bluuebunny/crossref_metadata_2025_split huggingface dataset:
DKG statement on the use of metal alloy discs for patch testing in suspected intolerance to metal implants
Authors: Thomas Peter , Geier Johannes , Dickel Heinrich , Diepgen Thomas , Hillen Uwe , Kreft Burkhard , Schnuch Axel , Szliska Christiane , Mahler Vera 
Published: September 2015

SummaryIntolerance reactions to metal implants may be caused by metal allergy. However, prior to implantation, ‘prophetic’/prophylactic patch testing should not be performed. Pre‐implant patch testing should only be done to verify or exclude metal allergy in patients with a corresponding history. In case of implant‐related complications – in particular following replacement arthroplasty – such as pain, effusion, skin lesions, reduced range of motion or implant loosening, orthopedic causes should be ruled out first. Workup of suspected metal implant allergy should then be done using the DKG standard series, which includes nickel, cobalt, and chromium preparations. Various studies assessing the usefulness of metal alloy discs for patch testing have shown this particular approach to be ineffective with respect to providing reliable information on metal allergy. Any positive reaction in such tests cannot be assigned to a specific metal contained within the alloy. Furthermore, there is a risk of broad and indiscriminate use of these readily available discs. Accordingly, given the lack of additional benefit compared to patch testing with standardized metal salt preparations, we do not recommend patch testing with metal alloy discs.
Obsessive‐compulsive disorder in dermatology
Authors: Mavrogiorgou Paraskevi , Bader Armin , Stockfleth Eggert , Juckel Georg 
Published: September 2015

SummaryPatients with obsessive‐compulsive (OCD) and related disorders – primarily trichotillomania, body dysmorphic disorder, and skin picking disorder – frequently present to dermatologists due to associated hair and skin symptoms. It is therefore crucial that dermatologists be familiar with these disorders. In this review article, we provide an update on clinical features, neurobiology factors, and treatment options for OCD spectrum disorders. Employing PubMed and Cochrane Library databases, a selective literature search was conducted using keywords related to dermatological disorders within the OCD spectrum. OCD and its related disorders share several phenomenological as well as pathophysiological similarities, thus warranting their classification within a separate nosological category of psychiatric disorders. Another similarity of OCD spectrum disorders is the frequent concurrence of hair and skin diseases. Besides symptomatic dermatological treatment, the combination of psychotherapy (behavioral therapy) and psychopharmacotherapy (SSRIs) may be helpful. Although recent insights into OCD have contributed to a better understanding and treatment thereof, more research is required, especially with respect to OCD spectrum disorders, for which large controlled treatment studies are still lacking.
Pain and pain management in dermatology
Authors: Beiteke Ulrike , Bigge Stefan , Reichenberger Christina , Gralow Ingrid 
Published: September 2015

SummaryIt is estimated that 23 million Germans suffer from chronic pain. A recent survey has revealed that 30 % of chronic pain patients are dissatisfied with their pain management. Furthermore, five million Germans suffer from neuropathic pain, 20 % of whom are inadequately treated. Pain is also a symptom of many dermatologic diseases, which is mostly somatic and may be classified as mild in the majority of cases. Nevertheless, research on the quality of life (QoL) has increasingly shown a marked impairment of QoL by moderate pain such as in psoriatic arthritis. ­Severe pain is associated with herpes zoster (shingles), leg ulcers, and pyoderma gangrenosum.This article addresses the basics of pain classification and, in a short excerpt, pain transduction/transmission and modulation. The use of standardized diagnostic ­scales is recommended for the purpose of recording and monitoring pain intensity, which allows for the optimization of therapy and consistent interdisciplinary ­communication.Any dermatology residency program includes the acquisition of knowledge and skills in pain management. This review therefore aims to present fundamental therapeutic concepts based on the expanded WHO analgesic ladder, and describes a step‐wise therapeutic approach and combination therapies. The article focuses on the pain management of the above‐mentioned severely painful, conservatively treated dermatoses. Besides well‐established therapeutic agents and current ­therapeutic standards, it discusses specific options based on guidelines (where available). Current knowledge on peri‐ and postoperative pain management is briefly outlined.This article addresses:

▸ The fundamentals of the classification and neurophysiology of pain;
▸ Standards for pain documentation in children and adults;
▸ General standards for pharmaceutical pain management;
▸ Current specific treatment options for postherpetic neuralgia, leg ulcers, and ­pyoderma gangrenosum in conjunction with the expanded WHO analgesic ­ladder.
Zwangsstörungen in der Dermatologie
Authors: Mavrogiorgou Paraskevi , Bader Armin , Stockfleth Eggert , Juckel Georg 
Published: September 2015

