bluuebunny/crossref_metadata_2025 huggingface dataset:
Terrorism and SAARC
Authors: Ghosh Partha S.
Published: July 2017

The menace of terrorism which is uppermost on the agenda of several governments of the world these days has rightly been characterised as wars that need not require violation of national frontiers. The allusion here of course is to international terrorism. But the border line demarcating “national” and international terrorism is itself so blurred that it would indeed be unrealistic to distinguish one from another. Thanks to the growing complexities of the international system, coupled with an unprecedented technological revolution, the tremour of terroristic activities are often felt thousands of miles away from their epicentres. The concept of a global village seems to be expressing itself with a vengeance.
Foreign Policy Coordination in the European Community
Authors: Bhattacharya Purusottam
Published: July 2017

One of the corner stones of the European Economic Community since its inception in 1958 has been the concept of political cooperation among the member states. Despite its economic character the founding fathers envisaged an essentially political community to be brought about by greater functional cooperation through Community organs such as the Commission, the Council of Ministers and the European Parliament.1 Greater harmony was also to be brought about in the conduct of Member States' foreign relations and the Community was increasingly to speak with one voice in international affairs.2

Although the necessity to impart a more formal character to the process of consultations on foreign policy issues was felt during the decade following the establishment of the Community the first concrete steps in this regard were initiated only in 1969 which resulted in the so-called ‘Davignon Report’ in 1970.3 Following its recommendation for a common European diplomatic effort European Political Cooperation (EPC) was set up in 1970. The process which was to consist of foreign policy coordination among the Member States of the European Community was to be conducted outside the framework of the treaties establishing the Community and thus not to be governed by the decision-making rules that applied to the meetings of the EEC Council of Ministers.4
Attitudes towards India: Contrasting Approaches of the United States and the Soviet Union
Authors: Vinod M.J.
Published: July 2017

A comparative study of India's relations with the two Super Powers, the US and the USSR provides a very complex and interesting model in the relations between nations. On the one hand it would appear rather paradoxical that two large and genuine democracies of the world, India and the United States should have but an ordinary relationship devoid of any deep and enduring rapport. At the people-to-people level there exists one might say, an abundance of goodwill and warmth for one another; yet at the state-to-state level there appears to be a lack of understanding and support for each other's position in vital spheres of activity. On the other hand, inspite of their ideological differences, relations between India and the Soviet Union have turned out to be friendly and enduring. The paradox deserves a closer study.
Latent Structure of the Mississippi Scale for Combat-Related Post-Traumatic Stress Disorder: Exploratory and Higher-Order Confirmatory Factor Analyses
Authors: King Lynda A. , King Daniel W.
Published: July 2017

A series of factor analyses evaluated the dimensionality of the Mississippi Scale for Combat-Related Post-Traumatic Stress Disorder. Over 2,200 Vietnam theater and era veterans were divided into three random subsamples, each of which was used in a separate stage of analysis. Initial exploratory factor analyses suggested an underlying single-factor solution. In the second subsample, a second-order solution comprised of a general factor subsuming several first-order factors was supported using chi-square difference testing. This model was successfully replicated with the third subsample. Cumulative evidence suggests that the latent structure of the Mississippi Scale is best represented as an umbrella Post-Traumatic Stress Disorder (PTSD) factor leading to four subsidiary facets or dimensions.
Coding and Interpreting Movement on the Rorschach
Authors: Holaday Margot
Published: July 2017

A survey was conducted to help beginning Rorschach students using the Exner Comprehensive System determine whether to code movement for nouns whose dictionary definitions included movement. A survey form listed 23 of these words, each followed by three options: Active?, Passive?, and No Movement? Results were disappointing because the participants (26 Rorschach experts and 19 students) failed to reach agreement (75% or more) for 15 of these “synopsis nouns.” A literature review on coding and interpreting movement responses led to the conclusion that a client efficiently using synopsis nouns most likely displays a higher cognitive functioning or life complexity than a client who uses several simple words to describe the same percept. Therefore, many of these words should be coded as movement if the examiner is convinced that the client intends to communicate movement. Guidelines supporting a decision to code a noun for movement are suggested.
Short, Shorter, Shortest
Authors: Miller Harold R. , Streiner David L. , Goldberg Joel O.
Published: July 2017

The accuracy of different subtest combinations in predicting Verbal, Performance, and Full Scale IQ, scores on the revised edition of the Wechsler Adult Intelligence Scale (WAIS-R) was examined. A best subset multiple regression technique with sample sizes ranging from 1,062 to 1,084 individuals was used. All possible subtest combinations were analyzed to determine the ones that showed the three best and the single worst multiple Rs with IQ scores from the complete WAIS-R. All short forms provided accurate estimates of Full Scale scores, and predictive accuracy increased slightly as more subtests were used. The data suggest that statistically searching for a “best” short form is largely futile. Short forms should be selected on the basis of their efficiency to provide the information required.
The Alternate Forms of the Positive and Negative Mood Scales: Reliability, Validity, and Equivalence in Nonreferred Samples
Authors: Lubin Bernard , Van Whitlock Rod
Published: July 2017

