bluuebunny/crossref_metadata_2025_split huggingface dataset:
Erosive mucosal lichen planus and secondary epiphora responding to systemic cyclosporin A treatment
Authors: Boyce Aaron E , Marshman Gillian , Mills Richard AD 
Published: July 2009

ABSTRACTErosive mucosal lichen planus (LP) is a well‐established variant of LP characterized by the formation of ulcerative lesions predominantly involving the oral and genital mucosae. Less commonly, this condition may involve oesophageal and/or ocular mucosal surfaces, and case reports within the ophthalmology literature have recently confirmed the potential for this condition to affect the nasolacrimal ducts. We report the case of a woman with severe cicatrizing mucosal LP and ocular symptoms secondary to presumed nasolacrimal duct involvement. We also report the potential for this newly appreciated manifestation of LP to respond to systemic cyclosporin A.
Recurrent keratoacanthoma with vascular invasion: A diagnostic and management dilemma
Authors: Kurien Anil , Henderson Christopher , Lee Simon 
Published: July 2009

ABSTRACTA 71‐year‐old man with chronic renal failure and on peritoneal dialysis presented with recurrence of multiple keratotic nodules along a surgical scar. This was 6 months after the excision of a recurrent keratotic nodule reported as squamous cell carcinoma from the same site. The lesions were initially reported as squamous cell carcinomas, but on review of histology were consistent with keratoacanthomas. One of the keratoacanthomas showed vascular invasion. These responded well to low‐dose acitretin at 10 mg three times per week and the patient stayed in remission after 18 months of follow up.
Refractory subacute cutaneous lupus erythematosus successfully treated with rituximab
Authors: Kieu Violet , O'Brien Timothy , Yap Lee‐Mei , Baker Christopher , Foley Peter , Mason Graham , Prince H Miles , McCormack Christopher 
Published: July 2009

ABSTRACTA 48‐year‐old woman presented with pruritic, scaly, annular plaques over her upper back and chest that were clinically, serologically and histologically characteristic of subacute cutaneous lupus erythematosus (SCLE). She failed to respond to conventional treatment, which included high‐dose hydroxychloroquine, methotrexate, prednisolone, chloroquine, acitretin, thalidomide, dapsone and azathioprine. Subsequently treated with intravenous rituximab 375 mg/m2 weekly for 4 weeks, she remained on adjuvant oral hydrochloroquine 600 mg daily and topical clobetasol propionate 0.05% ointment as required. Clearing of annular plaques was noted 8 weeks after the initial course of rituximab. By 12 weeks there were no new lesions and only post‐inflammatory hyperpigmentation remained. Both hyper‐ and hypopigmentation, which is more common, are consistent with SCLE lesion regression. Skin lesions recurred 11 months later; however, no further lesions occurred after re‐introduction of rituximab therapy. The treatment was well tolerated. A maintenance regimen of rituximab, 375 mg/m2 every 8 weeks for 2 years, was commenced 3 months after completing the second course of treatment, with ongoing disease remission. Rituximab appears to have activity in refractory SCLE and clinical trials are required to further assess this potential therapy.
Toxic epidermal necrolysis and neutropaenia: Complications of omeprazole
Authors: Thakor Avnesh S , Burke Ailbhe , Handfield‐Jones Susan , Sinha Ayush , Palmer Mike , Burns Alys 
Published: July 2009

ABSTRACTWorldwide, proton pump inhibitors (PPI) are one of the most frequently prescribed drugs; however, up to 70% of patients taking these drugs have no appropriate indication. Although PPI are relatively well tolerated, they are not free from side‐effects and several life‐threatening complications are associated with them. In the present report, a 43‐year‐old woman presented to her general practitioner with an erythematous rash over her face and chest, having been started on omeprazole for chronic abdominal bloating. Over the next 24 h she became increasingly unwell and was admitted to hospital with shortness of breath, pyrexia and the rash spreading over her back, arms and legs. Vesicles had now started to appear within the erythematous regions over her upper body and within 24 h the rash became confluent and desquamative, spreading to involve her entire body. A diagnosis of toxic epidermal necrolysis (TEN) was made. Despite supportive treatment within a critical care setting, she became neutropaenic and her skin loss became more extensive, resulting in 95% epidermal detachment. This case highlights that TEN is a life‐threatening condition associated with a high incidence of morbidity and mortality. Optimal management requires early diagnosis and transfer to a specialized unit. Clinicians need to be aware that PPI are not free from side‐effects and that their routine prescription should be strongly discouraged.
Repigmentation and curling of hair after acitretin therapy
Authors: Seckin Dilek , Yildiz Ayfer 
Published: July 2009

