bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gastro‐oesophageal reflux disease in obesity: pathophysiological and therapeutic considerations
Authors: Barak N. , Ehrenpreis E. D. , Harrison J. R. , Sitrin M. D> 
Published: March 2003

SummaryGastro‐oesophageal reflux disease (GERD) is common in obese patients. Apart from the physical discomfort and the economic burden, GERD may increase morbidity and mortality through its association with oesophageal carcinoma. The pathophysiology of GERD differs between obese and lean subjects. First, obese subjects are more sensitive to the presence of acid in the oesophagus. Second, hiatal hernia, capable of promoting GERD by several mechanisms, is more prevalent among the obese. Third, obese subjects have increased intra‐abdominal pressure that displaces the lower oesophageal sphincter and increases the gastro‐oesophageal gradient. Finally, vagal abnormalities associated with obesity may cause a higher output of bile and pancreatic enzymes, which makes the refluxate more toxic to the oesophageal mucosa. The altered body composition associated with obesity affects the pharmacokinetics of drugs. There are no data regarding the efficacy of any of the drugs used for GERD treatment. The dosages of cimetidine and ranitidine should be calculated according to the patient’s ideal body weight, not their actual weight. Of the operative procedures used for weight loss, Roux‐en‐Y gastric bypass was found to be most effective for GERD, while gastric banding was associated with a high prevalence of reflux. This review outlines the pathophysiology and the treatment of GERD in obesity with emphasis on the therapeutic considerations in this population of patients.
Disseminated infection due to Encephalitozoon cuniculi in a patient with AIDS: case report and review
Authors: Fournier S , Liguory O , Sarfati C , David‐Ouaknine F , Derouin F , Decazes Jm , Molina Jm 
Published: March 2003

Objective and methods Infections due to microsporidia are increasingly recognized as opportunistic infections in patients with AIDS. We describe here a case of disseminated infection due to Encephalitozoon cuniculi and review the literature on this microsporidial infection. Results All 12 patients reported in the literature had AIDS and nine presented with disseminated infection involving the kidneys, sinuses, lungs, brain and conjunctiva. Asymptomatic infection was seen in three patients. Microsporidia were detected by light microscopy examination of urine samples in all the cases. Species identification was performed by various genotypic methods or transmission electron microscopy. Eight of 12 patients who received albendazole therapy experienced clinical improvement with documented clearance of spores in five of these eight patients. Two patients relapsed. Conclusions E. cuniculi infection should be considered in severely immunocompromised HIV‐infected patients with multi‐organ involvement and fever, especially when renal failure is present. Microsporidial spores are usually seen in urine samples and in the involved organ. Albendazole therapy seems to be effective.
Cutaneous primary paracoccidioidomycosis
Authors: Bustínduy M García , Guimerá Fj , Arévalo P , Castro C , Sáez M , Alom S Dorta , Noda A , Diaz‐Flores L , Montelongo R García 
Published: March 2003

AbstractParacoccidioidomycosis is a common fungal infection in Latin America. Few cases have been described in non‐endemic countries and their diagnosis without the correct suspicion, bearing in mind that the latency period might be up to 60 years, may not be easy.We report the case of a 59‐year‐old man who worked as a taxi driver for 25 years in Venezuela. Cutaneous paracoccidioidomycosis was diagnosed one year after he returned to Spain. No internal signs or symptoms of the disease were found and cell‐mediated immunity showed no depression.Our case suggested us to consider direct cutaneous infection, although respiratory tract is believed to be the most frequent portal of entry for this infection.
Second intention healing after Mohs micrographic surgery
Authors: Moreno‐Arias Ga , Izento‐Menezes Cm , Carrasco Ma , Camps‐Fresneda A 
Published: March 2003

AbstractBackground Although second intention healing has been used for many years in Mohs micrographic surgery, it has lost popularity. This is due to the long process and functional alteration of important anatomical units if certain wound healing factors are not carefully taken into consideration.Objective To review indications, contraindications, complications, advantages, disadvantages, as well as basic concepts of the wound healing process, wound care and antibiotic prophylaxis in the management of open wounds after Mohs surgery.Methods A short but comprehensive review of studies published in the literature dealing with second intention healing as a reconstruction alternative option in certain situations.Conclusions Second intention healing is a simple and cost‐effective method for reconstruction after Mohs micrographic surgery in well‐defined cases. It allows adequate tumoral control with good to excellent functional and cosmetic results.
The depression, anxiety, life satisfaction and affective expression levels in psoriasis patients
Authors: Devrimci‐Ozguven Halise , Kundakci Nihal , Kumbasar Hakan , Boyvat Ayse 
Published: March 2003

