bluuebunny/crossref_metadata_2025_split huggingface dataset:
Socially marketed insecticide‐treated nets improve malaria and anaemia in pregnancy in southern Tanzania
Authors: Marchant Tanya , Schellenberg Joanna Armstrong , Edgar Tabitha , Nathan Rose , Abdulla Salim , Mukasa Oscar , Mponda Hadji , Lengeler Christian 
Published: March 2003

OBJECTIVES To study the uptake of socially marketed insecticide‐treated nets (ITNs) and their impact on malaria and anaemia in pregnancy; and to report on a discount voucher system which aimed to increase coverage in pregnancy. METHODS A 12‐month cross‐sectional study of women in the second or third trimester of pregnancy. ITN use and other factors were assessed by questionnaire and a blood sample taken for malaria parasitaemia and anaemia. `Non‐users' of ITNs included both women not using any net and women using untreated nets. RESULTS Fifty three per cent of pregnant women used ITNs. Women aged 15–19, primigravidae, unmarried women, and those with no access to cash had the lowest ITN use. Fewer ITN users were positive for malaria than ITN non‐users (25 vs. 33%: P=0.06), and the protective efficacy (PE) for parasitaemia was 23% (CI 2–41). Multiparous ITN users had a twofold decrease in parasite density compared with multiparous non‐ITN users (625parasites/μl vs. 1173 parasited/μl: P=0.01). Fewer ITN users were anaemic (Hb < 11 g/dl) than ITN non‐users (72 vs. 82%: P=0.01). ITNs had a PE of 12% (CI 2–21) against mild anaemia and a PE of 38% (CI 4–60) against severe anaemia (Hb < 8 g/dl). There was a trend in the prevalence of severe, mild and no anaemia, and of high density, low density and no malaria infection by ITN status. Recently treated nets were most effective at preventing malaria and anaemia (prevalence of mild anaemia was 68% compared with 82% for those without nets (P=0.002); prevalence of malaria was 22% compared with 33% for those without nets (P=0.02). Knowledge and reported use of the discount voucher system were low. Further qualitative research is ongoing. CONCLUSIONS A modest impact of ITNs on pregnancy malaria and anaemia was shown in our high malaria transmission setting. The development of ITN programmes for malaria control should include pregnant women as a specific target group.
Risk factors for presentation to hospital with severe anaemia in Tanzanian children: a case–control study
Authors: Kahigwa Elizeus , Schellenberg David , Sanz Sergi , Aponte John J. , Wigayi John , Mshinda Hassan , Alonso Pedro , Menendez Clara 
Published: March 2003

SummaryIn malaria endemic areas anaemia is a usually silent condition that nevertheless places a considerable burden on health services. Cases of severe anaemia often require hospitalization and blood transfusions. The objective of this study was to assess risk factors for admission with anaemia to facilitate the design of anaemia control programmes. We conducted a prospective case–control study of children aged 2–59 months admitted to a district hospital in southern Tanzania. There were 216 cases of severe anaemia [packed cell volume (PCV) < 25%] and 234 age‐matched controls (PCV ≥ 25%). Most cases [55.6% (n = 120)] were < 1 year of age. Anaemia was significantly associated with the educational level of parents, type of accommodation, health‐seeking behaviour, the child's nutritional status and recent and current medical history. Of these, the single most important factor was Plasmodium falciparum parasitaemia [OR 4.3, 95% confidence interval (CI) 2.9–6.5, P < 0.001]. Multivariate analysis showed that increased recent health expenditure [OR 2.2 (95% CI 1.3–3.9), P = 0.005], malnutrition [OR 2.4 (95%CI 1.3–4.3), P < 0.001], living > 10 km from the hospital [OR 3.0 (95% CI 1.9–4.9), P < 0.001], a history of previous blood transfusion [OR 3.8 (95% CI 1.7–9.1), P < 0.001] and P. falciparum parasitaemia [OR 9.5 (95% CI 4.3–21.3), P < 0.001] were independently related to risk of being admitted with anaemia. These findings are considered in terms of the pathophysiological pathway leading to anaemia. The concentration of anaemia in infants and problems of access to health services and adequate case management underline the need for targeted preventive strategies for anaemia control.
How better drugs could change kala‐azar control. Lessons from a cost‐effectiveness analysis
Authors: Boelaert M. , Le Ray D. , Van der Stuyft P. 
Published: March 2003

