‐dependency perspective this study presents results from 26 in‐depth interviews with international secondees within two UK‐based organizational contexts. The paper explores the perceived impact of an IA on the career capital of individuals, showing that the outcomes of IAs can be equivocal for expatriates. Each firm concentrated their human resource mechanisms on developing different types of career capital and this focused individual behaviour on diverse career capital activities. In one of the organizations there was an internal misalignment between organizational and individual assignee focus. Based on the research a number of propositions were developed. This study provided an exploratory insight into points of departure rather than complementarity in individuals' international careers in organizations, which has been at the core of much recent research and writing. A more complex, contextualized picture of the effects of IAs on the careers of individuals emerged.
Pressing: Smooth Isosurfaces with Flats from Binary Grids
Authors: Chica A. , Williams J. , Andujar C. , Brunet P. , Navazo I. , Rossignac J. , Vinacua A.
Published: June 2007

We explore the automatic recovery of solids from their binary volumetric discretizations. In particular, we propose an approach, called Pressing, for smoothing isosurfaces extracted from binary volumes while recovering their large planar regions (flats). Pressing yields a surface that is guaranteed to contain the samples of the volume classified as interior and exclude those classified as exterior. It uses global optimization to identify flats and constrained bilaplacian smoothing to eliminate sharp features and high frequencies from the rest of the isosurface. It recovers sharp edges between flat regions and between flat and smooth regions. Hence, the resulting isosurface is usually a very accurate approximation of the original solid. Furthermore, the segmentation of the isosurface into flat and curved faces and the sharp/smooth labelling of their edges may be valuable for shape recognition, simplification, compression and various reverse engineering and manufacturing applications.
A single question for the rapid screening of restless legs syndrome in the neurological clinical practice
Authors: Ferri R. , Lanuzza B. , Cosentino F. I. I. , Iero I. , Tripodi M. , Spada R. S. , Toscano G. , Marelli S. , Aricò D. , Bella R. , Hening W. A. , Zucconi M.
Published: June 2007

The purposes of this study were to validate the use of a single standard question for the rapid screening of restless legs syndrome (RLS) and to analyze the eventual effects of the presence of RLS on self‐assessed daytime sleepiness, global clinical severity and cognitive functioning. We evaluated a group of 521 consecutive patients who accessed our neurology clinic for different reasons. Beside the answer to the single question and age, sex, and clinical diagnosis, the following items were collected from all patients and normal controls: the four criteria for RLS, the Epworth Sleepiness Scale (ESS), the Clinical Global Impression of Severity (CGI‐S), and the Mini‐Mental State evaluation. RLS was found in 112 patients (70 idiopathic). The single question had 100% sensitivity and 96.8% specificity for the diagnosis of RLS. ESS and CGI‐S were significantly higher in both RLS patient groups than in normal controls. RLS severity was significantly higher in idiopathic than in associated/symptomatic RLS patients. RLS can be screened with high sensitivity and good reliability in large patient groups by means of the single question; however, the final diagnosis should always be confirmed by the diagnostic features of RLS and accompanied by a careful search for comorbid conditions.
The G2019S LRRK2 mutation is uncommon amongst Greek patients with sporadic Parkinson's disease
Authors: Kalinderi K. , Fidani L. , Bostantjopoulou S. , Katsarou Z. , Kotsis A.
Published: June 2007

Parkinson's disease (PD) is the second most common neurodegenerative disorder affecting approximately 2% of the population >60 years of age. Although, the etiology of PD is still unknown, the genetic background of the disease has been documented. Recently, a mutation in the LRRK2 gene, G2019S, was associated with 3–41% and 1–2% of familial and sporadic PD, respectively suggesting a pivotal role of LRRK2 in PD. In this report, we examine the association of the G2019S mutation with sporadic late‐onset PD, in an independent cohort of Greek patients and controls.
Fine Mapping of Disease Genes Using Tagging SNPs
Authors: Sjölander Arvid , Hössjer Ola , Hartman Linda Werner , Humphreys Keith
Published: June 2007

We describe a haplotype clustering approach for localising a disease mutation within a fixed genomic region, which supplements tagging SNP (tSNP) information with (external) information on linkage disequilibrium. By applying our method to simulated data based on the coalescent, and on real haplotype data, we demonstrate that there are situations where significant gains can be made by incorporating tagged SNPs into the analysis. The issues we explore are important not only to these types of studies, but also to studies that select tSNPs based on (external) HapMap phase II data, and those that use genome‐wide markers.
Isolation and characterization of microsatellite loci in the tapeworm Ligula intestinalis (Cestoda: Pseudophyllidea)
Authors: ŠTEFKA J. , GILLEARD J. S. , GRILLO V. , HYPŠA V.
Published: June 2007

