bluuebunny/crossref_metadata_2025_split huggingface dataset:
In vitro activities of four antifungal drugs against Trichophyton rubrum isolates exhibiting resistance to fluconazole
Authors: Santos D. A. , Hamdan J. S. 
Published: May 2007

SummaryThirty‐two clinical isolates of Trichophyton rubrum exhibiting resistance to fluconazole [minimum inhibitory concentrations (MICs) ≥ 64 μg ml−1] were selected to test the antifungal activity of ketoconazole, itraconazole, griseofulvin and terbinafine. We followed the guidelines of the National Committee for Clinical Laboratory Standards for testing filamentous fungi. The strains Candida parapsilosis (ATCC 22019), Candida krusei (ATCC 6258), T. rubrum (ATCC 40051) and Trichophyton mentagrophytes (ATCC 40004) were included for quality control. The microdilution plates were incubated at 28 °C and were read visually after 7 days of incubation and endpoint determination readings were performed visually. The MIC ranges for the four antifungals were: 0.0625–2 μg ml−1 for ketoconazole, 0.25–2.0 μg ml−1 for griseofulvin, ≤0.031–1.0 μg ml−1 for itraconazole and ≤0.031 μg ml−1 for terbinafine (for all tested isolates). Terbinafine was the most potent drug against T. rubrum, in vitro, followed by itraconazole, ketoconazole and griseofulvin. Much work is still needed to correlate the MICs of these drugs with clinical outcomes to develop interpretative breakpoints for T. rubrum and other dermatophytes.
A 7‐year survey of dermatophytoses in Crete, Greece
Authors: Maraki Sofia , Nioti Eleni , Mantadakis Elpis , Tselentis Yannis 
Published: May 2007

SummaryDermatophytoses are of worldwide distribution. Epidemiological studies concerning dermatophyte infections have been performed in many countries and differences in the incidence and the aetiological agents have been reported in different geographical locations. This study was undertaken to investigate the prevailing species of dermatophytes in the island of Crete, Greece, and their pattern of infection during a 7‐year period (1997–2003). A total of 5544 samples obtained from 3751 patients with clinically suspected dermatomycoses were examined mycologically in the laboratory of Clinical Microbiology at the University Hospital of Crete, Greece. Skin, hair and nail specimens were subjected to direct microscopy and culture. Dermatophytes were isolated from 520 patients (13.9%). Trichophyton rubrum was the most frequently isolated dermatophyte accounting for 48% of the infections, followed by Microsporum canis (17.9%), Trichophyton mentagrophytes var. interdigitale (14.2%) and Epidermophyton floccosum (6%). Tinea unguium, tinea pedis, tinea corporis, tinea capitis, tinea cruris, tinea manuum and tinea facei were the clinical types of dermatophytoses in decreasing order of frequency. Trichophyton rubrum is the predominant dermatophyte in our area. As the epidemiology of dermatophytoses is changing over time it is important to review periodically the incidence of dermatophytes and their distribution.
Majocchi's granuloma of the scrotum
Authors: Cho Hee‐Ryung , Lee Mu‐Hyoung , Haw Choong‐Rim 
Published: May 2007

SummaryMajocchi's granuloma is a well known but uncommon folliculitic and perifolliculitic dermatophyte infection of the dermal and subcutaneous tissue by fungal organism, usually limited to the superficial dermis. We report a rare case of superficial perifollicular form of Majocchi's granuloma, caused by Trichophyton rubrum on the scrotal skin of a healthy man. Histological examination of the biopsied nodule revealed perifolliculitis with fungal elements and the periodic acid schiff staining was positive to fungal elements. His lesion cleared completely with the use of a topical antifungal agent.
Rapid phenotypic assessment of bird cherry‐oat aphid resistance in winter wheat
Authors: Dunn B. L. , Carver B. F. , Baker C. A. , Porter D. R. 
Published: May 2007

