bluuebunny/crossref_metadata_2025_split huggingface dataset:
Melasma treatment using an erbium:YAG laser: a clinical, immunohistochemical, and ultrastructural study
Authors: Attwa Enayat , Khater Mohamed , Assaf Magda , Haleem Manal Abdel 
Published: September 2014

AbstractBackgroundMelasma is a common pigmentary disorder that remains resistant to available therapies.ObjectivesThe aim of the present study was to evaluate the efficacy of erbium:YAG lasers in the treatment of refractory melasma and investigate the histopathological and ultrastructural changes between melasma skin and adjacent control skin before and after surgery.MethodsFifteen Egyptian female patients with melasma unresponsive to previous therapy of bleaching creams and chemical peels were included in this study. Full‐face skin resurfacing using an erbium:YAG laser was performed. Clinical parameters included physician and patient assessment, and melasma area and severity index score were done. Adverse effects after laser resurfacing were recorded. Biopsies of lesions and adjacent healthy skin were stained using hematoxylin–eosin, immunohistochemically marked for Melan‐A, and evaluated by electron microscopy.ResultsThe amount of melanin, staining intensity, and number of epidermal melanocytes are increased in melasma lesions as compared to normal skin. Electron microscopic analysis revealed an increased number of mature melanosomes in keratinocytes and melanocytes, with more marked cytoplasmic organelles in melasma skin than in biopsy specimens from normal skin, suggesting increased cell activity. After surgery, the number of melanocytes and concentration of melanin decreased in melasma skin, and the mean melasma area and severity index score decreased dramatically.ConclusionsErbium:YAG laser resurfacing effectively improves melasma; however, the almost universal appearance of transient postinflammatory hyperpigmentation necessitates prompt and persistent intervention.
Downregulation of involucrin in psoriatic lesions following therapy with propylthiouracil, an anti‐thyroid thioureylene: immunohistochemistry and gene expression analysis
Authors: Gnanaraj Pushpa , Dayalan Haripriya , Elango Tamilselvi , Malligarjunan Hemamalini , Raghavan Vijayashree , Rao Ramesh 
Published: September 2014

AbstractBackgroundPropylthiouracil (PTU), an anti‐thyroid thioureylene, has been shown to be effective in chronic plaque psoriasis. Involucrin is a precursor protein that is upregulated in psoriasis.ObjectivesThis study evaluated the expression of involucrin in the epidermis of skin in psoriatic plaques before and after treatment with PTU.MethodsThis was an open‐label, prospective study in which 25 psoriasis patients underwent skin biopsies prior to treatment with oral PTU 100 mg three times per day for 12 weeks. Patients were assessed at 2, 6, and 12 weeks. Skin biopsies were repeated at the same sites at 12 weeks. Pre‐ and post‐treatment specimens were subjected to immunohistochemical staining and real‐time polymerase chain reaction for involucrin.ResultsMean ± standard deviation (SD) scores on the Psoriasis Area and Severity Index reduced significantly from 17.86 ± 9.9 at baseline to 4.63 ± 4.1 at week 12 (P < 0.001). Histomorphometric analysis revealed marked decreases in numbers of positively stained cells and intensity of staining. Staining became localized to the upper granular layers after therapy. Immunohistochemical scoring for involucrin reduced from a mean ± SD of 9.00 ± 0.67 at baseline to 3.90 ± 0.88 at week 12 (P < 0.0001).ConclusionsIn psoriasis, there is increased expression of involucrin, which leads to abnormal keratinocyte differentiation and hence to the formation of psoriatic plaques. The therapeutic effect of PTU in psoriasis may be attributable to the downregulation of involucrin. Larger trials should further elucidate the mechanism and therapeutic potential of PTU in psoriasis.
First reported case of Aspergillus nidulans eumycetoma in a sporotrichoid distribution
Authors: Verma Rajesh , Vasudevan Biju , Sahni Ajay K. , Vijendran Pragasam , Neema Shekhar , Kharayat Veena 
Published: September 2014