Ligula intestinalis is a species with a complex biology. Several strains, distinct in the host specificity and biogeography, are supposed to exist; however, their morphological or molecular identification remains unresolved. We describe the isolation of 16 polymorphic microsatellite markers. The number of alleles ranged from four to 14 in a population of 21 L. intestinalis individuals. Loci showed amplification success across samples of worldwide distribution. A cross‐amplification of 14 markers in Digramma interrupta (Cestoda: Pseudophyllidea) was observed.
Isolation and characterization of microsatellite loci from the endangered highlands scrub hypericum (Hypericum cumulicola)
Authors: EDWARDS C. E. , ARAKAKI M. , QUINTANA‐ASCENCIO P. F. , SOLTIS D. E. , SOLTIS P. S.
Published: June 2007

We report the isolation of 19 primer pairs for amplification of polymorphic microsatellite loci for Hypericum cumulicola. These markers were evaluated in 24 individuals from one population; two to four alleles were detected per locus, and observed heterozygosity ranged from 0 to 0.5. Two loci demonstrated significant heterozygote deficiencies, possibly due to null alleles, and significant linkage disequilibrium was found between six pairs of loci. The remaining microsatellite loci will help determine if genetic differentiation is responsible for life‐history differences between natural and anthropogenically disturbed populations of H. cumulicola.
The role and value of local knowledge in Jamaican agriculture: adaptation and change in small‐scale farming
Authors: BECKFORD CLINTON , BARKER DAVID
Published: June 2007

Local knowledge has played an active role in the lives of rural communities in virtually every part of the world. In Jamaica, traditional cropping systems based on local informal knowledge have been practiced since the days of slavery and play a vital role in meeting food security. Yet, some negative attitudes remain about the legitimacy and relevance of small‐scale farmers’ local and traditional knowledge. This paper discusses some conceptual and empirical issues related to the application of local knowledge among small‐scale food farmers in central Jamaica. The paper argues that contextually speaking, local and traditional knowledge is valuable, adaptable and necessary in coping with risk and uncertainty in a changing world, while cautioning against a misguided notion of traditional knowledge as a panacea to all the ills of local agriculture.
A Novel ATP1A2 Gene Mutation in an Irish Familial Hemiplegic Migraine Kindred
Authors: Fernandez Desiree M. , Hand Collette K. , Sweeney Brian J. , Parfrey Nollaig A.
Published: June 2007

Objective.— We studied a large Irish Caucasian pedigree with familial hemiplegic migraine (FHM) with the aim of finding the causative gene mutation.

Background.— FHM is a rare autosomal‐dominant subtype of migraine with aura, which is linked to 4 loci on chromosomes 19p13, 1q23, 2q24, and 1q31. The mutations responsible for hemiplegic migraine have been described in the CACNA1A gene (chromosome 19p13), ATP1A2 gene (chromosome 1q23), and SCN1A gene (chromosome 2q24).

Methods.— We performed linkage analyses in this family for chromosome 1q23 and performed mutation analysis of the ATP1A2 gene.

Results.— Linkage to the FHM2 locus on chromosome 1 was demonstrated. Mutation screening of the ATP1A2 gene revealed a G to C substitution in exon 22 resulting in a novel protein variant, D999H, which co‐segregates with FHM within this pedigree and is absent in 50 unaffected individuals. This residue is also highly conserved across species.

Conclusions.— We propose that D999H is a novel FHM ATP1A2 mutation.
Marketed Oral Triptans in the Acute Treatment of Migraine: A Systematic Review on Efficacy and Tolerability
Authors: Pascual Julio , Mateos Valentin , Roig Carles , Sanchez‐del‐Rio Margarita , Jiménez Dolores
Published: June 2007

Background.—In the current literature, there is neither a reported systematic review comparing the efficacy of triptans at 30 minutes and 1 hour after the migraine treatment, nor data related to efficacy of new marketed triptans.

Objective.—The main objective of this analysis was to compare the efficacy and tolerability of currently marketed oral, non‐reencapsulated triptan formulations vs placebo in the treatment of moderate‐to‐severe migraine attacks.

Methods.—A systematic review of double‐blind, randomized clinical trials reporting data after a single migraine attack was conducted. Efficacy results are shown using relative risk ratios with 95% confidence intervals. A sensitivity analysis was also conducted.

