bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative efficacy of two nit combs in removing head lice (Pediculus humanus var. capitis) and their eggs
Authors: Speare Rick , Canyon Deon V. , Cahill Christine , Thomas Genelle 
Published: August 2010

AbstractBackground  Fine tooth lice combs fall into two classes based on the material from which their teeth are made: plastic or metal. Metal combs are further divided into those that are made from a flat sheet of metal, and hence have rectangular teeth, and those that have cylindrical teeth embedded in a plastic base.Methods  The efficacy of two fine tooth combs [Lice Meister comb (metal) and Lady Jayne comb (plastic)] in removing head lice (Pediculus humanus var. capitis) and their eggs from the hair of children was evaluated after treatment with a viscous head lice product (Lice Blaster; Emerald Forest Pharmaceuticals Pty Ltd, Currumbin, Qld, Australia). The hair of 27 children was divided into two sections sagitally, and each comb was randomly assigned to one half of the hair, and the lice and eggs removed by the combs were counted.Results  In 96% of subjects, the Lice Meister comb removed more eggs than the Lady Jayne comb, with an average of three to four times more hatched, dead, and live eggs removed. The Lice Meister comb removed more lice than the Lady Jayne comb in 10 subjects, the same in eight subjects, and less in nine subjects.Conclusion  Overall, the Lice Meister comb is recommended as a more effective comb for use in controlling head lice infestations, whether employed with conditioner or with insecticide treatment. This appears to be the first study investigating the efficacy of nit combs in vivo. Further research is needed to determine which characteristics of fine tooth combs are the most important in removing head lice eggs.
Pheohyphomycosis caused by Exophiala spinifera: a rare occurrence
Authors: Singal Archana , Pandhi Deepika , Bhattacharya Sambit N. , Das Shukla , Aggarwal Sarla , Mishra Kiran 
Published: August 2010

AbstractA 10‐year‐old immunocompetent boy presented with multiple, verrucous, disseminated pheohyphomycotic lesions caused by Exophiala spinifera. The patient was not responsive to combination antifungal therapy (itraconazole, terbinafine, fluconazole) and cryotherapy. As antifungal susceptibility is known to be variable for Exophiala spinifera, in vitro sensitivity testing is recommended before medical treatment. This article reviews, in brief, all cases documented so far in the English literature.
Current status of HIV infection: a review for non‐HIV‐treating physicians
Authors: Knoll Bettina , Lassmann Britta , Temesgen Zelalem 
Published: August 2010

AbstractAn estimated 40 million people live with human immunodeficiency virus (HIV) globally, and over four million people were newly diagnosed with HIV infection in 2006. Twenty‐five million people have died as a result of HIV since its recognition in 1981. Where available, highly active antiretroviral therapy has resulted in significant decreases in HIV‐associated morbidity and mortality. Nevertheless, opportunistic infections and conditions continue to occur, and their recognition and management continue to be an important component of HIV care.
Herpes zoster‐associated voiding dysfunction in hematopoietic malignancy patients
Authors: Imafuku Shinichi , Takahara Masakazu , Uenotsuchi Takeshi , Iwato Koji , Furue Masutaka 
Published: August 2010

AbstractBackground  Voiding dysfunction is a rare but important complication of lumbo‐sacral herpes zoster. Although the symptoms are transient, the clinical impact on immunocompromised patients cannot be overlooked.Methods  To clarify the time course of voiding dysfunction in herpes zoster, 13 herpes zoster patients with voiding dysfunction were retrospectively analyzed.Results  Of 13 patients, 12 had background disease, and six of these were hematopoietic malignancies; four of these patients were hematopoietic stem cell transplant (HSCT) recipients. Ten patients had sacral lesions, two had lumbar, and one had thoracic lesions. Interestingly, patients with severe rash, or with hematopoietic malignancy had later onset of urinary retention than did patients with mild skin symptoms (Mann–Whitney U analysis, P = 0.053) or with other background disease (P = 0.0082). Patients with severe skin rash also had longer durations (P = 0.035). In one case, acute urinary retention occurred as late as 19 days after the onset of skin rash.Conclusions  In immune compromised subjects, attention should be paid to patients with herpes zoster in the lumbo‐sacral area for late onset of acute urinary retention even after the resolution of skin symptoms.
Increased insulin‐like growth factor binding protein‐3 expression level in psoriatic tissue before and after systemic treatment with cyclosporine A and methotrexate
Authors: Özden Müge Güler , İlter Nilsel , Suer Özlem Erdem , Solaktekin Nilgün , Gürer Mehmet Ali 
Published: August 2010

