bluuebunny/crossref_metadata_2025_split huggingface dataset:
Circumscribed palmar hypokeratosis: clinical evolution and ultrastructural study after prolonged treatment with topical calcipotriol
Authors: Urbina F , Misad C , González S 
Published: June 2005

AbstractCircumscribed palmar hypokeratosis is a recently described condition that consists of a solitary area of depressed skin affecting the palm (or sole). Its histopathological features include a thinned horny layer, a slightly diminished granular cell layer, and intraepidermal vacuolated cells. Prolonged treatment with topical calcipotriol resulted in complete recovery of the affected zone in the case reported here. A second biopsy of the lesion taken at around the fourth year of therapy showed a normalization of the granular layer, a reduction in the intraepidermal vacuolated cells, and a somewhat thicker horny layer. An ultrastructural study carried out at the same time showed a reduction in keratin bundles and keratohyalin granules, and an increase in lipid droplets up to the horny layer. These findings and the therapeutic response to topical calcipotriol support the concept that circumscribed palmar hypokeratosis is a focalized abnormal keratinization defect morphologically expressed at the granular and horny layers.
Recommendations for the topical treatment of psoriasis
Authors: Van De Kerkhof PCM , Kragballe K 
Published: June 2005

ABSTRACTSeveral topical treatments are available for patients with psoriasis. Although individualization of the treatment remains important, there is a need for treatment recommendations to identify the best treatment out of the available treatments and to help with improvement in treatment compliance. In this communication we give our views on the assessment of severity of psoriasis. We provide recommendations for selection of treatments, reconciling the clearance phase and the long‐term management. Finally, we provide recommendations for the treatment of particular localizations: the scalp and psoriasis at sensitive sites.
Effect of psoriasis treatment on plasma concentrations of metalloproteinase‐1 and tissue inhibitor of metalloproteinases‐1
Authors: Flisiak I , Myśliwiec H , Chodynicka B 
Published: June 2005

ABSTRACTAim  The aim of this study was to evaluate the effect of psoriasis treatment on plasma concentrations of metalloproteinase‐1 (MMP‐1) and tissue inhibitor of metalloproteinases‐1 (TIMP‐1) with respect to disease severity.Methods  MMP‐1 and TIMP‐1 were measured using an enzyme immunoassay in plasma of 32 patients before and after topical treatment. Data were analysed with respect to baseline values of the Psoriasis Area and Severity Index (PASI).Results  Baseline plasma concentrations of both TIMP‐1 and MMP‐1 (1487 ± 102 and 21.0 ± 2.5 ng/mL, respectively) were significantly higher (P = 0.02 and 0.03, respectively) than normal. Both TIMP‐1 and MMP‐1 decreased significantly after completion of treatment to values similar to normal (1112 ± 127 and 11.3 ± 1.3 ng/mL, respectively). There was a significant positive correlation (r = 0.522) between baseline PASI and TIMP‐1 values. Significant differences were observed between baseline TIMP‐1 concentrations in groups with PASI < 15 and PASI > 20. Baseline values (1697 ± 162 ng/mL) in patients with severe course of the disease (PASI > 20) were significantly elevated in comparison to normal values. Treatment caused a decrease in TIMP‐1 plasma concentrations in all groups, but a significant difference was noted only in patients with pretreatment PASI > 20. Baseline MMP‐1 concentrations exceeded significantly normal values only in patients with PASI < 15 (27.2 ± 6.3 ng/mL) and 15–20 (18.4 ± 1.4 ng/mL). Treatment caused a significant decrease in MMP‐1‐values in all groups to levels similar to normal.Conclusions  Our results confirm the role of TIMP‐1 and MMP‐1 in the pathogenesis of psoriasis. Pretreatment plasma TIMP‐1 increased whereas MMP‐1 decreased in patients with a more severe course of the disease. However, successful treatment causes normalization of these plasma protein concentrations irrespective of psoriasis baseline activity.
A phase I/II randomized, double‐blind, placebo‐controlled, dose‐ranging study evaluating the efficacy, safety and pharmacokinetics of ravuconazole in the treatment of onychomycosis
Authors: Gupta AK , Leonardi C , Stoltz RR , Pierce PF , Conetta B ,   the Ravuconazole onychomycosis group
Published: June 2005