Results.—After reviewing 221 publications, 38 studies were included. All marketed triptans provided significant relief and/or absence of pain at 2 hours, and relief at 1 hour when compared with placebo. After 30 minutes, fast‐dissolving sumatriptan 50 and 100 mg, sumatriptan 50 mg, and rizatriptan 10 mg showed significant relief when compared to placebo, whereas the fast‐dissolving formulation of sumatriptan 100 mg was the only oral triptan that was superior to placebo in meeting the pain‐free endpoint. On the other hand, fast‐dissolving sumatriptan 50 and 100 mg and eletriptan 40 mg showed a lower rate of recurrence than placebo, whereas rizatriptan 10 mg was the only triptan with a recurrence rate greater than that of placebo. Adverse events associated with treatment with tablet formulations of sumatriptan and zolmitriptan were significantly more frequent than those of the placebo group.

The inclusion of trials with reencapsulated triptans in the analysis introduced minor specific changes in these results.

Conclusion.—This analysis updates the comparative data available for the 7 currently marketed oral triptans and clearly demonstrates their efficacy when compared to placebo, even with stricter endpoints, such as efficacy at 30 minutes. No triptan exhibited better tolerability than placebo. Results are diverse, depending on the triptan, which probably is a reflection of heterogeneous pharmacokinetics.
Language Disturbances as a Side Effect of Prophylactic Treatment of Migraine
Authors: Coppola Francesca , Rossi Cristiana , Mancini Maria Luisa , Corbelli Ilenia , Nardi Katiuscia , Sarchielli Paola , Calabresi Paolo
Published: June 2007

Background.— Language disturbances have been previously described as word‐finding difficulties in epileptic patients. These disturbances have been recently reported in migraineurs in treatment with topiramate but they have never been defined and assessed in these patients with the aid of neuropsychological testing.

Objective.— To verify the occurrence of language disturbances as a side effect of topiramate treatment in episodic and chronic migraine patients.

Methods— Language disturbances were recorded on the basis of spontaneous reports of 30 migraine patients treated with topiramate and 2 control groups (20 patients treated with other prophylactic drugs and 20 patients without prophylactic treatment) and were explored with neuropsychological tests. Psychiatric comorbidity was assessed using Zung Anxiety and Depression Scales.

Results.— Language disturbances were referred by 26.7% (n = 8) of patients during topiramate treatment but by none of the patients in the 2 control groups. All patients in the topiramate group had a worse performance on all tests compared to patients of the 2 control groups. Moreover, in the topiramate group, patients with referred language disturbances had higher scores for all neuropsychological test variables, indicative of aworse performance. Some language functions (Trail Making Tests A and B) seemed to be influenced by the concomitant presence of psychiatric comorbidities, particularly anxiety and depression.

Conclusion.— It can be hypothesized that a disorder such as migraine, which involves numerous cortical and subcortical circuits implicated in the transmission and behavioral and emotional processing of pain, represents a facilitated substrate for the occurrence of language disturbances due to topiramate. This could be the expression of a more generalized impairment of cognitive processing. These aspects should be investigated in prospective studies involving larger migraine patient samples.
Episodic Dural Stimulation in Awake Rats: A Model for Recurrent Headache
Authors: Oshinsky Michael L. , Gomonchareonsiri Sumittra
Published: June 2007

Objectives.—To model, in rats, the development of chronic trigeminal nociceptive hypersensitivity seen in patients with recurrent headache.

Background.—Pathophysiology studies suggest that patients with recurrent migraine headache experience repeated bouts of dural nociceptor activation. In some patients, the severity and frequency of headache attacks increase over time. Patients with recurrent headache are hypersensitive to nitric oxide donors, such as glyceryl trinitrate (GTN).

Current trigeminal pain models do not reflect the repeated episodic nature of dural nociceptor activation in patients with recurrent headache. Repeated nociceptor activation creates long‐lasting changes in the periphery and brain due to activity‐dependent neuronal plasticity. An animal model of repeated activation of dural nociceptors will facilitate the study of the physiological changes caused by repeated, episodic pain and the factors important for the transition of episodic to chronic migraine.

Methods.—We induced dural inflammation by infusing an inflammatory soup (IS) through a cannula on the dura in awake behaving rats. This was repeated 3 times per week for up to 4 weeks. Periorbital pressure sensory testing was used to monitor the change in trigeminal sensitivity. Rats were challenged with GTN to test the hypothesis that many dural stimulations are required to model the hypersensitivity of migraine patients. Quantitative trigeminal sensory testing and microdialysis in the trigeminal nucleus caudalis (TNC) were used to measure GTN hypersensitivity.