ABSTRACTDrug‐induced hair colour and texture changes have been reported rarely. We describe a 70‐year‐old woman with psoriasis who noticed darkening of her previously white hair, which also gained a curly appearance after 6 months of acitretin treatment. We present this case to emphasize that acitretin can be added to the list of drugs that induce changes in hair colour and texture.
Granuloma faciale successfully treated with topical tacrolimus
Authors: Patterson Clare , Coutts Ian 
Published: July 2009

ABSTRACTGranuloma faciale (GF) is a benign chronic condition characterized by recurrent plaques and nodules most commonly found on the face. We report a man with a 6‐month history of plaques on his forehead and preauricular area consistent with GF that responded to twice‐daily application of topical tacrolimus ointment, and who remains in remission 1 year later. This case supports previous reports of the successful use of topical tacrolimus in treating GF.
Approach to treatment of mental illness and substance dependence in remote Indigenous communities: Results of a mixed methods study
Authors: Nagel Tricia , Robinson Gary , Condon John , Trauer Tom 
Published: July 2009

AbstractObjective:  To develop and evaluate a culturally adapted brief intervention for Indigenous people with chronic mental illness. Design:  A mixed methods design in which an exploratory phase of qualitative research was followed by a nested randomised controlled trial. Setting:  Psycho‐education resources and a brief intervention, motivational care planning (MCP), were developed and tested in collaboration with aboriginal mental health workers in three remote communities in northern Australia. Participants:  A total of 49 patients with mental illness and 37 carers were recruited to a randomised controlled trial that compared MCP (n = 24) with a clinical control condition (treatment as usual, n = 25).Intervention:  The early treatment group received MCP at baseline and the late treatment group received delayed treatment at six months. Main outcome measures:  The primary outcome was mental health problem severity as measured by the health of the nation outcome scales. Secondary measures of well‐being (Kessler 10), life skills, self‐management and substance dependence were chosen. Outcome assessments were performed at baseline, six‐month, 12‐month and 18‐month follow up. Results:  Random effects regression analyses showed significant advantage for the treatment condition in terms of well‐being with changes in health of the nation outcome scales (P < 0.001) and Kessler 10 (P = 0.001), which were sustained over time. There was also significant advantage for treatment for alcohol dependence (P = 0.05), with response also evident in cannabis dependence (P = 0.064) and with changes in substance dependence sustained over time.Conclusions:  These results suggest that MCP is an effective treatment for Indigenous people with mental illness and provide insight into the experience of mental illness in remote communities.
Do rural hospitals lag behind urban hospitals in addressing community health needs? An analysis of recent trends in US community hospitals
Authors: Zhang Wanqing , Mueller Keith J. , Chen Li‐Wu 
Published: July 2009

AbstractObjective:  This study examined whether rural and urban hospitals differ in their level of responsiveness to community health needs. Design:  This study used a multivariate, longitudinal research design. Research setting:  A cross‐sectional survey was the setting for this study. Participants:  The participants were rural or urban hospitals in the United States. Main outcome measures:  The dependent variables were selected from the American Hospital Association hospital survey questions that are related to community health needs. The independent variable was rural or urban location. Results:  Rural hospitals improved more than urban hospitals in addressing community health needs from 1997 through 2006 for most of the indicators, especially in working with other providers to conduct a community health assessment. However, rural hospitals still lag significantly behind urban hospitals in tracking health information. Conclusions:  This study suggests that rural hospitals do not lag behind urban hospitals in addressing community health needs. Further research is needed to understand the role of community hospitals in influencing local health delivery system activities regarding the potential community benefits and their impact on improving health of local populations.
Regional differences among employed nurses: A Queensland study
Authors: Henwood Tim , Eley Robert , Parker Deborah , Tuckett Anthony , Hegney Desley 
Published: July 2009

