bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metabolic and Cardiovascular Comorbidities Among Clinically Stable HIV Patients on Long-Term ARV Therapy in Five Ambulatory Clinics in Lima-Callao, Peru
Authors: Hidalgo Jose A , Florez Alberto , Agurto Cecilia , Pinedo Yvett , Ayarza Rosemarie , Rodriguez Lourdes , La Rosa Alberto , Gutierrez Raul 
Published: October 2018

Background:
There is scarcity of data about the prevalence of non-AIDS defining comorbidities among stable HIV-infected patients in Peru.

Objective:
We aimed to describe the most frequent cardiometabolic comorbidities found among ambulatory adults on ARV in Peru.

Methods:
A review of records for patients attending regular visits at 5 clinics in Lima-Callao in January-February 2016 is presented. Patients were adults on ARV for >6 months, with no recent AIDS-defining condition.

Results:
Three hundred and five medical charts were reviewed. Most patients were male (73.1%, n=223) with a mean age of 46.0 years. Mean time from HIV diagnosis was 9.41 yrs. and mean duration of ARV was 7.78 yrs. Most patients were on an NNRTI-based first line regimen (76.4%, n=233), and 12.1% (n=37) were on rescue regimens. Median CD4 count was 614.2 cells/µL and the proportion of patients with viral load <40 c/mL was 90.8% (n=277). Most frequent metabolic diagnoses were dyslipidemia (51.5%, n=157), obesity (11.1%, n=34), and diabetes mellitus (7.2%, n=22). Hypertension was diagnosed in 8.9% (n=27). Other diagnoses of cardiovascular disease were documented in 3.3% (n=10). Pharmacologic treatment was prescribed in 91.3% of patients with diabetes or hypertension, but in only 29.3% of patients with dyslipidemia.

Conclusion:
A high proportion of metabolic comorbidities was found, with dyslipidemia being the most frequent, followed by obesity and diabetes. In contrast, cardiovascular disease was documented less frequently. Medical treatment was started for only a third of dyslipidemia patients. HIV care policies need to consider proper management of chronic comorbidities to optimize long-term outcomes.
Evaluating the Effects of Monovalent and Divalent Salts on the Rheological Properties of Water Based Mud
Authors: Dankwa Ohenewaa K. , Appau Prince Opoku , Broni-Bediako Eric 
Published: October 2018

Introduction:Drilling fluid selection plays a key role in preventing major problems encountered during drilling operations such as hole pack-off, stuck pipe and loss circulation. Mud contamination which results from the overtreatment of the mud system with additives or foreign material entering the mud system during drilling operations causes unwanted changes in the properties of the mud. This makes the mud system inefficient in performing its major roles. This research studies the effects of monovalent and divalent salts namely Potassium Chloride, Calcium Chloride, and Magnesium Chloride on the rheological properties of water-based mud system which is most vulnerable to contamination.Methods:Sixteen mud samples were formulated of which fifteen were contaminated each with different concentrations (0.75 g, 1.50 g, 2.50 g, 3.50 g, and 5.0 g) of the various salts at ambient temperature.Results:The results showed that the rheological properties such as plastic viscosity, apparent viscosity and yield point of the mud samples decreased as the concentrations of various salts increase.Conclusion:It was concluded that increase in the concentration of the salts resulted in a decrease in the rheological properties of the mud samples. This indicates that with the monovalent and divalent salt contamination, there is a significant decline in the performance of drilling mud since the salts affect the dispersion, hydration and flocculation behaviour of the particles. The effect was more profound with CaCl2 and MgCl2 salts than the KCl salt.
Advice for Health Care Professionals and Users: An Evaluation of Websites for Perinatal Anxiety
Authors: Moore Donna , Harrison Virginia 
Published: October 2018