Results.—Multiple infusions of IS (>8), over weeks, induced a long‐lasting decrease in periorbital pressure thresholds that lasted >3 weeks after the last infusion. In contrast, IS infusion in IS‐naive rats and those that received 3 IS infusions produced only short‐lasting decreases in periorbital pressure thresholds.

Rats that received more than 8 IS infusions showed a marked increase in their neurochemical and behavioral responses to GTN. In these rats, GTN induced a decrease in periorbital von Frey thresholds that lasted >5 hours. In contrast, in rats that received only 3 IS infusions, GTN caused a threshold decrease for 1.5 hour.

In vivo microdialysis in the TNC showed that GTN increased extracellular glutamate levels in rats with more than 8 IS infusions to 7.7 times the basal levels. In IS‐naive rats and those that received only 3 IS infusions, the extracellular glutamate levels rose to only 1.7 and 1.9 times the basal level, respectively.

Conclusions.—Repeated IS stimulation of the dura produces a chronic state of trigeminal hypersensitivity and potentiates the response to GTN. This hyperresponsiveness outlasts the last IS infusion and is the basis of our rat model of recurrent headache. This model can be used to study the changes in the brain and periphery induced by repeated trigeminovascular nociceptor activation and has the potential to elucidate the mechanisms for the transition of episodic to chronic headache.
Diagnosis and Treatment of Cutaneous Melanoma: A Practical Guide
Authors: Zalaudek Iris , Ferrara Gerardo , Argenziano Giuseppe , Ruocco Vincenzo , Soyer H. Peter
Published: June 2007

During the past decades, a number of new scientific evidences have been provided allowing a better understanding of the nature of cutaneous melanoma. New scientific methods, such as dermoscopy, have been shown to improve the diagnostic accuracy of pigmented skin lesions and early recognition of melanoma. Aggressive approaches for the surgical treatment of melanoma have been shown to be useless and have been replaced by more conservative surgical protocols and by sentinal lymph node biopsy. In the advanced stage of melanoma, new chemotherapy protocols and immunotherapy have been proposed, whereas the role of vaccines is still under investigation. In this review, the authors present an up‐to‐date overview of the epidemiologic, clinical, histopathologic, and therapeutic aspects of melanoma that can be used as a practical guide for the management of this tumor.
The Proposed Inflammatory Pathophysiology of Rosacea: Implications for Treatment
Authors: Millikan Larry
Published: June 2007

The pathophysiology of the vascular and inflammatory stages of facial rosacea and proposes an underlying cause is reviewed. It can be argued that all the stigmata of rosacea are manifestations of an inflammatory process: neutrophilic dermatosis. For this reason, treatments that block neutrophil involvement in the development of rosacea, such as topical metronidazole and systemic antibodies, should be considered first‐line therapy for all stages of the disease.
Medical and Cutaneous Disorders Associated With Homelessness
Authors: Stratigos Alexander J. , Katsambas Andreas D.
Published: June 2007

Homelessness is a rising problem with socioeconomic roots that affects millions of people around the world. Homeless people suffer from a wide range of health problems and, consequently, have high rates of morbidity and mortality. Various infectious and noninfectious skin conditions have been described among the homeless, with trauma, superficial fungal infections, and foot problems being the most prevalent. Poor hygiene conditions, exposure to harmful environmental agents, and impaired access to health care May further exacerbate these skin diseases and lead to serious and occasionally life‐threatening situations. As an integral part of the medical care for the homeless, dermatologic care is essential in diagnosing and managing their skin diseases, in preventing more serious complications and in improving the overall health status of the homeless population.
Erectile Dysfunctions
Authors: Sehgal Virendra N. , Srivastava Govind
Published: June 2007

Erectile dysfunction is one of the prime challenges confronting the treating physician. Its prevalence is directly proportional to aging. It is imperative to comprehend the intricate mechanism of erection in order to individualize the approach to management. Thus, it is appropriate to evaluate the etiology of erectile dysfunction. Normal aging, as well as psychogenic, vascular, neurogenic, and endocrinologic causes and/or those due to structural abnormalities of the penis should be considered when evaluating details to determine its probable cause. An increasing use of drugs, a legacy of civilization, has considerably compounded the problem. Therapy for erectile dysfunction, apart from psychosexual counseling, includes medical treatment by alpha adrenoceptor antagonists, dopamine agonists, phosphodiesterase type 5 inhibitors, sublingual apomorphine hydrochloride, or hormone therapy. Transdermal or transurethral corporeal drug delivery are other possible treatment modalities. Vacuum devices and surgical approaches are considered relevant only in refractory cases.
Subcorneal Pustular Dermatosis Developing in a Patient With Rheumatoid Arthritis; Rheumatoid, Antimicrosomal, and Antimitochondrial Autoantibodies; and a Goiter
Authors: Scheinfeld Noah S , Worth Richard , Mallea Jorje , Shookster Linda , Weinberg Jeffrey M
Published: June 2007