The psychometric characteristics of the positive and negative mood scales of the trait version of the State Trait-Depression Adjective Check Lists (ST-DACL) were studied in three nonreferred age groups (i.e., adolescents, college students, and the elderly). Reliability (i.e., internal consistency, test-retest, and alternate form) for both the positive and negative mood scales was high. Validity of both mood scales, as determined by the appropriate level and direction of correlations with the Beck Depression Inventory (BDI), the Center for Epidemiologic Studies Depression Scale (CED-D), the Self-Rating Depression Scale (SDS), and the Profile of Mood States (POMS), was moderate. Correlations with the Positive and Negative Affect Scales (PANAS) indicated substantial common variance (i.e., from 41% to 74% for the positive mood scales, from 59% to 69% for the negative mood scales). Equivalence of the various positive and negative mood scales was established by the finding of nonsignificant differences among the means as well as high alternate form correlations.
The Adult Functional Adaptive Behavior Scale (AFABS) and Psychiatric Inpatients: Indices of Reliability and Validity
Authors: Spirrison Charles L. , Sewell Stephanie M.
Published: July 2017

The reliability and validity of Adult Functional Adaptive Behavior Scale (AFABS) data was examined for a group of 91 male inpatients of a state-operated psychiatric hospital. Item analyses documented a high degree of consistency among the items of the AFABS. Analyses of AFABS scores, patients' unit (i.e., Acute or Continued Care), and patients' placement level (i.e., higher, average, or lower relative to same unit peers) provide evidence for the concurrent validity of the AFABS as applied to psychiatric inpatients. The psychometric properties of the AFABS, coupled with its brevity, suggest it is suited for inclusion in an assessment battery for psychiatric inpatients.
Reliability and Validity of the Cognition Checklist With Psychiatric Outpatients
Authors: Taylor Steven , Koch William J. , Woody Sheila , McLean Peter
Published: July 2017

The Cognition Checklist Anxiety scale (CCL-A) and Depression scale (CCL-D) were administered to psychiatric outpatients with panic disorder ( n = 51), major depression ( n = 44), or panic disorder and major depression ( n = 38). Both scales showed good internal consistency and moderately high levels of test-retest reliability. The scales generally had good convergent and discriminant validities, except that the CCL-D had a moderate-sized correlation with fear of negative evaluation, and the CCL-A was uncorrelated with fear of negative evaluation. The CCL-D showed good criterion-related validity, whereas the CCL-A was weaker in this regard. The CCL scales showed good factorial validity. In all, the results suggest the CCL scales generally have adequate psychometric properties for research purposes.
Association of MMPI Validity Scales and Therapist Ratings of Psychopathology in Adolescent Psychiatric Inpatients
Authors: Pogge David L. , Stokes John M. , Frank Julian , Wong Hazel , Harvey Philip D.
Published: July 2017

Although some self-report instruments (e.g., the Minnesota Multiphasic Personality Inventory, MMPI) have specifically been designed to consider the effects of participants' response styles in their disclosure of psychopathology, many of the most commonly used instruments (e.g., the revised edition of the Symptom Checklist-90, SCL-90-R; the Beck Depression Inventory, BDI) do not. This may compromise the accuracy of these measures, particularly in patient populations that may be liable to biased self-reports. Although observer ratings are often preferred to self-report data, no effort has been made to determine whether or not participant response styles might influence ratings provided by clinicians. This study examined 235 adolescent psychiatric inpatients with both self-report and therapist ratings of depression and nondepressive psychopathology together with common measures of response styles. Confirmatory factor analysis revealed that MMPI scales sensitive to response style were strongly correlated with both self-report and therapist ratings of the severity of psychopathology. Both transparent self-report measures and therapist ratings of psychopathology were significantly higher in patients with high F scales, with both of these ratings significantly lower in individuals with high L or K scales. Despite arguments regarding the desirability of observer ratings to avoid the influence of response bias, these results suggest that they also share variance with measures of response style.
Do Normative Data From the Full WCST Extend to the Abbreviated WCST?
Authors: Axelrod Bradley N. , Paolo Anthony M. , Abraham Elizabeth
Published: July 2017

The standard Wisconsin Card Sorting Test (WCST) was administered to a mixed clinical sample of 332 individuals. The full version was compared to the 64-card version (WCST-64) by extracting the results of the first 64 cards. Percent scores for the WCST were converted to standard scores using the normative data corrected for age and education level. Percent scores for WCST-64 were converted to standard scores using the same WCST normative data. WCST-64 scores were not comparable to those obtained from the full WCST. A breakdown of the data based on performance level found WCST-64 to be useful only with respondents obtaining five or more categories by the end of the first deck. The authors recommend caution in applying WCST manual data to the WCST-64 in the clinical setting.
Partially Random MMPI-2 Protocols: When Are They Interpretable?
Authors: Gallen Robert T. , Berry David T. R.
Published: July 2017

