bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of the paediatric tuberculosis score chart in an HIV‐endemic area
Authors: Van Rheenen Patrick 
Published: March 2003

BACKGROUND
Diagnosing tuberculosis (TB) in a human immunodeficiency virus (HIV)‐endemic area is extremely difficult, as the clinical symptoms of HIV‐seropositive children can be easily confounded with TB. The paediatric tuberculosis score chart (TSC) was developed for resource‐poor countries and its use continues to be promoted despite the fact that this scoring system has not been evaluated in countries with a high HIV prevalence.
OBJECTIVE
To assess the utility of the TSC in an HIV‐endemic area.
METHOD
A prospective cohort study conducted between January and December 1999 at St Theresa's Mission Hospital, Copperbelt Province, Zambia. Results of the TSC (TB score) were compared with the results of a diagnostic algorithm, incorporating sputum smear microscopy, culture and polymerase chain reaction of Mycobacterium tuberculosis, tuberculin skin test, chest X‐ray and histology eventually.
RESULTS
A total of 147 children were enrolled in the study. On the basis of HIV‐serology and clinical findings they were divided into four groups: children with TB (23 HIV‐seropositive; 52 HIV‐seronegative), 21 HIV‐infected children without TB and 51 HIV‐seronegative children without TB. The differences in TB scores between the groups were not significant. The sensitivity of the TSC to diagnose TB in this study was 88%; but the specificity was only 25%.
CONCLUSION
The TSC should not be used as a diagnostic tool in countries with a high HIV prevalence. The low specificity of this scoring system leads to overdiagnosis of TB and unnecessary use of costly, antituberculous drugs. New tools for TB diagnosis in children in HIV‐endemic areas are urgently needed.
Epidemiology of leprosy on five isolated islands in the Flores Sea, Indonesia
Authors: Bakker Mirjam I. , Hatta Mochammad , Kwenang Agnes , Klatser Paul R. , Oskam Linda 
Published: March 2003

SummaryWe conducted a population‐based survey on five small islands in South Sulawesi Province (Indonesia) to collect baseline data previous to a chemoprophylactic intervention study aiming at interrupting the transmission of Mycobacterium leprae. Here we describe the present leprosy epidemiology on these geographically isolated islands. Of the 4774 inhabitants living in the study area 4140 were screened for leprosy (coverage: 87%). We identified 96 leprosy patients (85 new and 11 old patients), representing a new case detection rate (CDR) of 205/10 000 and a prevalence rate of 195/10 000. CDRs were similar for males and females. Male patients were more often classified as multibacillary (MB) than women. Of the new patients, 33 (39%) were classified as MB, 16 (19%) as paucibacillary (PB) 2–5 lesions and 36 (42%) as PB single lesion. In this area of high leprosy endemicity leprosy patients were extensively clustered, i.e. not equally distributed among the islands and within the islands among the houses.
Early treatment of childhood fevers with pre‐packaged antimalarial drugs in the home reduces severe malaria morbidity in Burkina Faso
Authors: Sirima Sodiomon Bienvenu , Konaté Amadou , Tiono Alfred B. , Convelbo Nathalie , Cousens Simon , Pagnoni Franco 
Published: March 2003

SummaryIn rural, malaria‐endemic Burkina Faso, we evaluated the impact of the use of pre‐packaged antimalarial drugs (PPAM), by mothers in the home, on the progression of disease in children from uncomplicated fever to severe malaria. In each village of one province, a core group of opinion leaders (mainly older mothers) was trained in the management of uncomplicated malaria, including the administration of PPAM. Full courses of antimalarial (chloroquine) and antipyretic (aspirin) drugs were packaged in age‐specific bags and made widely available through community health workers who were supplied through the existing drug distribution system. Drugs were sold under a cost‐recovery scheme. Local schoolteachers conducted surveys in a random sample of 32 villages at the end of the high transmission seasons in 1998 and 1999. Disease history and the treatment received were investigated for all children under the age of 6 years having suffered from a fever episode in the previous 4 weeks. ‘Uncomplicated malaria’ was defined as every episode of fever and ‘severe malaria’ as every episode of fever followed by convulsions or loss of consciousness. During the study period, 56%[95% confidence interval (CI) 50–62%] of 3202 fever episodes in children under 6 years of age were treated promptly by mothers with the pre‐packaged drugs made available by the study. A total of 59% of children receiving PPAM were reported to have received the drugs over the prescribed 3‐day period, while 52% received the correct age‐specific dose. PPAM use was similar among literate (61%) and non‐literate mothers (55%) (P = 0.08). The overall reported risk of developing severe malaria was 8%. This risk was lower in children treated with PPAM (5%) than in children not treated with PPAM (11%) (risk ratio = 0.47; 95% CI 0.37, 0.60; P < 0.0001). This estimate of the impact of PPAM was largely unchanged when account was taken of potential confounding by age, sex, maternal literacy status, year or village. Our findings support the view that, after appropriate training and with adequately packaged drugs made available, mothers can recognize and treat promptly and correctly malarial episodes in their children and, by doing so, reduce the incidence of severe disease.
Colonization of neonatal puppies by Staphylococcus intermedius
Authors: Saijonmaa‐Koulumies Leena E. , Lloyd David H. 
Published: March 2003