A 61‐year‐old African American woman with a history of a simple asymptomatic goiter of uncertain duration presented with a 2‐year history of rheumatoid arthritis, with an erosive, symmetric polyarthritis. Her arthritis was controlled by methotrexate 7.5 mg weekly. Vesiculopustules had developed on her trunk (Figures 1 and 2). A lesional biopsy was consistent with subcorneal pustular dermatosis, demonstrating epidermal subcorneal neutrophilic pustules without spongiosis, acanthosis or mitotic figures, findings making a diagnosis very unlikely of pustular psoriasis or immunoglobulin A (IgA) pemphigus. The patient was started on dapsone 50 mg daily, but developed peripheral neuropathy within 3 weeks, necessitating withdrawal of the drug. She was started on clobetasol propionate ointment, with lesion clearing. The patient's laboratory values showed: negative antinuclear antibody, rheumatoid factor 1:320, positive antimicrosomal antibodies, antimitochondrial antibodies 1:320, and negative anti‐smooth muscle antibodies. A serum protein electrophoresis demonstrated a polyclonal gammopathy.
Dermatologic Manifestations of Complementary Therapy
Authors: Witkowski Joseph A. , Parish Lawrence Charles
Published: June 2007

The dermatologic manifestations of complementary therapy include reactions to herbs used orally and topically for treating skin disease, cutaneous reactions to drugs used orally and topically for treating other diseases, and reactions to alternative interventions. The safety of alternative medicine is in question. Unlike approved drugs, the quality, efficacy, and safety of herbal medicines is not regulated. Herbal medicines May be misidentified and contaminated with a variety of substances. The following review identifies and categorizes therapies according to their common uses with their adverse reactions.
Latex Allergy
Authors: Warshaw Erin M.
Published: June 2007

Allergy to natural rubber latex affects people routinely exposed to rubber products. Groups thought to be at highest risk include atopics, health care workers, rubber industry workers, and individuals who have undergone multiple surgical procedures, especially those with spina bifida. Allergy to latex is a type I, immediate, IgE‐mediated reaction that can lead to anaphylaxis and death. The prevalence, risk factors, clinical manifestations, diagnosis, and management of latex allergy are summarized in this review.
Netherton Syndrome
Authors: Ibrahim Galadari , Jameelah Al‐Kaabi , Hassan Galadari
Published: June 2007

A 17‐year‐old Egyptian patient presented to the dermatology clinic of Al‐Ain Hospital with a complaints of pruritic dry skin and short brittle hair since early infancy. The patient was born to healthy nonconsanguineous parents. He was a product of full‐term normal pregnancy and delivery with a normal birth weight. At about age 4 weeks, he started to develop erythroderma and scaling. He had a history of recurrent infections, diarrhea, and failure to thrive in the first year of life. By age 2 years, the patient started to catch up with his weight and height. The erythroderma started to disappear slowly and erythematous, scaly, polycyclical, migratory lesions started to develop on his body. The patient achieved his developmental milestones with no delay and showed normal intelligence for his age. The family history was positive for eczema and allergic rhinitis in both his sister and brother. It was negative, however, for ichthyotic disorders. On physical examination, scaly, annular, migratory, and hyperkeratotic double‐edged lesions were noticed on his back, chest, and abdomen (Figures 1 and 2). His hair was short, lacked luster, brittle, and beaded (Figure 3). His eyebrows and lashes were sparse and he had facial and perioral erythema with dryness of the affected area (Figure 3). Laboratory investigations showed normal blood workup, but with an elevation in IgE levels. Examination of hair under light microscopy showed bulging with ball‐and‐cup formation typical for trichorrhexis invaginata or bamboo hair (Figures 4 and 5). Skin biopsy showed mild hyperkeratosis, parakeratosis, reduced granular layer with accumulation of eosinophilic material, and mixed perivascular inflammatory cells infiltrate. A diagnosis of Netherton syndrome was made and the patient was started on antihistamines, emollients, and 10% urea.