Abstract Rhopalosiphum padi L. causes significant damage to winter wheat (Triticum aestivum L.), even without obvious aboveground symptoms of injury. Our objectives were to develop a juvenile‐plant bioassay for bird cherry‐oat aphid (BCOA) resistance that allows rapid phenotypic differentiation. Central features of the bioassay include root and shoot weight measurements of 3‐week‐old seedlings produced in seed germination pouches, a 14‐day aphid exposure period, and a non‐infested control treatment to establish a baseline for expected biomass per genotype. Cultivars used in bioassay development were ‘Illinois Rustproof’ and ‘Skala’, which showed smaller BCOA‐induced reductions in biomass than the more susceptible genotypes, ‘Patrick’ and ‘Scout 66’. Mean reductions in root biomass were 48% for ‘Patrick’ and ‘Scout 66’, compared with 29% for ‘Illinois Rustproof’ and ‘Skala’. This rapid and repeatable bioassay is extendable to large wheat collections and inbred line populations.
Delayed decrease in differential renal function after successful pyeloplasty in children with unilateral antenatally detected hydronephrosis
Authors: Matsumoto Fumi , Shimada Kenji , Kawagoe Mari , Matsui Futoshi , Nagahara Akira 
Published: May 2007

Aim:  The aim of this study was to evaluate functional outcome of congenital hydronephrotic kidney.Methods:  The records of consecutive children who underwent pyeloplasty for unilateral prenatally detected ureteropelvic junction obstruction were reviewed. Renal function was assessed renographically before and after surgery. Mean follow‐up period was 100 months.Results:  Sufficient pre‐ and postoperative data were available for 60 children. Differential renal function (DRF) improved in 14 (23%) and decreased in nine (15%) of 60 patients in the early postoperative period. DRF improved in seven (18%) and decreased in 13 (34%) of 38 patients at the end of follow‐up. Five of 14 patients with increased DRF at early postoperative scan returned to the preoperative level at the end of follow‐up. No patients with decreased DRF at early postoperative scan showed any recovery in DRF and progressive decrease was seen in four of nine children.Conclusions:  The DRF was not stable in some patients after successful pyeloplasty. In some patients impairment of renal function came to be apparent with time. Improvement of DRF may be a transient phenomenon seen in the early postoperative period. To avoid overestimation of functional recovery, long‐term follow‐up with delayed renographic evaluation is recommended.
Is a complete urological evaluation necessary in all newborns with asymptomatic renal ectopia?
Authors: Arena Francesco , Arena Salvatore , Paolata Antonina , Campenni Alfredo , Zuccarello Biagio , Romeo Giuseppe 
Published: May 2007

Aim:  To evaluate if a complete urological screening is justified by potential urological anomalies in newborns or infants with asymptomatic renal ectopia (RE).Methods:  The database records of 60 consecutive neonatal cases of RE diagnosed at the authors' hospital from 1990 to 2004 were retrospectively reviewed.Results:  At diagnosis, mean patient age was 1.6 months. In 58 of 60 patients, the suspected diagnosis of RE was made during prenatal or postnatal screening ultrasonography, including two newborns with anorectal malformation. There were 24 patients with crossed RE (C‐RE) and 36 patients with simple RE (S‐RE). A solitary RE was present in two patients. The most frequent associated urological abnormality was vesico‐ureteral reflux (37.5% of C‐RE and 16.6% of S‐RE). Hydronephrosis was detected in seven RE and five contralateral kidneys. An obstructive megaureter was present in one patient with C‐RE. In 40% of S‐RE and 92.9% of C‐RE, the 99mTc DMSA documented reduction of function of RE. The longitudinal diameter of the ectopic kidney was significantly smaller than the contralateral one. Other non‐renal diseases were present in 15% of patients, of which the most frequent was cryptorchidism (6.6%).Conclusions:  A complete urological evaluation is necessary in newborns with C‐RE for the high incidence of associated urological anomalies, of which VUR is the most frequent. A complete urological evaluation is also reasonable in patients with S‐RE who have a pelvic dilatation. No diagnosis or treatment of the associated urological diseases, in consideration of congenital decreased function of the ectopic kidney, might predispose these children to improvement of renal function impairment.
Association analysis of glutathione‐S‐transferase P1 (GSTP1) polymorphism with urothelial cancer susceptibility and myelosuppression after M‐VAC chemotherapy
Authors: Yokomizo Akira , Yamamoto Ken , Kinukawa Naoko , Tsunoda Toshiyuki , Koga Hirofumi , Naito Seiji 
Published: May 2007

