bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sensitization to Ficus benjamina: relationship to natural rubber latex allergy and identification of foods implicated in the Ficus‐fruit syndrome
Authors: Hemmer W. , Focke M. , Götz M. , Jarisch R. 
Published: August 2004

SummaryBackground
Ornamental Ficus benjamina (FB) has been recognized as a new indoor allergen. Little is known about the prevalence in moderately exposed subjects and the proposed association with fruit and Hevea latex hypersensitivity.Objective
To study the prevalence of FB sensitization and the relationship with Hevea latex allergy, to identify cross‐reacting fruits, and to characterize the responsible allergens.Methods
A skin prick test solution prepared from FB latex (200 μg/mL) was included in our routine screening programme for suspect inhalant allergy. Patients reacting with the FB extract were further skin tested with exotic fruits by the prick‐to‐prick method. Inhibition of fig and FB CAP by FB latex, fig (Ficus carica), kiwi, the thiolproteases ficin and papain, Hevea latex and rHev b 6.02 (hevein) was performed in selected patients.Results
Of 2662 patients with a positive skin test to any aeroallergen, 66 (2.5%) reacted with FB. Ten patients showed isolated sensitization to FB. Although FB‐positive subjects were more often co‐sensitized to Hevea latex than FB‐negative (10.6% vs 3.8%, P<0.01), nearly 90% tested negative for Hevea latex. Sensitization to FB was specifically associated with positive skin tests to fresh fig (83%), dried fig (37%), kiwi fruit (28%), papaya (22%), avocado (19%), banana (15%), and pineapple (10%) (n=54). Clinical reactions were reported mainly from fresh and dried fig and kiwi (47%, 60%, and 64%, respectively, of skin test‐positive patients), including seven patients with systemic reactions (urticaria, angiooedema, asthma). CAP to fig in 11 patients with clinical fruit allergy was inhibited on average by 87% by FB latex, 89% by fresh fig, 80% by dried fig, 38% by kiwi (100 μg/mL each), and by 59% and 44% by ficin and papain (50 μg/mL), respectively. No inhibition was obtained with Hevea latex and rHev b 6.02. CAP to FB was inhibited on average by 95% by FB, 60% by fresh fig, 41% by ficin, 29% by papain, and less than 7% by rubber latex allergens.Conclusions
Sensitization to FB latex is found in 2.5% of atopic individuals and mostly occurs independently of Hevea latex allergy. Sensitization is commonly associated with allergic reactions to figs and other tropical fruits (‘Ficus‐fruit syndrome’). This cross‐reactivity is mediated at least in part by thiolproteases.
Specific immunoglobulin E for staphylococcal enterotoxins in nasal polyps from patients with aspirin‐intolerant asthma
Authors: Suh Y. J. , Yoon S. H. , Sampson A. P. , Kim H. J. , Kim S. H. , Nahm D. H. , Suh C. H. , Park H. S. 
Published: August 2004

SummaryBackground
Nasal polyps infiltrated with eosinophils are commonly found in chronic asthmatic patients, more frequently in those with aspirin‐intolerant asthma (AIA) than aspirin‐tolerant asthma (ATA). Some studies have suggested a contribution of superantigens derived from Staphylococcus sp to nasal polyposis and eosinophilia, but their relative importance in AIA and ATA subjects is unknown.Objective
We investigated whether local production of specific IgE to staphylococcal enterotoxins A and B (SEA and SEB) and relationships with markers of eosinophilic inflammation differ in the nasal polyps of AIA and ATA subjects.Methods
Fifteen AIA subjects with positive responses to lysine–aspirin bronchoprovocation and 15 ATA subjects underwent polypectomy. Immunoassays were used to quantify eosinophil cationic protein (ECP), IL‐5, mast cell tryptase, soluble IL‐2 recepters (sIL‐2R), total IgE, and specific IgE for SEA and SEB.Results
ECP levels in nasal polyp homogenates were higher in AIA subjects than in ATA subjects (P<0.02), with no significant differences in tryptase, IL‐5 or sIL‐2R. Total IgE, and specific IgE to both SEA and SEB, were detectable in some nasal polyps from both subject groups, but median levels were markedly higher in AIA subjects than in ATA subjects (P=0.04, 0.01, 0.05, respectively). Levels of specific IgE to SEA and SEB correlated significantly with levels of ECP and IL‐5, but not those of tryptase or sIL‐2R.Conclusion
These findings suggest that staphylococcal superantigens may drive local eosinophilic inflammation in nasal polyp tissue, and that this is exacerbated in subjects with AIA.
Introducing the Learning Practice – II. Becoming a Learning Practice
Authors: Rushmer Rosemary , Kelly Diane , Lough Murray , Wilkinson Joyce E. , Davies Huw T. O. 
Published: August 2004