Polycyclic, brownish hyperkeratosis

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Bamboo hair

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Ball‐and‐cup hair shaft deformity

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Mucous Aggregate of the Nasopharynx: the Mucolith
Authors: Boyd Alan S. , Langley Melissa , King Lloyd E.
Published: June 2007

A 30‐year‐old woman produced a single mass of gray material from her nose during a particularly forceful sneeze several hours before presenting to our clinic. She asked that the material be submitted for pathologic evaluation because she had experienced simultaneous discomfort behind her left eye and was worried that the mass might be “some kind of brain tissue.” She denied any additional symptoms and took no medications. This was her first such episode and she had no history of mental or emotional illness. An evaluation of the nasal mucosa and nasopharynx demonstrated slight hyperemia but no evidence of bleeding, infection, or foreign body. The specimen consisted of a single gray mass measuring 1 cm in diameter. It was fractured into smaller specimens 2–4 mm in diameter. Microscopically, aggregates of granular material with a gray, violet, or blue color were noted (Figure 1). No living tissues were visible. A vague configuration was appreciated with filamentous fraying at the edges and a palisading array of amorphous matter. Bacterial colonies were noted using a hematoxylin‐eosin and phenol green stain. Gram‐positive cocci and filamentous bacteria were abundant (Figure 2). Entrapped within the matrix were occasional erythrocytes, hemosiderin deposits, and several small refractile foreign bodies. An alcian blue stain demonstrated modest mucin deposition. A calcium stain was negative, but focal iron staining was noted.

Aggregation of amorphous granular material with frayed edge and bacterial colonies (mucolith) (hematoxylin‐eosin stain; original magnification×10)

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Numerous filamentous bacteria with scattered cocci (hematoxylin‐eosin stain; original magnification×40)

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Chemical Warfare Agents Chemical Warfare Agents: Their Past and Continuing Threat and Evolving Therapies Part II of II
Authors: Smith Kathleen J. , Skelton Henry
Published: June 2007

Chemical warfare agents are ideal weapons for terrorists and for use in military operations against both civilian populations and troops. Thus, there have been efforts by the United States in cooperation with other concerned nations to develop animal models to understand the pathophysiology of the injuries induced by these agents, and to develop suitable animal models for testing of pre‐and post‐exposure protectants and therapies. Sulfur mustard remains the most significant chemical warfare agent that produces cutaneous injuries. Institution of standard recommendations prior to threatened exposure or after exposure are something that we need to be aware of in the world we live in. In addition, pre‐and post‐exposure therapies now being studied offer hope for moderating the mortality and morbidity that can result from chemical exposure.
Air Bags and the Skin
Authors: Monica Corazza , Silvana Trincone , Maria Rosaria Zampino , Annarosa Virgili
Published: June 2007

Air bags, fitted in the majority of new automobiles, are safety devices activated when a sudden deceleration cause the ignition of a propellant cartridge containing sodium azide. The bag is inflated by nitrogen liberated during the combustion. Deployment releases various high‐temperature gases, including nitrogen and carbon dioxide, and produces sodium hydroxide, a highly irritant alkaline substance. In about 7%–8% of cases, air bags cause dermatologic injuries such as traumatic lesions, irritant dermatitis, and chemical and thermal burns. Nondermatologic lesions, such as ocular damage (alkali keratitis, corneal abrasions), ear lesions, bone fractures, and contusive damage can also be caused by air bag deployment.
HIV Revisited: The Global Impact of the HIV/AIDS Epidemic
Authors: Amy Evans , Rachel Lee , Amy Mammen‐Tobin , Anura Piyadigamage , Siobhan Shann , Michael Waugh
Published: June 2007

This review is intended as an update on modern trends in the global impact and epidemiology of human immunodeficiency virus infection for physicians who are not acquired immunodeficiency syndrome experts. Africa has been the most affected, but epidemics are spreading in Asia and Russia. Therefore, physicians should be informed about seroconversion disease and human immunodeficiency virus diagnosis as well as the impact of sexually transmitted infections on many stages of human immunodeficiency virus. International treatment guidelines are available. Highly active antiretroviral therapy has been the mainstream therapy since 1996, but all drugs—regardless of class used—have potent side effects, many of which are dermatologic. Others affect the neurologic, hematopoietic, cerebral, and abdominal systems, and drug interactions are common. Lipodystrophy is a common, long‐term side effect that is still not well understood. Broader use of highly active antiretroviral therapy has highlighted viral resistance. This is reviewed, and a simple explanation of therapeutic monitoring is provided.
Traumatic Transverse Leukonychia
Authors: LCDR Kimberly L. Maino , LCDR Mitchell E. Stashower
Published: June 2007

A 24‐year‐old white male presented with a 2‐year history of changes to his nails. He stated that the white discoloration had never completely resolved but improved from time to time with the nails appearing to “grow out normally.” He complained of intermittent tenderness at the lateral and proximal nail folds from occasional “infections” that he characterized as increased redness and pus. He worked as an administrative supervisor in a machine shop and he rarely was exposed to cutting oils. Hobbies included mechanical work on his car. The patient had a several‐year history of anxiety symptoms that caused interruption of his sleep patterns. He admitted to biting his fingernails and to tapping his fingernails repeatedly on flat surfaces like a desk on most days. He admitted to constantly picking at the proximal nail fold and hyponychium of the involved fingers. The patient did notice worsening of his fingernails during stressful periods in his life. Past medical history was otherwise negative. He denied medications including chemotherapy and underlying illnesses including thyroid disease. Review of systems was negative. There was no evidence of liver or renal disease. No history of possible arsenic exposure. Family history was negative for skin and nail disease. On physical exam, the patient appeared anxious but otherwise normal. He was directly observed tapping his nails on the armrest of the chair and picking at his nails during the exam. Patient otherwise had normal teeth, hair, and skin. On exam of the nails, multiple transverse white curvilinear bands were noted. The bands were separated by normal pink nail color (Figure 1). The proximal, distal, and lateral nail folds were noted to be slightly erythematous, frayed, and jagged (Figure 2). The cuticle was noted to be frayed and almost absent. The distal nail plate was ragged on the right nail. No frank signs of infection could be appreciated. Potassium hydroxide test was negative. The patient was referred to psychiatry to manage the anxiety symptoms.

Multiple transverse bands of white discoloration noted to involve almost all nails

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Close‐up view of thumbnails; notice ragged proximal, lateral, and distal nail folds and slight erythema but no frank infection

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Protective Effects of Oral Antioxidants on Skin and Eye Function
Authors: Pierfrancesco Morganti , Giuseppe Fabrizi , Bruno Cesare
Published: June 2007

Background. Antioxidants applied topically and/or taken systemically may play an important role in counteracting the oxidative injury to lipids and proteins on the skin and eye that are provoked by radical oxygen species. Objective. The aim of the study was to control photoprotective activity of the skin and eye through the use of oral antioxidants in 50 smoker volunteers (10 cigarettes/d) aged between 25–36 years and affected by dry skin. Methods. Oxidative stress was assessed by a randomized double‐blind study, and the ROS‐Meter System (Dermotech, Rome, Italy). Global visual function was determined by the use of different visual surveillance tests. Results. A 40% decrease of oxidative stress in blood serum was verified, with a clear relationship between global visual function and the oral intake of an oxygenated carotenoid (lutein). Conclusions. Carotenoids used as nutritional supplements seem to play an interesting photoprotective role for both skin and eyes, eventually increasing the activity of topical sunscreens.
A Primer of Mohs Micrographic Surgery: Uncommon Indications
Authors: Keyvan Nouri , Maria Patricia Rivas
Published: June 2007

Mohs micrographic surgery has been used for the treatment of tumors other than basal and squamous cell carcinomas. Parameters to be considered when deciding on a treatment include location, size, growth pattern, and recurrence rates. It is important to consider that sometimes the high‐risk nature of the tumor is more significant than the need for tissue sparing. Modifications to the Mohs micrographic surgery technique may be used to ensure diagnostic accuracy and confirm complete removal of the lesion (e.g., immunohistochemical staining and paraffin‐embedded sections).
Oral Lichen Planus Part II: Therapy and Malignant Transformation
Authors: Ana Líbia Cardozo Pereira , Claudio de Moura Castro Jacques , Marcia Grillo Cabral DrOdont , Abel Silveira Cardoso , Marcia Ramos‐e‐Silva
Published: June 2007

Oral lichen planus lesions can cause discomfort, pain, and a burning sensation. Therefore, all professionals who deal with the oral cavity must be aware of all the therapeutic options for it. This article presents a review of the literature on oral lichen planus, focusing on its treatment, and also discusses the important and controversial potential for the evolution of oral lichen planus into epidermoid carcinoma.
Louis‐Frédéric Wickham and the Wickham's Striae of Lichen Planus
Authors: Charles Steffen , LCDR Margaret L. Dupree
Published: June 2007

