bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and Pathological Features of the Porcine Ulcerative Dermatitis Syndrome (PUDS)
Authors: Schmoll F. , Sipos W. , Kahlbacher H. , Schilcher F. , Bagó Z. , Bunka S. , Miller I. , Schuh M. 
Published: April 2004

SummaryThe nomenclature of ulcerative dermatitis as used in literature is somehow confusing because on the one hand this skin disorder is associated with bacterial growth and on the other hand it is a synonym for a chronic sporadic disease of adult sows with unknown aetiology. Thus, we propose the terminus ‘Porcine Ulcerative Dermatitis Syndrome (PUDS)’ for the latter to distinguish between these two disease complexes. This syndrome could be identified by clinical and pathological examinations in six sows, that were submitted to the clinic. Epidermal ulcers could be found nearly all over the body, but teats were always spared. Haematological examination showed a slight anaemia but physiological leucocyte counts. However, lymphopenia (x = 44.8%), granulocytosis (x = 42.0%) and an increased number of monocytes (x = 13.1%) could be found. Histologically, a lymphoplasmacytic and granulohistiocytic infiltration in the corium was most prominent. In some cases, a moderate leucocytoclastic vasculitis and perivasculitis could be seen at the dermo‐epidermal border. Additionally, a multifocal interstitial nephritis with lymphoplasmacytic infiltration was a prominent feature in all animals. Participation of an immune complex associated disorder can be assumed when regarding histological findings as skin lesions in combination with glomerulonephritis are a common feature of such diseases. Also, IgG levels were elevated two‐ to fourfold in all affected sows when compared with healthy control pigs. This supports the hypothesis that not only T cells, as shown previously, but also the humoral branch of the immune system is involved in the aetiology of PUDS.
The use of pyruvic acid in the treatment of acne
Authors: Cotellessa C , Manunta T , Ghersetich I , Brazzini B , Peris K 
Published: April 2004

ABSTRACTBackground  Acne is one of the most common dermatological diseases, affecting about 50% of adolescents. Different chemical peelings are used in local treatment, either alone or in association with other therapies.Objective  To evaluate the efficacy and tolerability of chemical peeling with pyruvic acid for treatment of mild to moderate papulo‐pustular acne.Methods  We conducted an open‐label study in which patients affected by mild to moderate papulo‐pustular acne were treated with 40–50% pyruvic acid every 2 weeks for a total of 3–4 months. Forty patients (26 women and 14 men), ranging in age from 18 to 30 years, were enrolled in the study. Evaluations of sebum production and skin hydration were performed before and after treatment in 24 patients.Results  Complete remission was observed in 16 patients (40%), partial remission was detected in 20 patients (50%), and no improvement was seen in four patients (10%). No side‐effects were observed during or after treatment. Post‐treatment evaluation of sebum production in 24 patients revealed a reduction in sebum levels in all patients. Post‐treatment values of cutaneous hydration did not vary significantly from pretreatment values in the 24 patients evaluated.Conclusions  The results of our study indicate that peeling with pyruvic acid can be considered an effective, safe and well‐tolerated procedure in the treatment of patients affected by mild to moderate papulo‐pustular acne.
The effect of extracorporeal photopheresis on intracellular cytokine expression in chronic cutaneous graft‐versus‐host disease
Authors: Darvay A , Salooja N , Russell‐Jones R 
Published: April 2004