AbstractInsulin‐like growth factor (IGF) and its binding proteins (BPs) are candidates to play a role in the pathogenesis of psoriasis. IGF‐I and ‐II and their binding proteins (IGFBPs) have both growth inhibitory and mitogenic effects on a multitude of cell types. Current studies have explored the potential role of IGFBP‐3 in keratinocyte growth and differentiation. To gain more insight into the role of IGFBP‐3 in the pathogenesis of psoriasis, we investigated the changes in IGFBP‐3 expression levels in psoriatic plaque and compared these expressions with levels in other inflammatory skin diseases. In particular, we investigated whether or not the changes in IGFBP‐3 were affected by systemic treatment with cyclosporine A (CsA) or methotrexate (Mtx). We found significantly increased IGFBP‐3 expression levels in the psoriatic group compared with levels in patients with other, nonproliferative inflammatory skin diseases, and we demonstrated differences in distribution pattern before and after systemic treatment with Mtx or CsA. Mtx and CsA had no effect on tissue IGFBP‐3 expression levels. Before treatment with Mtx or CsA, IGFBP‐3 expression was limited to the basal layer and suprapapillary region. Unlike with Mtx, CsA significantly changed the IGFBP‐3 distribution pattern.
Anticonvulsant hypersensitivity syndrome: clinical and laboratory features
Authors: Mansur Ayşe Tülin , Pekcan Yaşar Şirin , Göktay Fatih 
Published: August 2010

AbstractBackground  Anticonvulsant hypersensitivity syndrome (AHS) is a severe adverse drug reaction with multiorgan involvement. Aromatic anticonvulsants are the most frequently involved drugs. This study was aimed to highlight the clinical and laboratory findings of AHS.Methods  The medical records of 31 patients diagnosed as AHS in a 12‐year period were evaluated retrospectively.Results  The syndrome was related to carbamazepine in 48.38%, phenytoin in 35.48%, lamotrigine in 9.6% and cotreatment with lamotrigine and valproic acid in 6.45% of cases. Symptoms appeared 2–86 (mean: 35.96) days after ingestion of the offending agent. The type of skin rash was maculopapular and/or erythrodermic in 77.42% of patients, bullous in 19.35%, and erythematopustular in 3.22%. Fever and peripheral lymphadenopathy were detected in 61.29% and 54.82% of cases, respectively. Laboratory investigations revealed elevation of hepatic enzymes in 70.96%, leucocytosis in 43.3%, and peripheral eosinophilia in 64.3% of patients.Conclusions  Our analysis showed that carbamazepine and phenytoin are still the major causes of AHS, with lamotrigine being the third etiologic agent. Valproic acid and benzodiazepines are safe alternatives of the causative anticonvulsants. As there are yet no strict diagnostic criteria, the constellation of clinical and laboratory features that occur within 3 months of the associated anticonvulsant agents helps to recognize the disorder. The risk of seizure due to withdrawal or changing of the anticonvulsant drug and the potentially serious clinical features often necessitates providing care and treatment in an inpatient setting.
Psychological stress, endocrine and immune response in patients with lichen planus
Authors: Krasowska Dorota , Pietrzak Aldona , Surdacka Agata , Tuszyńska‐Bogucka Violetta , Janowski Konrad , Roliński Jacek 
Published: August 2010

AbstractBackground  Lichen planus still remains a disease of unclear etiology. Inconclusive reports exist on the role of stress the pathophysiological mechanisms involved in this disease. The objective of this study was to find associations between levels of stress and indices of the endocrine and immune response in patients with lichen planus.Methods  A total of 57 patients with lichen planus and 27 healthy control volunteers took part in the study. All participants completed questionnaires measuring the frequency of stressful life events. Blood samples were collected and analyzed for levels of endocrine and immune parameters: neopterin, cortisol, interleukin (IL)‐2, IL‐6, IL‐18, soluble IL‐2 receptor (sIL‐2R), sIL‐6R, sFasL, T lymphocyte antigens CD3, CD4, CD8, CD25, CD69, HLA‐DR, CD16/56, CD45RO and CD45RA.Results  Patients differed significantly from the controls in the levels of neopterin (but not cortisol), expression of CD25, CD16, CD8, and CD45RA antigens on T lymphocytes. Patients had also significantly higher levels of sIL‐2R, sFasL, sIL‐6R and IL‐18 than healthy controls. Patients and controls did not differ in the overall frequency of stressful life events experienced over 1 year prior to the study. However, two subgroups of patients with various stress levels differed significantly in the expression of CD25, HLA‐DR, CD45RO, and CD45RA on T lymphocytes.Conclusions  Our findings suggest that stress may alter numerous parameters of endocrine and immune response in lichen planus, which provides support for its role in the etiopathogenesis of this disease.
Bronchial blocker compared to double‐lumen tube for one‐lung ventilation during thoracoscopy
Authors: Bauer C. , Winter C. , Hentz J. G. , Ducrocq X. , Steib A. , Dupeyron J. P. 
Published: August 2010