Aim:  Glutathione‐S‐transferase P1 (GSTP1) detoxifies a wide range of endogenous and exogenous carcinogens and anticancer agents such as cisplatin and doxorubicin. The aim of this study was to examine the association between GSTP1 polymorphism and both urothelial cancer susceptibility and adverse events of M‐VAC (methotrexate, vinblastine, doxorubicin and cisplatin) chemotherapy in Japanese urothelial cancer patients.Methods:  This cohort consisted of 179 urothelial cancer patients and 225 healthy controls matched for age and sex. GSTP1 Ile105Val polymorphism was identified by direct sequencing methods. Furthermore, the association of GSTP1 polymorphism and adverse events of M‐VAC chemotherapy was investigated.Results:  A similar frequency of GSTP1 Ile105Val allele was observed in the urothelial cancer patients and in the control group. However, when the 46 patients who underwent systemic M‐VAC chemotherapy were investigated, significantly more severe toxicity in leukocytopenia (P = 0.044, odds ratio +∞, 95% confidence interval 0.9203– +∞) and a prolonged duration of G‐CSF administration (P = 0.013, odds ratio 8.625, 95% confidence interval 1.390–89.98) were observed in patients with the Val allele in comparison to those with the Ile allele.Conclusions:  The GSTP1 Ile105Val polymorphism was not found to be significantly associated with urothelial cancer susceptibility but it may be associated with myelosuppressive adverse events in M‐VAC chemotherapy. The 105Val might therefore be a useful marker for predicting myelosuppression in M‐VAC chemotherapy.
Oncological outcome of laparoscopic prostatectomy
Authors: Hara Isao , Kawabata Gaku , Tanaka Kazushi , Kanomata Naoki , Miyake Hideaki , Takenaka Atsushi , Fujisawa Masato 
Published: May 2007

Aim:  Oncological outcomes including surgical margin status and biological progression‐free survival (bPFS) were analyzed in patients who underwent laparoscopic prostatectomy (LRP) only.Methods:  A total of 136 patients who underwent LRP only without lymph node metastasis or perioperative supportive therapy between April 2000 and October 2005 were analyzed. All patients received ≥6 months postoperative follow‐up. Biological progression was defined as elevation of prostate‐specific antigen by >0.2 ng/mL.Results:  The positive margin (ew+) rate was 36.8% and the 3‐year bPFS was 72.6% for all patients. Positive margin rates in pT2a–b, pT2c, pT3a and pT3b were 10.0%, 27.5%, 77.3% and 53.8%, respectively. Three‐year bPFS rates in pT2, pT3a and pT3b were 91.8%, 66.8% and 44.9%, respectively. Although the positive margin rate at posterior and anterior sites decreased as more patients were recruited, no significant improvements were observed at apex and base sites. Three‐year bPFS rates in pT2 ew–, pT2 ew+, pT3 ew– and pT3 ew+ were 95.8%, 85.7%, 81% and 48.5%, respectively, indicating that positive margins exert a greater impact in pT3 disease than in pT2 disease.Conclusions:  Although 3‐year bPFS results were almost identical to previous reports of LRP and retropubic radical prostatectomy, the positive margin rate in pT3a disease was particularly high, probably due to immature surgical skill. Although positive margins at posterior and anterior sites decreased with the leaning curve, improvements are needed to reduce positive margin rates at the apex. Positive margins exert greater impact in pT3 disease than in pT2 disease.
Upper urinary tract recurrence following radical cystectomy for bladder cancer
Authors: Furukawa Junya , Miyake Hideaki , Hara Isao , Takenaka Atsushi , Fujisawa Masato 
Published: May 2007

Aim:  The objective of this study was to analyze the clinicopathological features of upper urinary tract recurrence following radical cystectomy for bladder cancer.Methods:  Between 1995 and 2003, 583 patients underwent radical cystectomy and urinary diversion for bladder cancer at the authors' institution and the related hospitals. A retrospective review of patient records was carried out to evaluate characteristics of patients who underwent upper urinary tract recurrence after radical cystectomy.Results:  During the observation period (median, 41.5 months), 12 (2.1%) of the 583 patients had upper urinary tract recurrence. Of the 12 patients with upper urinary tract recurrence, there were multiple tumors in eight at the initial diagnosis of bladder cancer, and eight received transurethral resections two or more times before radical cystectomy. The median time to diagnosis of an upper urinary tract cancer after radical cystectomy was 29.5 months. When upper urinary tract recurrence was detected, five patients had metastatic diseases simultaneously, and two had bilateral upper urinary tract cancers. The cancer‐specific survival in patients with upper urinary tract recurrence was significantly poorer than that in those without upper urinary tract recurrence. In addition, eight of the 12 patients (66.7%) died of disease progression within 3 years after the diagnosis of upper urinary tract cancer.Conclusions:  These findings suggest that despite the low incidence of upper urinary tract recurrence following radical cystectomy, the prognosis of such patients was markedly poorer compared with that of those without upper urinary tract recurrence. Accordingly, intensive therapies should be considered when upper urinary tract recurrence is detected after radical cystectomy.
PERIOPERATIVE HIGH‐DOSE OXYGEN THERAPY IN VASCULAR SURGERY
Authors: Puckridge Phillip J. , Saleem Hafees A. , Vasudevan Thodur M. , Holdaway Christopher M. , Ferrar David W. 
Published: May 2007

