bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acne on pigmented skin
Authors: Poli Florence 
Published: October 2007

AbstractAcne on pigmented skin occurs in Africans and their descendants, as well as in patients with a skin phototype above IV. Acne is common in Africans and is often the primary reason for consulting a dermatologist. Acne on pigmented skin is principally inflammatory acne. The sequelae in terms of pigmentation are often the main reason for consulting a dermatologist, and take precedence over the acne itself. Research is needed into cosmetic acne and steroid‐induced dermatitis, which are common in users of skin bleaching products.The treatment for acne in pigmented skin involves the same medicines as used in acne in white skin. Of the available topical treatments, benzoyl peroxide is particularly effective for the inflammatory component. Retinoids act on both the retentional and inflammatory components of acne and have skin bleaching properties. Tetracyclines are essential on initiation of treatment, regardless of severity. They prevent an inflammatory episode at the onset of acne and rapidly improve the inflammatory component. Minocycline should not be prescribed in African patients. Fatal cases of hypersensitivity have been described, with a particular frequency in this population. Doxycycline is effective, but has photosensitizing properties. Lymecycline is well tolerated. Isotretinoin is indicated for nodular acne. The same precautions for use should be followed as in all cases of acne. The skin bleaching effects are considerable. Photoprotection should generally be imposed, but, in patients with black skin, photoprotective agents are often not applied. The administration of a cosmetic containing a skin bleaching agent combined with a photoprotective agent for application in the morning, instead of hydrating cream, is acceptable to patients, improves compliance, and is effective.
Dermatosis papulosa nigra in Dakar, Senegal
Authors: Niang Suzanne Oumou , Kane Assane , Diallo Moussa , Choutah Flavienne , Dieng Mame Tierno , Ndiaye Bassinou 
Published: October 2007

AbstractBackground  Dermatosis papulosa nigra (DPN) is a benign epithelial tumour, common in the black population. It is a special topographic form of ethnic seborrheic keratosis, which is more common in the white population. Its benign character has meant that very few studies have been performed. In Senegal, no investigation has been carried out to date.Aim  To determine the epidemiologic and semiological characteristics of DPN, and the aesthetic results of DPN exeresis.Methods  A prospective study was carried out over a period of 6 months (November 2005 to April 2006) at the Dermatology Department, Le Dantec CHU, Dakar, Senegal. The diagnosis of DPN was clinical. If desired, exeresis of the lesions by fine‐needle or fine‐scissor electrosurgery was carried out, and the results were evaluated over a period of 6 weeks.Results  Thirty patients were evaluated: 21 women and nine men. The average age was 39.8 years (range, 25–70 years). A family predisposition was found in 93.3% of cases. The average age of onset of the lesions was 22 years, with a progressive increase in size and number. The lesions appeared initially on the face and then spread to all photoexposed areas. The lesions were profuse, numbering between 50 and 100 in 66.6% of cases, and coalesced to form plaques in 26.6%. In other cases, the lesions were papular, pediculate, or wide‐based brown to deep black in colour, and with a keratotic appearance. Eight of the 21 women practiced artificial depigmentation and presented with profuse lesions. Aesthetic problems were found in 60% of patients. When performed, exeresis was satisfactory without scarring in 60% of cases at day 45. Hypochromic scars persisted in four patients who practiced artificial depigmentation and in one who had been treated with carbon dioxide snow.Conclusion  This study on 30 cases of DPN is the first in Senegal. The classic female predominance, family predisposition, and photodistribution of the lesions were found. The lesions were profuse, with a background of artificial depigmentation. This suggests that the sun may be an etiopathogenic factor. Aesthetic problems are an indication for ablation of the lesions using a method that minimises the risk of scarring. Artificial depigmentation may cause delayed healing and dyschromic scars, as may the application of carbon dioxide snow.
Development and evaluation of a decision aid for patients considering first‐line chemotherapy for metastatic breast cancer
Authors: Chiew Kimberly S. , Shepherd Heather , Vardy Janette , Tattersall Martin H.N. , Butow Phyllis N. , Leighl Natasha B. 
Published: October 2007