In clinical practice, the second edition of the Minnesota Multiphasic Personality Inventory (MMPI-2) validity indices are used to identify and subsequently exclude from interpretation protocols that include random responding. However, given that the items that comprise the clinical scales all fall within the first 370 items of the MMPI-2, if the onset of random responding occurs after item 370, then the clinical scales may be interpretable. The present report examines the utility of the standard and alternative MMPI-2 validity indices for detecting random responding within the first 370 items. Results suggested that all validity indices studied differed significantly between Interpretable and Uninterpretable protocols; however the Infrequency scale ( F), the alternative index F + Fb + | F − Fb|, and the Blocked Infrequency index (the number of 100 item MMPI-2 blocks with significant endorsements of F and Fb items equal to or exceeding 27%) provided for the highest hit rates across examined base rates of random responding. In addition, the proposed Variable Response Inconsistency-Front index ( VRINf) also provided for highly accurate classification rates and had specific advantages, including the scale's probable insensitivity to overreporting. Despite the promising nature of these findings, caution is encouraged in using MMPI-2 validity scales in this manner until these findings are cross-validated.
The Relationship Between the WRAML Memory Screening and General Memory Indices in a Clinical Population
Authors: Kennedy Mary Lynne , Guilmette Thomas J.
Published: July 2017

Fifty-one children between the ages of 5 and 16 years referred for outpatient neuropsychological evaluations were administered the Wide Range Assessment of Memory and Learning (WRAML), a standardized battery of memory and learning for children. This test yields four main indices, including a General Memory Index (GMI), which is a composite score of the child's performance across all subtests. A short form, the Memory Screening Index (MSI), composed of the first four WRAML subtests, can also be calculated. For each of the 51 WRAMLs administered, an MSI was calculated and compared to the GMI to evaluate the relationship between the two indices. In this sample, the MSI significantly overestimated the GMI (mean = 5.3 points, range = −8 to +23). The MSI was higher than the GMI in 41 out of 51 cases. In 95% of the sample, the MSI fell within 14 points of the GMI.
Mayo's Older American Normative Studies: Separate Norms for WMS-R Logical Memory Stories
Authors: Smith Glenn E. , Wong Jennifer S. , Ivnik Robert J. , Malec James F.
Published: July 2017

The present analyses provide separate norms for persons ages 56 to 93 years for each story from the Logical Memory subtests of the revised edition of the Wechsler Memory Scale. Norms for immediate (I) and delayed (II) trials are presented. Following our past Mayo's Older Americans Normative Studies (MOANS) methods, we established the need for age adjustments (but not education adjustments) based on multiple regression analyses. Norms with added reliability based on the method of overlapping intervals were developed. We present means and standard deviations for 3-year interval age groups from age 61 to 88 years.
The Multidisciplinary Hemodialysis Patient Satisfaction Scale: Reliability, Validity, and scale development
Authors: Martin Pamela Davis , Brantley Phillip J. , McKnight G. Tipton , Jones Glenn N. , Springer Annette
Published: July 2017

Patient satisfaction is frequently used to evaluate service quality. Although this is a common construct, satisfaction scale development has often overlooked the importance of psychometric properties and the uniqueness of patient experiences. Although there is a substantial body of literature investigating satisfaction with general patient services and physicians, development in the areas of multidisciplinary team assessment, specific patient populations, and minority groups is needed. To date, only one hemodialysis patient satisfaction scale with attention to psychometric properties appears to be available. However, this instrument does not assess satisfaction with the roles of the full hemodialysis treatment team. The present study reports the development and preliminary reliability and validity studies of the Multidisciplinary Hemodialysis Patient Satisfaction Scale (MHPSS). This 110-item Likert scale assesses the degree of satisfaction with the health care services of a multidisciplinary hemodialysis team. Methods used to construct the subscales, measuring different dimensions of service, include item analyses and principal components factor analysis. Matched-pair items were included and partialled out of a correlation matrix to control for inconsistent responding or for possible response biases. Results indicate that the MHPSS is psychometrically sound and may be a useful tool for assessment of patient satisfaction and continuous quality assessment of hemodialysis services.
Sensitivity of the WISC-III to Injury Severity in Children With Traumatic Head Injury
Authors: Donders Jacques
Published: July 2017

The criterion validity of the factor index scores of the third edition of the Wechsler Intelligence Scale for Children (WISC-III) was evaluated in a sample of 88 children with traumatic head injury. (THI). Only Perceptual Organization and Processing Speed scores demonstrated acceptable sensitivity to injury severity. It is concluded that Processing Speed is an adequate measure of performance efficiency, but that Freedom from Distractibility may not be an adequate measure of attention in children with THI.
Assessment of Borderline Personality Disorder Using the MMPI-2 and the Personality Assessment Inventory
Authors: Bell-Pringle Virginia J. , Pate James L. , Brown Robert C.
Published: July 2017

The usefulness of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the. Personality Assessment Inventory (PAI) in the classification of patients diagnosed with Borderline Personality Disorder (BPD) was investigated. Twenty-two female inpatients diagnosed as having BPD and 22 female student control participants participated in the study. Those who scored 70 or above on the Borderline Features ( BOR) scale of the PAI were classified as BPD. For the MMPI-2, participants with profile configurations of 8-4-2, 8-2-4, 8-4-7, or 8-2-7 were classified as BPD. Eighty-two percent of the patients and 77% of the students were classified correctly using the PAI, whereas 9% of the patients and 95% of the students were classified correctly based on the MMPI-2. The discriminant function for the selected scales of the PAI classified 8G% of the participants correctly, and the discriminant function for the selected scales of the MMPI-2 classified 84% of the participants correctly. This suggests that both tests include items that discriminate between the two groups. Overall, the classification of participants based on the BOR scale of the PAI was more accurate than the classification of participants using the profile configurations of the MMPI-2. Implications for the assessment of BPD are discussed.
Validity of the Basic Personality Inventory in a Correctional Setting
Authors: Kroner Daryl G. , Holden Ronald R. , Reddon John R.
Published: July 2017