Background:  Patients undergoing infrainguinal bypass surgery have reduced baseline tissue oxygen tension and high rates of wound infections. The hypoxaemia worsens during surgery, potentially reducing the ability to combat bacterial lodgement. We investigated whether high‐dose perioperative oxygen administration to patients undergoing infrainguinal arterial surgery results in increased tissue oxygenation.Methods:  Ten consecutive patients undergoing infrainguinal arterial surgery had transcutaneous partial pressure of oxygen (TcpO2) measured preoperatively, intraoperatively after arterial clamps applied, postoperatively and at discharge. Measurements were taken with inspired oxygen concentration (FiO2) of 30% then 80%. Arterial blood gases were measured at the same times.Results:  Tissue oxygenation showed no difference intraoperatively while arterial clamps were in place, but significantly higher tissue oxygenation was seen with use of high‐dose oxygen (FiO2 80%) postoperatively (P < 0.05). Carbon dioxide levels in tissue increased while arterial clamps were in place (P < 0.01) and pH fell intraoperatively and following reperfusion (P < 0.05).Conclusion:  The administration of high‐dose oxygen to vascular surgical patients undergoing lower‐limb arterial surgery results in increased tissue oxygen concentrations when perfusion is not reduced by the presence of arterial clamps. These results suggest the administration of high‐dose oxygen intraoperatively may be beneficial in reducing wound infections, but further research is required.
THE LENGTH OF SUPERFICIAL TEMPORAL ARTERY BIOPSIES
Authors: Sharma Neil S. , Ooi Ju‐Lee , McGarity Bruce H. , Vollmer‐Conna Uté , McCluskey Peter 
Published: May 2007

Background:  To compare temporal artery biopsy specimen lengths from a tertiary care and a community hospital in New South Wales to recommended clinical guidelines in suspected giant cell arteritis.Design:  A retrospective observational study of all patients who underwent temporal artery biopsy at Bathurst Base Hospital (BBH) and Royal Prince Alfred Hospital (RPAH) over a 5‐year period.Methods:  Patients who underwent temporal artery biopsy during the 5‐year period were identified using computerized hospital databases. A retrospective chart review was carried out on all cases. Data were collected regarding patient age, patient sex, length of biopsy specimen, histopathological results and surgical team carrying out the biopsy.Results:  During the 5‐year period, 157 temporal artery biopsies were carried out at both hospitals, with 38/157(24%) at BBH and 119/157 (76%) at RPAH. There was no significant difference in biopsy length at the two hospitals. The mean specimen length at BBH was 12.1 mm compared with 11.7 mm at RPAH (t = 0.35; P = 0.73). At RPAH, there was no significant difference in specimen length between the surgical specialties carrying out the biopsy (anovaF = 1.37; P = 0.26). Specimens of length 20 mm or greater were 2.8 times more likely to show features of giant cell arteritis than those less than 20 mm.Conclusion:  The mean length of temporal artery biopsy specimens at both hospitals was substantially shorter than recommended guidelines of a minimum 20 mm. We recommend all surgeons carrying out temporal artery biopsies ensure a specimen of sufficient length is obtained.
LAPAROSCOPIC BILE DUCT EXPLORATION: RESULTS OF 160 CONSECUTIVE CASES WITH 2‐YEAR FOLLOW UP
Authors: Taylor Craig J. , Kong Justin , Ghusn Michael , White Stephen , Crampton Nick , Layani Laurent 
Published: May 2007