AbstractObjective  Treatment decisions in advanced breast cancer are complex, with enhanced quality of life and survival among important treatment goals. Patients with metastatic breast cancer face the decision of whether or not to have chemotherapy, and many wish to be involved in this decision. We report the development and evaluation of a decision aid (DA) designed to assist patients facing this treatment decision.Design and sample  Women with metastatic breast cancer (n = 17) and medical oncologists in Australia and Canada (n = 7) were invited to evaluate the DA.Intervention  A DA was developed for patients with hormone‐resistant metastatic breast cancer considering chemotherapy. The DA presented options of supportive care, with or without chemotherapy. Potential benefits and side effects of different chemotherapy regimens, and evidence‐based prognostic estimates were described, and a values clarification exercise included.Main outcome measures  Patient questionnaires evaluating information and decision involvement preferences, attitudes toward the DA and oncologist feedback regarding attitudes toward the DA.Results  Seventeen patients participated; fifteen desired as much information about their illness as possible; sixteen wished to be actively involved in the decision‐making process. The majority rated the DA as highly acceptable, clear and informative, and would recommend it to others facing this treatment decision.Conclusion  This is the first DA for patients with advanced metastatic breast cancer considering chemotherapy. A randomized trial is underway to evaluate its role in clinical decision‐making.
Allergic sensitization to cat in childhood as major predictor of incident respiratory allergy in young adults
Authors: Schäfer T. , Wölke G. , Ring J. , Wichmann H.‐E. , Heinrich J. 
Published: October 2007

Background:  Little is known on the predictive value of sensitization to specific aeroallergens in children with respect to asthma and hay fever incidence in young adulthood. We followed the incidence of asthma and hay fever in children (mean age 11 years) over 9 years, and analyzed the predictive value of sensitization to five common aeroallergens.Methods:  Three consecutive surveys were conducted in East German school children. Specific IgE antibodies to birch and timothy grass pollen, house dust mite, cat, and cladosporium were measured. In 1207 out of the 2453 children, the 9‐year incidence of asthma and hay fever was assessed by reported doctors’ diagnoses. For sensitization, diagnostic parameters were determined and logistic regression analyses controlled for relevant confounders.Results:  A total of 176/78 incident hay fever/asthma cases occurred equaling a cumulative incidence of 1.93/0.86% per year. Incident asthma was associated with previous sensitization to cat [risk ratio (RR) 3.49, 1.57–7.74] and grass pollen (RR 1.79, 1.01–3.19), whereas incident hay fever was associated with each allergen, with grass pollen (RR 6.00, 4.04–8.90) and cat (RR 5.36, 2.87–9.99) exhibiting the strongest associations. When mutually adjusting for all allergens, sensitization to cat remained significantly associated with asthma and hay fever. The latter was also associated with sensitization to grass pollen. The highest positive predictive values for asthma and hay fever were obtained for cat sensitization (10/49 = 20.4% and 23/49 = 46.9%).Conclusions:  Childhood sensitization to cat and grass pollen predicts the incidence of asthma and hay fever in young adulthood. The predictive capacity differs by allergen and manifestation of atopy.
Natural rubber latex and chestnut allergy: cross‐reactivity or co‐sensitization?
Authors: Raulf‐Heimsoth M. , Kespohl S. , Crespo J. F. , Rodriguez J. , Feliu A. , Brüning Th. , Rihs H. P. 
Published: October 2007

