bluuebunny/crossref_metadata_2025_split huggingface dataset:
Einfluss einer Antimykotika‐Prophylaxe auf die gastrointestinale Besiedlung mit Sprosspilzen bei hämatologischen Patienten
Authors: Rimek Dagmar , Redetzke Kristin , Kappe R. 
Published: September 2006

ZusammenfassungHämatologische Patienten weisen ein hohes Risiko zur Entwicklung einer invasiven Candidose auf und sind häufig gastrointestinal mit Sprosspilzen besiedelt. Das Infektionsrisiko kann durch eine prophylaktische orale Antimykotikagabe reduziert werden. Oft wird Fluconazol eingesetzt, was zu einer vermehrten Rate von Besiedlungen und Infektionen durch resistente Sprosspilzarten führen kann. Wir untersuchten den Einfluss einer Antimykotika‐Prophylaxe auf die gastrointestinale Sprosspilzbesiedlung bei hämatologischen Patienten im Vergleich zu Gesunden.In die Studie eingeschlossen wurden 46 hämatologische neutropenische Patienten mit 52 Stuhlproben aus 52 Episoden antimykotischer Prophylaxe und 110 gesunde Kontrollen. Die Patienten erhielten Amphotericin B oral (n = 8), Amphotericin B und Fluconazol (n = 7), Amphotericin B und Itraconazol (n = 5), Fluconazol oral (n = 15) und Itraconazol oral (n = 17) Bei 63,5% der Patienten und 60% der Kontrollen wurden Sprosspilze im Stuhl nachgewiesen mit einer mittleren Keimzahl von 1,6 × 103 bzw. 0,4 × 103 KBE g−1 (P = 0,045). Niedrige Keimzahlen von 103 to 104 KBE g−1 wiesen 19,3% der Patienten und 37,3% der Kontrollen auf (P = 0,021), mehr als 105 KBE g−1 28,9% der Patienten und 10,9% der Kontrollen (P = 0,004). Der Anteil von Candida albicans betrug in der Patientengruppe 32,6%, in der Kontrollgruppe 54,1% (P = 0,021). In der Patientengruppe wurden im Vergleich zu den Kontrollen vermehrt Fluconazol‐resistente Arten nachgewiesen: C. glabrata in 20,9% vs. 11,7% (P = 0,168), C. krusei in 25,6% vs. 4,7% (P = 0,001). Kein Patient unter Antimykotika‐Prophylaxe erkrankte an einer gesicherten oder wahrscheinlichen invasiven Candidose.Als Schlussfolgerung ergibt sich, dass eine orale Antimykotika‐Prophylaxe bei neutropenischen hämatologischen Patienten zu einer höheren Kolonisationsrate mit Fluconazol‐resistenten Candida Arten führte, invasive Candidosen aber verhindert wurden.
Serum IL‐6 and IL‐1‐ra with sequential organ failure assessment scores in septic patients receiving high‐volume haemofiltration and continuous venovenous haemofiltration
Authors: GHANI ROHANA ABDUL , ZAINUDIN SOEHARDY , CTKONG NORELLA , RAHMAN AHMAD FAUZI ABDUL , WAFA SYED ROZAIDI WAFA SYED HUSSAIN , MOHAMAD MARLYN , MANAF MOHD RIZAL ABDUL , ISMAIL RAHIMAH 
Published: September 2006