ABSTRACTObjective  To determine the effectiveness and safety of ravuconazole in the treatment of toenail onychomycosis.Design  A phase I/II randomized, double‐blind, double‐dummy, placebo‐controlled, dose‐ranging study. Four 12‐week dosing regimens were used: 200 mg/day; 100 mg/week; 400 mg/week and placebo. Subjects returned at weeks 2, 4, 6, 8, 10, 12, 14, 16, 24, 36 and 48 for assessment. Subjects were enrolled at 10 dermatology practices (seven in the United States, one in Canada, two in France).Subjects  Adults with distal subungual onychomycosis of one great (hallux) toenail (minimum area of 25%), and at least 2 mm of proximal nail clear of disease were selected. Onychomycosis was confirmed by direct microscopy and/or fungal culture. Subjects with conditions known to produce abnormal‐appearing nails were excluded. One hundred and fifty‐one subjects were randomized in a 2 : 2 : 2 : 1 ratio to the treatments above.Main Outcome Measures  Primary efficacy was the effective cure rate at week 48 (mycological cure, and clinical cure or > 30% improvement).Results  Effective cure was found in 56% of subjects using 200 mg/day. Effective cure was 10% in subjects receiving 100 mg/week, 8% of subjects using 400 mg/week, and 15% of subjects using placebo. Mycological cure was seen in 59% of subjects in the 200‐mg/day group, which was significantly higher than the rates found in the other groups. Drug‐related adverse events were infrequent in all treatment arms. Headache was the most frequently reported event. Abnormal laboratory tests were infrequent over the 12 weeks of dosing. Abnormal laboratory findings with increases beyond normal of Grade 2, 3 or 4 were found in 8/148 subjects (5.4%). Only the 200 mg daily regimen had a mean plasma steady state concentration of ravuconazole exceeding the MIC90 adjusted for 98% protein binding (3000 ng/mL).Conclusions  For the treatment of onychomycosis, ravuconazole 200 mg/day for 12 weeks is the most effective of the regimens investigated. The safety of all regimens was acceptable. The concentrations of ravuconazole in the plasma compared to the adjusted MIC90 may be useful in predicting the clinical and mycologic response of therapy.
Reactivity to euro coins and sensitization thresholds in nickel‐sensitive subjects
Authors: Seidenari S , Giusti F , Pellacani G , Antelmi AR , Foti C , Bonamonte D , Ayala F , Balato G , Cristaudo A , Stingeni L , Lisi P 
Published: June 2005

ABSTRACTBackground  The 1‐ and the 2‐euro coins consist of nickel alloys, which release nickel. The nickel released by far exceeds the amount allowed by the European Union Nickel Directive referring to products intended to come into direct and prolonged contact with the skin. As there is only temporary contact with the skin, the clinical relevance of nickel‐containing coins with regard to nickel dermatitis is a matter of debate, although there is evidence that the nickel released from the coins affects some nickel‐sensitive subjects through occupational exposure.Objectives  Our aim was to study skin reactivity to euro coins, and to correlate the frequency and intensity of coin patch test responses to sensitization thresholds to nickel.Patients and methods  Sixty‐four nickel‐sensitized and 30 non‐nickel‐sensitized subjects were patch tested with serial dilutions of nickel sulfate (5, 1, 0.5, 0.1, 0.05, 0.01 and 0.005% in distilled water) and with coins. Italian coins (500, 200, 100 and 50 lira) and euro coins (2 and 1 euros, 20 and 5 euro cents) were used for patch testing and compared.Results  The application of 1‐ and 2‐euro coins to the skin induced eczematous reactions, being more frequent and intense in comparison with those provoked by other coins. A correlation between intensity of responses to coin patch tests and sensitization threshold to nickel was observed. Patients with the strongest reactions to 1‐ and 2‐euro coins showed positive responses to the lowest nickel concentrations.Conclusions  The nickel content in euro coins represents a possible health hazard, especially for highly nickel‐sensitive subjects. We recommend that nickel sulfate patch tests should be performed at different concentrations to determine sensitization thresholds at least in individuals with occupational exposure to coins.
Prevalence of Migraine and Cluster Headache in Swedish Men of 18
Authors: Ekbom Karl , Ahlborg Björn , Schéle Rickard 
Published: June 2005