Background:  Chestnut and natural rubber latex (NRL) allergy are often associated in the latex‐fruit syndrome.Aim of the study:  To establish whether the concurrent NRL and chestnut IgE antibody reactivity are the results of co‐sensitization or cross‐reactivity.Methods:  Sera from 19 patients with chestnut‐ and NRL‐specific IgE were selected and tested for reactivity with recombinant (r) latex allergens. Cross‐reactivity was explored by IgE‐inhibition experiments using chestnut or NRL allergens as solid phase on ImmunoCAP.Results:  IgE‐antibodies were detected to rHev b 6.01 (prohevein) in 58% of the sera, to rHev b 5 in 32%, to rHev b 12 in four of 13 sera, to rHev b 7.02 and rHev b 11 in four, and to rHev b 1 in two of 19 sera. rHev b 8‐IgE antibodies were found in nine sera (47%), whereas six displayed mono‐sensitization to rHev b 8 with regard to our test panel. Three of 16 sera showed IgE to cross‐reactive carbohydrate determinants. In most sera recognizing rHev b 5 and/or rHev b 6.01 as major allergens the IgE‐reactivity to NRL remained unaffected by chestnut extract and chestnut‐IgE remained unaffected by NRL extract. Conversely, in sera with rHev b 8 as dominant allergen IgE‐binding to NRL was nearly completely inhibited by chestnut and vice versa. IgE‐binding to rHev b 8 was abolished by chestnut extract.Conclusions:  Although patients have concomitant IgE antibody reactivity to chestnut and NRL, cross‐reactivity could be demonstrated mainly in those patients with IgE to Hev b 8 (profilin) from NRL.
Infrequent milk consumption plus being overweight may have great risk for asthma in girls
Authors: Mai X.‐M. , Becker A. B. , Sellers E. A. C. , Liem J. J. , Kozyrskyj A. L. 
Published: October 2007

Background:  Inadequate milk consumption and being overweight are each associated with asthma symptoms in children. Milk consumption has been inversely related to childhood overweight. Thus, being overweight may be a pathway or a confounder in milk–asthma relationship. A combination of both factors may be associated with greater risk of asthma than one factor alone.Methods:  This study included 246 children with allergist‐diagnosed asthma and 477 nonasthmatic controls at the age of 8–10 years. Information on milk consumption during the last 12 months was obtained from questionnaires. Being overweight was defined as body mass index ≥85th percentile. Being overweight as a possible pathway or confounder was formally tested. The odds ratio (OR) for combined infrequent milk consumption and being overweight in asthmatic vs nonasthmatic children was determined in multivariate logistic regression analyses.Results:  There was a significant interaction between milk consumption and sex of the child in relation to asthma. Asthma was significantly associated with infrequent milk consumption in girls (crude OR 2.11, 95% CI 1.05–4.24) but not in boys. The asthma–milk relation in girls was neither mediated by being overweight (pmediation tests = 0.27) nor was the relationship confounded by being overweight (a 9% change in coefficient). Asthmatic girls had 3.6 times increased odds of having combination of infrequent milk consumption and being overweight than nonasthmatic girls (adjusted OR 3.64, 95% CI 1.18–11.24). Asthma was not associated with either factor or with absence of the other in girls.Conclusion:  Infrequent milk consumption plus being overweight may have great risk for asthma in girls.
Specific oral tolerance induction in food allergy in children: efficacy and clinical patterns of reaction
Authors: Staden U. , Rolinck‐Werninghaus C. , Brewe F. , Wahn U. , Niggemann B. , Beyer K. 
Published: October 2007

Background:  Specific oral tolerance induction (SOTI) seems to be a promising treatment of food allergy. Specific oral tolerance induction and elimination diet were compared with respect to efficacy rate and patterns of clinical reaction.Methods:  Children with challenge proven immunoglobulin E (IgE)‐mediated cow’s milk (CM) allergy or hen’s egg (HE) allergy were randomly assigned to SOTI or elimination diet as a control group. Specific oral tolerance induction treatment was performed at home on a daily basis according to a study protocol with fresh CM or lyophilized HE protein. Re‐evaluation of clinically relevant food allergy was performed by food challenge after a median of 21 months. Children in the SOTI group received a secondary elimination diet for 2 months prior to follow‐up challenge to evaluate persistence of induced oral tolerance.Results:  At follow‐up challenge, nine of 25 children (36%) showed permanent tolerance in the SOTI group, three of 25 (12%) were tolerant with regular intake and four of 25 (16%) were partial responders. In the control group, seven of 20 children (35%) were tolerant. Allergen‐specific immunoglobulin E decreased significantly both in children who developed natural tolerance during the elimination diet (P < 0.05) and in those with SOTI (P < 0.001).Conclusions:  Specific oral tolerance induction seems a valid treatment option for patients with persistent food allergy. Indications may be given if avoidance cannot be guaranteed or for those who are eager to eat the food in question. Advantages of SOTI are the increased threshold dose for allergic reactions and the substantially reduced risk of severe allergic reactions after inadvertent ingestion of the allergen. However, careful monitoring during SOTI is mandatory.
Oat sensitization in children with atopic dermatitis: prevalence, risks and associated factors
Authors: Boussault P. , Léauté‐Labrèze C. , Saubusse E. , Maurice‐Tison S. , Perromat M. , Roul S. , Sarrat A. , Taïeb A. , Boralevi F. 
Published: October 2007

Background:  Topical treatments of atopic dermatitis (AD) may be responsible for cutaneous allergies. Percutaneous sensitization to oat used in emollients/moisturizers has already been reported. Our objectives were to measure the prevalence of oat sensitization in AD children, to assess its relevance, and to look at related parameters.Methods:  We recruited prospectively children with AD referred for allergy testing between June 2001 and December 2004. Atopy patch tests (APT) and skin prick tests (SPT) to oat proteins (1%, 3% and 5%) and to the European standard series were performed followed by oral food challenge (OFC) and repeated open application test (ROAT) in the oat‐sensitized group.Results:  About 302 children were enrolled. Oat APT and SPT were positive in 14.6% and 19.2% of cases, respectively. Children under 2 years of age were more likely to have positive APT. In oat‐sensitized children, OFC and ROAT were positive in 15.6% (five of 32) and 28% (seven of 25) of cases, respectively. Thirty‐two percentage of oat cream users had oat‐positive atopy patch test (APT) vs 0% in the nonusers group.Conclusions:  Oat sensitization in AD children seen for allergy testing is higher than expected. It may be the result of repeated applications of cosmetics with oats on a predisposed impaired epidermal barrier. We suggest avoiding topical‐containing oat proteins in infants with AD.
Ins and outs of inferior vena cava filters in patients with venous thromboembolism: the experience at Monash Medical Centre and review of the published reports
Authors: Seshadri T. , Tran H. , Lau K. K. , Tan B. , Gan T. E. 
Published: October 2007

AbstractBackground:  Inferior vena cava (IVC) filters are an alternative management strategy to anticoagulation in patients with venous thromboembolism (VTE). However, an IVC filter has its own inherent risks and complications and may not be the best management strategy. The aims of this study were to evaluate our institution’s practice of permanent Vena Tech (B. Braun Medical S.A., Boulogne, France) and retrievable Gunther Tulip (William Cook Europe, Bjaeverskov) IVC filters and to review the available published reports.Methods:  Retrospective single centre audit from the medical record.Results:  Eighty‐three and 42 patients had a VT and GT filter inserted, respectively. Median age was 57 years for VT and 63 years for GT. The majority (75% for VT and 83% for GT) was inserted for acute VTE and contraindication to anticoagulation. Both filters were efficacious at preventing pulmonary embolism (PE) and there was a low rate of recurrent deep venous thrombosis in both groups. Insertion‐related complications were low in both groups. Of the GT filters (n = 42), 16 were deemed an ongoing requirement, and thus, removal was not planned. In a further six patients, there was insufficient documentation as to why removal was not planned. Removal was attempted in 19 patients and was successful in 11. Failure of removal was as a result of clot in the filter (n = 7) or inability to snare it (n = 1).Conclusions:  Both the permanent and retrievable filters are efficacious at preventing PE and are associated with a low complication rate. Planned removal of the GT filter may not be possible in a significant proportion of cases.
The use of dexmedetomidine during laryngoscopy, bronchoscopy, and tracheal extubation following tracheal reconstruction
Authors: SEYBOLD JEANNIE L. , RAMAMURTHI RADHAMANGALAM J. , HAMMER GREGORY B. 
Published: October 2007

SummaryWe report the use of dexmedetomidine for laryngoscopy, rigid bronchoscopy, and tracheal extubation in the operating room in two children who had undergone tracheal reconstruction 1 week previously. Dexmedetomidine in combination with propofol provided appropriately deep anesthesia during these brief but stimulating procedures without cardiovascular or respiratory depression.
Structured training in intraosseous infusion to improve potentially life saving skills in pediatric emergencies – Results of an open prospective national quality development project over 3 years
Authors: PFISTER CHRISTOPH ALEXANDER , EGGER LARS , WIRTHMÜLLER BEAT , GREIF ROBERT 
Published: October 2007

SummaryBackground:Children in emergencies need peripheral intravenous (IV) access in order to receive drugs or fluids. The success of IV access is associated with the age of patients and fails in up to 50% of children younger than 6 years. In such situations, it is essential that physicians and paramedics have a tool and easily learnable skills with a high chance of success. According to international guidelines intraosseous (IO) access would be the next step after failed IV access. Our hypothesis was that the success rate in IO puncturing can be improved by standardizing the training; so we developed an IO workshop.Methods:  Twenty‐eight hospitals and ambulance services participated in an evaluation process over 3 years. IO workshops and the distribution of standardized IO sets were coordinated by the study group of the University Hospital of Berne. Any attempted or successful IO punctures were evaluated with a standardized interview.Results:  We investigated 35 applications in 30 patients (a total of 49 punctures) between November 2001 and December 2004. IO puncture was not successful in 5 patients. The success rate depended neither on the occupation nor the experience of users. Attendance at a standardized IO workshop increased the overall success rate from 77% to 100%, which was statistically not significant (P = 0.074).Conclusions:  Standardized training in IO puncturing seems to improve success more than previous experience and occupation of providers. However, we could not show a significant increase in success rate after this training. Larger supranational studies are needed to show a significant impact of teaching on rarely used emergency skills.
Intranasal clonidine as a premedicant: three cases with unique indications
Authors: STELLA MICHAEL J. , BAILEY ANN G. 
Published: October 2007

SummaryClonidine is experiencing increasing use in the pediatric population as a sedative and analgesic because of its central α2‐adrenergic agonism. We report three cases of preoperative use of intranasal clonidine in pediatric patients, all for different indications. One patient was treated for preoperative agitation and hallucinations associated with oral midazolam. One patient was given clonidine as a premedicant. The third patient was treated for preoperative agitation and hypertension. All three patients had subjective resolution of indicated symptoms and none experienced adverse outcomes.
The incidence of land tenure insecurity in Southern Africa: Policy implications for sustainable development
Authors: Mutangadura Gladys 
Published: October 2007

Abstract The study presented in this article used a combination of key informant interviews and a review and synthesis of existing country level literature to identify the major sources of land tenure insecurity in six Southern African countries: Botswana, Lesotho, Malawi, Mozambique, South Africa, and Zambia. Findings reveal that the main causes of land tenure insecurity experienced in Southern Africa include lack of land rights of minority groups, unclear or overlapping land rights, overcrowding, land alienation into leasehold, insecurity of farm workers and farm labour tenants, inappropriate and exploitative administrative practices, land encroachment and illegal settlers and limited women's land rights. The article presents a summary of land tenure security related initiatives that the study countries have or are in the process of adopting. Analysis of these initiatives shows that tenure reforms have focused on changing the law and rules but little has been done to translate new laws into implementable programs; capacity building; prioritization of resources to support tenure reform; provision of complementary policies and incentives; addressing HIV/AIDS‐land tenure related problems; and monitoring and evaluation. The paper contends that these policy issues should be addressed in order to ensure realization of land tenure security for all.