Abstract Cutaneous and mucosal carriage of Staphylococcus intermedius was determined in five Cavalier King Charles spaniel bitches, living in normal domestic environment, and their 18 puppies during the immediate prepartum period and after whelping, over a total of 8 weeks, using quantitative swab techniques. Within 8 h of birth S. intermedius was isolated from each puppy. The nose and mouth were the most frequently colonized mucosal sites (83 and 78%, respectively). At that time S. intermedius was isolated from the abdominal skin in 78% of the puppies. One day postpartum the mucosal populations increased significantly (P < 0.001) but fell 6 (P < 0.01) and 20 (P < 0.001) days later. Populations from abdominal skin reduced during the first and fourth weeks postpartum (P < 0.05 for both). This study indicates that in the domestic environment S. intermedius establishes itself soon after birth. The level of colonization by S. intermedius in the bitches seems to influence the colonization by pathogenic staphylococci in puppies.
Serological responses to house dust mite antigens in atopic dogs while receiving allergen‐specific immunotherapy
Authors: Foster A. P. , Jackson H. A. , Stedman K. , Knowles T. G. , Day M. J. , Shaw S. E. 
Published: March 2003

In human atopic disease a beneficial response to immunotherapy may be associated with humeral changes in serum IgE and subclass IgG. The aim of this study was to investigate the humeral response to allergen‐specific immunotherapy (ASIT) in dogs with atopic dermatitis. Twelve dogs with clinical signs consistent with atopic dermatitis and positive intradermal test reactions to house dust mite antigens (Greer Laboratories, Lenoir NC, USA) were studied. The clinical response to ASIT (Greer) was evaluated when blood samples were collected at 0, 2 and 4 weeks; and at 3, 6 and 12 months after starting ASIT. The ASIT was administered for a minimum of 9 months. The serum concentration of total and subclass IgG antibodies was measured against Dermatophagoides farinae and Dermatophagoides pteronyssinus antigens (Greer) by ELISA using polyclonal and monoclonal antidog IgG reagents, respectively. Serum IgE was measured using a Fc‐epsilon R1 receptor alpha chain‐based ELISA. The data were analysed using a multilevel model in MLwiN software (Institute of Education, University of London, UK). Antibody concentrations of IgE and total IgG increased during the period of administration of ASIT and decreased after ASIT was stopped. There was no obvious pattern in subclass‐IgG concentrations during ASIT. Response to ASIT was excellent (four dogs), equivocal (three dogs) or poor (five dogs). During ASIT a poor or equivocal response was associated with a statistically significant increase in IgE to D. pteronyssinus antigen compared with the excellent responders. This relationship was present to a lesser extent with IgE to D. farinae and total IgG to both antigens. This study was supported, in part, by the RCVS Alison Alston Canine Award and by Heska Corporation.
Determination of strain variability of Microsporum canis to disinfectants
Authors: Moriello K. A. , Deboer D. J. , Volk L. 
Published: March 2003