Background: Video‐assisted thoracoscopic surgery (VATS) requires one‐lung ventilation with a properly collapsed lung. This study compared the Broncho‐Cath double‐lumen endotracheal tube with the Wiruthan bronchial blocker to determine the advantages of one device over the other during anaesthesia with one‐lung ventilation for thoracoscopy.Methods: Thirty‐five patients undergoing VATS were randomly assigned to one of two groups. Sixteen patients received a left‐sided double‐lumen tube (DLT) and nineteen a Wiruthan bronchial blocker (BB). The BB group was subdivided in two: BB in the right mainstem bronchus (BBR) for right‐sided VATS (9 patients), BB in the left mainstem bronchus (BBL) for left‐sided VATS (10 patients). The position of the devices was checked using a fibreoptic bronchoscope. The following variables were measured: 1) number of unsuccessful placement attempts; 2) number of malpositions of the devices; 3) time required to place the device in the correct position; 4) number of secondary dislodgements of the devices after turning the patient into the lateral decubitus position. The quality of lung deflation was evaluated by the surgeons who were blinded to the type of tube being used.Results: The number of unsuccessful placement attempts was one in the DLT group (1/16), three in the BBL group (3/10) and none in the BBR group (0/9). The number of malpositions was significantly greater in the BBL group (10/10) compared to the DLT group (2/16) and to the BBR group (1/9) (P<0.001). The time (mean±SD) required to place a BBL was 4.21 min±1.28, significantly longer than the time required to place a DLT (2.26 min±0.55, P<0.0006) or a BBR (2.41 min±0.53, P<0.008). The difference in placement time between DLT and BBR was not significant. The number of secondary dislodgements was one in the DLT group, one in the BBR group and none in the BBL group (NS). The quality of lung deflation was judged excellent or fair in all patients in the DLT and the BBL groups and poor in 44% of the patients in the BBR group.Conclusion: It took significantly longer to place a left BB than a DLT (P<0.0006) or a right BB (P<0.008). The number of initial malpositionings of the left BB was significantly greater than in the other groups (P<0.001). The quality of lung deflation was better in the BBL and in the DLT groups than in the BBR group. We conclude that for routine use during left‐sided VATS, the use of a DLT is preferable to a left BB because of its greater ease of placement. For right‐sided VATS, DLT and right BB showed the same facility of placement but the DLT provided a better quality of lung deflation.
Plasma lidocaine levels and risks after liposuction with tumescent anaesthesia
Authors: Nordström H. , Stånge K. 
Published: August 2010

Background:  It is common today to use tumescent anaesthesia with large doses of lidocaine for liposuction. The purpose of the present study was to evaluate lidocaine plasma levels and objective and subjective symptoms during 20 h after tumescent anaesthesia with approximately 35 mg per kg bodyweight of lidocaine for abdominal liposuction.Methods:  Three litres of buffered solution of 0.08% lidocaine with epinephrine was infiltrated subcutaneously over the abdomen in eight female patients during monitored intravenous (i.v.) light sedation. Plasma levels of lidocaine and signs of subjective and objective symptoms were recorded every 3 h for 20 h after liposuction.Results:  Lidocaine 33.2 ± 1.8 mg/kg was given at a rate of 116 ± 11 ml/min. Peak plasma levels (2.3 ± 0.63 µg/ml) of lidocaine occurred after 5–17 h. No correlation was found between peak levels and dose per kg bodyweight or total amount of lidocaine infiltrated. One patient experienced tinnitus after 14 h when a plasma level of 3.3 µg/ml was recorded.Conclusion:  Doses of lidocaine up to 35 mg/kg were sufficient for abdominal liposuction using the tumescent technique and gave no fluid overload or toxic symptoms in eight patients, but with this dose there is still a risk of subjective symptoms in association with the peak level of lidocaine that may appear after discharge.
Effect of levosimendan on ventriculo‐arterial coupling in patients with ischemic cardiomyopathy
Authors: Guarracino F , Cariello C , Danella A , Doroni L , Lapolla F , Stefani M , Baldassarri R , Vullo C 
Published: August 2010