SummaryConditional on correct diagnosis and treatment, current drug regimens for visceral leishmaniasis (VL) will only prevent about 90% of deaths. Furthermore, the cost of pentavalent antimonials, the long duration of the regimen and its parenteral administration are major obstacles for patients. Poor patient compliance and the use of counterfeit drugs contribute to therapeutic failure, amplification of the reservoir and the appearance of drug resistance. We assessed the impact of potential improvements in chemotherapy on the cost‐effectiveness of VL test‐treatment strategies. Competing test‐treatment strategies were compared in a formal decision analysis – from the viewpoint of the clinician facing a VL suspect –, with avoided VL‐mortality and cost as outcomes of interest. Sensitivity analysis was done involving the following parameters: efficacy, toxicity and cost of treatment including patient care. When safer and more efficacious drugs are considered, they only result in a more cost‐effective strategy if the total cost of treatment falls below US$ 390 per patient. A serological test‐treatment strategy remains the optimal choice, also when better drugs become available.
Short communication: Use of a recombinant antigen‐based ELISA to determine prevalence of brugian filariasis among Malaysian schoolchildren near Pasir Mas, Kelantan – Thailand border
Authors: Rahmah N. , Lim B. H. , Azian H. , Ramelah T. S. Tengku , Rohana A. R. 
Published: March 2003

SummaryBrugian filariasis infects 13 million people in Asia. The routine prevalence survey method using night thick blood smear is not sensitive enough to reflect the actual infection prevalence. In 1997–2001, only three microfilaraemic cases (of 5601 individuals screened; 0.05%) were reported in Pasir Mas, a district in Kelantan (Malaysia), which shares a border with Thailand. We therefore investigated the infection prevalence in this district by employing a sensitive and specific serological assay (Brugia‐Elisa). This test is based on detection of specific IgG4 antibody against a Brugia malayi recombinant antigen. A total of 5138 children, aged 7–12 years, from 16 primary schools, were tested. Eighteen pupils in eight schools, located in five subdistricts, tested positive, giving an overall prevalence rate of 0.35%. Infection in these children is significant as they represent more recent cases. These subdistricts should be included in the national filariasis elimination programme.
Ultrastructural findings of feline eosinophilic dermatoses
Authors: Bardagí M. , Fondati A. , Ferrer L. 
Published: March 2003

Despite the increasing evidence that degeneration of collagen is not involved in the histogenesis of the eosinophilic debris observed with light microscopy in feline eosinophilic dermatoses (FED), flame figures and foci of ‘collagen degeneration’ are still reported as degenerated collagen mixed with degranulated eosinophils. The purpose of this study was to investigate ultrastructurally eosinophil degranulation pathways and dermal collagen morphology in FED. Four patients with histopathological diagnosis of FED, three clinically diagnosed with eosinophilic granulomas and one with an eosinophilic plaque, and one healthy control were studied. Areas that contained eosinophils, collagen, flame figures and ‘collagen degeneration’ were ultrasectioned and examined with transmission electron microscope. Eosinophils (48 to 123 per cat) were classified into resting (intact cells), undergoing piecemeal degranulation (PMD) (viable cells with partially empty granules) and cytolytic [disrupted cells with clusters of free eosinphil granules (Cfegs)]. Longitudinal and transverse sections of collagen fibrils were also evaluated. 9.01% of eosinophils examined were resting, whereas 90.98% had released their content, 70.14% by cytolysis and 20.84% by PMD. Collagen fibrils showed no ultrastructural abnormalities and appeared identical to those observed in the control. Flame figures and foci of ‘collagen degeneration’ appeared constituted by collagen fibrils–fibers interspersed with cytolytic eosinophils. Based on these findings we conclude that eosinophils play an active role in the pathogenesis of FED through their granule content release, by cytolysis and PMD. Moreover, based on the normal collagen ultrastructure, the use of the term ‘collagen degeneration’ to describe the eosinophilic debris observed with light microscopy in FED should be definitely avoided. The study was funded by a grant of the European Society of Veterinary Dermatology.
Epidermodysplasia verruciformis with neurological manifestations
Authors: Rubaie Salah Al , Breuer Judith , Inshasi Jihad , Saady Samira Al , Fathi Iman 
Published: March 2003