The isolated infected hair model is a commonly used technique to test the fungicidal efficacy of topical therapies and/or disinfectants against Microsporum canis. Results from various laboratories have differed and it is unclear if they are due to methodology and/or strain variability. The objective of this study was to look for strain variability of M. canis to disinfectants. Ten strains of M. canis were used in this study. Infected hairs and crusts were soaked and processed in order to remove and isolate ectothrix spores. Eight dilutions of the following disinfectants were tested: Virkon® S, (Antec International Ltd, Suffolk, UK), chlorhexidine, lime sulfur, enilconazole and bleach. Sterile distilled water was used as a control. An equal volume of spore suspension and disinfectant solution were incubated for 5 min and then plated onto Mycosel fungal culture plates (Mycosel Agar, Becton Dickinson, Cockeysille, MD, USA). Fungal cultures were counted at days 7 to 10. Fungal culture data was evaluated using an end‐point dilution at which there was 100% fungicidal activity, i.e. no growth on the plates. The 10 samples showed identical results. Chlorhexidine and Virkon® S were ineffective even when used at 4× the manufacturer’s recommended dilution. Lime sulfur (1:33), enilconazole (20 µL mL−1), and bleach (1:10) were consistently effective when used at the recommended dilution. In addition, lime sulfur and enilconazole were 100% fungicidal even when the recommended concentration was diluted 1:4 or 4× as dilute as recommended. In conclusion, using isolated infective spores of M. canis we were unable to detect strain variability to commonly used disinfectants. This study was funded by the Winn Foundation and the SVM Companion Animal Research Fund.
Importance of psychogenic dermatoses in dogs with pruritic behavior
Authors: Nagata M. , Shibata K. , Irimajiri M. , Luescher A. U. 
Published: March 2003

Canine psychodermatopathies are appreciated, but our knowledge of this field is extremely limited. We suspect that psychodermatopathies could be expanded to include dermatoses featuring pruritic behavior such as licking, scratching and biting. The purpose of this study was to evaluate these clinical findings of a series of suspect dogs. Seven dogs with psychogenic dermatoses featuring pruritic behavior are described. Differential diagnoses including infectious disease, allergy, congenital disorder, metabolic and neurological disturbances, and previous trauma at the lesions were all ruled out. All dogs had concurrent behavior problems or inductive life events, and both skin and behavior problems were improved with behavior modification with or without psychopharmacological therapy. The type and distribution of the skin lesions and incidental context of pruritic behavior were evaluated. Histopathological examination of the skin lesion was performed in five cases. In the seven dogs, characteristic skin lesions included: broken hairs (n = 7); and erythema and/or excoriation (n = 3); broken hairs located on the lateral thigh (n = 4), medial forearm (n = 4), flank (n = 3), and perioral area (n = 3); and erythema and/or excoriations located on the cheek (n = 2), perioral area (n = 2), periocular area (n = 1) and nails (n = 1). In all cases, the onset of pruritic behavior was associated with emotionally unstable situations, and did not appear during sleep or during periods of focused attention. Histopathological findings were unremarkable in all cases. In conclusion, psychogenic disorders should be considered as a cause of dermatoses in dogs with pruritic behavior, and this disorder can be identified with clinical evaluation of skin lesions and the relationship between the behavior and its context.
A randomized controlled trial of misoprostol monotherapy for canine atopic dermatitis: effects on dermal cellularity and cutaneous tumour necrosis factor‐alpha
Authors: Olivry Thierry , Dunston Stanley M. , Rivierre Christine , Jackson Hilary A. , Murphy K. Marcy , Peters Erin , Dean Gregg A. 
Published: March 2003

Abstract In this blinded randomized placebo‐controlled trial, 20 dogs with atopic dermatitis (AD) were given placebo (8 dogs) or misoprostol (12 dogs) at 5 µg kg−1, orally, three times daily for 3 weeks. Administration of the active drug, but not of placebo, led to a significant decrease in lesional and pruritus scores. The median reduction from baseline of both scores was ≈30%. Misoprostol therapy did not lead to decreases of dermal cell counts or skin tumour necrosis factor (TNF)α mRNA copy numbers that were significantly different from those of placebo. Skin TNFα protein production, assessed using indirect immunofluorescence, decreased or remained unchanged in dogs receiving misoprostol. In contrast, post treatment TNFα fluorescence scores were higher in all but two dogs given placebo. The changes from baseline of TNFα fluorescence scores did not correlate significantly with those of lesional or pruritus indices. These observations confirm the modest efficacy of misoprostol for treatment of canine AD and suggest that its mild anti‐allergic effects are not associated with either inhibition of inflammatory cell emigration or TNFα production.
Annual cycles of germinability and differences between primary and secondary dormancy in buried seeds of Echinochloa crus‐galli
Authors: Honek  , Martinkova  , Jarosik  
Published: March 2003

The seasonal changes in percentage of dormant seeds of Echinochloa crus‐galli in the field were recorded for 4 years. The lots of seeds were wrapped in nylon fabric, buried 20 cm under the grass sward and exhumed at monthly intervals. The proportion of seeds germinating under light conditions at a constant temperature of 25 °C fluctuated between 0% and 96%, with maxima in May–July and minima in September–November. Small between‐year differences in the course of summer dormancy induction and its winter termination were probably caused by variation of weather conditions.Attributes of dormancy innate to seeds after maturation (primary dormancy) and dormancy induced in buried seeds during the summer (secondary dormancy) were compared by investigating the rate of dormancy termination during storage of (a) dry seeds at 25 °C, (b) imbibed seeds at 5°C and (c) in seeds buried under field conditions during October–June. Percentage of germination increased faster in secondary than primary dormant seeds at both constant 25 °C and 5 °C. The seeds with primary and secondary dormancy also differed in the response to `germination pre‐treatment', a 10‐day exposure of imbibed seeds at 25 °C that causes germination of the non‐dormant fraction of seed materials. After this treatment the time to resuming germination in primary dormant seeds was substantially increased, whereas the secondary dormant seeds were much less affected. Annual variation in the proportion of germinable seeds explains the low efficiency of autumn soil cultivation for decreasing reserves of E. crus‐galli seeds in the soil.
Immunoperoxidase evaluation of lichen planus biopsies for hepatitis C virus
Authors: Boyd MD Alan S. , Nanney PhD Lillian B. , King Jr MD, PhD Lloyd E. 
Published: March 2003

Background Lichen planus is a papulosquamous dermatosis which has recently been linked to infection with hepatitis C virus. It is unclear whether or not viral antigens may be present in the cutaneous lesions of lichen planus. Materials and methodsTwenty‐five paraffin‐embedded samples of glabrous lichen planus were evaluated using immunoperoxidase staining for the presence of hepatitis C virions. Control tissues consisted of hepatitis C‐infected hepatic tissue (n = 2), normal hepatic tissue (n = 2), normal human skin (n = 1), and two cutaneous biopsies of lichen planus from persons known to be infected with hepatitis C. Results The sections of hepatitis C‐infected liver tissue stained positive for hepatitis C virions. The 25 biopsies of glabrous lichen planus, the two biopsies of lichen planus from hepatitis C patients, the two sections of normal liver, and the one normal skin sample all failed to take up the stain. Conclusions Cutaneous lesions of lichen planus are more probably reactive to the underlying infection than a manifestation of skin involvement by this disease. This theory is supported by the histologic findings in a lichenoid drug eruption, which are virtually identical to those of idiopathic lichen planus. Insufficient sensitivity by the immunoperoxidase procedure used is a possible explanation for our results; however, it appears more probable that no virus exists at the sites of cutaneous involvement.
Panniculitis in tuberculosis: a clinicopathologic study of nodular panniculitis associated with tuberculosis
Authors: Boonchai MD Waranya , Suthipinittharm MD Puan , Mahaisavariya MD Punkae 
Published: March 2003

Background Certain types of panniculitis, erythema induratum of Bazin and erythema nodosum, have been well documented as tuberculids. Many histopathologic diagnoses of panniculitis have been reported in tuberculosis patients. This study investigates the correlation between underlying tuberculosis and clinicopathologic findings of panniculitis. Methods We retrospectively reviewed the clinical files of histologic‐proven panniculitis cases at the Dermatologic Clinic, Siriraj Hospital from January 1992 to December 1995; only cases with active tuberculous foci were analyzed. Results The incidence of panniculitis caused by tuberculosis was 8.2%. The ratio of men to women was 1 : 1. The mean age of onset was 35.3 years. The average duration of the nodules was 35.5 days. There was a history of contact tuberculosis in 16.6%. Constitutional symptoms and a strongly positive purified protein derivative (PPD) reaction were found in 66.6%. Chest roentgenograms were abnormal in 83.3%. The erythrocyte sedimentation rate was elevated in all tested cases. The histopathologic diagnoses were nodular vasculitis (33.3%), erythema nodosum (50%), and cutaneous periarteritis nodosa (16.4%). The panniculitis lesion responded to standard antituberculous regimens in 4.6 weeks, on average, with residual hyperpigmentation. Conclusions In panniculitis patients, clues for the investigation of tuberculosis included constitutional symptoms, elevated erythrocyte sedimentation rate, and abnormal chest roentgenograms. Histopathologic changes of panniculitis did not seem to correlate with underlying tuberculosis. The clinician should be aware of the tuberculosis, however, and should carefully search for active foci in all panniculitis patients.
Familial pemphigus vulgaris in mother and daughter
Authors: Starzycki MD Zbigniew , Chorzelski MD Tadeusz P. , Jablonska MD Stefania 
Published: March 2003

BackgroundPemphigus vulgaris is an autoimmune disease in which genetics appears to be of basic importance. Although association with certain human leukocyte antigen (HLA) alleles has been found in some ethnic groups and individuals, no true disease susceptibility genes have been established, and familial cases are very unusual. MethodsWe report a Polish family with pemphigus vulgaris in the mother and daughter. The diagnosis was confirmed by cytologic, histologic, and immunofluorescence studies. ResultsThe course was severe and the disease long‐lasting in the mother, probably due to treatment with small doses of corticosteroids without immunosuppressive drugs. In the daughter, treated with larger doses of corticosteroids and azathioprine, the lesions regressed within 4 months, after which maintenance therapy was instituted with 10 mg of prednisone daily. The HLA studies performed in the daughter and her three children after the mother had died showed identical haplotypes in both the patient and the healthy children. The patient has given birth to a healthy child while still having a high titer of intercellular (IC) antibodies. ConclusionsThe familial occurrence of pemphigus in first‐degree relatives is suggestive of inherited susceptibility to the disease, transmitted as a dominant trait. The identical haplotypes in the healthy children of the patient favor the role of other, unknown factors required for the development of the disease in predisposed individuals.
Primary therapy of malignant melanomas: sentinel lymphadenectomy
Authors: Bachter MD Dieter , Balda MD Bernd‐Rüdiger , Vogt MD Harry , Büchels MD Herbert 
Published: March 2003

Background Each melanoma is drained by one or, occasionally, several individual lymph nodes within the nearest lymph node region (sentinel lymph node). Objective By histopathologic examination of the removed sentinel lymph node (SLN), it is possible to select patients clinically according to stage I or II (UICC classification), but who, microscopically, represent stage III. Methods Sentinel lymphadenectomies (SLNEs) were performed initially by the vital blue dye technique, and later by γ‐probe guidance only. The removed SLNs were examined by hematoxylin and eosin as well as immunohistochemical stains (S100, and HMB 45). Results We have performed 115 γ‐probe‐guided SLNEs in 100 patients. The SLN could be found in all cases. In pT3 + 4 melanomas, 27.5% of the SLNs were positive; in only one patient with a pT2 tumor were micrometastases found. Conclusionsγ‐Probe‐guided SLNE is a reliable procedure with minimal complications that should be performed in all pT3 + 4 (intraoperative frozen section histology) melanomas without clinically evident metastases.
Cutaneous leishmaniasis in Multan, Pakistan
Authors: Mujtaba Ghulam , Khalid Muhammad 
Published: March 2003

AbstractBackground Cutaneous leishmaniasis (CL) is endemic in certain areas of Pakistan. This study was carried out to determine the incidence and clinical pattern of the disease in Pakistan.Methods CL patients presenting in the out‐patient clinic of the Department of Dermatology, Nishtar Hospital, Multan from January 1995 to June 1997 were included in the study. The patients were diagnosed clinically and confirmed by laboratory demonstration of the parasite in a Giemsa‐stained smear from the lesion. All important clinical details were recorded on specially designed forms.Results Three hundred and five patients with 681 lesions were seen during 30 months. All the lesions were of the dry type. Most of the lesions (97%) were present on exposed areas of the body. One hundred and thirty‐four (44%) patients had one and 75 (24%) had two lesions. Eight five per cent of the sufferers were less than 30 years of age. The disease was slightly more preponderant in males (60%). Most cases presented during winter.Conclusions Lack of wet type lesions may be due to complete absence of Leishmania major in this area. This is in contrast to other areas of Pakistan where both dry and wet types of CL are present.