SYNOPSISThe prevalence of migraine and cluster headache was investigated in a well‐defined homogeneous non‐hospital population of 9,803 18‐year‐old men from east central Sweden. The occurrence of headache was recorded by means of a questionnaire technique which proved to have a high degree of reliability as shown in personal interviews with a randomly chosen series of more than one‐fifth of the subjects. Personal interviews were held in all subjects. Personal interviews were held in all suspected cases of cluster headache. Recurrent headache occurred in 4.4% of the cases: migraine in 1.7%; cluster headache in 0.09%; other, non‐migrainous headache (MNH) in 2.6%. The majority of subjects had relatively frequent headaches, but only 43% of the migraine and 32% of the MNH subjects had sought medical advice for their complaint. Daily or almost daily consumption of analgetics was reported by 14% of the migraine and 11% of the NMH subjects. Ergotamine tartrate had been used by 15% of those suffering from migraine.Only 4 of the 9 subjects with cluster headache had been to a doctor on account of their headache, and only in one of them had a correct diagnosis been made. One subject had primary chronic symptoms, the remainder suffered periodically from cluster headache. Three subjects had symptoms since the age of 8‐9 years.
A Double Blind Trial of Acebutolol For Migraine Prophylaxis
Authors: Nanda R.N. , Johnson R.H. , Gray Janet , Keogh H.J. , Melville I.D. 
Published: June 2005

SYNOPSISDrugs which block adrenergic receptors have previously been used in the prophylactic treatment ofmigraine with varying success. We report a double blind crossover trial with the ß‐blocker acebutolol(Sectral, May & Baker Ltd) in which 43 patients took part. The number, frequency, duration and intensity of the headaches were recorded by the patients and results were analysed for the 33 patients who completed the trial. Plasma levels of acebutolol were measured during the trial. There was good patient compliance but here was no obvious correlation found between any of the parameters measured and the concentration of the drug. Although there was a general reduction in frequency with intensity of migraine during treatment when compared with a pre‐trial period, there was also a large placebo effect which made it difficult to separate the true effect of the ß‐blocking drug. 13 patients, however, said that they felt better during the period of the trial when they were receiving acebutolol and continued on this treatment when the trial finished. The value of acebutolol therefore requires further evaluation in such patients.
Plasma 18 Hydroxy‐ II ‐ Deoxycorticosterone In Dialysis Patients With Headache
Authors: Bana Dhirendra S. , Graham John R. 
Published: June 2005

SYNOPSISIn previous studies, we reported chronic hemodialysis patients who suffer with headaches to have low renin, low aldosterone, and high blood pressure. We report the role of plasma 18 Hydroxy‐II‐deoxycorticosterone 18 OHDOC as another mineralocorticoid responsible for such biochemical change. Plasma 18 OHDOC level was found to be low in these patients.
Mast Cells and Headache in Crohn's Disease
Authors: Atkinson Ruth , Appenzeller Otto 
Published: June 2005

SYNOPSISFour patients with vascular headaches of remarkable severity and chronicity not responding to usual therapies brought attention to their families in which at least two members each also have Crohn's disease. Hitherto an association of Crohn's disease with vascular headache of the migrainous type has not been recognized.One patient suffered bouts of extreme constipation at age four years. When eight years old he developed “screaming, pounding headaches”. During headaches, intermittent crampy periumbilical pain and diarrhea appeared. Subsequent radiologic and surgical evidence resulted in a diagnosis of Crohn's disease. His 11‐year‐old brother was seen for headaches which were intractable over a period of at least six months, but bowel symptoms has not appeared as yet. Their father has Crohn's disease.A 19‐year‐old woman with Crohn's disease presented with headaches of the migrainous type of eight months duration, resistent to all therapies. Her mother has Crohn's disease and migraine and a sister has peptic ulcers, “gaseous colon” and migraine.Resected bowel of three of these patients showed large numbers of mast cells. We suggest that vasoactive substances, including histamine released from mast cells, could cause headache. Moreover, impaired sulfate conjugation of monamines, or decreased monoamine oxidase in diseased bowel could facilitate the absorption and increase the circulation of vasoactive substances causing headache.
Rhinologic Causes of Facial Pain and Headache
Authors: Ryan Robert E. , Kern Eugene B. 
Published: June 2005

SYNOPSISFacial pain and headache are common and difficult problems encountered by physicians. A rather common cause, frequently overlooked, is rhinologic. Structural or nasal mucosal (or both) disorders are capable of producing facial pain or headache. In addition, either benign or malignant lesions of the nose and or paranasal sinuses can cause facial pain and headache. An outline of the various rhinologic causes for facial pain and headache is offered. Speculations and correlations with various experimental studies are included in an attempt to explain some of the mechanisms of referred pain from the nose and sinuses to the head and face.
Response of Cluster Headache Attacks to Oxygen Inhalation
Authors: Kudrow Lee 
Published: June 2005

SYNOPSISFifty‐two randomly selected patients diagnosed as having either active episodic or chronic cluster headaches were evaluated for symptomatic response to oxygen inhalation. At the onset of attacks, 100% oxygen was administered through a facial mask at a rate of 7 liters per minute, for 15 minutes. Each patient self‐treated ten attacks, and timed the rated reduction of pain. A successful treatment result required complete or almost complete reduction of pain in seven of ten attacks, within 15 minutes.In a second (crossover) trial involving an additional 50 patients, sublingual ergotamine tartrate (ErgomarÒ) was compared to oxygen inhalation for symptomatic relief of cluster attacks. Each patient treated ten attacks with either preparation in accordance with the crossover design. Oxygen was administered as described above. Sublingual ergotamine was used every five minutes, to a maximum of three tablets, if necessary.In the first trial 3952 (75%) of patients obtained significant relief from cluster pain. The greatest benefit (92.9%) was found among episodic patients under 50 years of age. The least benefit (57%), was found among chronic patients over 49 years of age. In the second trial, results among oxygen users were better (82%) than those of ergotamine users (70%), but not significantly. Rapidity of relief was similar in both groups.The results of both series indicate that oxygen inhalation is an efficacious symptomatic treatment for cluster attacks. It is superior to ergotamine since there are neither complications nor contraindications to its use. Ergotamine, however, has the advantage of convenience.
5‐Hydroxytryptamine in Platelets of Patients with Muscle Contraction Headache
Authors: Rolf L.H. , Wiele G. , Brune G.G. 
Published: June 2005

SYNOPSIS5‐Hydroxytryptamine (5‐HT) was determined in platelets of 23 patients with muscle contraction headache and the results were compared to those obtained in a control group of 20 healthy persons. 5‐HT was observed to be significantly lower in patients with muscle contraction headache as compared to the control group. It is concluded that 5‐HT may be involved in peripheral andor central pain mechanisms of muscle contraction headache.
EMG Biofeedback During Dynamic Movement as a Treatment for Tension Headache
Authors: Ahles Tim A. , King Abby , Martin John E. 
Published: June 2005

SYNOPSISRecent attempts to identify EMG elevations in patients with tension headaches have produced contradictory results. In the present case study, a 36‐year‐old male with a 17 year history of tension headaches was treated with trapezius EMG biofeedback while walking on a treadmill. The results demonstrated that: (1) EMG elevations could be identified during dynamic movement but not while in a static position and (2) EMG biofeedback during dynamic movement was effective in reducing EMG levels and headache activity. The results are discussed in terms of the potential importance of assessing and modifying patterns of elevated EMG activity which contribute to headaches during naturalistic activities such as walking.
Exteroceptive Suppression of Temporalis Muscle Activity in Patients with Chronic Headache and in Normal Volunteers: Methodology, Clinical and Pathophysiological Relevance
Authors: Schoenen J. 
Published: June 2005

SYNOPSISExteroceptive suppression of temporalis muscle activity was studied in patients with chronic headache and in healthy controls. Among different methods of recording, averaging 10 full‐wave rectified EMG responses produces results with acceptable variability and discomfort. The late temporalis exteroceptive suppression period (ES2) is reduced on average in patients with chronic tension‐type headache; this finding has been reproduced by several independent laboratories. Mean duration of temporalis ES2 is also diminished, but to a lesser degree, in daily drug abuse headache and, as shown by others, in episodic tension‐type headache. It is normal in migraine between attacks, cluster headache and various types of symptomatic headaches. Temporalis ES2 may be decreased in untreated patients with major depression.In healthy volunteers, temporalis ES2 duration is reduced by a short‐lasting painful stimulus to peripheral limbs after a delay of 50 to 60 ms, and by a sub‐motor threshold electromagnetic stimulation to the contralateral cerebral cortex after a delay of 20 to 30 ms. In contrast, long‐lasting trains of peripheral painful stimuli have no effect. Various pharmacological agents are able to modify temporalis ES2. Its duration is increased by 5‐HT antagonists, but decreased by 5‐HT uptake blockers. Pharmacological effects may differ between controls and patients. Considering these results and available data on the anatomo‐functional organization of masticatory reflexes, we postulate that temporalis ES2 is a marker of the excitability of interneuronal nets in the ponto‐medullary reticular formation. In chronic tension‐type headache, excitability of these interneurons is decreased because of inadequate control by the serotonergic raphe magnus nucleus and the periaqueductal gray matter. Dysfunctioning of the latter structures might be caused by abnormal limbic inputs to the brain stem. Some steps of this pathophysiological hypothesis can be verified by modern neurophysiological techniques.
Head Band for Migraine Headache Relief
Authors: Vijayan N. 
Published: June 2005

SYNOPSISApplication of an ice pack and local scalp pressure are the most commonly used non‐pharmacological methods for temporary relief of migraine headache pain. An elastic band secured around the head with Velcro(r) and firm rubber discs inserted under the band was used to apply local pressure over the area of maximum pain in 25 patients with migraine headache. Three headaches were studied in each patient. Two patients dropped out because of local tenderness which prevented them from using the band. The 23 remaining patients used the band in a total of 69 headaches. Pain relief was monitored for 30 minutes at 10 minute intervals. Sixty headaches (87%) were relieved. Nine headaches (13%) were not improved. Sixty‐seven percent of those who improved (40 headaches) had relief of over 80%, twenty‐five percent (15 headaches) improved between 50–60% and eight percent (5 headaches) had less than 50% improvement. Pain severity steadily increased when the band was released. Temporary relief of pain from mechanical compression of the scalp supports the possibility that at least part of the pain in migraine headache originates from dilated blood vessels in the scalp.
Failure to Mourn as a Possible Contributory Factor to Headache Onset in Adolescence
Authors: Kaiser Ronald S. , Primavera Joseph P. 
Published: June 2005

SYNOPSISPatients who have suffered from chronic headaches frequently are unable to identify a triggering physical or emotional event that precipitated the headache process. This study examined the headachehistories of teenage headache patients, the majority of whom were found to be depressed, and found that personal loss occurred within 12 months of headache onset in 11 of 15 cases. Among the losses that were identified were those involving terminal illness and death of family members, separation and/or divorce in the family, or change of residence from a familiar area.It is recommended that opportunities for dealing with feelings about their losses should be presented to patients, whether or not the patients express a need for this. Furthermore, it is recommended that patients of any age who cannot identify a triggering event prior to the onset of their headache histories should be questioned in detail about the possible correlation with personal loss.
Sometimes Jello Helps: Perceptions of Headache Etiology, Triggers and Treatment in Literature
Authors: Patterson Stephanie , Silberstein Stephen D. 
Published: June 2005

SYNOPSISThroughout history writers have attempted to describe the symptoms and evoke the misery of “a dismal headache.”Writers from Plato to Stephen King have used the phenomenology of headache to illustrate their work. Lewis Carroll, for example, vividly describes the central scotoma, tunnel vision, phonophobia, vertigo, distortions in body image, dementia and visual hallucinations that often accompany migraine.Although many authors have discussed the topic seriously, others have addressed the issue in a dismissive and even contemptuous manner, relegating this very real disorder to the status of a medical stepchild. We will examine headache etiology, triggers and treatment and explore the attitudes toward headache and headache sufferers found in literature.We have recently seen a growing understanding of the physiological basis of headaches. However, this knowledge has not yet reached the level of literature or popular culture. In an age when it seems every Sunday night brings a new “disease of the week” movie, and every human ill is subjected to often intense and numbing scrutiny by the media, the anguish of a chronic migraine sufferer will probably remain unexplored ‐ unless she kills her husband and children during an attack.