AbstractObjective:  To ascertain differences in the working lives of geographically dispersed nurses. Design:  Cross‐sectional. Setting:  Registered, enrolled and assistants‐in‐nursing members of the Queensland Nurses' Union employed in nursing in Queensland, Australia. Participants:  A total of 3000 members of the Union, equally stratified by sector (public, private, aged care). Among them, 1192 responded and 1039 supplied postcodes matching the Australian Standard Geographical Classification. Main outcome measures:  Statistically significant differences in working lives of nurses employed in different geographical locations. Results:  Nurses in outer regional/remote/very remote localities are more likely to be employed as permanent full‐time staff and self‐report higher levels of work stress. These levels could be explained by: lack of replacement staff for leave, longer working and on call hours and lack of support for new staff. Distance remains a major barrier to accessing continuing professional education. However, outer regional/remote/very remote nurses were more likely to be provided employer support for professional education. Inner regional nurses were more likely to work part time, would work more hours if offered and were more likely to have taken a break from nursing as a result of family commitments. Conclusion:  The data confirm that current policies are not addressing the differences in the working lives of geographically dispersed nurses. Policies addressing orientation, mentoring and workloads should be implemented to address these issues.
What stresses remote area nurses? Current knowledge and future action
Authors: Lenthall Sue , Wakerman John , Opie Tess , Dollard Maureen , Dunn Sandra , Knight Sabina , MacLeod Martha , Watson Colin 
Published: July 2009

AbstractObjective:  Review and synthesise the literature identifying the stresses experienced by remote area nurses (RANs). Identify interventions implemented to address identified stresses. Explore the use of the job demands–resources (JD‐R) model. Methods:  A comprehensive literature review was conducted using the meta‐databases Ovid and Informit. Setting:  Remote Australian primary health care centres. Results:  The reported demands experienced by RANs can be grouped into four themes: (i) the remote context; (ii) workload and extended scope of practice; (iii) poor management; and (iv) violence in the workplace and community. In this high‐demand, low‐resource context, the JD‐R model of occupational stress is particularly pertinent to examining occupational stress among RANs. The demands on RANs, such as the isolated geographical context, are immutable. However, there are key areas where resources can be enhanced to better meet the high level of need. These are: (i) adequate and appropriate education, training and orientation; (ii) appropriate funding of remote health services; and (iii) improved management practices and systems. Conclusion:  There is a lack of empirical evidence relating to stresses experienced by RANs. The literature identifies some of the stresses experienced by RANs as unique to the remote context, while some are related to high demands coupled with a deficit of appropriate resources. Use of models, such as the JD‐R model of occupational stress, might assist in identifying key areas where resources can be enhanced to better meet the high level of need and reduce RANs' levels of stress.
Review article: Coagulation cascade and therapeutics update: Relevance to nephrology. Part 1: Overview of coagulation, thrombophilias and history of anticoagulants
Authors: ADAMS REBECCA L C , BIRD ROBERT J 
Published: July 2009