This study investigates the validity of the Basic Personality Inventory (BPI) with a sample of 101 adult male offenders in a medium security institution. The criterion measures consisted of self-ratings (i.e., bipolar dimensional and adjective ratings), correctional officer ratings, and institutional adjustment (i.e., contact with medical staff, verbal warnings, institutional charges, days segregated, and cell maintenance). The majority of the scales corresponded well to the self-ratings. The Denial, Persecutory Ideation, Anxiety, and Thinking Disorder scales had poor convergent and discriminant validity with the correctional officer ratings. Interpersonal Problems, Alienation, and Impulse Expression scales predicted behavioral adjustment indexes. The results are summarized in relation to the higher order factors of emotional adjustment, antisocial orientation, cognitive functioning, and social or self-perception. Overall, the BPI scales adequately measure psychopathology and adjustment within a correctional setting.
Correlates of the MMPI-A Immaturity (IMM) Scale in an Adolescent Psychiatric Sample
Authors: Imhof Eric A. , Archer Robert P.
Published: July 2017

The Immaturity ( IMM) scale was developed for the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A) to provide an objective measure of ego development or maturation. The present study examines the concurrent validity of the IMM scale based on a residential treatment sample of 66 adolescents, ages 13 through 18 years. Participants were administered the MMPI-A, the Defining Issues Test (DIT), a short form of the Washington University Sentence Completion Test (WUSCT), the Extended Objective Measure of Ego Identity Status-2nd Revision (EOM-EIS-2), and standardized measures of intelligence and reading ability. The results of this study provide evidence of the concurrent validity of the IMM scale, and a number of correlate descriptors are reported for the IMM scale.
Sensitivity of Outcome Measures for Treatments of Generalized Social Phobia
Authors: Taylor Steven , Woody Sheila , McLean Peter D. , Koch William J.
Published: July 2017

To accurately evaluate treatments of generalized social phobia, it is not sufficient that measures be reliable and valid, they also must be sensitive to treatment-related changes. The present study evaluated the sensitivity of the following five measures: (a) The Social Phobia scale from the Social Phobia and Anxiety Inventory (SPAI-SP), (b) the SPAI difference score (SPAI-D), (c) the short form of the Fear of Negative Evaluation Scale (FNE-S), (d) the Social Phobia scale from the Fear Questionnaire (FQ-SP), and (e) peak anxiety during an impromptu speech task. Unmedicated people with generalized social phobia ( N = 60) were randomly allocated to one of the following two treatments: (a) eight sessions of associative therapy (AT; i.e., free association to socially relevant thoughts and memories), followed by eight sessions of in vivo exposure (EXP); or (b) eight sessions of cognitive restructuring (CR), followed by eight sessions of EXP. Outcome measures were completed on entry into the study, after completing AT or CR (post-I), after completing EXP (post-II), and at 3-month follow-up. For each outcome measure, effect sizes were computed for post-I, post-II, and follow-up. The SPAI-SP and SPAI-D tended to have the largest effect sizes, and the FNE-S and FQ-SP tended to yield the smallest effects. The results add to the growing body of research supporting the usefulness of the SPAI scales as a treatment-outcome measure for studies of generalized social phobia.
Mixed Boundary Value Problems of the Fourth Kind in an Enhanced Theory of Bending of Elastic Plates
Authors: Mitric R. , Schiavone P.
Published: July 2017

The real boundary integral equation method is used to solve a specific type of mixed boundary value problem in an enhanced theory of bending of elastic plates with transverse shear deformation and transverse normal strain. This type of problem (often referred to as a mixed problem of the fourth kind) is characterized by the fact that a combination of the twisting displacement rotations and transverse shear force is prescribed on the curve which bounds the middle surface of the plate. Both interior and exterior problems are formulated and the corresponding existence and uniqueness results derived.
Swelling-Induced Cavitation of Elastic Spheres
Authors: Pence Thomas J. , Tsai Hungyu
Published: July 2017

Swelling, generally referring to volumetric change and typically due to mass addition from some diffusive or transport mechanism, is central to a variety of physical phenomena. Here we consider the role of swelling as it relates to the inflation of hollow spheres and to cavity formation at the center of solid spheres. The swelling is modeled in terms of a prescribed scalar field that gives the local free volume. The finite deformation theory of incompressible hyperelasticity is generalized so as to include the effect of this swelling field directly in the stored energy density. The general framework is based on global energy minimization wherein the stored energy density is minimized at the locally prescribed swollen state. On this basis it is found that both inflation and cavitation can be caused solely by swelling. This result is intuitive with respect to inflation where it follows from a simple uniform swelling field. In contrast, to obtain swelling-induced cavitation we consider a non-uniform swelling field and study how this field can cause a cavity to nucleate, grow, shrink and disappear.
Open-Label Study to Evaluate the Healing Rate and Safety of the Profore™ Extra Four-Layer Bandage System in Patients with Venous Leg Ulceration
Authors: Gupta Aditya K. , De Koven Joel , Lester Robert , Shear Neil H. , Sauder Daniel N.
Published: July 2017

Background:

Venous ulcers are increasing in prevalence, especially since these are observed more frequently in the elderly, and the number of individuals in this age group is becoming a larger portion of the population.