SUMMARY:Aim:  Sepsis is characterized by an uncontrolled release of pro‐inflammatory and anti‐inflammatory mediators leading to immunoparalysis, cellular and humoral dysfunction, multiorgan dysfunction and death. This study evaluated the efficacy of high‐volume haemofiltration (HVHF) compared with continuous venovenous haemofiltration (CVVH) in removing these inflammatory mediators. Clinical responses were assessed with the sequential organ failure assessment (SOFA) score.Methods:  Septic patients with an end‐organ dysfunction or septic shock were randomized to receive 6 h of CVVH (ultrafiltration dose of 2 L/h equivalent to about 35 mL/kg per hour or HVHF (ultrafiltration dose of 100 mL/kg per hour or 6 L/h, whichever was higher). The sequential organ failures were scored for the 24 hours preceding recruitment; at day 1, day 7, at discharge from the intensive care unit and at hospital discharge.Results:  Thirty‐three patients were enrolled. Fifteen received HVHF and 18 received CVVH. The serum IL‐6 levels (pg/mL) at baseline were similarly elevated in both groups (P = 0.745). The HVHF group showed a significant reduction after 6 h of treatment with a median interquartile range (IQR) of 20.62 (49.21) pg/mL (P = 0.025) with no similar result in the CVVH group. Non‐survivors showed a higher baseline serum IL‐6 compared with the survivors (median (IQR) 172.31 (261.34) vs 58.9 (104.21), P = 0.044). In the HVHF group there was a positive association between the IL‐6 levels at 6 h with the SOFA scores at day 1 (r = 0.392, P = 0.001) but not at day 7. After 6 h of treatment in the HVHF group there was a direct correlation between the IL‐6 levels and number of hospital days (r = 0.90, P = 0.040). The maximum SOFA scores were persistently recorded before treatment. The SOFA scores reduced in both groups from baseline to day 7 (HVHF P = 0.048; CVVH P = 0.006). The SOFA scores at day 1 is significantly higher in the non‐survivors compared with the survivors (P = 0.038).Conclusions:  High‐volume haemofiltration at 6 L/h may seem to successfully remove some inflammatory cytokines in septic patients. The improvement in the SOFA scores at day 7 promises benefit of continuous renal replacement therapy in septic patients, but after 20 days this effect may be lost. In addition, the baseline serum IL‐6 and IL‐1‐ra were independent predictors of a poor outcome as reflected by the higher SOFA scores at day 1.
Proton pump inhibitors and acute interstitial nephritis: Report and analysis of 15 cases
Authors: SIMPSON IAN J , MARSHALL MARK R , PILMORE HELEN , MANLEY PAUL , WILLIAMS LAURIE , THEIN HLA , VOSS DAVID 
Published: September 2006

SUMMARY:Aim:  Although proton pump inhibitors (PPI) are usually safe and effective therapeutic agents, serious adverse effects can occur. The aim of the present study was to report and analyse the clinical features of 15 patients with acute interstitial nephritis (AIN) and acute renal failure from PPI that were referred to renal services in Auckland over a period of 3 years.Methods:  The clinical presentation, therapeutic drugs, demographic details and renal outcome of the patients were considered. The population at risk and total PPI exposure were able to be defined. The diagnosis of AIN was made by renal biopsy in 12 cases. In all patients, the time‐course of drug exposure and improvement of renal function on withdrawal suggested PPI were causal.Results:  The median patient age was 78 years. The mean baseline serum creatinine level was 83 µmol/L, peak level 392 µmol/L, and recovery level 139 µmol/L. The erythrocyte sedimentation rate (ESR) and C‐reactive protein were elevated at the time of diagnosis in the 11 and 12 patients, respectively, where this information was collected (ESR mean 85 mm/h, and C‐reactive protein mean 81 mg/L). AIN occurred at 8 per 100 000 patient years (95% confidence level 2.6–18.7 per 100 000 patient years). Although four patients presented with an acute systemic allergic reaction, 11 were asymptomatic with an insidious development of renal failure.Conclusion:  PPI are now the most commonly identified cause of AIN in the Auckland area. Recovery occurs after withdrawal of the drug but is often incomplete. Early diagnosis may be facilitated by clinician awareness of the insidious onset of renal failure, and an elevated erythrocyte sedimentation rate and C‐reactive protein.
Comparison of biochemical, haematological and volume parameters in two treatment schedules of nocturnal home haemodialysis
Authors: MAHADEVAN KUMAR , PELLICANO REBECCA , REID ALISTAIR , KERR PETER , POLKINGHORNE KEVAN , AGAR JOHN 
Published: September 2006