SUMMARYCoagulation involves the regulated sequence of proteolytic activation of a series of zymogens to achieve appropriate and timely haemostasis in an injured vessel, in an environment that overwhelmingly favours an anticoagulant state. In the non‐pathological state, the inciting event involves exposure of circulating factor VII/VIIa to extravascularly expressed tissue factor, which brings into motion the series of steps which results in amplification of the initial stimulus, culminating in the conversion of fibrinogen to fibrin and clot formation. The precisely synchronized cascade of events is counter‐balanced by a system of anticoagulant mechanisms, which serve to ensure that the haemostatic effect is regulated and does not extend inappropriately. Conversely, in pathological states, these events can escape normal control mechanisms, due to either inherited or acquired defects, which lead to thrombosis. Current anticoagulant therapy, although based on medications that have been in existence for upwards of 80 years, is moving towards targeted therapy for specific coagulation factors and events in the coagulation cascade, based on the current knowledge of the main triggers and key events within the series of reactions that culminates in haemostasis. It remains to be seen whether these newer medications will become first‐line therapies for thrombosis in the coming decade. This review aims to elucidate the main events within the coagulation cascade as it is currently understood to operate in vivo, with a brief discussion focusing on hypercoagulable states, and also a short review of the history of anticoagulants as they relate to this model.
Associations between functional tooth number and physical complaints of community‐residing adults in a 15‐year cohort study
Authors: Fukai Kakuhiro , Takiguchi Toru , Ando Yuichi , Aoyama Hitoshi , Miyakawa Youko , Ito Gakuji , Inoue Masakazu , Sasaki Hidetada 
Published: July 2009

Background:  Oral function influences various general health and organ diseases. We wondered if physical complaints of unknown origin were related to oral function.Methods:  Five thousand five hundred and eighty‐four community residents (2206 men and 3378 women, aged 40–89 years) on the Miyako Islands, Okinawa Prefecture, Japan, were recruited for the baseline study in 1987 and followed up for 15 years. Physical complaints and functional tooth numbers were assessed for the baseline study in 1987 by dentists and followed up for 15 years. Physical complaints of unknown origin included shoulder stiffness, lower back pain, pain of upper extremity, pain of lower extremity, neuralgia, ear ringing, difficult of hearing, dizziness and sleeping difficulties.Results:  Physical complaints were significantly associated with functional tooth number in the baseline study. There were no systematic differences between physical complaints and functional tooth number among different age groups. Physical complaints did not influence the survival rates in either men or women.Conclusion:  Oral function may be related to physical complaints. Dental care may be one of the targets to treat these physical complaints of unknown origin.
Comprehensive geriatric assessment of elderly highlanders in Qinghai, China I: Activities of daily living, quality of life and metabolic syndrome
Authors: Matsubayashi Kozo , Kimura Yumi , Sakamoto Ryota , Wada Taizo , Ishimoto Yasuko , Hirosaki Mayumi , Konno Akiko , Chen Wingling , Ishine Masayuki , Kosaka Yasuyuki , Wada Chizu , Nakatsuka Masahiro , Otsuka Kuniaki , Fujisawa Michiko , Wang Hongxing , Dai Qingxiang , Yang Airong , Gao Jidong , Li Zhanquan , Qiao Haisheng , Zhang Yongshou , Ge Ri Li , Okumiya Kiyohito 
Published: July 2009

Aim:  To reveal the comparison of comprehensive geriatric functions of elderly highlanders in Qinghai Plateau in China among three different ethnic groups.Methods:  Activities of daily living (ADL), screening‐based depression, quality of life (QOL) and checking‐up of metabolic syndrome including community‐based oral glucose tolerance test were assessed in 393 community‐dwelling elderly subjects aged 60 years or more (247 Han elderly subjects, 49 Mongolian ones and 97 Tibetan ones).Results:  Tibetan elderly highlanders were more disabled in ADL, but had higher QOL than Han elderly ones in Qinghai Plateau. Blood pressure measurements, rate of hypertension and hemoglobin concentrations in Tibetan elderly highlanders were lower than Han ones. Rates of diabetes and impaired glucose tolerance in elderly highlanders were relatively lower than other Asian elderly lowlanders.Conclusion:  Prevalence of metabolic syndrome in elderly highlanders in Qinghai was still not high, however, we should pay attention to its tendency related with socialglobalism in the near future. Further investigation on physiological adaptability to hypoxic environment and human ageing phenomena in a global context may open a new research frontier for ageing science.
Shrub encroachment can reverse desertification in semi‐arid Mediterranean grasslands
Authors: Maestre Fernando T. , Bowker Matthew A. , Puche María D. , Belén Hinojosa M. , Martínez Isabel , García‐Palacios Pablo , Castillo Andrea P. , Soliveres Santiago , Luzuriaga Arántzazu L. , Sánchez Ana M. , Carreira José A. , Gallardo Antonio , Escudero Adrián 
Published: July 2009