AbstractBackgroundMycetomas are chronic subcutaneous infections caused by either fungi (eumycetomas) or bacteria (actinomycetomas). Eumycetoma is commonly seen in tropical and subtropical climates, usually in males working in occupations prone to trauma. Aspergillus spp. are an uncommon cause of mycetomas.ObjectivesWe describe a patient with eumycetoma attributable to Aspergillus nidulans presenting in a sporotrichoid distribution.Case reportA 45‐year‐old man with type 2 diabetes mellitus and hypertension presented with multiple lumps over the right lower limb of four months in duration. He had initially developed a solitary lesion over the right ankle, followed by multiple similar lumps which had spread upwards to involve the right thigh. The entire lower limb was edematous. The patient denied any trauma preceding the symptoms. Biopsy revealed pseudoepitheliomatous hyperplasia with extensive granulomatous infiltrate in the dermis and subcutaneous tissue. Grocott–Gomorri staining revealed fungal elements. Culture on Sabouraud's agar revealed a whitish colony that later turned green. Aspergillus nidulans mycetoma in a sporotrichoid distribution was diagnosed. The patient was started on oral itraconazole 200 mg twice daily, which resulted in complete regression of the lesions.ConclusionsAspergillus spp. have emerged as important opportunistic pathogens, especially in immunosuppressed patients. Aspergillus nidulans occurs frequently in soil, decaying vegetation, and water but has very rarely been described as a cause of mycetoma. The infection responds well to treatment with itraconazole, voriconazole, and amphotericin B. The current patient represents the first demonstration of A. nidulans mycetoma presenting in a sporotrichoid distribution.
A randomized, double‐blind, placebo‐controlled clinical trial on the efficacy and safety of 3% Rumex occidentalis cream versus 4% hydroquinone cream in the treatment of melasma among Filipinos
Authors: Mendoza Clarisse G. , Singzon Ivan A. , Handog Evangeline B. 
Published: September 2014

AbstractBackgroundMelasma is a commonly acquired hyperpigmentation symmetrically distributed on the face, neck, and arms. The skin‐lightening properties of Rumex occidentalis make it a therapeutic alternative to the reference standard treatment of hydroquinone (HQ).ObjectivesThis study was conducted to evaluate the safety and efficacy of 3% R. occidentalis cream versus 4% HQ cream in the management of epidermal and mixed melasma.MethodsThis was a randomized, double‐blind, placebo‐controlled trial. Forty‐five subjects with epidermal and mixed melasma were recruited to compare 3% R. occidentalis cream, 4% HQ cream, and placebo cream applied twice daily for eight weeks. Changes in pigmentation were measured every two weeks using the Melasma Area Severity Index (MASI) and a mexameter. Adverse events were noted on every visit. Patient and investigator global evaluations were performed at the end of the study.ResultsOverall mean MASI and mexameter readings in the three groups decreased from baseline to week 8. The greatest decline in score from weeks 2 to 6 was achieved by the HQ group, followed by the R. occidentalis group. By week 8, the R. occidentalis group showed a greater mean ± standard deviation decline in MASI and mexameter readings from baseline (MASI: 0.60 ± 0.86; mexameter: 50.56 ± 25.63) than the HQ group (MASI: 0.55 ± 0.62; mexameter: 45.89 ± 47.83). The efficacy of R. occidentalis cream and HQ cream were assessed as similarly favorable by both study subjects and investigators.ConclusionsRumex occidentalis 3% cream is a safe and effective skin‐lightening agent for melasma and is comparable in efficacy with 4% HQ cream.
Association between pre‐donation serum uric acid concentration and change in renal function after living kidney donation in women
Authors: Cho A. , Lee J. E. , Jang H. R. , Huh W. , Kim D. J. , Oh H. Y. , Kim Y.‐G. 
Published: September 2014