AbstractRationale, aims and objectives  This paper is the second of three related papers exploring the ways in which the principles of Learning Organizations (LOs) could be applied in Primary Care settings at the point of service delivery.Methods  Based on a theoretical and empirical review of available evidence, here we introduce the process by which a Practice can start to become a Learning Practice (LP).Results and conclusions  Steps taken to enhance both individual and organizational learning begin the process of moving towards a learning culture. Attention is given to the routines that can be established within the practice to make learning systematically an integral part of what the practice does. This involves focusing on all three of single‐, double‐ and triple‐loop learning. Within the paper, a distinction is made between individual, collective and organizational learning. We argue that individual and collective learning may be easier to achieve than organizational learning as processes and systems already exist within the Health Service to facilitate personal learning and development with some opportunities for collective and integrated learning and working. However, although organizational learning needs to spread beyond the LP to the wider Health Service to inform future training courses, policy and decision‐making, there currently seem to be few processes by which this might be achieved. This paper contributes to the wider quality improvement debate in three main ways. First, by reviewing existing theoretical and empirical material on LOs in health care settings it provides both an informed vision and a set of practical guidelines on the ways in which a Practice could start to effect its own regime of learning, innovation and change. Second, it highlights the paucity of opportunities individual general practitioner practices have to share their learning more widely. Thirdly, it adds to the evidence base on how to apply LO theory and activate learning cultures in health care settings.
The impact of economic information on medical decision making in primary care
Authors: Wu Olivia , Knill‐Jones Robin , Wilson Philip , Craig Neil 
Published: August 2004

AbstractBackground  Many general practitioners (GPs) are concerned about the increasing dominance of economic issues in major decisions about clinical care, and feel their opinions on economic matters have not been heard. It is unclear whether this information has any impact on everyday clinical practice in a primary care setting.Aim  To investigate GPs’ perspectives on the use of economic information in medical decision making.Design of study  Cross‐sectional survey.Setting  GP members of the West of Scotland Primary Care Research and Development Network (WestNet).Methods  Questionnaire survey sent to GPs by post and by email.Results  The overall response rate was 44%, favouring postal over email responses. All respondents indicated that economic information has previously influenced them and should be incorporated into their medical decision making. The most common source of this information was generated by local authorities such as health boards, primary care groups and local prescribing advisors – used by 80% of the respondents. However, publications, such as the British Journal of General Practice, locally produced newsletters and prescribing formularies, and feedback from the General Practice Administration System for Scotland, were used as sources of economic information by 20%, 27% and 33%, respectively. Published materials – in particular, locally specific information and summarized information in leaflet format – were favoured (54%) in comparison to verbally presented material.Conclusions  GPs believe that economic information should be incorporated in medical decision making. The need for precise and summarized information, produced locally, has been highlighted. Better understanding towards the type of economic evidence GPs find useful and comprehensible is required.
How information retrieval technology may impact on physician practice: an organizational case study in family medicine
Authors: Pluye P. , Grad R. M. 
Published: August 2004

AbstractRationale  Information retrieval technology tends to become nothing less than crucial in physician daily practice, notably in family medicine. Nevertheless, few studies examine impacts of this technology and their results appear controversial.Aims and objectives  Our article aims to explore these impacts using the medical literature, an organizational case study and the literature on organizations.Methods  The case study was embedded in an evaluation of the implementation of medical and pharmaceutical databases on handheld computers in a Canadian family medicine centre. Six physicians were interviewed on specific events relative to the use of these databases and on their general perception of impacts of this use on clinical decision making and the doctor–patient relationship. A thematic data analysis was performed concomitantly by both authors.Results and conclusion  Findings indicate six types of impact: practice improvement, reassurance, learning, confirmation, recall and frustration. These findings are interpreted in accordance with both a medical and organizational perspective. The fit with the literature on inter‐organizational memory supports the transferability of the findings. In turn, this fit suggests how information retrieval technology may change physician routine. This study suggests a new basis for evaluating the impact of information retrieval technology in daily clinical practice. In conclusion, our paper encourages policy‐makers to develop, and physicians to use, this technology.
Evidence into practice: a theory based study of achieving national health targets in primary care
Authors: Michie Susan , Hendy Jane , Smith Jonathan , Adshead MSc FFPH Fiona 
Published: August 2004

AbstractRationale, aims and objectives  This study investigates reasons why general practices achieve nationally set milestones to different extents. It compares the beliefs, self‐reported behaviours and organizational context of general practitioners (GPs) who have been successful in achieving milestones set out in the UK's National Service Framework (NSF) for Coronary Heart Disease (CHD) with those who have been less successful.Methods  Sixteen London GPs were interviewed, eight ‘high implementers’ (having met five or more of six CHD NSF milestones) and eight ‘low implementers’ (having met one or two milestones). Practices were matched for practice size across the groups as far as possible. The interview consisted of open‐ended questions, based on theoretical constructs identified as key to implementation research in a previous project. Interviews were transcribed and analysed with Interpretative Phenomenological Analysis (IPA).Results  There were three main areas that differentiated high and low implementers: beliefs about evidence‐based practice, control over professional practice and consequences of achieving the milestones.Low implementers: (i) expressed less belief in evidence‐based guidelines as the basis of their practice; (ii) were more concerned about their lack of control over the development and implementation of the guidelines (lack of ownership), and over their own practice (lack of autonomy); and (iii) perceived more negative consequences and fewer positive consequences, both for themselves and for patient care.Conclusions  This study demonstrates the application of psychological theory in trying to understand and improve professional practice. The results suggest areas that could be targeted in developing interventions to increase guideline implementation in primary care.
Using iron deficiency tests for colorectal cancer screening: a feasibility study in one UK general practice
Authors: Edwards Adrian , Penney Michael , Allison Miles 
Published: August 2004

AbstractIron deficiency is common at presentation in colorectal cancer. Testing for it may complement other screening tests such as faecal occult blood testing and sigmoidoscopy. We therefore examined the feasibility of offering iron deficiency testing to patients in a primary care setting in the UK, offering testing to all 1240 patients aged 55–74 years in one general practice in South Wales, UK. Patients with abnormal results were assessed and offered further investigations. Five hundred and fifty‐one people (44.4%) attended for iron deficiency blood tests, of whom 26 patients (4.7%) were iron deficient and offered endoscopic assessment. This identified two cases of benign neoplasia amenable to treatment and no cases of cancer. Iron deficiency testing in a screening context appeared feasible although uptake may be low.
Modes of transmission of Glugea plecoglossi (Microspora) via the skin and digestive tract in an experimental infection model using rainbow trout, Oncorhynchus mykiss (Walbaum)
Authors: Lee S‐J , Yokoyama H , Ogawa K 
Published: August 2004

Abstract Glugea plecoglossi (Microspora) is a significant cause of economic loss in cultured ayu, Plecoglossus altivelis, in Japan, due to the unsightly appearance of infected fish harbouring xenomas in the body cavity. Modes of transmission of G. plecoglossi via the skin and digestive tract were studied in an experimental infection model using rainbow trout, Oncorhynchus mykiss. Combined with Uvitex 2B and in situ hybridization (ISH) assays, the early development of G. plecoglossi was successfully traced. Following a bath exposure of fish Uvitex 2B‐labelled G. plecoglossi spores were observed to attach to microscopic injuries (trypan blue‐positive sites) of fish skin, after which ISH‐positive sporoplasms were found to invade the epidermis as early as 5 min post‐infection (PI), migrating rapidly to the subdermis. It was also shown that G. plecoglossi entering via the skin does not spread into the internal organs but develops into subdermal xenomas. After rainbow trout were exposed to G. plecoglossi spores by oral intubation, spores germinated in the intestinal lumen, followed by penetration of sporoplasms into the gut mucosal epithelium 5 min PI. In vitro trials determining stimulation factors (fish mucus, changes in pH, digestive enzymes) for the extrusion of the polar tube were inconclusive. The present study indicates that skin wounds and the gut epithelium can be portals of entry of G. plecoglossi and that natural infection in fish seems to occur perorally rather than via the skin.
The induction of laboratory‐based amoebic gill disease revisited
Authors: Morrison R N , Crosbie P B B , Nowak B F 
Published: August 2004

AbstractPrevious work in our laboratory defined a method of inducing laboratory‐based amoebic gill disease (AGD) in Atlantic salmon, Salmo salar L. Gills of AGD‐affected fish were scraped and the debris placed into fish‐holding systems, eliciting AGD in naïve Atlantic salmon. While this method is consistently successful in inducing AGD, variability in the kinetics and severity of infections has been observed. It is believed that the infections are influenced by inherently variable viability of post‐harvest amoeba trophozoites. Here, a new method of experimental induction of AGD is presented that redefines the infection model including the minimum infective dose. Amoebae were partially purified from the gills of AGD‐affected Atlantic salmon. Trophozoites were characterized by light microscopy and immunocytochemistry and designated Neoparamoeba sp., possibly Neoparamoeba pemaquidensis. Cells were placed into experimental infection systems ranging in concentration from 0 to 500 cells L−1. AGD was detected by gross and histological examination in fish held in all systems inoculated with amoebae. The number of gross and histological AGD lesions per gill was proportional to the inoculating concentration of amoebae indicating that the severity of disease is a function of amoeba density in the water column. The implications of these observations are discussed in the context of the existing AGD literature base as well as Atlantic salmon farming in south‐eastern Tasmania.
Tinea capitis in a dermatology center in the city of Fortaleza, Brazil: the role of Trichophyton tonsurans
Authors: Brilhante Raimunda S. N. , Cordeiro Rossana A. , Rocha Marcos F. G. , Monteiro Andre J. , Meireles Tereza E. F. , Sidrim Jose J. C. 
Published: August 2004

AbstractBackground  Over a 3‐year period (March 1999 to March 2002), 944 patients with scalp lesions attended a dermatology reference center in the city of Fortaleza, Ceará, Brazil. Clinical specimens were examined at the Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza‐CE, Brazil, to detect patients with tinea capitis.Methods  Specimens were obtained from pus, scales, and hairs from suspected lesions of tinea capitis. Mycologic analyses were conducted by direct microscopy and by fungal culture on Sabouraud dextrose agar, with or without chloramphenicol and Mycosel agar. The culture tubes were incubated at 28 °C and examined daily for 1 month.Results  Fungi were seen in 438 (46.4%) of the 944 clinical specimens. The percentage of positive direct microscopic examinations of the clinical specimens was 83.7%. Of those patients with tinea capitis, 157 (35.8%) were males and 281 (64.2%; P < 0.001) were females. The distribution of dermatophyte species in males, from 136 positive cultures, was Trichophyton tonsurans (54.41%), Microsporum canis (38.97%), T. rubrum (4.41%), T. mentagrophytes var. mentagrophytes (1.47%), and M. gypseum (0.74%). On the other hand, only three species, from 251 positive cultures, were present in females: T. tonsurans (80.08%), M. canis (17.53%), and T. rubrum (2.39%). There was a high proportion of positive results in children under 10 years of age (n = 309). No significant difference was detected in the seasonal distribution of tinea capitis.Conclusions  Our data show that T. tonsurans is the main etiologic agent of tinea capitis, and is more likely to be found in females and in the prepubertal population.
Additional conjunctival and penile pigmentation in Laugier–Hunziker syndrome: a report of two cases
Authors: Ayoub Nakhlé , Barete Stéphane , Bouaziz Jean‐David , Pelletier François Le , Frances Camille 
Published: August 2004

AbstractBackground Laugier–Hunziker syndrome is a rare acquired hyperpigmentation of the oral mucosa and lips which is often associated with longitudinal melanonychia. We report two patients exhibiting the classical features of Laugier–Hunziker syndrome with additional and previously unreported conjunctival and penile pigmentation.Patients and methods Two patients presented with a history of progressive acquired macular pigmentation of the oral mucosa, the lips, the ocular conjunctiva and the penis. Longitudinal melanonychia was found in one patient. Microscopic features (basal epithelial melanosis, moderate acanthosis and superficial pigmentary incontinence) and ultrastructural details (increased number of normal‐appearing melanosomes inside basal keratinocytes and dermal melanophages) were characteristic of Laugier–Hunziker syndrome.Conclusions These two observations illustrate the topographical variations of Laugier–Hunziker syndrome and highlight the need to expand the originally described features to include more widespread areas of hyperpigmentation.
Use of Ber‐EP4 protein in recurrent metastatic basal cell carcinoma: a case report and review of the literature
Authors: Saladi Rao N. , Singh Fiza , Wei Huachen , Lebwohl Mark G. , Phelps Robert G. 
Published: August 2004

AbstractThe occurrence of metastatic basal cell carcinoma (MBCC) is extremely low, ranging from 0.0028 to 0.5%. We present a rare case report of MBCC in a 57‐year‐old Caucasian male with a known history of numerous nonmelanoma cutaneous neoplasms. The patient presented with a large ulcerated right axillary mass that recurred 2 months after an initial BCC was resected from the same site. An excisional biopsy of the recurrent mass and regional lymph nodes showed atypical basaloid cells with hyperchromatic nuclei, stromal retraction and rare squamous features in the soft tissue and lymph node. The tumor cells were bcl‐2 negative and positive for Ber‐EP4. The negative expression of bcl‐2 correlates with the aggressive nature of this tumor and Ber‐EP4 confirmed the diagnosis of BCC.
Bee moth (Galleria mellonella) allergic reactions are caused by several thermolabile antigens
Authors: Villalta D. , Martelli P. , Mistrello G. , Roncarolo D. , Zanoni D. 
Published: August 2004

Background:  Exposure and contact with bee moth (Galleria mellonella) larvae (Gm) can cause an allergic reaction both in anglers and breeders. We described the case of an amateur fisherman who experienced an allergic reaction using Gm but not using heat‐treated Gm (h‐Gm) (mummies). The aim of this study was to demonstrate by immunoblotting and radioallergosorbent test (RAST)‐inhibition experiments the loss of allergenic epitopes in h‐Gm extracts.Methods:  Galleria mellonella larvae and h‐Gm were homogenized and extracted at 10% (w/v) in 0.5 M phosphate‐buffered saline, pH 7.4 containing 0.5% NaN3 for 16 h at 4°C. Gm and h‐Gm extracts were electrophoresed in a 10% polyacrylamide precast Nupage Bis–Tris gel at 180 mA for 1 h and the resolved proteins stained with 0.1% Coomassie brilliant blue and the molecular weight calculated. For the immunoblotting detection of allergenic components the resolved extracts were transferred onto a nitrocellulose membrane and incubated with the patient's serum. Bound specific‐IgE was detected by peroxidase‐conjugated anti‐human IgE. RAST inhibition experiments were performed according to the Ceska method.Results:  The protein profile of Gm and h‐Gm extracts resulted markedly different in number, intensity and the position of bands, indicating that heat‐treatment modifies the chemical–physical characteristics of the protein contents. The Gm extract showed a strong‐coloured band at 73 kDa and more than 20 components ranging from 12 to 133 kDa; h‐Gm showed two main band at 77 and 38 kDa and about 15 faint bands between 20 and 133 kDa apparently without any correspondence to the bands present in the Gm extract. Immunoblotting with the patient's serum demonstrated several bands of reactivity with the Gm extract ranging from 20 to 100 kDa and no recognizable bands, but only a diffuse smear with h‐Gm. When used in a RAST inhibition experiment the h‐Gm extract demonstrated an inability to compete with the Gm one for the binding to patient's IgE serum.Conclusions:  The h‐Gm seems to lose the allergenic epitopes and has two advantages for anglers: to avoid new possible sensitizations as well as allergic symptoms in sensitized people, without interfering with their skills and satisfaction in their fishing performance.