Background:  Levosimendan, a novel calcium sensitizer, enhances myocardial contractility without affecting intracellular calcium concentration. It also dilates peripheral arterial vessels by acting on ATP‐dependent K+ channels. Ventriculo‐arterial coupling, the relationship between myocardial contractility and the arterial system, describes the efficiency of the cardiovascular system by analysing the relationship between myocardial contractility expressed by ventricular elastance (Ees) and arterial elastance (Ea). The aim of this prospective clinical investigation was to evaluate the effects of levosimendan on ventriculo‐arterial coupling in patients with ischemic cardiomyopathy.Methods:  Fifteen patients with stable angina and left ventricular dysfunction underwent elective coronary surgery. Before surgery started, ventriculo‐arterial coupling and several variables of cardiovascular performance were assessed by invasive monitoring and transoesophageal echocardiography before and after administration of levosimendan (12 μg/kg bolus) in coronary patients under general anesthesia.Results:  The cardiac index and ejection fraction increased significantly [from 1.92 ± 0.4 to 2.1 ± 0.4 l/min/m2 (P = 0.0004) and from 31% ± 6 to 40% ± 9 (P = 0.001), respectively], while mean arterial pressure and systemic vascular resistances decreased significantly [from 83 ± 10 to 72 ± 5 mmHg (P = 0.0016) and from 997 ± 341 to 855 ± 324 dyne s/cm5 (P = 0.0002), respectively]. After administration of levosimendan, Ea decreased significantly (from 4.3 ± 1.8 to 3.2 ± 1.3 mmHg/ml/m2, P= 0.005), while Ees significantly increased (from 2.8 ± 1.6 to 4.4 ± 2.3 mmHg/ml/m2, P= 0.05); as a result, Ea/Ees decreased significantly (from 1.76 ± 1 to 0.83 ± 0.2, P= 0.002).Conclusion:  Levosimendan improves ventriculo‐arterial coupling and cardiovascular performance in coronary patients with left ventricular dysfunction by enhancing myocardial contractility and reducing arterial elastance.
Tracheostomy: current practice on timing, correction of coagulation disorders and peri‐operative management – a postal survey in the Netherlands
Authors: Veelo D. P. , Dongelmans D. A. , Phoa K. N. , Spronk P. E. , Schultz M. J. 
Published: August 2010

Background:  Several factors may delay tracheostomy. As many critically ill patients either suffer from coagulation abnormalities or are being treated with anticoagulants, fear of bleeding complications during the procedure may also delay tracheostomy. It is unknown whether such (usually mild) coagulation abnormalities are corrected first and to what extent. The purpose of this study was to ascertain current practice of tracheostomy in the Netherlands with regard to timing, pre‐operative correction of coagulation disorders and peri‐/intra‐operative measures.Methods:  In October 2005, a questionnaire was sent to the medical directors of all non‐pediatric ICUs with ≥5 beds suitable for mechanical ventilation in the Netherlands.Results:  A response was obtained from 44 (64%) out of 69 ICUs included in the survey. Seventy‐five percent of patients receive tracheostomy within 2 days after the decision to proceed with a tracheostomy. Reasons indicated as frequent causes for delay were most often logistical factors. A heterogeneous attitude exists regarding values of coagulation parameters acceptable to perform tracheostomy. Fifty percent of the respondents have no guideline on correction of coagulation disorders or anticoagulant therapy before tracheostomy. Antimicrobial prophylaxis is almost never administered before tracheostomy. Forty‐eight percent mentioned always using endoscopic guidance and 66% of ICUs only perform chest radiography on indication.Conclusions:  There is a high variation in peri‐ and intra‐operative practice of tracheostomy in the Netherlands. Especially on the subject of coagulation and tracheostomy there are different opinions and protocols are often lacking.
The effects of vasoactive agents, platelet agonists and anticoagulation on thrombelastography
Authors: Kawasaki J. , Katori N. , Taketomi T. , Terui K. , Tanaka K. A. 
Published: August 2010