ZusammenfassungPatienten mit einer Zwangsstörung und verwandte Störungen, zu denen die Trichotillomanie, die körperdysmorphe Störung und die Dermatillomanie (skin picking) in erster Linie zählen, konsultieren aufgrund der dabei auftretenden Haar‐ und Hautsymptome häufig einen Dermatologen. Es ist somit wichtig, auch von dermatologischer Seite über diese Erkrankungen gut informiert zu sein. In dieser Übersichtarbeit werden aktuelle Aspekte zur Klinik, Neurobiologie und Therapie der Zwangsspektrumsstörungen dargestellt. Es wurde eine selektive Literaturrecherche (PubMed und Cochrane Library) mit Suchbegriffen bzgl. dermatologischer Störungen bei Zwangsspektrumsserkrankungen durchgeführt. Die Zwangsstörung und die ihr verwandten Störungen haben zahlreiche phänomenologische und pathophysiologische Gemeinsamkeiten, so dass ihre Einordnung in einer eigenen nosologischen Kategorie psychiatrischer Störungen begründet ist. Eine weitere Gemeinsamkeit der Zwangsspektrumsstörungen ist das häufig gleichzeitig bestehende Vorhandensein von Haut‐ und/oder Haarerkrankungen. Neben der symptomatischen, dermatologischen Behandlung kann eine Kombination von Psychotherapie (Verhaltenstherapie) und Psychopharmakotherapie (SSRIs) hilfreich sein. Obwohl das Wissen über die Zwangsstörung einiges zum Verständnis und zur deren besseren Behandlung beigetragen hat, besteht weiterhin Forschungsbedarf vor allem im Bereich der Zwangsspektrumsstörungen, für die große kontrollierte Behandlungsstudien fehlen.
DKG‐Stellungnahme zur Epikutantestung von Metalllegierungsplättchen bei Verdacht auf Metallimplantat‐Unverträglichkeit
Authors: Thomas Peter , Geier Johannes , Dickel Heinrich , Diepgen Thomas , Hillen Uwe , Kreft Burkhard , Schnuch Axel , Szliska Christiane , Mahler Vera 
Published: September 2015

ZusammenfassungEine Metallallergie kann zu Unverträglichkeit von Metallimplantaten führen. Vor Implantation sollte eine Epikutantestung aber nicht prophetisch‐prophylaktisch, sondern nur bei anamnestischen Hinweisen auf eine potenzielle Metallallergie erfolgen. Sofern nach Einsetzen von Metallimplantaten – speziell Endoprothesen – Komplikationen wie Schmerzen, Ergüsse, Hauterscheinungen, Bewegungseinschränkung oder Lockerung auftreten, empfiehlt sich bei Verdacht auf das Vorliegen einer Metallimplantatallergie nach orthopädisch‐chirurgischer Differenzialdiagnostik ein Epikutantest mit der Nickel‐, Cobalt‐, Chrom‐Präparationen enthaltenden DKG‐Standardreihe. Studien zum Einsatz von Metalllegierungsplättchen haben gezeigt, dass damit kein verlässlicher Nachweis einer Metallallergie möglich ist, und bei einer allergischen Epikutantestreaktion auf ein Metallplättchen diese auch keinem konkreten Legierungs‐Metall der Plättchen zugeordnet werden kann. Zudem besteht die Gefahr der unkritischen, breiten Testanwendung der leicht zugänglichen Metalllegierungsplättchen. Aufgrund fehlenden Zusatznutzens gegenüber der Epikutantestung mit standardisierten Metallsalzpräparationen empfehlen wir die Testung mit Legierungsplättchen nicht.
Plattenepithelkarzinome in chronischen venösen Ulcera crurum. Daten aus dem deutschen Marjolin‐Register und Übersichtsdarstellung
Authors: Reich‐Schupke Stefanie , Doerler Martin , Wollina Uwe , Dissemond Joachim , Horn Thomas , Strölin Anke , Erfurt‐Berge Cornelia , Stücker Markus 
Published: September 2015