BackgroundMany websites are available with information and resources for perinatal anxiety; however, there is limited research on the quality and content of these sites.ObjectiveThis study aims to identify what sites are available on perinatal anxiety, identify any information and therapeutic advice given, and review its accuracy and website design.MethodsWe conducted an evaluation of websites for perinatal anxiety. Eligible websites (N=50) were evaluated for accuracy of information, resources for mothers, website quality, and readability.ResultsInformation was often incomplete and focused on symptoms rather than risk factors or impact of untreated perinatal anxiety. Websites often had information on treatment (46/50, 92%), but much less on screening (19/50, 38%). Most sites provided at least some resources to support mothers (49/50, 98%), but active, guided support was infrequent (25/50, 50%). Website quality was extremely variable and mostly difficult to read (42/50, 84%).ConclusionsThis study recommends the top 4 websites on perinatal anxiety for health care professionals and users. There is a need for websites to be developed that provide accurate, evidence-based information that women can relate to with quality support resources. Furthermore, these sites should be easy to use and readable.
Sarcoidosis Appearing in a Tattoo
Authors: Ali Saba M. , Gilliam Anita C. , Brodell Robert T. 
Published: October 2018

Background: Sarcoidosis is a systemic disease that may present as tattoo granulomas. Objective: A patient with systemic sarcoidosis who developed a granulomatous reaction within a tattoo is presented to stimulate interest in this unusual phenomenon. Methods and Results: A patient with a 6-year history of pulmonary sarcoidosis developed sarcoidal granulomas restricted to one pigment of a tattoo. Previous reports of sarcoidal granulomas within tattoos are reviewed, and information about the pathogenesis of this process is explored. Conclusion: Sarcoid granulomas may develop in tattoos as an isolated local reaction or as the presenting sign of systemic sarcoidosis. The reaction itself may provide insight into further understanding the pathogenesis of sarcoidosis.
Use of Pimecrolimus Cream in Disorders Other than Atopic Dermatitis
Authors: Day Isaiah , Lin Andrew N. 
Published: October 2018

Background: Pimecrolimus is indicated for treatment of atopic dermatitis and has been evaluated in many other disorders. Objective: To review the efficacy of pimecrolimus in treatment of disorders other than atopic dermatitis. Methods: We performed a PubMed search of the English-language literature using the key word “pimecrolimus.” We reviewed articles reporting the use of pimecrolimus in disorders other than atopic dermatitis and classified them by the type of study used to evaluate efficacy. Results: Randomized, double-blind studies have shown that pimecrolimus is superior to vehicle in treatment of seborrheic dermatitis, hand dermatitis, and asteatotic eczema but have yielded conflicting results regarding intertriginous psoriasis and vitiligo. Open-label studies involving four or more patients have shown favorable results in many disorders, including contact dermatitis, rosacea, lichen sclerosus, and oral and genital lichen planus. Case reports have shown that topical pimecrolimus may be useful in cutaneous graft-versus-host disease, lichen striatus, cutaneous lichen planus, and many other disorders. Conclusions: Topical pimecrolimus appears to be an effective treatment for many disorders other than atopic dermatitis, especially seborrheic dermatitis, hand dermatitis, and asteatoic eczema. It may be effective in many other disorders, but its role in these disorders remains to be clarified by additional studies.
Laser Therapy for Onychomycosis
Authors: Gupta Aditya K. , Simpson Fiona C. 
Published: October 2018

Background: Laser therapy is a rapidly expanding new treatment modality for onychomycosis. Objective: To review current and prospective laser systems for the treatment of onychomycosis. Method: We searched the PubMed database, the Food and Drug Administration 510(k) database, ClinicalTrials.gov , and Google Scholar for in vitro studies, peer-reviewed clinical trials, manufacturers' white papers, and registered clinical trials of laser systems indicated for the treatment of onychomycosis. All published clinical trials were assessed on a 20-point methodological quality scale. Results: We identified three basic science articles, five peer-reviewed articles, three white papers, and four pending clinical trials, as well as numerous gray literature documents. The overall methodological score for the clinical trials was 9.1 ± 1.1, with peer-reviewed studies showing a higher score (9.8 ± 1.5) than white papers (7.5 ± 0.7). We also identified 11 commercial laser device systems of varying global availability. Conclusion: Laser therapy has been tested and approved as a cosmetic treatment only for onychomycosis. It cannot be recommended as a therapeutic intervention to eradicate fungal infection at this time as more rigorous randomized, controlled trials are required to determine if laser therapy is efficacious on par with oral and topical interventions.
Familial Classic Kaposi Sarcoma in Two Siblings: Case Report and Literature Review
Authors: Almohideb Mohammad , Waiters A. Kevin , Gerstein William 
Published: October 2018