Background:  Despite numerous reports showing the advantages of laparoscopic common bile duct exploration (LCBDE), many general surgeons, particularly those working outside of nonspecialist units, continue to rely heavily on endoscopic retrograde cholangiography with sphincterotomy (ERCP) to manage bile duct stones (BDS). This article investigates the performance of LCBDE when adopted as the preferred first‐line management of both suspected and incidental BDS by general surgeons in a regional setting.Methods:  A retrospective review was conducted of all patients in whom LCBDE was attempted by a regional general surgical unit. The unit policy was to preferentially treat all incidental and suspected BDS (except in ascending cholangitis or severe pancreatitis) by LCBDE, with ERCP used only if unsuccessful. In addition to chart review, formal prospective follow up by telephone interview was carried out.Results:  A total of 160 consecutive patients with BDS (mean age 66.9 years, 65% suspected and 35% incidental) underwent attempted LCBDE between January 2000 and July 2005. Successful clearance was achieved in 84.3% according to chart review. However, four additional cases of retained choledocholithiasis shown by late telephone interview (median interval 2.5 years) yielded a more accurate clearance rate of 81.8%. Major morbidity occurred in 13.8%, including biliary leak in 7.5% and one late biliary stricture (0.6%). Median length of hospital stay was 4.8 days. In‐hospital mortality was 0.6%.Conclusion:  Laparoscopic common bile duct exploration remains an effective, efficient and safe first‐line treatment of BDS even when carried out in regional nonspecialist units. In spite of the wide availability of ERCP, general surgeons should be encouraged to continue performing LCBDE in order to optimise patient care and maintain important surgical skills.
PANCREATIC INJURY AFTER THORACOABDOMINAL AORTIC OCCLUSION IN A PORCINE MODEL
Authors: Papakostas John C. , Toumpoulis Ioannis K. , Pappa Lina S. , Arnaoutoglou Helen M. , Kirou Ioanna E. , Malamou‐Mitsi Vasiliki D. , Kappas Angelos M. , Matsagas Miltiadis I. 
Published: May 2007

Background:  The aim of this study was to investigate pancreatic injury after 45 min of thoracoabdominal aortic occlusion in a porcine model.Methods:  Twenty‐four pigs were used. Six pigs underwent sham operation and 18 intravascular balloon thoracoabdominal aortic occlusions for 45 min. The animals were randomly killed at 12, 48 and 120 h after reperfusion. After killing, all pancreata were examined macroscopically for any signs of acute pancreatitis, whereas gland specimens were harvested for histological study to evaluate pancreatic injury (haematoxylin and eosin staining) and acinar cell apoptosis (Terminal deoxynucleotidyl transferase mediated dUTP Nick‐End Labelling staining).Results:  Pancreatic injury severity score was mildly increased in terms of oedematous features at 12 h after reperfusion, but normalized to sham levels by the second day and thereafter. Necrotic injury was not statistically significant at any time point. Acinar cell apoptotic index was mildly increased at 12 and 48 h, but showed a tendency to decrease towards sham levels by the fifth day. One animal developed acute pancreatitis.Conclusion:  Acute pancreatitis is unlikely to occur after 45 min of thoracoabdominal aortic occlusion. However, an early, mild oedematous and apoptotic injury that occurs subclinically seems to be a constant event. This injury might have clinical significance when combined with pre‐existent pancreatic pathologies.
Engineering a safe landing: engaging medical practitioners in a systems approach to patient safety
Authors: Brand C. , Ibrahim J. , Bain C. , Jones C. , King B. 
Published: May 2007

AbstractBackground: Several event studies, including the Australian Safety and Quality in Healthcare Study, emphasize gaps in safety for hospitalized patients. It is now recognized that system‐based factors contribute significantly to risk of adverse events and this has led to a shift in focus of patient safety from the autonomous responsibility of medical clinicians to a systems‐based approach. The aim of this study was to determine medical practitioner awareness of, level of engagement in and barriers to engagement in a systems approach to patient safety and quality.Methods: Information from acute and subacute care medical practitioners at a metropolitan public hospital was collected within an anonymous structured electronic survey, a discussion group and key informant interviews.Results: There were 73 survey respondents (response rate 7.6%). Fifty‐one (69.9%) were unaware of the Institute of Medicine report ‘To Err is human’. Thirty‐six (49.3%) were unaware of the Australian Quality in Healthcare Study and 12 (16.4%) had read the article. There was a positive relation identified between awareness and seniority. There was a low level of participation in systems‐focused quality and safety activities and limited understanding of the role of systems in medical error causation. There was uncertainty about the changing role of medical practitioners in patient safety and perceived lack of skills to effectively engage with hospital management about safety and quality issues.Conclusion: Several factors are limiting engagement of medical practitioners in a systems approach to patient safety. Increased educational support is needed and may be best focused within clinical effectiveness activities pertinent to practitioner interest and expertise.