ABSTRACTBackground  Cytokines derived from T helper (Th)1 lymphocytes are thought to be involved in the pathogenesis of graft‐versus‐host disease (GVHD) and extracorporeal photopheresis (ECP) has been reported to affect Th1/Th2 lymphocyte ratios. It may also influence the balance of cytotoxic Tcells (Tc1/Tc2).Objectives  This study was formulated to assess the effect of ECP on the cytokine profiles of peripheral blood (PB) lymphocytes from patients with chronic GVHD.Patients and methods  Nine patients were studied. Peripheral blood was sampled at baseline and between 3 and 4 months of therapy when clinical effects are demonstrable. Intracellular cytokine production was assessed in vitro by stimulating PB lymphocytes with phorbol‐12‐myristate 13‐acetate (PMA), inhibiting cytokine release and staining with fluorescein‐labelled monoclonal antibodies to interleukin (IL)‐2, interferon gamma (IFN‐γ) and IL‐4. Flow cytometry analysis gave the absolute number and the percentage of cells expressing a particular cytokine within each lymphocyte subset.Results  Absolute counts of CD3, CD4, CD8, CD19 and CD16+ cells per microlitre were recorded before and after ECP. There was a small but non‐significant reduction in all subsets after 3 months of ECP. The percentage of cells expressing IL‐2 and IFN‐γ rose following ECP in both the CD4 and CD8 subsets. However, only the percentage of CD4 cells expressing IFN‐γ reached statistical significance (P = 0.02; 95% confidence interval, CI 0.6–15.6). There were no significant changes in the percentage of CD4 cells expressing IL‐4.Conclusions  Our findings appear to be inconsistent with current theories regarding the pathogenesis of GVHD as increased production of Th1 or Tc1 cytokines might be expected to exacerbate GVHD. However, chronic GVHD is characterized by a relative deficiency of IL‐2 and IFN‐γ producing cells compared with other patients post‐bone marrow transplantation (BMT). This indicates that Th1 and Tc1 cytokines are depleted in chronic GVHD. Thus, by reducing disease activity, ECP could allow cytokine production by these cells to recover. This indicates that the therapeutic effect of ECP is mediated by a different mechanism, and that the changes observed in this study are epiphenomena.
Pyogenic granulomas following topical application of tretinoin
Authors: Teknetzis A , Ioannides D , Vakali G , Lefaki I , Minas A 
Published: April 2004

ABSTRACTTopical tretinoin is used in the treatment of acne and other dermatoses. The most common side‐effects are itching, dryness and reddening of the skin. We report an additional cutaneous reaction, which occurred in patients using topical tretinoin. Pyogenic granulomas developed in two patients with acne and in one with dermatofibroma following application of tretinoin. The granulomas grew on the lesions after 2–3 weeks of therapy initiation. All patients were men and the granulomas developed in their trunk. The lesions resolved when topical tretinoin was ceased. Although the number of patients reported is too small to estimate the true incidence of this reaction, it is likely that dermatologists will encounter similar reactions in patients treated with topical tretinoin for acne or other reasons.
Cutaneous basosquamous carcinoma infiltrating cerebral tissue
Authors: Şendur N , Karaman G , Dikicioglu E , Karaman CZ , Savk E 
Published: April 2004

ABSTRACTBasosquamous carcinoma of the skin is a rare malignancy with specific histopathological features of both basal cell carcinoma and squamous cell carcinoma. Some authors believe that basosquamous carcinoma is a variant of basal cell carcinoma, while others suggest that this tumour may behave more aggressively. We present a 44‐year‐old female patient who was diagnosed with a basosquamous carcinoma histopathologically. She had extensive ulcero‐vegetative lesions, involving the anterior half of the scalp, the left orbit and the left side of the face. With this case we aim to emphasize the aggressive nature of basosquamous carcinoma and review the literature.
Serum interleukin‐6, procalcitonin and C‐reactive protein levels in subjects with active Behçet's disease
Authors: Adam B , Calikoglu E 
Published: April 2004

ABSTRACTBackground  Erythrocyte sedimentation rate (ESR), C‐reactive protein (CRP) and cytokines, including serum interleukin (IL)‐6, IL‐8 and IL‐10, and tumour necrosis factor‐alpha (TNF‐α) have been proposed as disease activity markers in Behçet's disease (BD), although studies have shown conflicting results for IL‐6. Serum procalcitonin (PCT) levels in active BD have not yet been investigated.Objective  The aim of the present study was to determine the reliability of serum IL‐6 and PCT levels as well as CRP as biological markers for activity of BD.Methods  Serum PCT, IL‐6 and CRP protein levels were measured in patients with active BD (n = 15) and in healthy control subjects (n = 15). IL‐6 and PCT levels were measured in serum by chemiluminescent assay. In addition, a nephelometric method was used to analyse CRP concentrations in serum.Results  Serum CRP and IL‐6 values were significantly higher in the subjects with active disease than in the healthy controls (P < 0.05), but there was no significant difference in the levels of PCT in the two groups.Conclusion  The results of our study suggest that serum CRP and IL‐6 levels are elevated in patients with active BD, but that serum PCT values are not elevated in these patients.
Closing the feedback loop: an audit of the use of imiquimod for the treatment of genital warts
Authors: Brady S , Wilson JD 
Published: April 2004

ABSTRACTA retrospective case‐note audit of 74 patients with 81 treatment episodes of anogenital warts with imiquimod from April 1999 until July 2000 was performed. The majority of patients had failed to clear their warts with other treatments, had recurrences after other treatments, or had other medical problems complicating their genital wart treatment. The overall clinically confirmed complete clearance rate was 33%. This is lower than other published data, but may be so because it includes patients with immunosuppression and difficult‐to‐treat warts. The complete clearance rate in immunocompetent patients was 37%. In addition, in this audit of clinical practice 17% of the patients did not return for full response to be assessed. The complete clearance rate in those who were able to tolerate treatment and who returned for follow‐up was 45%. Based on the results of the audit we have extended the indications for the use of imiquimod in the clinic treatment guidelines. Patients are now offered imiquimod if six or more episodes of other treatments fail to give a good response. Earlier treatment with imiquimod is also offered to those patients with recurrent anogenital warts, and it is recommended as a first‐line therapy for patients with multiple keratinized warts.
What Determines Corporate Transparency?
Authors: BUSHMAN ROBERT M. , PIOTROSKI JOSEPH D. , SMITH ABBIE J. 
Published: April 2004

ABSTRACTWe investigate corporate transparency, defined as the availability of firm‐specific information to those outside publicly traded firms. We conceptualize corporate transparency within a country as output from a multifaceted system whose components collectively produce, gather, validate, and disseminate information. We factor analyze a range of measures capturing countries' firm‐specific information environments, isolating two distinct factors. The first factor, interpreted as financial transparency, captures the intensity and timeliness of financial disclosures, and their interpretation and dissemination by analysts and the media. The second factor, interpreted as governance transparency, captures the intensity of governance disclosures used by outside investors to hold officers and directors accountable. We investigate whether these factors vary with countries' legal/judicial regimes and political economies. Our main multivariate result is that the governance transparency factor is primarily related to a country's legal/judicial regime, whereas the financial transparency factor is primarily related to political economy.
Investor Protection and Corporate Governance: Evidence from Worldwide CEO Turnover
Authors: DEFOND MARK L. , HUNG MINGYI 
Published: April 2004

ABSTRACTRecent research asserts that an essential feature of good corporate governance is strong investor protection, where investor protection is defined as the extent of the laws that protect investors' rights and the strength of the legal institutions that facilitate law enforcement. The purpose of this study is to test this assertion by investigating whether these measures of investor protection are associated with an important role of good corporate governance: identifying and terminating poorly performing CEOs. Our tests indicate that strong law enforcement institutions significantly improve the association between CEO turnover and poor performance, whereas extensive investor protection laws do not. In addition, we find that in countries with strong law enforcement, CEO turnover is more likely to be associated with poor stock returns when stock prices are more informative. Finding that strong law enforcement institutions are associated with improved CEO turnover‐performance sensitivity is consistent with good corporate governance requiring law enforcement institutions capable of protecting shareholders' property rights (i.e., protecting shareholders from expropriation by insiders). Finding that investor protection laws are not associated with improved CEO turnover‐performance sensitivity is open to several explanations. For example, investor protection laws may not be as important as strong law enforcement in fostering good governance, the set of laws we examine may not be the set that are most important in promoting good governance, or measurement error in our surrogate for extensive investor protection laws may reduce the power of our test of this variable.
Transitional Care of Older Adults Hospitalized with Heart Failure: A Randomized, Controlled Trial
Authors: Naylor Mary D. , Brooten Dorothy A. , Campbell Roberta L. , Maislin Greg , McCauley Kathleen M. , Schwartz J. Sanford 
Published: April 2004

Objectives: To examine the effectiveness of a transitional care intervention delivered by advanced practice nurses (APNs) to elders hospitalized with heart failure.Design: Randomized, controlled trial with follow‐up through 52 weeks postindex hospital discharge.Setting: Six Philadelphia academic and community hospitals.Participants: Two hundred thirty‐nine eligible patients were aged 65 and older and hospitalized with heart failure.Intervention: A 3‐month APN‐directed discharge planning and home follow‐up protocol.Measurements: Time to first rehospitalization or death, number of rehospitalizations, quality of life, functional status, costs, and satisfaction with care.Results: Mean age of patients (control n=121; intervention n=118) enrolled was 76; 43% were male, and 36% were African American. Time to first readmission or death was longer in intervention patients (log rank χ2=5.0, P=.026; Cox regression incidence density ratio=1.65, 95% confidence interval=1.13–2.40). At 52 weeks, intervention group patients had fewer readmissions (104 vs 162, P=.047) and lower mean total costs ($7,636 vs $12,481, P=.002). For intervention patients, only short‐term improvements were demonstrated in overall quality of life (12 weeks, P<.05), physical dimension of quality of life (2 weeks, P<.01; 12 weeks, P<.05) and patient satisfaction (assessed at 2 and 6 weeks, P<.001).Conclusion: A comprehensive transitional care intervention for elders hospitalized with heart failure increased the length of time between hospital discharge and readmission or death, reduced total number of rehospitalizations, and decreased healthcare costs, thus demonstrating great promise for improving clinical and economic outcomes.
Effect of Hip Fracture on Mortality in Elderly Women: The EPIDOS Prospective Study
Authors: Empana Jean‐Philippe , Dargent‐Molina Patricia , Bréart Gérard ,   for the EPIDOS Group
Published: April 2004

Objectives: To assess whether the occurrence of a hip fracture is associated with an increased risk of mortality even after taking into account age and prefracture health status and whether this increased risk of mortality persists beyond the first 6 months after the fracture.Design: A prospective study of risk factors for hip fracture.Setting: Five French areas: Amiens, Lyon, Montpellier, Paris, and Toulouse.Participants: The cohort consisted of 7,512 volunteer ambulatory women aged 75 and older who were recruited from voter registration lists. Women who had a history of hip fracture or bilateral hip replacement were excluded.Measurements: The baseline examination included a functional and clinical examination and a questionnaire on life style and treatments. Thereafter, women were followed every 4 months for 4 years to record the occurrence of fractures and deaths. A multivariable proportional hazards model was used to determine the association between hip fracture (treated as a time‐dependent variable) and mortality, after adjustment for age and baseline health status.Results: During a mean±standard deviation follow‐up of 3.9±0.9 years, 338 women had a first hip fracture, and their postfracture mortality rate was 112.4 per 1,000 woman‐years, compared with 27.3 per 1,000 woman‐years for the 6,115 women who did not have any fracture (P<.001). After adjusting for age and baseline health status, women with hip fracture were more than twice as likely to die (95% confidence interval (CI)=1.6–2.8). This increased risk appeared more pronounced in the first 6 months (relative risk (RR)=3.0, 95% CI=1.9–4.7) than after (RR=1.9, 95% CI=1.6–2.2) (P=.09).Conclusion: In ambulatory elderly women, the occurrence of a hip fracture is associated with an increased risk of death, even after prefracture health status is taken into account. Although the effect of the fracture is stronger in the first 6 months, it persists for several years thereafter, which suggests that prevention of hip fracture and improved care after the fracture may contribute to increase life expectancy in addition to preserving quality of life.
Infections and Functional Impairment in Nursing Home Residents: A Reciprocal Relationship
Authors: Büla Christophe J. , Ghilardi Giuseppe , Wietlisbach Vincent , Petignat Christiane , Francioli Patrick 
Published: April 2004

Objectives: To determine the relationship between infections and functional impairment in nursing home residents.Design: Prospective cohort study (follow‐up period, 6 months).Setting: Thirty‐nine nursing homes in western Switzerland.Participants: A total of 1,324 residents aged 65 and older (mean age 85.7; 76.6% female) who agreed to participate, or their proxies, by oral informed consent.Measurements: Functional status measured every 3 months. Two different outcomes were used: (a) functional decline defined as death or decreased function at follow‐up and (b) functional status score using a standardized measure.Results: At the end of follow‐up, mortality was 14.6%, not different for those with and without infection (16.2% vs 13.1%, P=.11). During both 3‐month periods, subjects with infection had higher odds of functional decline, even after adjustment for baseline characteristics and occurrence of a new illness (adjusted odds ratio (AOR)=1.6, 95% confidence interval (CI)=1.2–2.2, P=.002, and AOR=1.5, 95% CI=1.1–2.0, P=.008, respectively). The odds of decline increased in a stepwise fashion in patients with zero, one, and two or more infections. The analyses predicting functional status score (restricted to subjects who survived) gave similar results. A survival analysis predicting time to first infection confirmed a stepwise greater likelihood of infection in subjects with moderate and severe impairment at baseline than in subjects with no or mild functional impairment at baseline.Conclusion: Infections appear to be both a cause and a consequence of functional impairment in nursing home residents. Further studies should be undertaken to investigate whether effective infection control programs can also contribute to preventing functional decline, an important component of these residents' quality of life.
Hospice Admission Practices: Where Does Hospice Fit in the Continuum of Care?
Authors: Lorenz Karl A. , Asch Steven M. , Rosenfeld Kenneth E. , Liu Hui , Ettner Susan L. 
Published: April 2004

Objectives: To evaluate selected hospice admission practices that could represent barriers to hospice use and the association between these admission practices and organizational characteristics.Design: From December 1999 to March 2000, hospices were surveyed about selected admission practices, and their responses were linked to the 1999 California Office of Statewide Health Planning and Development's Home and Hospice Care Survey that describes organizational characteristics of California hospices.Setting: California statewide.Participants: One hundred of 149 (67%) operational licensed hospices.Measurements: Whether hospices admit patients who lack a caregiver; would not forgo hospital admissions; or are receiving total parenteral nutrition (TPN), tube feedings, radiotherapy, chemotherapy, or transfusions.Results: Sixty‐three percent of hospices restricted admission on at least one criterion. A significant minority of hospices would not admit patients lacking a caregiver (26%). Patients unwilling to forgo hospitalization could not be admitted to 29% of hospices. Receipt of complex medical care, including TPN (38%), tube feedings (3%), transfusions (25%), radiotherapy (36%), and chemotherapy (48%), precluded admission. Larger program size was significantly associated with a lower likelihood of all admission practices except restricting the admission of patients receiving TPN or tube feedings. Hospice programs that were part of a hospice chain were less likely to restrict the admission of patients using TPN, radiotherapy, or chemotherapy than were freestanding programs.Conclusion: Patients who are receiving complex palliative treatments could face barriers to hospice enrollment. Policy makers should consider the clinical capacity of hospice providers in efforts to improve access to palliative care and more closely incorporate palliation with other healthcare services.
Neuroleptic Drug Therapy in Older Adults Newly Admitted to Nursing Homes: Incidence, Dose, and Specialist Contact
Authors: Bronskill Susan E. , Anderson Geoffrey M. , Sykora Kathy , Wodchis Walter P. , Gill Sudeep , Shulman Kenneth I. , Rochon Paula A. 
Published: April 2004

Objectives:  To describe the incidence and dose of neuroleptic drug therapy newly dispensed for behavioral disorders to older adults admitted to nursing homes and to determine whether this use is associated with patient characteristics and contact with specialists.Design:  A retrospective cohort study using administrative data from a comprehensive and universal drug program.Setting:  All licensed nursing homes in Ontario, Canada.Participants:  All 19,780 adults aged 66 and older who had no evidence of neuroleptic drug use in the previous year and no history of major psychosis and were newly admitted to a nursing home between April 1, 1998, and March 31, 2000.Measurements:  Exposure to neuroleptic drug therapy and initial dose were measured using claims submitted to the Ontario Drug Benefit Program.Results:  A prescription for a neuroleptic therapy was dispensed to 17% of older adults with no previous neuroleptic exposure within 100 days and to 24% within 1 year of their nursing home admission. New exposure to a neuroleptic therapy was less likely in women (odds ratio (OR)=0.7, 95% confidence interval (CI)=0.6–0.8) and more likely in residents with dementia (OR=3.5, 95% CI=3.2–3.8). Almost 10% of nursing home residents received an initial dose that exceeded recommended thresholds. Only 14% of those newly exposed had prior contact with a geriatrician or psychiatrist.Conclusion:  Incident use of neuroleptics in Ontario nursing homes is substantial. Use of high doses suggests that some physicians may need better information about using these agents, particularly given the rapid adoption of atypical neuroleptic drug therapies.