SUMMARY:Background:  The biochemical, haemodynamic, clinical and nutritional benefits of nocturnal home haemodialysis (NHHD) compared with 4 h, three times per week conventional haemodialysis are well known and accrue by increasing dialysis time and frequency either for 8 h alternate night per week (NHHD3.5) or for 8 h six nights per week (NHHD6). However, there are little data comparing NHHD3.5 with NHHD6.Method and Results:  Thirteen patients on NHHD6 were compared with 21 patients on NHHD3.5, all with similar demographic profiles. Pre‐ and post‐dialysis phosphate (PO4) control was ideal between the groups. However, all NHHD6 needed PO4 supplementation compared with 4/21 (19%) NHHD3.5. In the present study, 8/21 (38%) NHHD3.5 needed PO4 binders whereas none was required with NHHD6. The pre‐haemoglobin (Hb) 122.8 g/L (NHHD6) versus 124.9 g/L (NHHD3.5) and the pre‐albumin 38.31 g/L (NHHD6) versus 37.71 g/L (NHHD3.5) were not significantly different. NHHD6 had significantly lower pre‐blood urea and creatinine (10.16 vs 19.54 mmol/L and 437.0 vs 812.3 µmol/L, respectively). Less interdialytic urea and creatinine fluctuation were also noted in NHHD6. Of major significance was the significantly lower ultra filtration rate and intradialytic weight gains (mean ± SEM) of NHHD6 (249 ± 76 mL/h and 2.0 ± 0.65 kg) versus NHHD3.5 (425 ± 168 mL/h and 2.9 ± 1.2 kg).Conclusion:  The authors conclude that NHHD6 offers the optimum biochemical, volume and clinical outcome, but NHHD3.5 has additional appeal to providers seeking home‐based therapy cost advantages and consumable expenditure control. A flexible dialysis programme should offer all the time and frequency options of NHHD but in particular, should support NHHD at a frequency sympathetic to the clinical rehabilitation and lifestyle aspirations of individual patients.
Tracheal rupture in a child with blunt chest injury
Authors: EIPE NAVEEN , CHOUDHRIE ASHISH 
Published: September 2006

SummaryA 10‐year‐old boy fell from a tree and sustained blunt injury to his chest. He was brought to the hospital (6 h later) with difficulty in breathing and inability to speak. There was a bruise on the neck and extensive subcutaneous emphysema over the neck and chest and decreased air entry over the right hemithorax. Radiographs revealed a right‐sided pneumothorax, pneumomediastinum and tracheal deviation. An intercostal drain (with underwater seal) was inserted and he was transferred to the operating room for bronchoscopy. Anesthesia was induced with IV midazolam and ketamine. The trachea was intubated orally and anesthesia maintained with spontaneous breathing of halothane in oxygen. Flexible fiberoptic bronchoscopy performed via the tracheal tube revealed no injury to bronchi or carina. Bronchoscopy through the tracheal tube withdrawn to the level of the vocal cords revealed a 1‐cm long posterior longitudinal tear approximately 2–3 cm below the cords. The surgeons planned a definitive tracheostomy distal to the traumatic tracheal opening. This was difficult and initially unsuccessful because of subcutaneous emphysema. A ureteric catheter was introduced through the tracheal tube and a tracheostomy tube mounted on the fiberoptic bronchoscope, which was then inserted through the surgical tracheostome. This followed the ureteric catheter into the distal trachea and the trachea was successfully cannulated. We review the mechanism of tracheal injuries with special reference to its occurrence in children with blunt injury. We discuss the airway management in these potentially life‐threatening injuries.
Steal‐induction after clonidine premedication: a comparison of the oral and nasal route
Authors: ALMENRADER NICOLE , PASSARIELLO MAURIZIO , COCCETTI BRUNO , HAIBERGER ROBERTA , PIETROPAOLI PAOLO 
Published: September 2006