Objective:

To determine the healing rate and safety of the Profore™ Extra Four-Layer Bandage System in the management of venous leg ulcers.

Methods:

In an open-label study, patients aged 18 years or older with venous leg ulcers were treated with a high compression four-layer bandage system in which a hydrocellular dressing was placed in contact with the wound. The combination is designated the “Profore Extra Four-Layer Bandage System.” Follow-up visits took place weekly unless there was heavy exudation from the ulcer or if there was marked edema of the leg at the start of the study requiring reapplication of the bandage system.

Results:

Fifteen patients were entered into the study (men 8, women 7, mean age 66 years, mean duration of ulcers 1.3 years). Thirteen of the 15 patients completed the study, with two withdrawals. In one patient who withdrew, the ulcer became infected and required treatment with antibiotics. The other termination from the study occurred for reasons unrelated to treatment. The ulcer in this patient healed in 7 weeks. Ten of the 13 patients (77%) who completed the study, and 10 (67%) of 15, who had enrolled experienced complete (100%) healing. Healing of > 80% of the ulcers occurred in 11 of 13 patients (85%) who completed the study and in 12 (80%) of 15 enrolled patients. No patient experienced a study-related adverse event. One patient developed contact dermatitis and was later found to have stasis dermatitis. It is unclear whether the initial event was contact or stasis dermatitis.

Conclusion:

In this open-label study, a high compression system, using the Profore Extra Four-Layer Bandage with a hydrocellular dressing in contact with the wound, was found to be effective and safe for the treatment of venous leg ulcers.
The Interpretation of Test Results
Authors: Binder Michael , Dreiseitl Stephan
Published: July 2017

Background:

Dermatologists need to interpret an increasing number of research studies and diagnostic tests. Understanding the techniques for interpreting test results and making decisions based upon those tests represent important tools for decision making for both clinicians and researchers.

Objective:

This article focuses briefly on the key parameters of diagnostic tests: sensitivity, specificity, prevalence, predictive values, likelihood ratios, and the concept of receiver-operating-characteristic (ROC) curves. A simple example is presented in a step-by-step manner.

Conclusion:

The principles of interpreting test results are easy to learn and applicable in daily clinical routine. Therefore, dermatologists should be familiar with the concepts outlined in this paper.
Delay in Diagnosis: Indeterminate Leprosy Presenting with Rheumatic Manifestations
Authors: Sadeghi Parrish , Dupree Marsha , Carlson J. Andrew
Published: July 2017

Background:

Rheumatic complications are common in leprosy (Hansen's disease) and can be the primary complaint delaying accurate diagnosis.

Objective:

Such a case is reported here: a 61-year-old woman with indeterminate leprosy presented with symmetric arthritis and purpura. Despite biopsy and evaluation by several physicians, leprosy was not suspected. After 2 years of progressive symptoms, a second biopsy revealed lepromatous leprosy.

Conclusion:

In this case, lack of clinical suspicion and unfamiliarity with the histology of indeterminate leprosy delayed diagnosis and treatment. Leprosy should be considered in the differential diagnosis of patients presenting with unusual rheumatic and persistent cutaneous manifestations.
Treatment of Vascular Lesions in Pigmented Skin with the Pulsed Dye Laser
Authors: Garrett Algin B. , Shieh Sherry
Published: July 2017

Background:

Vascular lesions occurring in African-American patients are often not treated because of the risk of local side effects.

Objective:

The study was to determine the efficacy of the flashlamp-pumped dye (FLPD) laser in the treatment of vascular malformations in African-American patients.

Methods:

All lesions in three patients were treated with the FLPD laser using a 585 nm wavelength, 5 mm spot size, 450 pulse width, and fluences ranging from 6.5 to 8.5J per cm2.

Conclusion:

The FLPD was effective in treating vascular malformations. Transient changes in colour and skin texture occurred at the treated sites.
Sporotrichosis Infection on Mines of the Witwatersrand
Authors: Quintal Diane
Published: July 2017

Background:

Our knowledge of skin disease is often based on fortuitous situations that have provided opportunities for observation and study of the disease. One of these diseases is sporotrichosis.

Objective:

This article examines a symposium published in 1947 by the Transvaal Chamber of Mines in South Africa. It reviews the approach taken in the investigation of a large outbreak of sporotrichosis in the mine workers.

Conclusion:

The investigation of this outbreak has contributed significantly to our present day knowledge of sporotrichosis, the causative organism, its mode of spread, and its clinical features. It is also a striking example of meticulous scientific research and observation.
Nodular Amyloidosis: Case Report and Literature Review
Authors: Kakani Rajesh S. , Goldstein Amy E. , Meisher Irina , Hoffman Cindy
Published: July 2017

Background:

Amyloidosis refers to a group of depositional diseases that are classified into two main types: systemic and localized. Large nodules of localized cutaneous amyloidosis of the nasal ala and surrounding skin are rare and the treatment is often unsatisfactory.