Background:  Platelet activation is a critical step in primary hemostasis and clot formation. We tested a hypothesis that platelet stimulating effects of vasoactive agents or platelet agonists could be shown using thrombelastography (TEG®) as faster onset or increased clot strength. We further examined if TEG® could be modified to evaluate activated platelets as a reversal of anticoagulation in the presence of partial thrombin inhibition.Methods:  Blood samples were obtained from 126 non‐cardiac surgical patients. Effects of vasoactive agents on TEG® and aggregometry were examined using epinephrine, norepinephrine, vasopressin, desmopressin acetate, milrinone and olprinone (Experiment I). Platelet agonists (epinephrine, ADP and collagen) were separately tested on TEG® (Experiment II). Effects of platelet agonists (ADP and collagen) on TEG® under anticoagulation in the absence or presence of abciximab were studied (Experiment III). We also tested antiplatelet effects of milrinone and olprinone in the presence of anticoagulants on TEG® (Experiment IV).Results:  Neither vasoactive agents nor platelet agonists affected TEG® or aggregometry results except for milrinone and olprinone on aggregometry (Experiment I, II). Platelet agonists facilitated clotting in the presence of anticoagulants (Experiment III). Abciximab‐treated platelets still exhibited procoagulant effects in the presence of heparin, while not in the presence of argatroban (Experiment III). Platelet inhibition on the modified TEG® was more extensive with milrinone than olprinone, and it was dose dependent (Experiment IV).Conclusion:  Modified TEG® using heparin or argatroban might delineate the procoagulant effects of platelets by adding platelet specific agonist.
Prospective randomized comparison of the new Laryngeal Tube Suction LTS II and the LMA‐ProSeal for elective surgical interventions
Authors: Genzwuerker H. V. , Altmayer S. , Hinkelbein J. , Gernoth C. , Viergutz T. , Ocker H. 
Published: August 2010

Background and aim:  The Laryngeal Tube Suction (LTS) has recently undergone considerable changes in design. The new LTS II was compared with the LMA‐ProSeal to determine device performance during general anaesthesia and controlled ventilation.Methods:  After Institutional Review Board approval, 100 elective surgical patients were randomized to be ventilated with LTS II or LMA‐ProSeal. The number of attempts (maximum of two, and then other device tested) and time until first tidal volume were recorded. Ventilation was standardized (tidal volume, 7 ml/kg; respiratory rate, 12 breaths/min) and the resulting end‐tidal CO2 was recorded. The airway leak pressure (maximum of 40 cmH2O) was measured at cuff pressures of 60 cmH2O. The ease of gastric tube insertion was evaluated. The devices were inspected for traces of blood after removal. Patients were questioned regarding post‐operative complaints. The Mann–Whitney U‐test was used to compare the groups.Results:  The demographic data, American Society of Anesthesiologists’ group, Mallampati score, and haemodynamic and respiratory variables were comparable for both groups of 50 patients. Insertion was successful in the first/second attempts in 44/4 patients for LTS II and in 43/6 patients for LMA‐ProSeal. After two failed attempts, the other device was successfully used in one patient for LMA‐ProSeal and in two patients for LTS II. The times until first tidal volume for LTS II and LMA‐ProSeal were 25.0 ± 10.1 and 25.5 ± 11.5 s, respectively. The airway leak pressures were comparable: 33.1 (15–40) and 32.0 cmH2O (18–40 cmH2O) for LTS II and LMA‐ProSeal, respectively. Gastric tube insertion failed in two patients in each group. Traces of blood were found in two patients with LTS II and in three patients with LMA‐ProSeal. In both groups, post‐operative complaints were mild and infrequent.Conclusion:  In this prospective randomized trial, LMA‐ProSeal and LTS II were comparable in all respects.
Brain damage following severe acute normovolemic hemodilution in combination with controlled hypotension in rats
Authors: Ge Y. L. , Lv R. , Zhou W. , Ma X. X. , Zhong T. D. , Duan M. L. 
Published: August 2010

Background and aim:  The reduced oxygen content and perfusion pressure during acute normovolemic hemodilution (ANH) and controlled hypotension (CH) raise concerns about hypoperfusion and ischemic injury to the brain. In this study on rats, we examined the brain damage following four different degrees of ANH combined with CH.Methods:  Forty rats were randomly assigned to receive a sham operation or CH and ANH [with a hematocrit (Hct) of 30, 25, 20 or 15%]. ANH was performed after baseline physiological parameters had been monitored for 20 min; 30 min later, CH was induced using sodium nitroprusside, and the mean arterial blood pressure was maintained at 50–60 mmHg for 1 h. Rats were killed 3.5 h after hemodilution. Ultrastructural alterations in the CA1 region of the rat hippocampus were observed, and serum concentrations of S100B and neuron‐specific enolase (NSE) were measured before and after ANH.Results:  The serum S100B concentration increased significantly in the Hct 20% + CH and Hct 15% + CH groups. However, there were no significant differences in the serum levels of NSE between the groups. In the CA1 region of the rat hippocampus, marked ultrastructural alterations, such as mitochondrial denaturalization and nucleus distortion, were observed in the Hct 20% + CH and Hct 15% + CH groups.Conclusion:  Severe ANH (Hct ≤ 20%) combined with CH may induce cerebral damage, as confirmed by marked ultrastructural alterations in the CA1 region of the rat hippocampus and significantly increased serum levels of S100B, and should be avoided.