AbstractObjectiveThe aim of this study was to determine the effect of stressful life events on the onset and exacerbation of psoriasis, depression, anxiety, life satisfaction and affective expression levels in psoriasis patients and psychological risk factors related to psoriasis.MethodFifty psoriasis patients were examined dermatologically and psychiatrically and then administered the Beck Depression Inventory (BDI), Spielberger State‐Trait Anxiety Scale (STAI I–II), Life Satisfaction Scale (LSS), Courtauld Emotional Control Scale (CECS) and Body Image Satisfaction Scale (BIS). Symptom severity was measured by the Psoriasis Area Severity Index (PASI).ResultsThirty‐four patients declared that they had had a psychologically stressful life event in the last 3 months prior to the beginning of the illness. The mean PASI score was 1.75 ± 1.65; BDI score 13.58 ± 6.11; STAI‐I score 39.54 ± 9.18, STAI‐II score 46.58 ± 8.05; LSS score 9.18 ± 4.39; CECS score 51.64 ± 9.75; BIS score 93.74 ± 16.67.ConclusionPsoriasis patients reported significantly higher degrees of depression and more body cathexis problems than controls. In addition, the risk for developing psoriasis increased significantly in patients with moderate and severe depression. We also found a relationship between symptom severity and low affective expression and high BDI scores in this study. These findings suggest that the relationship between psoriasis and psychological problems can be reciprocal and requires further investigation.
Basal cell carcinoma on the dorsum of the hand: report of 11 cases
Authors: Van Zuuren Ej , Bastiaens Mt , Posma An , Bavinck Jn Bouwes 
Published: March 2003

AbstractBackgroundBasal cell carcinoma (BCC) is the most common cutaneous malignancy, although the appearance on the dorsum of the hand appears to be rare.ObjectivesThe purpose of this study was to identify and describe patients with BCC of the dorsum of the hand in a large cohort of BCC patients and to provide a review of the literature.MethodsEleven patients with a BCC on the dorsum of the hand were identified. Information on age at diagnosis, sex, treatment and follow up, presence of additional malignancies, etc., was gathered from medical records.ResultsBetween January 1985 and December 1995, 2990 BCCs were registered, of which 11 were located on the dorsal aspect of the hand (0.37%). Nine patients were male and most patients had a history of multiple skin malignancies. Most of the BCCs were nodular or had a nodular component. Solar elastosis was frequently seen. The percentage of 0.37% compares well with BCC located on the dorsum of the hand in other studies, but also with other parts of the body per skin surface area (except the face and neck area).ConclusionsThe density of BCC on the dorsum of the hand is much lower than in the face and neck area but compares well with other parts of the body.
Clearance of ichthyosis linearis circumflexa with balneophototherapy
Authors: Gambichler Thilo , Senger Erik , Altmeyer Peter , Hoffmann Klaus 
Published: March 2003

AbstractWe report a 13‐year‐old boy suffering from severe ichthyosis linearis circumflexa. Evidence of hair shaft abnormalities and impaired immunity could not be found. The patient was treated with salt water baths and artificial UVB radiation (balneophototherapy) 3–5 times weekly. After 40 treatments with balneophototherapy the skin lesions were almost completely cleared and maintenance UVB monotherapy was performed twice weekly for 2 months. After 4 months, however, the disease relapsed. Balneophototherapy presents a potentially effective and well tolerated phototherapeutic option for ichthyosis linearis circumflexa. As only short periods of remission may be expected, intermittent balneophototherapy would be probably necessary to control the disease.
Treatment of Miescher’s cheilitis granulomatosa in Melkersson–Rosenthal syndrome
Authors: Camacho F , García‐Bravo B , Carrizosa A 
Published: March 2003

AbstractCheilitis granulomatosa is the most frequent dermatological sign in the Melkersson–Rosenthal syndrome. We reviewed 27 cases of this syndrome diagnosed and treated in the last 20 years. All the patients were surgically treated and received intralesional corticosteroids during surgery and tetracycline hydrochloride (500 mg, twice daily) after the operation to prevent recurrence.
Verrucous form of chilblain lupus erythematosus
Authors: Pock L , Petrovská P , Becvár R , Mandys V , Hercogová J 
Published: March 2003