Objective:

We report a case of rapidly enlarging, localized, nodular cutaneous amyloidosis of the nose and the surrounding skin with a brief review of the current literature regarding treatment of this rare disease.

Conclusion:

Nodular amyloidosis can be treated successfully with cold steel excision in combination with carbon dioxide laser. Close followup of these patients is warranted, as nodular amyloidosis may be the precursor to systemic amyloidosis.
Measurement Properties of Skindex-16: A Brief Quality-of-Life Measure for Patients with Skin Diseases
Authors: Chren Mary-Margaret , Lasek Rebecca J. , Sahay Anju P. , Sands Laura P.
Published: July 2017

Background:

An accurate, sensitive, but brief quality-of-life outcomes measure is needed for studies of dermatologic care.

Objective:

To construct a single-page version of Skindex (a dermatologic quality-of-life instrument) that would have two new features compared with the current 29-item version: (1) fewer items to which a majority of patients choose the same response, and (2) measurement of bother rather than frequency of patient experiences.

Methods:

Random samples of patients waiting for dermatology appointments in clinics of Veterans Affairs hospitals and in private dermatology practices completed questionnaires; 692 patients responded to the parent instrument and 541 additional patients responded to the brief version. Reproducibility, internal consistency reliability, validity, and responsiveness of the brief version of Skindex were determined.

Results:

For 16 items of the current 29-item version (55%), more than 50% of patients responded “Never.” After an explicit process of item analysis and elimination, a single-page 16-item version was composed that asks patients about bother from their experiences; responses are reported as three scales, Symptoms, Emotions, and Functioning. For 6 items of the 16-item version (38%), more than 50% of patients responded “Never.” Scale scores were reproducible after 72 hours ( r = 0.88–0.90) and were internally reliable (Cronbach's a = 0.86–0.93). The instrument demonstrated both content and construct validity: Most patients' responses to an open-ended question about their skin disease was addressed by the items; patients with inflammatory dermatoses had higher scores than those with isolated lesions; and in an exploratory principal axes factor analysis with an oblique rotation, 74% of the common variance was explained by three factors that correlated with the a priori scales. Mean scale scores stayed the same or changed in the expected direction in patients who reported that their skin was the same or had improved.

Conclusion:

This brief single-page version of Skindex accurately and sensitively measures how much patients are bothered by their skin conditions.
Postirradiation Multiple Minute Digitate Porokeratosis
Authors: Pujol Ramon M. , Perez–Losada Eugenia , Matias–Guiu Xavier , Fuentes Josefina , Alonso Carmen M. , Alomar Agustin , Craven–Bartle Jordi
Published: July 2017

Background:

Development of multiple minute digitate hyperkeratoses (MMDH) after irradiation has been reported previously. The keratotic lesions in these cases were confined within the irradiation field, and histopathological examination disclosed a focal column of parakeratosis (cornoid lamella) arising from an epidermis devoid of granular layer.

Objective:

We describe a 78-year-old woman who developed multiple, discrete, tiny, filiform, keratotic papules on the anterior aspect of the right chest wall, 13 months after postmastectomy cobalt irradiation therapy for mammary infiltrating ductal carcinoma.

Conclusion:

Postirradiation MMDH represents a peculiar radiation-induced disorder that we believe should be distinguished from other cases of MMDH and included within the spectrum of porokeratosis.
Using the Internet to Assess and Teach Medical Students in Dermatology
Authors: Hong Chih-Ho , McLean David , Shapiro Jerry , Lui Harvey
Published: July 2017

Background and Objectives:

We wish to develop and evaluate a user-friendly online interactive teaching and examination model as an adjunct to traditional bedside teaching of medical students during a clinical rotation in dermatology.

Methods:

Following completion of an online examination, senior medical students at the University of British Columbia ( n = 178) were asked to complete an online survey to evaluate their acceptance of this new method. The online examination model was evaluated through students' responses to the questionnaire-based evaluation they were asked to complete following their examination. Responses were evaluated on a standardized 5-point scale.

Results:

A high response rate was achieved (98.9%). Overall, 93% of senior medical students felt that the Internet was a useful and effective way to administer a dermatology examination. Most (90%) preferred the online examination to a traditional paper-and-pencil examination and the majority (88%) felt that the quality of digital images presented was sufficient to make an accurate diagnosis. In addition, students strongly supported the further development of teaching resources on the web and would use these resources in learning dermatology (93%).

Conclusions:

The development of an online interactive examination tool for dermatology is technically feasible with current technology. Senior medical students are not only accepting of this new technology but also prefer it to more traditional formats and indicate enthusiasm for the development of further online teaching resources in dermatology.
Free Flap Coverage of Pyoderma Gangrenosum Leg Ulcers
Authors: Classen Dale A. , Thomson Chris
Published: July 2017

Background:

Pyoderma gangrenosum is a necrotizing skin disorder of unknown cause. Treatment of pyoderma gangrenosum usually entails medical treatments. Surgical treatment is generally not successful.

Objective:

Two patients with pyoderma gangrenosum of their lower extremities are presented. The application and utility of microvascular free flap coverage of their ulcers is discussed.

Results:

Both patients achieved successful healing with microvascular free flaps.

Conclusion:

Microvascular free flap coverage may be a surgical treatment option for selected patients with pyoderma gangrenosum.
Experimental Keloid Scar Models: A Review of Methodological Issues
Authors: Hillmer M. P. , MacLeod S. M.
Published: July 2017

Background:

Keloid scars are benign fibrous proliferations in the dermis that arise after dermal trauma. The scars are raised in appearance and extend beyond the boundaries of the original wound. Scarring in predisposed individuals is out of proportion to the severity of the inciting wound. Current treatments sometimes yield early benefit but scars often resume exuberant growth. The pathophysiology of keloid scars is still poorly understood. In order for new treatments to be developed, the mechanisms leading to the formation of keloid scars must be further elucidated. The search for improved experimental models is of critical importance because such models have an important role to play in both the study of keloid formation and in the development of new therapies.

Objective:

The objective of this article is to introduce the reader to the experimental models available for studying keloid scars and to outline the advantages and limitations of animal and tissue culture models.

Conclusion:

Both models may help to elucidate the pathways of keloid formation and promote development and testing of therapies. Tissue culture is better suited to studies of pathogenesis, whereas the animal models are more suitable for therapeutic testing.
Barrier and Antibacterial Properties of 2-Octyl Cyanoacrylate-Derived Wound Treatment Films
Authors: Mertz Patricia M. , Davis Stephen C. , Cazzaniga Alejandro L. , Drosou Anna , Eaglstein William H.
Published: July 2017

Background:

Besides enhancing healing, an ideal dressing should prevent invasion of pathogens and control the number of bacteria already present in the wounds.

Objective:

To evaluate the barrier and antimicrobial properties of a cyanoacrylate-based bandage (LAB) against Staphylococcus aureus or Pseudomonas aeruginosa on partial thickness wounds in swines.

Methods: Barrier study:

Bacteria were inoculated over test materials (LAB, standard bandage, air-exposed) that were placed over wounds. The bacteria from wounds were quantitated at 24, 48, and 72 hours postinoculation. Antimicrobial study: Wounds inoculated with bacteria were covered with LAB, standard bandage, or hydrocolloid bandage or left air-exposed. The bacteria recovered from wounds were quantitated at 24 and 72 hours after treatment.

Results: Barrier study:

No bacteria were recovered from LAB-treated wounds. Antimicrobial study: LAB reduced the number of inoculated bacteria in comparison to all other groups.

Conclusion:

LAB is effective in protecting wounds from external bacterial invasion and reducing bacterial contamination.
In-vitro Analysis for Microbial Barrier Properties of 2-Octyl Cyanoacrylate-Derived Wound Treatment Films
Authors: Narang Upvan , Mainwaring Lawrence , Spath Gina , Barefoot Joe
Published: July 2017

Background:

In recent years, 2-octyl cyanoacrylate monomer has been formulated for various wound care products that have been approved by the Food and Drug Administration (FDA).

Purpose:

To evaluate the in vitro effectiveness of 2-octyl cyanoacrylate formulation-based films as barriers to various pathogens, including bacteria, fungi, and yeast.

Methods:

The barrier properties of the cyanoacrylate films prepared by the following two methods were tested: (1) prepolymerized film and (2) in situ polymerized film. The upper surface of films was inoculated such that the microorganisms would have to penetrate the film to colonize the media beneath. Nine different organisms were used. Plates were observed for growth at two, four, and seven days after inoculation.

Results:

No growth was observed in any test, with the exception of prepolymerized film challenged with Pseudomonas aeruginosa. The pattern of growth observed suggests that the bacteria colonized the medium by traveling around and not through the film.

Conclusions:

2-Octyl cyanoacrylate-based films are excellent microbial barriers.
Keloid Morphea and Nodular Scleroderma: Two Distinct Clinical Variants of Scleroderma?
Authors: Rencic Adrienne , Brinster Nooshin Ketabchi , Nousari Carlos H.
Published: July 2017

Background:

For nearly a century, the terms “keloid morphea” and “nodular scleroderma” have been used interchangeably without defined clinical or histologic criteria.

Objective:

To define the conditions “keloid morphea” and “nodular scleroderma” by correlating the clinical and histologic features.

Methods:

We retrospectively identified six patients with keloidal lesions and nodules from 70 consecutive patients with scleroderma seen in the dermatology clinic. The clinical presentation and histopathological findings were reviewed.

Results:

Six of 70 patients with scleroderma (45 systemic and 25 morphea) exhibited keloidal or nodular lesions. All these patients had systemic sclerosis. Clinically one patient (case 1) had nodules; five (cases 2–6) had keloids. The nodular lesions had histologic findings consistent with keloid, while the keloidal plaques were variably keloids or morphea histopathologically. There was no correlation between the clinical morphology and the histologic findings, except for cases 5 and 6. These patients were African–American, with a family history of keloids and typical keloids clinically and histologically that developed from sites with normal skin.