ZusammenfassungHintergrundDas sekundäre Plattenepithelkarzinom (engl. squamous cell carcinoma, SCC) ist eine seltene Komplikation bei chronischem Ulcus cruris venosum. Über seine Pathophysiologie und den klinischen Verlauf ist bislang wenig bekannt. Das aktuelle Marjolin‐Register geht aus einer Initiative der Arbeitsgruppe „Wundheilung“ (AGW) der Deutschen Dermatologischen Gesellschaft (DDG) hervor und erfasst Fälle von aus venösen Ulcera hervorgehenden Plattenepithelkarzinomen mit dem Ziel der Beurteilung diagnostischer Merkmale.Patienten und MethodenAlle Mitglieder der AGW beantworteten Fragebögen über Patientenbasisdaten, Ulkusmerkmale und die durchgeführte Therapie.ErgebnisseZwischen 2010 und 2013 wurden 30 Patienten (20 Frauen, 10 Männer) aus sechs tertiären Wundbehandlungseinrichtungen registriert. Das Durchschnittsalter betrug 76,17 Jahre. Die durchschnittliche Dauer der Ulcera crurum venosa vor Diagnose des Plattenepithelkarzinoms betrug 15,93 Jahre. Als auffällige Wundmerkmale wurden in erster Linie Schmerz (n = 3), Therapieresistenz (n = 27) und Fötor (n = 12) sowie ein klinisches Erscheinungsbild (n = 10) mit atypischer Morphologie, nodulärem Wundbett und Hypergranulation festgestellt.SchlussfolgerungenAtypische Morphologie oder verändertes Erscheinungsbild sowie Therapieresistenz trotz optimaler Versorgung (6–12 Wochen) sollten zum Anlass genommen werden, wenn nötig mehrere und serielle spindelförmige Biopsien zu entnehmen. Die Hauptrisikofaktoren für eine maligne Transformation sind das Patientenalter und die Ulkusdauer.
Risikofaktoren für eine MRSA‐Kolonisation bei dermatologischen Patienten in Deutschland
Authors: Daeschlein Georg , von Podewils Sebastian , Bloom Tina , Assadian Ojan , Napp Matthias , Haase Hermann , Jünger Michael 
Published: September 2015

ZusammenfassungHintergrund und ZielsetzungDie Erkennung des methicillinresistenten Staphylococcus aureus (MRSA) erfordert gut definierte Risikofaktoren (RFs). Abgesehen von „chronischen Wunden“ sind RFs meist in nationalen Empfehlungen spezifiziert. Zur Vermeidung von erfolglosem und teurem Screening haben wir die Einheit „Wunden“ in verschiedene Kategorien aufgeteilt und weitere RFs bei dermatologischen Patienten ermittelt.Patienten und MethodenNach einem Untersuchungszeitraum mit allgemeinem MRSA‐Screening korrelierten wir die MRSA‐Ergebnisse mit den Wundkategorien und mit dermatologisch relevanten Diagnosen. Wir analysierten die Screening‐Wirksamkeit durch die Ergänzung von potentiellen neuen RFs.ErgebnisseUlzera (Dekubitus, arterielle, kombinierte Dekubitus/arterielle Ulzera, nicht anderweitig spezifiziert), Typ II Diabetes mellitus (DM), und atopische Dermatitis (AD) waren signifikant mit dem Vorliegen von MRSA verbunden. Tumore (Subgruppe Basal‐ und Plattenepithelkarzinome) waren ebenfalls signifikant mit dem Vorliegen von MRSA verbunden, hatten jedoch eine schützende Odds‐Ratio. Die Unterscheidung von Wundtypen bot keinen zusätzlichen Nutzen. Bei allen MRSA‐­positiven Patienten mit chronischen Wunden wurden andere vom RKI gelistete RFs oder Typ II DM gefunden. Die Screening‐Empfindlichkeit wurde durch die Kombination von klassischen RFs (außer Wunden) mit Typ II DM und AD erhöht.SchlussfolgerungenBei dermatologischen Patienten wurden AD und Typ II DM als neue RFs identifiziert. Verschiedene Wundtypen wurden ebenfalls als signifikante RFs festgestellt, aber ein differenziertes Screening bietet keinen Nutzen. Beim Screening von Patienten nach nationalen Empfehlungen gibt es, wenn Wunden ausgeschlossen, Typ II DM und AD aber eingeschlossen werden, keinen Sensibilitätsverlust.
Does the host plant affect the benefits from mutualisms?The invasive mealybug and ghost ant association
Authors: ZHOU AIMING , KUANG BEIQING , GAO YINGRUI 
Published: September 2015