SummaryBackground:  Clonidine premedication in children reliably provides preoperative sedation and anxiolysis, but onset of oral clonidine is known to be slow. Nasal clonidine has been shown to reach peak plasma levels within 10 min in rodents. The aim of the present study was to compare clinical effects and percentage of steal‐induction after clonidine premedication by the oral and nasal route.Methods:  Forty children, aged 1–6 years, scheduled for minor infraumbilical surgery, were randomly assigned to receive either pure clonidine 4 μg·kg−1 intranasally (group CN, n = 20) or clonidine 4 μg·kg−1 orally in syrup (group CO, n = 20) prior to mask induction. Drug acceptance, preoperative sedation and anxiolysis, quality of mask acceptance, recovery profile and parents’ satisfaction were evaluated.Results:  Drug acceptance was similar between groups, but quality of taste was significantly better in the oral group. There was no significant difference of preoperative anxiolysis and sedation. The onset of sedative effect was after 38.3 min for oral clonidine and 47.5 min for nasal clonidine. A steal‐induction could be performed in 60% of children in each group. Emergence from anesthesia and parents’ satisfaction were comparable.Conclusions:  Intranasal clonidine administration has no advantage over the oral route. Clinical effects were similar with both routes; there was a trend towards a faster onset of sedation with oral clonidine. Clonidine premedication causes light sleep, which allows a steal‐induction in 60% of patients.
ON PREDICTION OF TOTAL VALUE IN INCOMPLETELY SPECIFIED DOMAINS
Authors: Ża̧dło Tomasz 
Published: September 2006

SummaryThis paper presents the problem of prediction of a domain total value based on the general linear model. In many methods presented in the survey sampling literature (e.g. Cassel, Särndal & Wretman, 1977[Foundations of inference in survey sampling, New York: John Wiley & Sons]; Valliant, Dorfman & Royall, 2000[Finite population sampling and inference. A prediction approach. New York: John Wiley & Sons]; Rao, 2003[Small area estimation. New York; John Wiley & Sons]) a common assumption is that for each element of a population the domain to which it belongs is known. This assumption is especially important in the situation when a superpopulation model with auxiliary variables is considered. In this paper a method is proposed for prediction of the domain total when it is not known whether a unit belongs to a given domain or not, or when the information is available only for sampled elements of the population.
Intergenerational Transfer of Human Capital and Optimal Education Policy
Authors: CREMER HELMUTH , PESTIEAU PIERRE 
Published: September 2006

AbstractWe study the design of education policies (subsidies and public education) when parents' investment in education is motivated by warm‐glow altruism and determines the probability that a child has a high ability. The optimal subsidy is not necessarily positive. It is determined by two conflicting terms: a Pigouvian term (warm‐glow altruists do not properly account for the impact of education on future generations) and a “paternalistic” effect (the warm‐glow term may not be fully included in social welfare). Finally, total crowding out of private expenditure (for one of the types) by public education may be desirable.
The Signaling Effect of Tax Policy
Authors: BARIGOZZI FRANCESCA , VILLENEUVE BERTRAND 
Published: September 2006

AbstractThe paper focuses on the signaling value of a tax when agents are less informed than the government on the effect of their consumption. The policy making process is analyzed as a game in which the government wants to influence consumers' behaviors through tax policy, consumers being rational and Bayesian. The marginal cost of public funds induces the government to provide biased information to pursue budgetary objectives. We analyze the tax distortion that is required for credibility.
Advances in the understanding of malignant transformation of keratinocytes: an immunohistochemical study
Authors: Tucci M.G. , Offidani A. , Lucarini G. , Simonelli L. , Amati S. , Cellini A. , Biagini G. , Ricotti G. 
Published: September 2006

AbstractAimWe set out to investigate the interactions between malignant transformation of keratinocytes, presence of oncoproteins and immunosurveillance in squamous cell carcinoma (SCC) and in a preneoplastic lesion, actinic keratosis (AK).MethodsSamples of SCC, AK and normal skin (NS) were subjected to quantitative analysis using the following antibodies: anti‐p53, Ki67, OKT6, OK‐DR, B7/BB1, anti‐CD54, anti‐CD11, OKT3, OKT4, OKT8; positivity for ras‐p21, EGFr and bel‐2 was evaluated by semiquantitative analysis.ResultsOncoprotein alterations and increased keratinocyte proliferative activity were observed both in AK and SCC. The number of Langerhans cells (CD1a+ cells) was similar in the two lesions but lower in SCC compared to AK. The proportion of CD1a+‐B7/BB1+ cells was slightly higher in AK and SCC than in NS. The Langerhans cells expressed the HLA‐DR antigen in all groups. Values were highest in AK and NS, and quite low in SCC. Cytotoxic T lymphocytes were more numerous in SCC than in AK and NS. Interestingly, the total CD4/CD8 ratio was much lower in SCC than in AK and NS, which indicates an increase in the CD8+ subpopulation in samples of SCC. In the epithelia of SCC samples there were a considerable number of B7/BB1+ keratinocytes.ConclusionsWe suggest that alterations in the immunodefence mechanisms have an important role in the transformation of AK into SCC, and that these changes affect not only lymphocytes, but also professional (i.e., Langerhans cells) and non‐professional (i.e., keratinocytes) antigen presenting cells.
A clinical survey of psoriasis in Italy: 1st AISP report
Authors: Finzi Aldo F. , Benelli Cinzia 
Published: September 2006

AbstractBackgroundPsoriasis is present all over the world and its prevalence varies in the different populations and different geographical areas. For example, Northern European countries seem to have rates of incidence which are greater than those known for Southern Europe. However, today there is still a lack of adequate data to allow comparisons at an international level.MethodsIn Italy in 1994 the AISP (Interdisciplinary Association for the Study of Psoriasis) co‐ordinated the recording of monthly case histories and clinical results relating to psoriasis in patients observed in dermatology centres homogeneously distributed throughout Italy. The results were extrapolated from the overall case series.ResultsA sample of nearly 8000 cases was collected, most presenting psoriasis vulgaris. This pathology, prevalent in males, first appears at an age somewhere between the teens and twenties. Numerous factors may be involved, and onset is mainly attributed to stress, viral or bacterial infections and pharmacological therapy. Over 90% of cases lost between 1 and 7 working days in the course of the year. Local anti‐psoriasis treatment in monotherapy was administered more frequently than systemic therapy or combined therapy.ConclusionsThe results of this first Italian epidemiological study confirm that psoriasis is homogeneously distributed throughout the country. About 50% of patients avail themselves of specialist cures, even several times in the course of the year, and use a wide range of therapies which may be more or less demanding. The internal socio‐economic cost of the disease is evident, particularly in terms of working days lost and/or medical expenses.
Comparison of skin atrophy and vasoconstriction due to mometasone furoate, methylprednisolone and hydrocortisone
Authors: Hoffmann K. , Auer T. , Stücker M. , Hoffmann A. , Altmeyer P. 
Published: September 2006