AbstractA 45‐year‐old woman had symmetrical livid plaques with yellowish hyperkeratoses for 5 years, which progressed on to the fingers and toes and on the soles of the feet. Two years later creamy, whitish areas and maceration appeared on the buccal mucosa and the lips. A skin biopsy revealed massive collagen hyaline degeneration in the perivascular area, hyperkeratosis and hypergranulosis, small lymphocyte infiltrates with several melanophages and extravasates of erythrocytes in the upper corium in perivascular areas and hydropic degeneration of basal keratinocytes. The findings using direct immunofluorescence were compatible with lupus erythematosus (LE). Laboratory investigation showed a slight leucopenia and thrombopenia, a slightly elevated erythrocyte sedimentation rate, hypocomplementaemia C3 and C4, a high titre of rheumatoid factor and antinuclear antibodies positivity of extractable nuclear antigen. The results reflected probably the development of a systemic form of the disease. The patient was successfully managed by methylprednisolone and hydroxychloroquine. After 1 year of therapy, a new skin biopsy revealed a substantial reduction of hyperkeratosis and hyaline degeneration of collagen tissue in the perivascular areas. The combination of the extensive hyperkeratosis and hyalinization thus seems to be features of the long‐lasting, untreated lesions in chilblain LE.
Nd:YAG 1064 nm laser in the treatment of facial and leg telangiectasias
Authors: Major A , Brazzini B , Campolmi P , Bonan P , Mavilia L , Ghersetich I , Hercogova J , Lotti T 
Published: March 2003

AbstractBackground Facial and leg telangiectasias are a frequent cosmetic concern for both females and males with various skin types and ages. To date the different treatments for these problems, in particular leg telangiectasias, have frequently failed or led to negative side‐effects.Objective This study examines the clinical effects and safety of applications with a 1064‐nm Nd:YAG laser system (SmartEpil II, DEKA M.e.l.a., Florence, Italy) to treat vessels on the face and legs.Materials and methods Twenty‐five subjects with facial telangiectasias underwent one treatment at 100 J/cm2, 10 ms and 2 Hz repetition rate. Thirty‐two subjects with leg telangiectasias, measuring 0.1–3 mm in diameter, were treated at 125–200 J/cm2, 10–30 ms and 2 Hz repetition rate. Subjects in this group underwent one to five treatment sessions at 8 week intervals.Results All subjects showed visible improvement, with 95–100% clearing of the face telangiectasias after only one treatment, and 50–100% clearing of the lower extremity vessels after three to five treatments. Transitory hypopigmentation was seen in two cases subjected to leg vessel treatment.Conclusions Treatment of facial and leg telangectasias using a true long pulse 1064 nm Nd:YAG laser is an effective and safe method. The relative lack of discomfort combined with a high degree of individual satisfaction should play a part in the fairly high level of acceptance of this new form of therapy for the treatment of leg and face telangiectasias.
Rheumatoid neutrophilic dermatitis: an initial dermatological manifestation of seronegative rheumatoid arthritis
Authors: Lazarov A , Mor A , Cordoba M , Mekori YA 
Published: March 2003

AbstractRheumatoid neutrophilic dermatitis (RND) is an uncommon, but distinctive manifestation of rheumatoid arthritis (RA). We describe the case of a 35‐year‐old female who developed RND as an early stage of seronegative RA. Clinically, the lesions were presented by erythematous, slightly tender, papules, 5–10 mm in diameter, on the extensor surface of the left arm. The histopathological findings revealed a dense, dermal, mainly neutrophilic infiltrate, with prominent leucocytoclasia, but without any features of vasculitis. There was fibrinoid degeneration of collagen, resembling the collagen changes present in rheumatoid nodules in a miniaturized form. RND can be a reliable, early clinical sign of RA, as seen in our patient. Furthermore, this case demonstrates that RND may be associated not only with seropositive RA, as described in the literature, but also with seronegative RA, never before reported. The histological findings in our case are remarkable because of the fibrinoid collagen degeneration, which is described here for the first time in RND. Thus, RND may, in fact, be the initial phase of a spectrum that begins with a neutrophilic reaction and mild fibrinoid collagen degeneration, and evolves into rheumatoid nodules at the final stage.
Inpatient dermatology: characteristics of patients and admissions in a Spanish hospital1
Authors: García‐Doval I , Feal C , Rosón E , De La Torre C , Abalde MT , Flórez A , Cruces MJ 
Published: March 2003