1. The benefits to trophobionte hemipterans are affected by the ant tending level, which is a widely accepted statement. The ant tending level is closely related to multiple factors. It is clear that the ant tending level can be affected by the temporal factor, age‐specific, the density of the hemipterans, and quantity and quality of honeydew produced by hemipterans.2. Few studies of ant–hemipteran mutualisms have reported the patterns of host plants‐dependent effects, and whether host plants influence the ant tending level that is also unclear. As such, laboratory experiments were conducted to test whether the colony growth rate of an invasive mealybugPhenacoccus solenopsisTinsley, parasitism ofAenasius bambawaleiHayat, an dominant parasitoid ofP. solenopsis, are affected by tending by ghost ants (Tapinoma melanocephalum(Fabricius)], host plants (tomato and cotton), and interactions between the two factors. The difference in the ant tending level between the host plants was also determined.3. The results showed that mealybug colony growth and parasitism were significantly affected by ant tending and host plant separately. There were significant interactions between the independent factors on the mealybug colony growth rate and percentage parasitism. These results suggest that benefits to mealybugs are host plant‐dependent.
Retrospective evaluation of all recorded horse race starts in Switzerland during a four year period focusing on discipline‐specific risk factors for clinical events
Authors: Schweizer C. , Ramseyer A. , Gerber V. , Christen G. , Burger D. , Wohlfender F. D. 
Published: September 2015

SummaryReasons for performing studyRacetrack injuries are of welfare concern and the prevention of injuries is an important goal in many racing jurisdictions. Over the years this has led to more detailed recording of clinical events on racecourses. However, risk factor analyses of clinical events at race meetings have not been previously reported for Switzerland.ObjectivesTo identify discipline‐specific factors that influence the occurrence of clinical events during race meetings with the ultimate aim of improving the monitoring and safety of racetracks in Switzerland and optimising racehorse welfare.Study designRetrospective study of horse race data collected by the Swiss horse racing association.MethodsAll race starts (n = 17,670, including 6198 flat, 1257 obstacle and 10,215 trot race starts) recorded over a period of 4 years (2009–2012) were analysed in multivariable mixed effect logistic regression models including horse and racecourse related data. The models were designed to identify discipline‐specific factors influencing the occurrence of clinical events on racecourses in Switzerland.ResultsFactors influencing the risk of clinical events during races were different for each discipline. The risk of a clinical event in trot racing was lower for racing on a Porphyre sand track than on grass tracks. Horses whose driver was also their trainer had an approximately 2‐fold higher risk for clinical events. In obstacle races, longer distances (2401–3300 m and 3301–5400 m, respectively) had a protective effect compared with racing over shorter distances. In flat racing, 5 racecourses reported significantly fewer clinical events. In all 3 disciplines, finishing 8th place or later was associated with clinical events.ConclusionsChanges in management that aim to improve the safety and welfare of racehorses, such as racetrack adaptations, need to be individualised for each discipline.
Doing more with less: the challenging diagnosis of polymorphous low‐grade adenocarcinoma in incisional biopsy samples
Authors: Sedassari Bruno T , dos Santos Harim T , Pigatti Fernanda M , Martins Mussi Maria C , Tobouti Priscila L , Altemani Albina , Sousa Suzana 
Published: September 2015

AimsThe diagnosis of polymorphous low‐grade adenocarcinoma (PLGA) remains difficult for general pathologists, particularly in cases of small biopsy samples. We aimed to characterize the histopathological spectrum and immunohistochemical aspects by using an accessible immunohistochemical panel of cytoskeletal proteins in limited samples of PLGA.Methods and resultsForty‐six patients diagnosed with PLGA in incisional biopsies were identified retrospectively. Seventy‐two per cent of patients were women and 28% were men, with a mean age of 55 years. The palate was the most affected site. Grossly, the mean size of the samples was 0.8 cm and 74% of specimens were fragmented. All tumours characteristically displayed the microscopic features of architecturally diverse patterns, infiltrative areas and low‐grade cytology. Neoplastic cells were diffusely positive to cytokeratin (CK) 7, vimentin and S100 protein, but only focally positive to CK14 and negative to α‐smooth muscle actin (α‐SMA), thus lacking myoepithelial differentiation.ConclusionsMicroscopic recognition of PLGA is facilitated by a characteristic combination of multiple architectural patterns of growth, infiltration of adjacent tissues and cytological aspects. These features are present even in small biopsy samples. The association of histopathological aspects with CK7, CK14, vimentin, S100 and α‐SMA immunoexpression is helpful in reaching the diagnosis of doubtful cases.
Paediatric chondrosarcomas: a retrospective review of 17 cases
Authors: Gambarotti Marco , Righi Alberto , Picci Piero , Bertoni Franco , Manfrini Marco , Donati Davide M , Dei Tos Angelo P , Vanel Daniel 
Published: September 2015