AbstractBackground/aimsTopical glucocorticoids with improved benefit/risk ratio are of great interest in dermatology, but there are very few trials directly comparing the efficacy and side‐effects of these new preparations. In our study the vasoconstrictor effect and side‐effects of two of these new glucocorticoids were evaluated and blanching effect was determined by two‐dimensional laser scanning.MethodsIn a randomised, double blind intra‐individual comparative trial, 10 subjects were treated with various glucocorticoids or drug‐free vehicle. The test drugs were mometasone furoate (MF), methylprednisolone aceponate (MP) and hydrocortisone (OH‐C). The preparations were tested for a period of 3 weeks with occlusion on the flexor side of the forearm. Skin thickness and vasoconstriction were determined using 20 MHz ultrasound scanning, laser Doppler scanning (LDS) and chromometry.ResultsNo adverse effects were observed during the observation period. Only partial vasoconstriction occurred in most cases during the observation period. MP and MF produced maximal blanching between days 3 and 5 of treatment, while with OH‐C clinically visible blanching did not occur. Ultrasound evaluation of skin thickness showed similar behaviour for all three steroids tested: there were no signs of skin atrophy in any of the cases. LDS evidenced hypoperfusion of a test area on the perfusion image in only a few patients and there were no significant differences between the steroids tested. On evaluation of vasoconstriction caused by the steroids tested using chromometry there was a significant difference between MF and OH‐C on the L*a*b* scale (P < 0.005). Only at day 3 was a blanching effect caused by MP and MF demonstrable (a‐value, P < 0.05).ConclusionIn summary, the synthetic steroids MF and MP presented side‐effects similar to those of OH‐C but much greater vasoconstrictor effect; after an application period of over 5 days under occlusion a blanching effect in our model was not demonstrable by means of chromometry. Two‐dimensional laser scanning offers no advantage in the evaluation of the blanching effect in comparison to one‐dimensional laser fluxmetry (LDF). © 1998 Elsevier Science B.V.
Lipodystrophia centrifugalis abdominalis infantilis
Authors: Takeda Hikaru , Mitsuhashi Yoshihiko , Ishizawa Toshiyuki , Kondo Shigeo 
Published: September 2006

AbstractAimTo describe the clinical features of lipodystrophia centrifugalis abdominalis infantilis (LCAI) with special attention to the erythema which is seen around the depressed lesion.BackgroundLCAI is a rare disorder which occurs mainly in Asian people, particularly in Japanese; it usually begins as an erythematous macule which subsequently expands centrifugally and leaves a central depression. However, the erythema has been seldom documented in detail. We here report a case of LCAI observed from its early stage and review the literature.Case reportA 2‐year‐old Japanese girl was brought to our out‐patient clinic. Clinical examination revealed a slight depression surrounded by faint erythema that mimicked morphea on her left inguinum, but there was no hardening of the skin. The erythema disappeared 5 months after onset. Thereafter, the lipodystrophy expanded irrespective of the treatment to her right inguinum and lower abdomen.ConclusionsThe depression continues to grow without the erythema in most patients. This suggests that the erythema is not necessary for enlargement of the depression although it precedes the depression in most patients.
Acquired ichthyosis, alopecia and loss of hair pigment associated with leiomyosarcoma
Authors: Farrell A.M. , Ross J.S. , Thomas J.M. , Fisher C. , Bunker C.B. 
Published: September 2006

AbstractAcquired ichthyosis is an important clinical finding; internal malignancy, systemic disease and medication are recognised associations. We present a 70‐year‐old lady with acquired ichthyosis and leiomyosarcoma, one of the less frequently associated malignancies. An additional unusual finding was generalised thinning and loss of pigment affecting her hair. Scalp biopsy showed histological evidence of ichthyosis. Following resection of the tumour the ichthyosis resolved and there was regrowth of darker hair.
Generalized cutaneous leishmaniasis in acquired immunodeficiency syndrome1
Authors: Rosatelli J.B. , Souza C.S. , Soares F.A. , Foss N.T. , Roselino A.M.F. 
Published: September 2006

AbstractBackgroundLeishmaniasis associated with HIV/AIDS has been reported in the last decade.Case reportA case of generalized cutaneous leishmaniasis in a patient with AIDS is described. The case is paradoxical in that the cutaneous lesions resemble anergic leishmaniasis caused by Leishmania (L.) amazonensis and Jorge Lobo's disease, but the positive Montenegro test and the clinical improvement with antimonial are more commonly observed in leishmaniasis caused by L.(V.) braziliensis.CommentThe immunosuppression due to HIV/AIDS seen in this patient may explain the dissemination of the lesions, but the positive specific response to leishmanial antigen may explain the good response to the antimonial treatment.