Conclusion:

Keloid morphea and nodular scleroderma are clinical terms that describe keloidal and nodular lesions in patients most commonly with scleroderma. The clinicopathologic association is variable. Based on a review of the English literature and our series of six patients, we identified two clinical variants; (1) keloidal or nodular lesions arising from sclerodermatous skin with histologic findings of keloid or scleroderma, (2) typical keloids clinically and histologically, arising in normal skin in patients with a family history of keloids. Awareness of these entities is important for proper diagnosis of the cutaneous lesions and for recognizing that the cutaneous findings may be a sign of systemic sclerosis.
A Randomized, Double-Blind, Multicenter, Parallel Group Study to Compare Relative Efficacies of the Topical Gels 3% Erythromycin/5% Benzoyl Peroxide and 0.025% Tretinoin/Erythromycin 4% in the Treatment of Moderate Acne Vulgaris of the Face
Authors: Gupta Aditya K. , Lynde Charles W. , Kunynetz Rod A. W. , Amin Smita , Choi Ken Lee , Goldstein Eric
Published: July 2017

Background:

Combination treatments for acne vulgaris, such as Benzamycin® (3% erythromycin/5% benzoyl peroxide) and Stievamycin® (0.025% tretinoin/erythromycin 4%), reduce bacterial growth, which contributes to the inflammatory lesions typical of adolescent acne, and also decrease the epidermal cell compaction which may form the characteristic noninflammatory comedone. Both agents contain erythromycin to reduce the growth of Propionibacterium acnes in skin. Benzoyl peroxide has antibiotic activity as well as anticomedogenic properties. Tretinoin may increase the turnover of epidermal cells and loosen the cells compacted to form comedones. A combination preparation containing the two antibiotics may reduce the development of resistance; the combination preparation containing tretinoin and erythromycin will have an antibiotic effect as well as acting on differentiation.

Patients and Methods:

This multicenter, randomized, double-blind, parallel group study compared the effectiveness of 3% erythromycin/5% benzoyl peroxide and 0.025% tretinoin/erythromycin 4%, each applied twice daily in patients with moderate acne vulgaris. Overall physician and patient ratings of severity of acne symptoms were performed at baseline and at weeks 2, 4, 8, and 12.

Results:

At baseline the two treatment groups had similar disease severity. The number of papules, pustules, and comedones was reduced in both treatment groups at week 12, and the reductions were not significantly different between the two comparators. Global physician rating of improvement was significantly higher in the 3 % erythromycin/5% benzoyl peroxide group compared with the 0.025% tretinoin/ erythromycin 4% group; however, there was no significant difference in global patient ratings between the two treatment groups. An aggregate score was produced, for both physician rating and patient rating, by adding up individual symptom severity ratings. Compared with 0.025% tretinoin/erythromycin 4%, 3% erythromycin/5% benzoyl peroxide provided significantly greater reduction in both physician- and patient-rated severity of acne symptoms; there was a significant difference between the two groups as early as week 2. The 3% erythromycin/5% benzoyl peroxide demonstrated significantly greater reduction of erythema and scaling, as evaluated by the study physician, compared with tretinoin 0.025%/erythromycin 4%. Patients judged 3% erythromycin/ 5% benzoyl peroxide to have a significantly greater effect on redness, dryness, oiliness, and burning.

Conclusion:

In moderate acne vulgaris, 3% erythromycin/5% benzoyl peroxide may provide a greater beneficial effect than 0.025% tretinoin/erythromycin 4%.
Encephalocraniocutaneous Lipomatosis
Authors: Gawel Julita , Schwartz Robert A. , Józwiak Sergiusz
Published: July 2017

Background:

Encephalocraniocutaneous lipomatosis (ECCL) is a relatively new, nonhereditary, but congenital, neurocutaneous syndrome with unilateral cutaneous tumors and ipsilateral ophthalmologic and neurologic malformations. The syndrome is rare, with only 25 cases reported since first communication in 1970. The primary clinical features noted for almost all cases are as follows: (1) unilateral porencephalic cysts with cortical atrophy, (2) ipsilateral lipomatous hamartoma of the scalp, eyelids, and outer globe of the eye, (3) cranial asymmetry, (4) marked developmental delay and mental retardation, (5) seizures, and (6) spasticity of the contralateral limbs.

Objective:

We discuss underlying pathophysiology, diagnostic difficulties, differential diagnosis, and therapeutic possibilities of the syndrome.

Conclusions:

The syndrome seems to be more frequent than it was thought. ECCL may remain unrecognized, as some patients may not represent the full clinical spectrum of the disease. Periodic neurologic and cardiologic assessment with echocardiography and electrocardiography should be carried out in all patients with ECCL because of a possible progressive disease course.
Alopecia Mucinosa: Report of a Case and Review
Authors: Anderson Bryan E. , Mackley Christine L. , Helm Klaus F.
Published: July 2017

Background:

Alopecia mucinosa has been shown to be associated with many benign and malignant conditions. It can be seen in childhood but is seen more commonly in adulthood. Alopecia mucinosa is generally felt to occur in three settings: a primary idiopathic form, a form associated with malignancy, and a form secondary to inflammatory conditions. The histologic hallmark is the accumulation of mucin in the follicular epithelium, called follicular mucinosis. Therapy for alopecia mucinosa remains problematic.

Objective:

We present a representative case of alopecia mucinosa and discuss the etiology, histology, epidemiology, treatment, and prognosis.

Conclusion:

We report a case of idiopathic alopecia mucinosa that responded to minocycline with a complete remission and we review the literature on alopecia mucinosa.