Background: Kaposi sarcoma (KS) is a cutaneous endothelial vascular proliferation with four subtypes: iatrogenic, acquired immune deficiency syndrome (AIDS) related, African, and classic. Familial cases of KS are rare, with 72 cases reported to date, and all were described with the classic variant. The occurrence of classic KS in the Jewish population is well documented, and most of the familial classic KS cases were also reported in Jewish families. Objective: We briefly present the history, biopsies, laboratory data, diagnosis, and treatment of localized lower limb classic KS in two siblings of Jewish Eastern European ethnic descent with their response to different therapy modalities. One of our cases had the second longest reported period of follow-up for familial classic KS of 40 years.
Clinical and Immunologic Characterization in 26 Indian Pemphigus Patients
Authors: Tsuruta Daisuke , Kanwar Amrinder J. , Vinay Keshavamurthy , Fukuda Shunpei , Koga Hiroshi , Dainichi Teruki , Ohata Chika , Ishii Norito , Hashimoto Takashi 
Published: October 2018

Background: Pemphigus shows geographically variable characteristics. Objective: To study the clinical and immunologic characteristics of Indian pemphigus patients before and after treatment. Methods: Twenty-six Indian pemphigus patients were analyzed with regard to age, gender, clinical features, treatments and response, the results of histopathology, direct and indirect immunofluorescence (IF), enzyme-linked immunosorbent assay (ELISA), and immunoblot analyses. Results: There were 22 pemphigus vulgaris (PV) and 4 pemphigus foliaceus (PF) patients. Direct and indirect IF was positive in 95.8% and 56% of patients, respectively. Indices of ELISA were lower in our study. Immunoblot assays detected the 130 kDa desmoglein-3 in 10 PV patients and the 160 kDa desmoglein-1 in 1 PV patient; 190 kDa periplakin was unexpectedly detected in 8 patients. Conclusion: Indian pemphigus patients showed several unique characteristics, including younger population, predominance of PV, low ELISA indices, lower sensitivity of indirect IF and immunoblotting, and the presence of the 190 kDa periplakin in nearly one-third of patients.
Mycophenolic Acid for Lymphomatoid Papulosis
Authors: Champagne Trevor , Walsh Scott 
Published: October 2018

Background: Lymphomatoid papulosis is a rare CD30+ lymphoproliferative T-cell disorder with limited effective treatments. Objective: We describe the case of a 50-year-old woman diagnosed with lymphomatoid papulosis who was unable to access phototherapy and who failed to clear while on systemic treatment with methotrexate. Methods: The patient was initiated on mycophenolate mofetil (MMF), a prodrug of mycophenolic acid, at a dose of 2 g divided twice daily. Results: MMF produced a rapid response with complete clearing within 8 weeks, and the patient has been successfully maintained for 2 years at the same dose with no noted side effects. Other patients in our clinic have had similar success. Conclusions: Mycophenolic acid is a safe and well-tolerated therapy for lymphomatoid papulosis.
Intralesional Candida Antigen for Common Warts in People with HIV
Authors: Wong Aaron , Crawford Richard I. 
Published: October 2018

Background: Intralesional Candida antigen has been used as immunotherapy to treat refractory warts in the immunocompetent pediatric and adult populations but has not been reported in individuals with human immunodeficiency virus (HIV). Purpose: To examine if Candida antigen resulted in clearance of medically refractory, long-standing common warts in a series of HIV patients. Method: At a hospital-based, adult, outpatient dermatology clinic, seven patients with HIV with common warts of the hands and feet were treated with intralesional Candida antigen. The warts had been resistant to standard patient- and physician-applied modalities. Results: Clearance was achieved in three of seven patients, whereas four of seven did not respond due to a lack of effectiveness or an inability to tolerate treatment. Adverse events included injection-site redness, pruritus, and pain. Conclusion: This is the first reported case series using Candida antigen for warts in individuals with HIV. The use of Candida antigen represents a simple and novel approach to the management of treatment-refractory warts in those with HIV. This case series provides a foundation for future larger, randomized trials.
Compact Fluorescent Lamps and Risk of Skin Cancer
Authors: Korgavkar Kaveri , Xiong Michael , Weinstock Martin A. 
Published: October 2018