In 1895, Louis‐Frédéric Wickham described whitish streaks, now known as Wickham's striae, on the surface of lichen planus papules. This historical note reprises the original article by Wickham, discusses his life and work, and describes the clinical picture and histopathologic foundation of the striae. The clinical features, the histopathology, and the pathogenesis of lichen planus are not discussed.
Jefferson Medical College Class of 2007 White Coat Keynote Address
Authors: Studdiford James S.
Published: June 2007

Dr. James Studdiford's keynote address was delivered August 8, 2003, as part of the ninth White Coat Ceremony at Jefferson Medical College of Thomas Jefferson University. The ceremony, designed as part of opening exercises for matriculating medical students, welcomes students into the professional family of medicine. Following Dr. Studdiford's comments, family and faculty circulated among the class and helped the students put on their new white coats. No student put on her/his own white coat. It is a moment to be shared with the loved ones and faculty who will support and shepherd students through the adventure of medical training, training replete with the triumphs and challenges, as Dr. Studdiford describes. A powerful piece of the ceremony occurs after the coating, when students join a legacy dating to the fifth century BC by reciting the Oath of Hippocrates. The original Hippocratic Oath charged physicians with the weighty responsibility of selecting worthy individuals for training in the art of medicine. Candidates for medical training were to be individuals with characters marked by moral discipline, reverence for life, and a capacity for commitment to the core Hippocratic values: beneficence, honesty, respect for the doctor‐patient relationship, and protection of the privacy of the details of individuals' lives and ills. Students of medicine were required to so commit themselves before they could commence medical training. In a return to Hippocratic tradition, the White Coat Ceremony represents a welcome as well as a shared covenant to a unifying professionalism in medicine. With the challenges to professionalism detailed by Dr. Studdiford, the White Coat Ceremony reminds aspiring and practicing physicians of the heritage that is ours to protect.—Mitchell J.M. Cohen, MD, the Pain Medicine Program and the Department of Undergraduate Medical Education, Department of Psychiatry and Human Behavior, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA
Clinical Management of Skin Scarring
Authors: Bayat Ardeshir , McGrouther Duncan Angus
Published: June 2007

Not all scars are the same. They vary from normal skin scars to distinct types of abnormal scars, such as hypertrophic and disfiguring keloids. Physicians need to identify different types of skin scars and treat them appropriately. Misdiagnosis and mismanagement of scars can be costly for both the patient and physician. Patients with scars often face aesthetic, physical, psychological, and social consequences that result in substantial emotional and financial costs. This article reviews the spectrum of abnormal scar types and problems associated with scarring.
Creating and Utilizing a Multimedia Dermatology Medical Record for a PocketPC Personal Digital Assistant
Authors: Scheinfeld Noah S
Published: June 2007

Personal digital assistants are lightweight computers that capture and display data via tapping on their screens with a stylus and are easily linked to desktop and network computers. They have been used in medicine for a variety of purposes, and many believe personal digital assistant use can improve the provision of medical care. The author created a multimedia dermatology electronic medical record for a PocketPC (Microsoft Corp., Redmond, WA) personal digital assistant that contains patient images, tables of phototherapy, laboratory and systemic medication data, and typed chart notes. Such a record can be created and utilized but requires more time to assemble than a handwritten note, mostly due to capturing and organizing images. Future challenges involve streamlining record assembly, integrating multimedia records with hospital and office medical records, and assessing how having multimedia data available might affect care.
The Cultural and Philosophical Aspects of Pressure, Massage, and Touch Healing as Alternative Therapies
Authors: Oumeish Oumeish Youssef
Published: June 2007

Integrative medicine is becoming more popular, not only in developing nations, but also in countries such as the United States. Acupuncture, which is practiced more than any other kind of alternative medicine, is based on the philosophy and culture of old Chinese healing. Pressure, massage, and touch healing depend on stimulation by the fingers rather than needles, although they are based on acupuncture principles. Touch has social, educational, cultural, and humanitarian aspects. Touch therapy has been shown to have excellent effects on childrens' growth, development, and emotional well‐being. In adults, a 15‐minute rubdown by fingertips can lead to relaxation and sleep. It is also useful for premature babies. Such therapies were practiced in the Old World, but have been rediscovered in the New World. They represent some aspects of the old, noble art of healing.
Cutaneous Signs and Syndromes Associated With Internal Malignancies
Authors: Claudia C. Ramirez , Brian Berman
Published: June 2007

Cutaneous changes may indicate the presence of or herald the incipient development of internal malignancies. The authors review 24 cutaneous signs, symptoms, diseases, and syndromes associated with internal malignancies. Early recognition of these cutaneous changes may allow for vigilance for, and prompt detection and management of, the underlying neoplasm.