AbstractThe worldwide phenomenon of shrub encroachment in grass‐dominated dryland ecosystems is commonly associated with desertification. Studies of the purported desertification effects associated with shrub encroachment are often restricted to relatively few study areas, and document a narrow range of possible impacts upon biota and ecosystem processes. We conducted a study in degraded Mediterranean grasslands dominated by Stipa tenacissima to simultaneously evaluate the effects of shrub encroachment on the structure and composition of multiple biotic community components, and on various indicators of ecosystem function. Shrub encroachment enhanced vascular plant richness, biomass of fungi, actinomycetes and other bacteria, and was linked with greater soil fertility and N mineralization rates. While shrub encroachment may be a widespread phenomenon in drylands, an interpretation that this is an expression of desertification is not universal. Our results suggest that shrub establishment may be an important step in the reversal of desertification processes in the Mediterranean region.
Lifestyle of Lactobacillus plantarum in the mouse caecum
Authors: Marco Maria L. , Peters Theodorus H. F. , Bongers Roger S. , Molenaar Douwe , Van Hemert Saskia , Sonnenburg Justin L. , Gordon Jeffrey I. , Kleerebezem Michiel 
Published: July 2009

Summary Lactobacillus plantarum is a common inhabitant of mammalian gastrointestinal tracts. Strains of L. plantarum are also marketed as probiotics intended to confer beneficial health effects upon delivery to the human gut. To understand how L. plantarum adapts to its gut habitat, we used whole genome transcriptional profiling to characterize the transcriptome of strain WCFS1 during colonization of the caeca of adult germ‐free C57Bl/6 J mice fed a standard low‐fat rodent chow diet rich in complex plant polysaccharides or a prototypic Western diet high in simple sugars and fat. Lactobacillus plantarum colonized the digestive tracts of these animals to high levels, although L. plantarum was found in 10‐fold higher amounts in the caeca of mice fed the standard chow. Metabolic reconstructions based on the transcriptional data sets revealed that genes involved in carbohydrate transport and metabolism form the principal functional group that is upregulated in vivo compared with exponential phase cells grown in three different culture media, and that a Western diet provides a more nutritionally restricted, growth limiting milieu for the microbe in the distal gut. A set of bacterial genes encoding cell surface‐related functions were differentially regulated in both groups of mice. This set included downregulated genes required for the d‐alanylation of lipoteichoic acids, extracellular structures of L. plantarum that mediate interactions with the host immune system. These results, obtained in a reductionist gnotobiotic mouse model of the gut ecosystem, provide insights about the niches (professions) of this lactic acid bacterium, and a context for systematically testing features that affect epithelial and immune cell responses to this organism in the digestive tract.
Host–virus shift of the sphingolipid pathway along an Emiliania huxleyi bloom: survival of the fattest
Authors: Pagarete António , Allen Michael J. , Wilson William H. , Kimmance Susan A. , De Vargas Colomban 
Published: July 2009

SummaryThe interactions between viruses and phytoplankton play a key role in shaping the ecological and evolutionary dynamics of oceanic ecosystems. One of the most fascinating examples of horizontal gene transfer between a eukaryotic host and its virus is a de novo sphingolipid biosynthesis pathway (SBP) found in the genomes of both Emiliania huxleyi and its coccolithovirus EhV‐86. Here, we focus on a natural E. huxleyi/coccolithovirus system off the coast of Norway and investigate the dynamics of host and virus homologous gene expression for two of the most important sphingolipid biosynthesis enzymes, serine palmitoyl transferase (SPT) and dihydroceramide desaturase (DCD). Transcriptional dynamics display three defined stages along E. huxleyi bloom formation and decline, with the coccolithovirus transcripts taking over and controlling the SBP in stages 2 and 3. The observed patterns fit the hypothesis according to which viral sphingolipids are involved in the timing and physical processes of virion release from the host cells. This study provides a unique insight into the transcriptional interplay of homologous metabolic pathways between virus and host during temporal progression of oceanic E. huxleyi blooms.