Background: Previously considered safe for typical use, concerns have recently been expressed regarding the potential effect of compact fluorescent lamps (CFLs) on human skin and, in particular, on skin cancer risk. Objective: We sought to address this concern by reviewing the current literature on CFLs, ultraviolet (UV) radiation, and photocarcinogenic exposure. Results: On average, the UV radiation from CFLs and subsequent carcinogenic exposure is lower than that from incandescent bulbs. However, defective bulbs can emit higher levels of UV radiation, which may cause significant damage. Conclusion: Our review calls for further investigation to determine how frequently these bulbs are sufficiently defective to lead to adverse effects.
Giant Merkel Cell Carcinoma of the Lower Limb: Case Report and Review of the Literature
Authors: Marchesi Andrea , Parodi Pier Camillo , Brioschi Marco , Sileo Giorgio , Marchesi Matteo , Vaienti Luca 
Published: October 2018

Background: Merkel cell carcinoma (MCC) is a rare cutaneous neuroendocrine malignancy that usually grows rapidly at the head and neck. Giant forms at the lower limbs are rarely reported and usually affect patients in the eighth decade or older. Methods: We report the case of a 60-year-old man who presented with a giant MCC on his right thigh. We managed this case by applying the 2012 updated guidelines and reviewed all cases of giant MCC of the lower limbs reported in the literature. Results: At the 4-month follow-up, the patient showed complete remission. Conclusion: Giant forms of MCC are still treated as typical cases of MCC, when these patients show a very poor prognosis. In young and adult people, such as our case, wide surgical excisions, sentinel lymph node biopsy in clinically negative node cases, radiotherapy of the regional drain area, and a strict follow-up should be routinely performed to improve patients' survival.
Preparing for Subsequent Entry Biologies in Dermatology and Rheumatology in Canada
Authors: Papp Kim , Bourcier Marc , Ho Vincent , Burke Karen , Haraoui Boulos 
Published: October 2018

Background: Patents on several biologies will expire in Canada in the coming years. As they expire, applications to market subsequent entry biologies (SEBs) may be filed in Canada. Objective: To provide an understanding of the regulatory pathway and types of trials used for SEB authorization in Canada. Methods: Health Canada's draft guidance on SEBs was reviewed in regards to key issues and challenges in the development and authorization of SEBs. Results: Health Canada states that SEBs are not “generic biologies” and their authorization is not a declaration of pharmaceutical or therapeutic equivalence to the originator. The agency recommends that physicians make well-informed decisions regarding therapeutic interchange. Conclusions: Decisions on how to determine the place of SEBs in clinical practice for biologic-naive patients and those already receiving biologies should be made on a case-by-case basis, considering the patient's needs, the characteristics of the biologic required, and the clinical development programs of the applicable SEB.
Perceptions, Attitudes, and Satisfaction concerning Resident Participation in Health Care among Dermatology Outpatients
Authors: AlGhamdi Khalid M. , AlMohanna Hind M. , AlKeraye Salim S. , AlSaif Fahad M. , AlRasheed Saleh K. 
Published: October 2018

Background: A limited number of published studies have discussed patient attitudes toward resident physicians' participation in dermatology clinics. A literature search failed to identify any such study in the Middle East. Objective: The aim of this study was to explore patient perceptions and attitudes toward resident participation in dermatology outpatient clinics. Methods: A self-administered questionnaire focused on patient attitudes toward dermatology resident participation was distributed randomly to all adult outpatients attending dermatology clinics at a university hospital in Saudi Arabia between July and September 2010. Results: The questionnaire was returned by 742 of 900 patients, for an 82% response rate. The mean patient age was 30.58 ± 11.67 years. Forty-two percent (311 of 742) of the respondents were male. The major reason for visiting the hospital was a medical dermatology consultation (80.4%). Only 35% of the patients self-reported an accurate understanding of the “resident” designation. In total, 86.4% of patients were satisfied with the residents' behavior. Furthermore, 98.4% of the patients were satisfied with the medical care provided by the residents. The patients agreed with resident participation in their health care. The majority of the patients expressed their willingness to provide a medical history and receive counseling from residents (87.6% and 86.3%, respectively). There was no gender-associated effect on the understanding of the resident position or the decision to receive a physical examination by a resident. Conclusion: Dermatology outpatients are satisfied and have positive perceptions and attitudes toward resident participation in the dermatology clinic.
Successful Treatment of Necrobiotic Xanthogranuloma with Intravenous Immunoglobulin
Authors: Rubinstein Arye , Wolf David J. , Granstein Richard D. 
Published: October 2018