AimsChondrosarcoma is primarily a tumour of adulthood and old age. Some studies indicate that survival is worse in paediatric than in adult chondrosarcomas. In view of the rarity of paediatric chondrosarcoma, few large studies are currently available.Methods and resultsWe evaluated the clinical, radiological and pathological features of a single institution series of chondrosarcomas presenting in patients younger than 17 years between 1981 and 2014. Seventeen patients with central (10), peripheral (five) and periosteal (two) chondrosarcoma were retrieved. The patients received various treatments according to the dimension, stage and grading of the lesions. Only two tumours, treated with resection, recurred after the first diagnosis, at 11 and 108 months, respectively. All patients but one were alive without disease at the time of the last follow‐up (median: 148 months). The one patient who died of disease 27 months after diagnosis had a grade 2 central chondrosarcoma of the metacarpal bone. He was affected by Maffucci syndrome and developed multiple bone and lung metastases.ConclusionsChondrosarcoma in children is rare but does exist, and is not limited to the head and neck region. Our findings do not support the current view that chondrosarcomas are more aggressive in children than in adults.
Performance evaluation of the Sysmex XN‐1000 hematology analyzer in assessment of the white blood cell count differential in pediatric specimens
Authors: Becker P.‐H. , Fenneteau O. , Da Costa L. 
Published: September 2015

AbstractIntroductionThe automated XN‐1000 hematology analyzer enables to perform a blood cell count and a leukocyte differential. When abnormal cells were detected, a flag was generated by the analyzer and a manual microscopic examination of the corresponding blood film was performed.MethodsWe compared the white blood cell differentials provided by the automated hematology analyzer XN‐1000 in a pediatric population (n = 765) with those obtained through microscopic examination by cytologists and those obtained using a previous version of this analyzer, the XE‐2100. Leukocytes count as well as flags sensitivity and specificity was analyzed.ResultsThe leukocytes count provided by the analyzer is in good accordance with the differential obtained by manual count in children older than 3 months. The sensitivity for blast detection is 99% and the detection of reactive cells is 63%. The flag specificity remains low (<35%) for blood samples collected from infants between 8 days and 2 years of age, but increases up to 67% thereafter. The results obtained with the XN‐1000 analyzer show an improvement in comparison with those obtained with the XE‐2100 analyzer.ConclusionThe automated WBC differential provided by the XN‐1000 analyzer in the pediatric setting is accurate, but a meticulous microscopic examination of blood smears remains necessary for infants up to 3 months of age to validate the analyzer flags.
Testing for parallel allochronic isolation in lake–stream stickleback
Authors: Hanson D. , Barrett R. D. H. , Hendry A. P. 
Published: September 2015

AbstractThe evolution of reproductive isolation (RI) is a critical step shaping progress towards speciation. In the context of ecological speciation, a critical question is the extent to which specific reproductive barriers important to RI evolve rapidly and predictably in response to environmental differences. Only reproductive barriers with these properties (importance, rapidity, predictability) will drive the diversification of species that are cohesively structured by environment type. One candidate barrier that might exhibit such properties is allochrony, whereby populations breed at different times. We studied six independent lake–stream population pairs of threespine stickleback (Gasterosteus aculeatus Linnaeus, 1758) that are known from genetic studies to show RI. However, the specific reproductive barriers driving this RI have proven elusive, leading to a ‘conundrum of missing reproductive isolation’. We here show that breeding times differ among some of the populations, but not in a consistent manner between lakes and streams. Moreover, the timing differences between lake and stream populations within each pair could account for only a small proportion of total RI measured with neutral genetic markers. Allochrony cannot solve the conundrum of missing reproductive isolation in lake–stream stickleback.
The association between the emergence of cooperative breeding and clutch size
Authors: Koykka C. , Wild G. 
Published: September 2015

AbstractPrevious theoretical work has suggested that smaller brood sizes helped facilitate the emergence of cooperative breeding in birds. However, recent empirical evidence has found no statistically significant difference between the clutch sizes of cooperative breeders and that of noncooperative breeders. One explanation for this finding is that while small clutch sizes may predispose species to cooperative breeding, the emergence of cooperative breeding itself may influence the evolution of clutch size. Here, we develop a set of models using population dynamics to describe how the emergence of cooperative breeding influences clutch size. We find, in contrast to previous theoretical work, that the emergence of cooperative breeding does not necessarily decrease (and under certain conditions may actually increase) clutch size. In particular, clutch size may increase after the emergence of cooperative breeding if helpers – philopatric individuals that assist their breeding relatives – are able to substantially improve breeder fecundity at low costs to their own survival, and if the association between breeder and helper is brief. In many cases, clutch size increases following the emergence of cooperative breeding not because it is optimal for the breeder, but as the result of breeder–helper conflict over resource allocation.