Abstract Background Epidermodysplasia verruciformis (EV) is a rare, inherited disorder in which there is widespread and persistent infection by multiple subtypes of human papilloma virus, tinea versicolor‐like lesions and plaques, and frequently malignant manifestations. Materials and methods We report two cases of EV—a sister and brother aged 14 and 18 years respectively. Both had classical skin lesions together with neurological manifestations and deafness. In addition the man had plantar hyperkeratosis. They were treated with etretinate. Conclusions PCR and DNA hybridization of skin lesions from the man contained HPV‐20 and HPV‐57. He was treated with long‐term oral acitretin; the warty lesions became partly or wholly flattened and the plantar hyperkeratosis showed a remarkable improvement. The woman died 10 years later as a result of metastasizing breast cancer.
A new model of epidermal culture for the surgical treatment of vitiligo
Authors: Andreassi Lucio , Pianigiani Elisa , Andreassi Andrea , Taddeucci Paolo , Biagioli Maurizio 
Published: March 2003

Abstract Background Vitiligo can be successfully treated with grafts of autologous cultured epidermal cells. Objective To evaluate the efficacy of autologous grafting of epidermal cells, cultured by an original method, in the treatment of localized vitiligo refractory to other therapies. Methods Autologous normally pigmented skin was used to culture keratinocytes and melanocytes on a supporting layer of biomaterial (Laserskin), which was grafted directly onto achromatic skin after de‐epithelialization with liquid carbon dioxide. The percentage area of repigmentation was calculated by image analysis. Results Initial repigmentation of the treated areas was observed 1 month after treatment. Repigmentation continued to increase for 3 months after grafting. Follow‐up at 3, 6, 12, and 18 months showed almost complete repigmentation in six out of 11 cases. In four other patients, 40–71% of the grafted achromatic area was repigmented. In one patient, repigmentation was impeded by sepsis. Conclusions The method was found to be effective in the treatment of localized vitiligo refractory to other treatments. The therapeutic procedure was simple, reproducible, and easy to use.
Lipid profile in actinic keratosis and basal cell carcinoma
Authors: Vural Pervin , Canbaz Mukaddes , Sekçuki Dilek , Murat Ahmet 
Published: March 2003

Abstract Background The lipid content of the skin and its changes are important in the pathogenesis of many disorders affecting the skin, particularly actinic keratosis (AK) and basal cell carcinoma (BCC). Methods Cholesterol, phospholipid, triglyceride, and total lipid levels were studied in paired lesional (AK and BCC) and nonlesional intact skin of 13 patients with AK and 12 patients with BCC. Serum concentrations of the same lipid fractions studied in the skin were investigated in AK and BCC patients and in 11 healthy, age‐matched controls. Results Levels of all lipid fractions were increased in both AK and BCC skin. When AK and BCC skin were compared with each other, a significant increase in phospholipids (p < 0.02) and total lipids (p < 0.01) was found in BCC. Serum cholesterol (p < 0.001), phospholipid (p < 0.001), triglyceride (p < 0.05), and total lipid (p < 0.001) concentrations of AK patients were significantly higher than those of the control group. When BCC and controls were compared, a significant increase in phospholipids and total lipids (p < 0.001) was seen. Serum cholesterol in BCC patients was significantly lower (p < 0.001) and serum phospholipid levels were significantly higher (p < 0.05) than those in the AK group. Conclusions An increase in the metabolically active serum phospholipid fraction is reflected in elevated neoplastic tissue phospholipid. This produces altered proportions between lipid fractions in tumorous areas and may result in changes in the intact nature of the cellular membrane, spread, and malignant proliferation.
Skin problems of musicians
Authors: Önder Meltem , Aksakal A. Burhan , Öztaş Murat Orhan , Gürer M. Ali 
Published: March 2003

Abstract Objective We investigated the skin problems of high level musicians in a professional orchestra. This study was prompted by our observation of violinists with skin changes. Methods Ninety‐seven musicians were evaluated. Twelve reporting dermatitis associated with the playing of their instruments were patch tested. We also examined 20 singers (nonplayers). Results Positive patch test reactions to nickel and colophony were found in only three patients. Musicians were subject to a variety of skin problems from playing their instruments, however, such as hyperhidrosis, cheilitis, and calluses of the fingertips. Singers had skin problems including lichen planus, psoriasis, seborrheic dermatitis, and urticaria. It was thought that emotional factors exacerbate their problems. Conclusions The results of this survey suggest a significant incidence of occupational‐ and stress‐related skin problems in musicians.
Mondor's disease
Authors: Mayor M. , Burón I. , De Mora J. Calvo , Lázaro T. E. , Hernández‐Cano N. , Rubio F. A. , Casado Mariano 
Published: March 2003

Abstract Background  Mondor's disease is a rare entity characterized by thrombophlebitis of the subcutaneous veins of the anterolateral thoraco‐abdominal wall. The most common clinical manifestations are a painful subcutaneous cord, sensation of tension, and skin retraction. This condition is usually a benign and self‐limited process, although it has been associated with breast cancer.Methods  We describe four new cases, two men and two women, and comment on the clinical signs and possible etiopathogenic features. General physical examination, radiologic and ecographic studies, laboratory analysis including tumor markers, and exhaustive coagulation study were carried out on all patients.Results  No cases were associated with malignant disease and/or hypercoagulability stage. With conservative treatment, the evolution proved favorable in all patients.Conclusions  Mondor's disease is usually a benign and self‐limited process, but we recommend laboratory studies and physical examination, including mammography in women, in order to rule out the presence of systemic disorders, especially breast cancer.
HLA in alopecia areata
Authors: Kavak Ayşe , Baykal Can , Özarmağan Güzin , Akar Uğur 
Published: March 2003

Abstract Background  The aim of this study was to investigate the human leukocyte antigen (HLA) characteristics of Turkish alopecia areata patients, and the correlation of the HLA profile with age of onset, severity and duration of the disease, presence of ophiasis, and family history.Methods  A total of 88 patients with alopecia areata, alopecia totalis, or alopecia universalis were compared with 100 healthy controls. HLA typing was performed by the Terasaki microlymphocytotoxicity method.Results  The frequency of HLA‐A1, HLA‐B62(15), HLA‐DQ1, and HLA‐DQ3 was significantly higher in patients than in controls. HLA‐DR16 was significantly less common in patients than in the control group, and we concluded that this allele might have a protective role for alopecia areata. Juvenile onset and severe involvement were related with HLA‐Cw7 and HLA‐DR1, respectively. The HLA profile was independent of the existence of long‐standing disease, presence of ophiasis, and a positive family history.Conclusions  In HLA–alopecia areata association, ethnic differences may play a role.
The molecular basis of dystrophic epidermolysis bullosa in Mexico
Authors: Salas‐Alanis Julio C. , Amaya‐Guerra Mario , McGrath John A. 
Published: March 2003

Abstract Background Type VII collagen gene (COL7A1) mutations are the cause of dystrophic epidermolysis bullosa (DEB), but most mutations are specific to individual families, and there are limited data on the nature of COL7A1 mutations in certain ethnic populations. Objective To determine the molecular basis of DEB in Hispanic Mexican patients. Methods Patients were recruited through a newly established support group, Fundaçion DEBRA México. Molecular analysis was performed by polymerase chain reaction (PCR) of genomic DNA using COL7A1‐specific primers, heteroduplex analysis, and direct nucleotide sequencing. Results Fifty‐nine of a possible 67 COL7A1 mutations (88%) were identified in 36 affected individuals (31 recessive, five dominant) in 21 families. Recessive mutations included six frameshift mutations, four silent glycine substitutions, and two splice‐site mutations. Dominant mutations comprised a de novo glycine substitution and an internal deletion. Conclusions This study establishes the molecular basis of DEB in a group of Mexican patients. Only two of the mutations have been identified previously in other ethnic groups; the remainder are specific to this population. These new data are helpful in facilitating the accurate diagnosis of DEB subtype, in improving genetic counseling, and in providing further insight into the pathophysiology of this mechanobullous disease.
Nevus lipomatosus cutaneous superficialis (Hoffmann‐Zurhelle) with localized scleroderma like appearance
Authors: Ioannidou Despina J. , Stefanidou Maria P. , Panayiotides Joannis G. , Tosca Androniki D. 
Published: March 2003