Background: Necrobiotic xanthogranuloma (NXG) is a rare chronic disorder characterized by firm yellow to red-orange nodules and plaques affecting the face, abdomen, and extremities with the potential for systemic involvement. NXG has a close association with monoclonal gammopathies, and there is a predilection for the development of multiple myeloma. Treatment options are varied due to inconsistent results seen with the use of corticosteroids, immunomodulators, chemotherapeutic agents, and antibiotics. Objective: We describe a patient with smoldering multiple myeloma associated with progressive NXG successfully treated with high-dose intravenous immunoglobulin (IVIG). Conclusion: Our case adds to the single previous report of two cases of NXG with significant improvement from treatment with IVIG and confirms the efficacy of this treatment modality.
Higher Frequency of Psychiatric Morbidity in Patients with Bacterial Infection of the Skin and Subcutaneous Tissue versus Cutaneous Neoplasms: Results from a Nationally Representative Sample from the United States
Authors: Gupta Madhulika A. , Gupta Aditya K. , Vujcic Branka 
Published: October 2018

Background: Poor hygiene and nutrition and resultant compromised immune status in some psychiatric patients can increase susceptibility to bacterial skin infections. Objective: We examined the frequency of ICD9-CM psychiatric disorders (codes 290–319) in bacterial skin infections (ICD9-CM codes 680–686) ( N = 18,734) versus malignant and benign cutaneous neoplasms (ICD9-CM codes 172, 173, 232, 216) ( N = 8,376), conditions that would be expected to cause psychological distress for the patient. Methods: Logistic regression analysis was conducted controlling for age, sex, race, diabetes, obesity, and the use of antineoplastic and immunosuppressant medications. Results: Skin infections were more commonly (odds ratio = 3.03, 95% CI 1.58–5.82) associated with a psychiatric disorder; the most frequent diagnoses were substance dependence and abuse (19.5%), depressive disorder (19.0%), attention-deficit disorder (14.4%), and anxiety disorders (11.6%). Conclusion: In contrast to cutaneous neoplasms, bacterial skin infections were three times as likely to be associated with a psychiatric disorder. Psychiatric comorbidity should be ruled out as a factor in patients with intractable skin infections.
Mobile Teledermatology: A Promising Future in Clinical Practice
Authors: Zuo Kevin J. , Guo Danny , Rao Jaggi 
Published: October 2018

Background: As a product of electronic health, teledermatology is a cost-effective means of improving access to care, facilitating specialist consultations, and supporting patient self-management. Even so, use of traditional teledermatology services is limited by infrastructure and costs in the form of digital cameras, computers, and Internet access. Methods: Considering the significant improvement in smartphone camera resolution and the rapidly increasing number of physicians using smartphones, we explored the use of smartphones as reliable, effective clinical tools in store-and-forward teledermatology. We describe the technical specifications of modern smartphone cameras, the widespread use of smartphones by physicians, and the advantages of smartphones over traditional camera and Internet teledermatology, and we propose recommendations as to how mobile teledermatology may be more effectively used in modern dermatologic practice.
Contact Dermatitis Mimickers: A Tertiary Care Center's Experience
Authors: Velykoredko Yuliya , Houle Marie-Claude , Skotnicki Sandy 
Published: October 2018

Background: Contact dermatitis (CD) is very common but can be mimicked by numerous dermatologic conditions. Thus, a wide differential must be considered before a definitive diagnosis of CD is made to ensure the patient receives appropriate treatment and follow-up. Objective: To describe conditions that can present similarly to contact dermatitis. Methods: We retrospectively analyzed patients referred to the Occupational Disease Specialized Program at St. Michael's Hospital in Toronto between 2009 and 2011 for CD investigations but with a final diagnosis other than CD. Results: We report cases of 2 feet-1 hand syndrome, Dermatitis Herpetiformis, Sézary syndrome and two cases of Pityriasis Rubra Pilaris misdiagnosed as CD and referred for patch testing at our busy tertiary care centre. Failing to recognize these mimickers of CD resulted in a significant delay in diagnosis for the patients and resulting initiation of necessary intervention. Conclusions: It is important to consider numerous mimickers before making a diagnosis of CD to ensure optimal outcome for patients.