AbstractBackground Inpatient dermatology has not been properly described in many countries. National differences might be important in the evaluation of its usefulness and the applicability of politics of health expenditure restrictions.Objective To describe inpatient activity and readmission rates in a dermatology department in Spain.Study design Cross‐sectional prospective study in a single hospital.Setting Secondary care hospital of the National Health Service in Pontevedra (Spain).Methods From May 1997 to December 2000, all discharge sheets (1048) were included in the study, codified and described.Results Surgery was the reason for admission in 37% of the inpatients. The most frequent diagnosis were: neoplasm (36%), infection (15%), psoriasis (10%), other (10%), dermatitis (6%) and drug reaction (5%). Readmission rates were 1.8% within 30 days, and 12.5% within 1 year.Conclusions Inpatient dermatology is different in different countries. Compared with what has been described in the USA or UK, our data suggest an important surgical content of inpatient dermatology in Spain, not reported in those countries. Medical diagnoses also differ, consisting of more infections, and less psoriasis and dermatitis in our setting. Readmission rates are low when compared with previously published ones, a finding that supports a long‐term benefit of hospitalization.
Lichen sclerosus – a keratotic variant
Authors: Criado PR , Lima FHSD , Miguel DS , Valente NYS , Vasconcellos C , Sittart JAS 
Published: March 2003

AbstractWe describe an unusual case of keratotic lichen sclerosus with extragenital and genital lesions in a 34‐year‐old Brazilian man. The disease was characterized by several erythematous and brownish keratotic papules on the man's back, trunk and extensor areas of the limbs; histologic findings were typical of lichen sclerosus. Others atypical extragenital forms of lichen sclerosus are discussed.
Serum levels of interleukin‐18 and s‐ICAM‐1 in patients affected by psoriasis: preliminary considerations
Authors: Gangemi S , Merendino RA , Guarneri F , Minciullo PL , DiLorenzo G , Pacor M , Cannavò SP 
Published: March 2003

ABSTRACTObjective To find new aspects of the systemic involvement of the Immune System in psoriasis, we determined serum levels of interleukin‐18 (IL‐18) (Th1‐inducing factor cytokine), CD30 (Th2 marker) and sICAM‐1 (adhesion molecule). In addition we evaluated the correlation between these molecules and psoriasis area and severity index (PASI).Background Psoriasis is associated to an overexpression of Th1 cytokines and a relative underexpression of Th2 cytokines.IL‐18 plays an important role in inducing Th1 response because it is a potent inductor of synthesis of IFN‐γ, TNF and other mediators. The two major sources of IL‐18 are monocytes and macrophages but also human keratinocytes constitutively synthesized IL‐18.Subjects and methods We selected two groups of subjects: 16 healthy donors (HD) and 16 patients affected by psoriasis, matched for sex and age.Serum IL‐18, CD30 and sICAM‐1 levels were assayed by immunoenzymatic method with commercial kits.Results IL‐18 and sICAM‐1 levels in the patients were significantly higher than in the HDs (385.94 ± 193.89 vs. 227.38 ± 92.76 pg/mL, P = 0.005 and 445.00 ± 152.67 vs. 317.88 ± 107.20 ng/mL, P = 0.02, respectively).On the contrary, no significant difference was found between serum sCD30 levels of patients in respect to those of HDs.A significant correlation was found between serum IL‐18 and PASI (Rho = 0.695, P = 0.0071), serum IL‐18 and sICAM‐1 (Rho = 0.543, P = 0.0356) and between sICAM‐1 and PASI (Rho = 0.659, P = 0.0107).
Turner's syndrome associated with psoriasis and alopecia areata
Authors: Rosina P , Segalla G , Magnanini M , Chieregato C , Barba A 
Published: March 2003

ABSTRACTTurner's syndrome is a sex chromosomal abnormality characterized by gonadal failure, short stature, skeletal and medical anomalies due to structural defects or monosomy of the X chromosome. The association between this syndrome and autoimmune diseases has been reported in the literature. This case report highlights the finding of two immunological skin diseases, alopecia areata and psoriasis, in an 18‐year‐old girl with Turner's syndrome. By the time of her referral to the Department of Dermatology, Verona University (Italy) the girl had suffered from psoriasis on the scalp for 5 years and alopecia for 6 months; the diagnoses were confirmed by histological evaluation. Topical therapy was useful for the treatment of the psoriatic lesions but not for the alopecia areata. Alopecia areata and psoriasis occurring together in Turner's syndrome may indicate some genetic relationship and could support the concept that these patients have the tendency to develop autoimmune or immunological diseases. Anxiety, depression and unsatisfactory relationships could have been important trigger factors in our patient. Multidisciplinary management, including psychological, educational and behavioural techniques, in addition to other therapies, could be useful in treating these conditions.
Nitric oxide levels in Behçet's disease
Authors: Sancak B , Önder M , Öztas MO , Bukan N , Gürer MA 
Published: March 2003