An otherwise healthy 56‐year‐old woman presented with three symptomless unilateral plaques extending from the right lower lip to the submandibular region and the posterior lateral cervical area. Initially, one year previously, a solitary 2 × 3 cm plaque appeared with irregular distinctive borders that extended progressively. Two new plaques with the same characteristics developed slowly near the initial one within six months. Their color was ivory‐pale, with a hyperpigmented margin. The lesions were primarily soft but later became firm and indurated with smooth, shiny, mild scaling, and wrinkled surfaces. A unilateral distribution with no contraction of the skin over the affected area was observed ( Fig. 1).Multiple plaques on the face, ivory‐pale colored with irregular borders, smooth, shiny, mild scaling and with wrinkled surfaceimageThere was no history of neurologic abnormalities or existence of skin lesions in other members of the family.X‐Ray of the mandibular area was normal as well as electroencephalogram and magnetic resonance imaging scanning of the brain. Laboratory examinations including blood cell counts, urinalysis, routine blood chemistry, immunoserologic and endocrinic functions tests, were within normal limits or negative. Antibodies against Borrelia burgdorferi were also negative. Histology showed slightly flattened epidermal ridges, and a slight mononuclear inflammatory infiltrate around capillaries of the papillary dermis. The thickness of the dermis was considerably reduced and adipocytes were present extending up to a short distance from the epidermis. The focal presence within the dermis of thickened collagen bundles was ascertained both in hematoxylin and eosin stained sections and in sections stained with Masson's trichrome. These bundles did not encircle cutaneous appendages, but extended instead into the underlying adipose tissue, delimiting clusters of adipocytes. A Verhoeff‐Van Gieson stain showed a marked reduction in the amount and caliber of elastic fibers in the dermis. All adipocytes had a unilocular cytoplasm without any nuclear abnormalities or size variation (
Fig. 2a,b). These histological features were consistent with the diagnosis of nevus lipomatosus cutaneous superficialis (NLCS).(a)  Clusters of adipocytes in the dermis, a short distance from the epidermis (Hematoxylin and Eosin, × 250). (b)  Marked reduction in the amount and caliber of elastic fibres in the dermis (Verhoeff–Van Gieson stain, × 400)imageThe presumptive clinical diagnosis was that of a connective tissue disorder classified as localized scleroderma (morphea) or a connective tissue nevus. Plastic surgery was not considered in our case mainly because of the extent and particular location of the NLCS.
Investigator‐masked comparison of tazarotene gel q.d. plus mometasone furoate cream q.d. vs. mometasone furoate cream b.i.d. in the treatment of plaque psoriasis
Authors: Koo John Y. M. , Martin Dale 
Published: March 2003

Seventy‐three patients with stable plaque psoriasis entered an investigator‐masked trial comparing once‐daily tazarotene 0.1% gel plus once‐daily mometasone furoate 0.1% cream with twice‐daily mometasone furoate 0.1% cream. The aim of the study was to determine whether tazarotene and mometasone furoate act synergistically –‐ a previous study showed that tazarotene plus mometasone furoate offered greater efficacy than tazarotene alone, and this study investigated whether tazarotene plus mometasone furoate also offered greater efficacy than mometasone furoate alone.The patients had psoriasis affecting up to 20% of their total body surface area, with at least moderate plaque elevation. Washout periods were: 2 weeks for UVB phototherapy or topical antipsoriatic therapies; 4 weeks for psoralen plus UVA (PUVA) therapy or systemic antipsoriatic drugs other than retinoids; and 8 weeks for oral retinoids. All patients gave written informed consent and the study was conducted in compliance with the ethical standards of the governing institutional review boards and the Declaration of Helsinki.Patients were treated for up to 12 weeks. If they achieved clearance by week 4, or at least 50% global improvement by week 12, they were entered into the 12‐week no‐treatment follow‐up phase.Patients were evaluated every 4 weeks in terms of percentage global improvement, plaque elevation, scaling, erythema, and pruritus. They also rated the efficacy of their own treatment (as very effective, effective, neutral, ineffective, or less effective) and the duration of improvement in their psoriasis (as much better, better, somewhat better, indifferent, or worse than that achieved with other topical medications they had used in the past).The two regimens were compared by analysis of variance, with the last recorded score for any patient who discontinued prematurely (due to lack of efficacy, adverse events, or disease flare) being carried forward to all subsequent visits.