AbstractBackgroundReduction in renal mass after unilateral nephrectomy causes functional and structural changes in the remaining kidney.AimWe aimed to investigate the association between pre‐donation serum uric acid (SUA) concentration and the change in renal function after living kidney donation.MethodsThis retrospective study included 413 living kidney donors from a single centre. We collected medical history and laboratory findings at baseline and 6 months after donation. Renal function was assessed by calculating the estimated glomerular filtration rate (eGFR) using the Chronic Kidney Disease Epidemiology Collaboration equation. Main outcomes were the percentage change in eGFR from before to 6 months after donation and the percentage of patients whose eGFR decreased by >25% after donation compared with the pre‐donation baseline value.ResultsMean age was 40 ± 11 years, and eGFR was 106 ± 14 mL/min/1.73 m2. In women, the SUA concentration was linearly associated with the change in eGFR after donation independently of baseline eGFR (standardised coefficient – 0.16, P = 0.04). Multiple logistic analysis showed that a 59.5 μmol/L increase in baseline SUA concentration was associated with a 1.7‐fold higher risk of a > 25% decrease in eGFR after donor nephrectomy (95% confidence interval, 1.2–2.5; P = 0.007) in women. In contrast, SUA concentration was not an independent risk factor of decrease in eGFR after donor nephrectomy in men.ConclusionsPre‐donation SUA concentration is associated independently with the change in renal function after donor nephrectomy in women but not in men.
Characteristics of circulating CD31+ cells from patients with coronary artery disease
Authors: Kim Moo Hyun , Guo Longzhe , Kim Han‐Soo , Kim Sung‐Whan 
Published: September 2014

AbstractRecently, we reported the properties of CD31‐expressing cells in healthy individuals. However, the characteristics of CD31‐expressing cells derived from coronary artery disease (CAD) patients remain unknown. This study aimed to investigate the relationship between circulating CD31+ cells and CAD as well as their biological characteristics. Analysis with flow cytometry revealed that CD31+ cells (C‐CD31) from the peripheral blood (PB) of CAD patients exhibited low levels of T‐cell marker and high levels of macrophage marker compared with the PB‐CD31+ cells from healthy individuals (H‐CD31). In addition, the expression levels of multiple pro‐angiogenic and chemokine genes were significantly down‐regulated in C‐CD31. However, inflammatory gene IL‐1α was highly up‐regulated in C‐CD31. Patients with unstable angina (UA) had significantly more CD31+ cells in the PB than healthy control group (P < 0.001). Moreover, there were significant correlations between the number of CD31+ cells and cardiovascular (CV) disease activity (R = 0.318, P = 0.006) and the number of diseased coronaries (R = 0.312, P = 0.005). For the diagnostic category of UA, the area under curve was 0.803 (P < 0.001). In conclusion, C‐CD31 have impaired angiogenic potential and the number of circulating CD31+ cells were correlated with CV risk. These findings may contribute to the understanding of the pathogenesis of CAD.
Body mass index is negatively associated with acne lesion counts in Taiwanese women with post‐adolescent acne
Authors: Lu P. H. , Hsu C. H. 
Published: September 2014

AbstractBackgroundAcne in adult women tends to be chronic, refractory to treatment and associated with psychosocial problems. Body mass index (BMI) has been reported to be a risk factor for acne in school children and adolescents, but not in adult women.ObjectivesThe aim of this study was to demonstrate the relationship between BMI and acne lesion counts in women with post‐adolescent acne.MethodsHundred and four women between 25 and 45 years of age, with moderate or severe acne vulgaris were enrolled in this study. The main outcome evaluated was the number of acne lesions, which were then assessed using multiple linear regression analysis.ResultsThe coefficients of multiple regression analysis with stepwise model showed that BMI (β = −0.36; p = 0.001) and family history (β = 0.21; p = 0.04) were the main predictors of the number of acne lesions.ConclusionInitial findings indicate that BMI is negatively associated with the number of acne lesions in Taiwanese women with moderate to severe post‐adolescent acne.
Impact of a priority system on patients in waiting lists for knee arthroplasty
Authors: Tebé Cristian , Comas Merce , Adam Paula , Solans‐Domènech Maite , Allepuz Alejandro , Espallargues Mireia 
Published: September 2014

AbstractRationale, aims and objectivesThe Agency for Health Quality and Assessment of Catalonia (AQuAS) developed a system for the prioritization of patients on non‐urgent waiting lists for cataract as well as knee and hip arthroplasty. The aim was to evaluate the impact of the priority system's application for primary knee arthroplasty (PKA).MethodsA retrospective evaluative study with data from the Data Tracking and Management Registry of the CatSalut Waiting Lists for PKA of hospitals in the public hospital network in the period 2003–2009. A description of the characteristics of patients on waiting lists was made and the association between priority scoring and waiting time and the order of operation analysed. Finally, waiting times were simulated that patients would have experienced if being operated on strictly according to a first in first out system or one of priority scoring, to compare them with real waiting times.ResultsThe number of people included on waiting lists for PKA was 67 403. 67% had a priority score. The distribution of the priority score was negatively skewed with an average score of 70 points. The association with the priority score for the waiting time as well as the order of the operations performed was practically null.ConclusionsThe study concludes that, globally, the prioritization system for PKA has been implemented but had no effect on the prioritization of patients based on their severity. Nevertheless, in some centres, a moderate correlation between the order of operations performed and the priority score was identified.
Developing minimum clinical standards for physiotherapy in South African intensive care units: the nominal group technique in action
Authors: Hanekom Susan , Van Aswegen Helena , Plani Natascha , Patman Shane 
Published: September 2014

AbstractRationale, aims and objectivesPhysiotherapists form an important part of the inter‐professional team that cares for critically ill patients in intensive care units (ICU). No formalized clinical practice guidelines or standards exist for the educational profile or scope of practice requirements for physiotherapy within critical care, which poses a threat to physiotherapy practice and professional credibility.MethodsThe aim of this paper was to describe the nominal group technique (NGT) used to identify the minimum standards of clinical practice needed by physiotherapists to ensure safe and independent practice in South African ICUs.ResultsTwenty‐five subjects participated in one of three forums. Sixty‐six concepts were considered in the three domains (knowledge, skills and attitudes). Not all concepts were discussed by all three focus groups. Just over half (54% n = 14) the concepts generated in the knowledge domain; a third of the concepts (35% n = 7) generated in the skills domain and only 10% (n = 2) of attitudes were consistently raised by all three groups. Almost two‐thirds of the concepts generated (62% n = 41) were considered in more than one domain. Only six concepts reached the threshold consensus level across all three focus groups, four knowledge parameters and two skills.ConclusionThe NGT allowed for the cross‐stimulation of ideas in an engaging yet anonymous and structured manner. The importance of discussion in reaching consensus is highlighted. Going forward, it is intended to use the concepts generated through this process as the foundation for further consensus‐building activities among the wider physiotherapy and intensive care communities.
Ceftriaxone modulates uptake activity of glial glutamate transporter‐1 against global brain ischemia in rats
Authors: Hu Yu‐Yan , Xu Jing , Zhang Min , Wang Dan , Li Li , Li Wen‐Bin 
Published: September 2014

AbstractCeftriaxone(Cef) selectively increases the expression of glial glutamate transporter‐1 (GLT‐1), which was thought to be neuroprotective in some circumstances. However, the effect of Cef on glutamate uptake of GLT‐1 was mostly assayed using in vitro studies such as primary neuron/astrocyte cultures or brain slices. In addition, the effect of Cef on neurons in different ischemic models was still discrepant. Therefore, this study was undertaken to observe the effect of Cef on neurons in global brain ischemia in rats, and especially to provide direct evidence of the up‐regulation of GLT‐1 uptake for glutamate contributing to the neuronal protection of Cef against brain ischemia. Neuropathological evaluation indicated that administration of Cef, especially pre‐treatment protocols, significantly prevented delayed neuronal death in hippocampal CA1 subregion normally induced by global brain ischemia. Simultaneously, pre‐administration of Cef significantly up‐regulated the expression of GLT‐1. Particularly, GLT‐1 uptake assay with 3H‐glutamate in living cells from adult rats showed that up‐regulation in glutamate uptake accompanied up‐regulated GLT‐1 expression. Inhibition of GLT‐1 by antisense oligodeoxynucleotides or dihydrokainate significantly inhibited the Cef‐induced up‐regulation in GLT‐1 uptake and the neuroprotective effect against global ischemia. Thus, we may conclude that Cef protects neurons against global brain ischemia via up‐regulation of the expression and glutamate uptake of GLT‐1.
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Glutamate uptake by glial glutamate transporter‐1 (GLT‐1) is the principal way to regulate extracellular glutamate homeostasis in central nervous system. Over‐accumulation of glutamate results in excitotoxicity and injures neurons after cerebral ischemia. Ceftriaxone up‐regulates GLT‐1 expression and uptake of glutamate, diminishes the excitotoxicity of glutamate and then protects neurons against global brain ischemia.
Factors influencing why nursing care is missed
Authors: Blackman Ian , Henderson Julie , Willis Eileen , Hamilton Patricia , Toffoli Luisa , Verrall Claire , Abery Elizabeth , Harvey Clare 
Published: September 2014

Aims and objectivesThis study explores the reasons nurses identify missed care and what factors account for this variance in nursing practice. Second, the study seeks to understand if the identified reasons behind missed care interact with one another and form a multidimensional construct.BackgroundThis study draws on the results of previous research conducted by Kalisch in developing the MISSCARE research survey tool and now applies it to an Australian context.DesignThis study engages a nonexperimental exploratory approach where 16 latent variables are identified and estimated using structural equation modelling to determine the capacity each of these factors has in predicting the reasons for reported missed nursing care.MethodsData were obtained from an electronic survey sent to nursing members of the Australian Nursing and Midwifery Federation of South Australia. A self‐report, Likert‐type instrument was used to capture the strength and direction of consensus derived from a sample of 289 nurses and midwives.Results/FindingsEight variables were identified as having direct predictor effects as to why nursing care was being missed, and included shift type, nursing resource allocation, health professional communication, workload intensity, workload predictability, the nurses' satisfaction with their current job and their intention to remain working. Additional indirect effects of other variables explained 34% of the variance of the total scores for why nursing care was reported as being missed.ConclusionHistorically, the MISSCARE survey has identified and quantified what types of nursing care is missed. This paper takes this concept further by producing an interactional model identifying the effects different variables have on why nursing care is missed.Relevance to clinical practiceThese Australian findings not only contribute to other international studies that identify why nursing care is omitted, it provides a framework for why reported episodes of missed care can be predicted and subsequently addressed.
Intermittent midline suprasternal neck mass caused by superior herniation of the thymus
Authors: Su Siew Choo , Hess Thomas , Whybourne Annie , Chang Anne B 
Published: September 2014

AbstractNeck masses in infants and children have a wide differential diagnosis. However, neck masses apparent only during raised intrathoracic pressure are rare with a limited number of causes, including superior herniation of the normal thymus, apical lung herniation, jugular phlebectasia and laryngocoele. These conditions can easily be differentiated from one another by imaging. We present an infant with intermittent suprasternal neck mass visible only during increased intrathoracic pressure, produced either by crying or straining. Diagnosis of superior herniation of the thymus into the neck was confirmed by ultrasonography with the characteristic sonographic appearances of the normal thymus as well as its shape, size and location. Ultrasonography should be the first imaging modality of choice. Management of superior herniation of the thymus into the neck should be conservative as the thymus naturally involutes with increasing age. Awareness of the differential diagnosis of neck swelling present only on Vasalva manoeuvre or increased intrathoracic pressure is important to prevent unnecessary tests, avoid radiation, biopsy and surgery.
Zinc glycine chelate absorption characteristics in Sprague Dawley rat
Authors: Yue M. , Fang S. L. , Zhuo Z. , Li D. D. , Feng J. 
Published: September 2014

SummaryThis study was conducted to investigate absorption characteristics of zinc glycine chelate (Zn–Gly) by evaluating tissues zinc status and the expression of zinc transporters in rats. A total of 24 male rats were randomly allocated to three treatments and administered either saline or 35 mg Zn/kg body weight from zinc sulphate (ZnSO4) or Zn–Gly by feeding tube separately. Four rats per group were slaughtered and tissues were collected at 2 and 6 h after gavage respectively. Our data showed that Zn–Gly did more effectively in increasing (p < 0.05) serum zinc levels, and the activities of serum and liver alkaline phosphatase (ALP) and liver Cu/Zn superoxide dismutase (Cu/Zn SOD) at 2 and 6 h. By 2 h after the zinc load, the mRNA and protein abundance of intestinal metallothionein1 (MT1) and zinc transporter SLC30A1 (ZnT1) were higher (p < 0.05), and zinc transporter SLC39A4 (Zip4) lower (p < 0.05) in ZnSO4 compared to other groups. Zinc transporter SLC39A5 (Zip5) mRNA expression was not zinc responsive, but Zip5 protein abundance was remarkably (p < 0.05) increased in ZnSO4 2 h later. Overall, our results indicated that in short‐term periods, Zn–Gly was more effective in improving body zinc status than ZnSO4, and ZnSO4 did more efficiently on the regulation of zinc transporters in small intestine.