ABSTRACTBehçet's disease(BD) is a chronic multisystemic disorder which is characterized by a relapsing systemic inflammatory process. In certain inflammatory conditions such as rheumatoid arthritis, over production of nitric oxide (NO) could damage host cells and tissues, either directly and/or following reaction with other free radicals, such as superoxide anion to form species including peroxynitrite or hydroxyl radicals. Excessive superoxide radical production and impaired antioxidant mechanism in both the neutrophils and plasma of patients with BD have been reported. Our study was designed to investigate the role of NO in BD. NO is an extremely unstable molecule and rapidly converted in vivo and in vitro to nitrate () and nitrite (). For this reason serum and have been used as an index of NO generation. We measured serum nitrate + nitrite levels, by using an enzymatic one‐step methodology based on the reduction of nitrate to nitrite by nitrate reductase from Aspergillus species, in the presence of β‐NADPH. When compared to healthy controls, serum nitrate + nitrite levels were found to be higher in active periods of BD patients (P < 0.01). It was concluded that increased NO production in patients with BD might have critical biological activities relevant to vasculitic events in the active period of disease.
The differential diagnosis of enlarged hyperechogenic kidneys with normal or increased liquor volume: report of five cases and review of the literature
Authors: Chitty L. S. , Griffin D. R. , Johnson P. , Neales K. 
Published: March 2003

AbstractWe report five cases of enlarged, hyperechogenic kidneys detected prenatally where the liquor volume was normal or increased. The etiology was different in all cases and included infantile and adult polycystic kidney disease, Perlman syndrome, trisomy 13 and cystic dysplasia. The differential diagnosis of such findings is discussed and other cases reported in the literature are reviewed. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Is the ultrasound definition of fluid collections in non‐immune hydrops fetalis helpful in defining the underlying cause or predicting outcome?
Authors: Skoll M. A. , Sharland G. K. , Allan L. D. 
Published: March 2003

AbstractThe ultrasound findings in 132 patients with non‐immune hydrops referred for echocardiographic assessment were retrospectively reviewed. Structural assessment was combined with evaluation of pleural and pericardial effusions, ascites and skin edema. Patients were divided into groups based on the underlying etiology of hydrops. Seventy patients were found to have cardiac abnormalities, including 45 with structural heart disease. Other causes included. chromosomal anomalies, infection, extra‐cardiac anomalies, genetic syndromes and, in 40 patients, unknown cause. Analysis of patterns of fluid accumulation revealed a significantly decreased incidence of pleural effusions and ascites in fetuses with an underlying cardiac abnormality. Cardiomegaly based on the cardio‐thoracic ratio was significantly more frequent in the cardiac group. When patients were grouped by outcome, no pattern of fluid distribution was found to be characteristic for survival or death. We conclude that ultrasound definition of fluid collections in non‐immune hydrops may be helpful in predicting the underlying cause of the hydrops, although there are no specific patterns predictive of outcome. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Doppler studies of the uteroplacental circulation in pregnancies complicated by diabetes
Authors: Bracero L. A. , Schulman H. 
Published: March 2003

AbstractThe aim of this study was to evaluate the uteroplacental side of the circulation in pregnancies complicated by diabetes. A total of 54 women with pregnancies complicated by diabetes underwent uterine and umbilical artery Doppler studies. Uterine Doppler velocity waveforms were not obtained in two women. The prevalence of abnormal uterine artery velocity waveforms was much higher than in a non‐diabetic population (15.4% vs. 2%, p < 0.001). Those eight women with abnormal uterine Doppler studies had a statistically higher incidence of poor glycemic control, chronic hypertension, polyhydramnios, vasculopathy, pre‐eclampsia, Cesarean births for fetal distress and newborns with respiratory distress syndrome. In this group of patients, the umbilical circulation was not considered to be a contributing factor in the development of problems. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology