bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in lean body mass and total body weight are weakly associated with physical functioning in patients with HIV infection
Authors: Wilson IB , Jacobson DL , Roubenoff R , Spiegelman D , Knox TA , Gorbach SL 
Published: March 2003

ContextFor clinicians managing weight loss in patients with HIV, it would be useful to understand how changes in lean body mass (LBM) effect physical functioning, and whether LBM is more strongly related to physical functioning than total body weight (TBW).ObjectiveTo determine the relationship of changes in LBM and changes in total body weight (TBW) to changes in self‐reported physical functioning in men and women with HIV infection.MethodsStudy design was longitudinal analysis of 1474 patient‐intervals (each interval was approximately 6 months long) in 486 persons. Patients were participants in Nutrition for Healthy Living, a cohort study of HIV positive persons in Massachusetts and Rhode Island. The main outcome measure was change in self‐reported physical functioning.ResultsOf the 1474 intervals, 1165 were contributed by men and 309 by women. The mean CD4 count for the 1474 intervals was 383 cells/µL. In men, 5 kg changes in LBM and TBW were associated with 2.2 (95% confidence interval, 0.9, 3.4, P= 0.001) and 2.6 (95% confidence interval, 1.3, 3.9, P= 0.0002) point changes in physical functioning (on a 100‐point scale), respectively, after adjusting for covariates. The relationships of changes in LBM and TBW to changes in physical functioning were linear. In women, there were no significant relationships between changes in LBM or TBW to changes in physical functioning.ConclusionsIn this longitudinal analysis of relatively healthy persons with HIV infection, changes in LBM and TBW were significantly related to changes in physical functioning in men, but the magnitude of the relationship was small. In women, changes in LBM and TBW were not related to changes in physical functioning. Our data suggest that it is not necessary to measure body composition (lean and fat compartments) to understand the impact of changes in weight on physical functioning – it is sufficient to follow total body weight.
Discrepant results in the interpretation of HIV‐1 drug‐resistance genotypic data among widely used algorithms
Authors: Kijak GH , Rubio AE , Pampuro SE , Zala C , Cahn P , Galli R , Montaner JS , Salomón H 
Published: March 2003

ObjectivesThe aim of this study was to assess the concordance on the interpretation of HIV‐1 drug‐resistance genotypic data by three widely used algorithms: Stanford University Database (SU), TruGene (Visible Genetics, Canada) (VG) and VirtualPhenotype (Virco, Belgium) (VP).MethodsGenotypic data from 293 HIV‐1‐infected individuals with treatment failure was interpreted for 14 antiretroviral drugs by the three algorithms.ResultsComplete concordant results among the three systems for all the drugs studied were found in 40/293 (13.7%) samples. Low concordance in the interpretation was observed for most nucleoside reverse transcriptase inhibitors (NRTIs), while results agreed highly for all nonnucleoside reverse transcriptase inhibitors (NNRTIs) and most protease inhibitors (PIs). In pair‐wise comparisons, discordant interpretations between SU and VP were found in over 50% of the samples for didanosine, zalcitabine, stavudine and abacavir, and the level of disagreement between VG and VP exceeded 40% for the same drugs. Major discrepancies (high‐level resistance interpretation by one algorithm with sensitive interpretation by another) were observed between VG and VP in over 10% of the cases for didanosine, zalcitabine, stavudine and abacavir. On the other hand, the three algorithms had concordant results for lamivudine in over 90% of the cases.ConclusionsThis work demonstrates the great level of discordance in the interpretation of genotyping results among algorithms, clearly showing the necessity for clinical validation. Moreover, these results suggest that a joint effort from the scientific community as well as national and international HIV societies is needed to achieve a consensus for the interpretation of genotypic data.
Modelling the 3‐year risk of myocardial infarction among participants in the Data Collection on Adverse Events of Anti‐HIV Drugs (DAD) study
Authors: Law M , Friis‐Møller N , Weber R , Reiss P , Thiebaut R , Kirk O , D'Arminio Monforte A , Pradier C , Morfeldt L , Calvo G , El‐Sadr W , De Wit S , Sabin CA , Lundgren JD ,   for the DAD Study Group
Published: March 2003

ObjectivesTo estimate the 3‐year risk of myocardial infarction (MI) among participants in the Data Collection on Adverse Events of Anti‐HIV Drugs (DAD) study.MethodsConventional cardiovascular risk equations were applied to baseline data from the DAD study to estimate the 3‐year risk of MI. Best estimates were obtained by simply applying the risk equations, with upper and lower limits based on worst case and optimistic case scenarios. Three‐year risks of AIDS or death were also estimated based on a prognostic scoring system for patients receiving antiretroviral (ARV) treatment, and on estimated AIDS rates in untreated people with HIV for those patients not on ARVs or if they were to cease ARVs.ResultsAnalyses were based on 17 600 patients (24.3% female) recruited into the DAD study with baseline data and no previous MI. The overall 3‐year risk of MI was estimated to be 0.72% (lower limit 0.35, upper limit 1.12%), corresponding to a total predicted 127 (65–197) MIs over a 3‐year follow‐up period. The risk was much greater for men than women (0.92% vs. 0.07%), with only three (2–8) MIs predicted in women. The 3‐year risk of MI was estimated to increase from 0.30% (0.20–0.38%) in ARV naive patients to 1.07% (0.43–1.77%) in patients receiving ARVs from all three drug classes. The estimated 3‐year risk of AIDS or death was in the range 6.2% to 11.1% in patients receiving ARVs if they continued treatment, and 22.5% to 29.4% if they ceased ARVs.DiscussionThese models suggest that although the increase in relative risk of MI as a result of ARV treatment may be as high as threefold in a worst case scenario, the absolute risk is modest with a best estimate of 3‐year risk less than or equal to 1% in all groups of patients, and is outweighed by the benefits of ARV treatment in terms of reduced risk of AIDS and death in most patients. As estimates are based on models not validated for people receiving ARV drugs, all estimates should be interpreted cautiously.
Epidemiological study of classic Kaposi’s sarcoma: a retrospective review of 125 cases from Northern Israel
Authors: Weissmann A , Linn S , Weltfriend S , Friedman‐Birnbaum R 
Published: March 2003

Abstract Background The morphology of Kaposi’s sarcoma is clinically and histologically the same in all clinical forms of the disease. However, there is a difference in the clinical and biological behaviour of the different forms of the disease. The behaviour also differs among individuals with the same form. The factors involved in the initiation and prognosis of the disease are still unknown. The classical form is more common in middle‐aged Jews of East European or Mediterranean origin, people of Italian and southern Greek origin. Classic Kaposi’s Sarcoma is seen relatively more frequently in Israel than in many other countries. Objective The aim of this study was to examine risk factors that influence the development and course of the disease. Methods This retrospective study includes 125 patients with Kaposi’s sarcoma, all diagnosed and followed in the Department of Dermatology at Rambam Medical Center in Haifa. Results The group included 85 (68%) men and 40 (32%) women. Fourteen subjects received corticosteroid therapy and three were kidney transplant recipients. Age at onset of the disease was 21–87 years, with a mean age of 67. A total of 121 patients (96.8%) were Jews and four (3.2%) were non‐Jews. A majority (61.6%) were of East European origin. The number of new cases each year was constant in relation to the general population, except for two peaks, one in 1970 and another in 1986–89. The lower limbs were involved in most patients.123 Extracutaneous involvement was present in 18.4%. Of all the subjects, 28 (22.4%) had diabetes mellitus and 21 (16.8%) had a second primary malignancy. The malignancies were of lymphoreticular origin in 10 patients, four in the urinary bladder, three had carcinoma of the large bowel and one of the pancreas. Conclusion Our study shows similar clinical findings to those described in other series. The relatively high frequency of carcinomas of the colon and urinary bladder was not reported elsewhere. We observed a consistent rate of new cases each year with two peaks in 1970 and 1986–1989, the cause of which deserves explanation. Of interest is the relative rise in the number of females with Kaposi’s sarcoma. A relative high risk for developing Kaposi’s sarcoma has been found among Jews of Ashkenazi origin compared to those of other ethnic groups. Israeli‐born subjects presented a relatively more aggressive course of disease than others.
Melanoma screening: results of the first one‐day campaign in Belgium (‘Melanoma Monday’)
Authors: Vandaele Mm , Richert B , Van der Endt Jd , Boyden B , Brochez L , Del Marmol V , De Boulle K , Garmyn M , Laporte M , Maselis T , Pirard Ch , Roseeuw D , Schramme M , Tromme I 
Published: March 2003

AbstractBackgroundAlthough the incidence of melanoma is increasing and many informative campaigns have been organized. The general population is still little informed about this tumour.AimsTo organize a media campaign, with more relevant information and the opportunity for free skin inspections.MethodsA ‘Task Force’ organized a media campaign in April 1999 and convinced 65% of the Belgian dermatologists to give up 4 h of their time to do free skin examinations for skin cancer on Monday 26 April 1999; it was called ‘Melanoma Monday’.ResultsA total 2767 patients were screened. We found 25 melanomas and suspected 59 basal cell carcinomas. In the following 4 weeks another 141 melanomas were found. These 166 melanomas found in one month represent 15–20% of the total number of melanomas per year in Belgium.SummaryA media campaign with relevant information combined with screening opportunities can lead to the early detection of melanomas in a large number of patients and can continue to alert people at risk in the following weeks.
Dermoscopy as a second step in the diagnosis of doubtful pigmented skin lesions: How great is the risk of missing a melanoma?
Authors: Carli P , De Giorgi V , Giannotti B 
Published: March 2003

AbstractBackgroundLittle is known about the occurrence of false negatives in the diagnosis of melanoma using dermoscopy in clinical practice: in the literature dermoscopy only increased the accuracy of diagnosis of equivocal lesions that were to undergo biopsy anyway.Aim and methodsWe collected the 81 lesions clinically diagnosed as probable melanomas by experienced specialists (from a series of 256 pigmented skin lesions submitted to excisional biopsy) and reviewed them for possible false negative results in the diagnosis of melanoma using in vivo dermoscopy and dermoscopy performed on slide images. Both procedures were carried out by the same experienced dermatologists who classified the lesions clinically.ResultsDermoscopy made on slide images (observers blinded for clinical features of the lesions) yielded three false negative results (91% sensitivity) in a group of 35 histologically confirmed melanomas. In vivo dermoscopy showed better results, with no melanomas missed (100% sensitivity). The frequency of false positive results in the diagnosis of melanoma was 13.5% (11 of 81) with dermoscopy on slide images and 2.5% (two of 81) with in vivo dermoscopy.ConclusionsOnly in vivo dermoscopy by fully trained dermatologists with both clinical and dermoscopic experience avoids the risk of misclassification of melanomas otherwise correctly classified on clinical grounds.
The use of antidepressant drugs in dermatology
Authors: Gupta MA , Gupta AK 
Published: March 2003

AbstractThis paper provides an updated review of the use of antidepressant drugs in dermatology. Some of the psychiatric disorders that are usually comorbid with dermatological disorders and respond to antidepressants include major depressive disorder, obsessive compulsive disorder, body dysmorphic disorder, social phobia and post‐traumatic stress disorder usually secondary to trauma and abuse during early life. Cutaneous symptoms may be the feature of a primary psychiatric disorder, e.g. cutaneous body image problems, dermatitis artefacta, neurotic excoriations and trichotillomania, or psychiatric syndromes may be comorbid with a primary dermatological disorder such as the association of major depressive disorder or social phobia with psoriasis and obsessive compulsive disorder with acne excoriee. Some of the salient pharmacological properties of the tricyclic antidepressants (TCAs) and the selective serotonin reuptake inhibitor (SSRI) antidepressants are reviewed. The review indicates that the SSRI antidepressants are potentially beneficial in the management of all the major psychiatric syndromes that are encountered in dermatological disorders. The generally more favourable side‐effect profile of the SSRIs, such as lower cardiotoxicity in contrast to the TCAs, has made them the first‐line agents for the treatment of depression. Furthermore, some of the pharmacological properties of the antidepressant agents that are not related to their antidepressant activity, such as the histamine H1 blocking effect of TCAs, such as doxepin, amitriptyline and trimipramine, are of benefit in dermatological conditions such as urticaria and pruritus. This paper reviews the general guidelines for use of antidepressants and salient drug–drug interactions resulting mainly from the inhibition of the cytochrome P450 (CYP) 2D6 and 3A3/4 isoenzymes by some of the SSRI antidepressants. Before prescribing an antidepressant agent, the specific guidelines, side‐effect profile, drug–drug interactions and most current indications should always be obtained.
Hypopigmentation after non‐permanent henna tattoo
Authors: Wöhrl S , Hemmer W , Focke M , Götz M , Jarisch R 
Published: March 2003

AbstractA young girl presented with a hypopigmentation in the shape of the sun. During a holiday in Egypt 3 months before a non‐permanent henna tattoo had been applied on her right upper arm. Three to 4 days later there was a severe cutaneous reaction followed by massive swelling of the arm. The lesion took 6 weeks to subside. Patch testing revealed positive reactions to para‐phenylenediamine (PPD) but not to henna or any other standard allergen. Especially in Arabic countries PPD is a common additive in natural henna preparations to enhance the weak colouring properties of the natural henna dye. We conclude that henna preparations may contain ‘hidden’ allergens, such as PPD, which can provoke severe cutaneous reaction without any cosensitization to the henna dye itself.
Treatment principles of atopic dermatitis
Authors: Thestrup‐Pedersen K. 
Published: March 2003

AbstractAtopic dermatitis (AD) is today the most common, chronic inflammatory skin disease among children in developed countries. Its cumulative prevalence varies from 20% in northern Europe and the USA to approximately 5% in Mediterranean countries. As a chronic disease it puts a special demand on treatment. There is no curative therapy, but competent guidance on treatment principles can control the disease in most, if not all children. This article summarizes the evidence‐based knowledge that relates to the treatment of atopic eczema. It also gives advice and opinions on prophylactic measures as these are the focus of interest from most parents.Learning objectiveThis article should enable you to give advice and guidance to parents of children with AD, including what is necessary for diagnosis, what is of value and importance considering allergies and allergological investigations, allergen exposure, prophylactic measures, diets and indoor environment. Finally, you should be able to explain the diversity of treatment principles for parents.
Chronic prostatitis and chronic pelvic pain in men: aetiology, diagnosis and management1
Authors: Luzzi GA 
Published: March 2003

ABSTRACTPatients with chronic prostatitis/pelvic pain syndrome typically report genital or pelvic pain (in or around the penis, perineum, scrotum) lasting >3 months. Whereas true chronic bacterial prostatitis is an uncommon condition characterised by recurrent prostatic and urinary infection, chronic pelvic pain syndrome (CPPS) is a common condition in which no infection is found. Recent surveys suggest a prevalence of 2.5–3% for CPPS. The four‐glass test, traditionally used to distinguish inflammatory and inflammatory forms of CPPS, has not been adequately validated; whether the distinction is clinically meaningful is increasingly questioned. The aetiology of CPPS is not known; urodynamic studies imply a neuromuscular origin. More recent work supports a role for proinflammatory cytokines in the pathogenesis. In the management of chronic bacterial prostatitis, trials support the use of quinolone antibiotics as first‐line treatment. In contrast, the management of CPPS is generally unsatisfactory, as no reliable treatment has been identified. Treatments commonly tried include antibiotics (notably tetracyclines, quinolones and macrolides), anti‐inflammatory agents, and alpha blockers. Newer approaches include trials of finasteride, quercetin and rofecoxib. A recent systematic review demonstrated that none of the current diagnostic and treatment methods for CPPS is supported by a robust evidence base.
Temporal arteritis presenting with scalp ulceration
Authors: Monteiro C , Fernandes B , Reis J , Tellechea O , Freitas J , Figueiredo A 
Published: March 2003

ABSTRACTWe report the case of a 75‐year‐old‐woman who presented with bilateral scalp ulcerations and blindness, accompanied by severe headache and scalp tenderness, due to bilateral temporal arteritis without systemic involvement. A biopsy taken from the border of an ulceration showed evidence of giant cell arteritis. She was treated with oral prednisone, 60 mg per day. The ulcerations healed in a few weeks but the vision loss was irreversible. This case highlights for temporal arteritis the importance of accurate and timely diagnosis as well as the need for prompt therapy with systemic steroids in order to avoid major complications, namely loss of vision. It also demonstrates that scalp necrosis and ulcerations are skin signs associated with a poor prognosis.
A case of bacillary angiomatosis presenting as leg ulcers
Authors: Karakaş M , Baba M , Homan S , Akman A , Acar MA , Memişoǧlu HR , Gümürdülü D 
Published: March 2003

ABSTRACTWe report a 32‐year‐old immunocompetent man who had multiple leg ulcers caused by bacillary angiomatosis without a history of direct contact with cats. Bacillary angiomatosis should be kept in mind in the differential diagnosis of leg ulcers in cases of unknown aetiology.
A Preliminary Study Investigating How People with Mild Intellectual Disabilities Perform on the Rivermead Behavioural Memory Test
Authors: Martin Claire , West Jenny , Cull Chris , Adams Malcolm 
Published: March 2003

AbstractTwenty participants with mild intellectual disabilities (IQ = 55–75) completed the Rivermead Behavioural Memory Test (RBMT; adult version). There was a significant difference in performance across the 12 subtests, with the tests relying on verbal memory (e.g. story recall) proving the most difficult and those depending on visual memory (e.g. picture recognition) the easiest. There was also a negative correlation between age and RBMT scores. It is concluded that the RBMT is a suitable test to use with this population; it provides useful clinical information, but as the test currently stands, identification of specific memory impairments may not be possible.
Interrogative Suggestibility, Memory and Intellectual Disability
Authors: Beail Nigel 
Published: March 2003

Background  Psychologists are often asked to prepare reports on suspects, complainants and witnesses with intellectual disabilities for court. Increasingly, the Gudjonsson Suggestibility Scales are being used as part of the assessment process. This paper critically examines the use of the Gudjonsson Suggestibility Scales with adults with intellectual disabilities and considers alternative explanations for test data.Argument  It is argued that the scales have been developed in a way that significantly disadvantages people with intellectual disabilities compared with those of average ability. The scales are more likely to elicit acquiescent responses from people with intellectual disabilities as participants are questioned on information they can barely recall. Drawing on models of memory developed in the field of cognitive neuroscience, it is argued that this is a consequence of examining unimodal input into semantic memory, which is impaired in people with intellectual disabilities. Police interviews are rarely concerned with semantic memory alone but with autobiographical event memory of multimodal input. Research on people with intellectual disabilities' event memory shows higher levels of accuracy, less of a tendency to acquiesce and greater resistance to suggestion.Conclusions  Currently, the Gudjonsson Suggestibility Scales are the only tests available for the assessment of interrogative suggestibility. However, psychologists using these scales with adults with intellectual disabilities should do so with caution as their validity is questionable. Studies of intellectually disabled adults' autobiographical event memory show that they can provide reasonably accurate accounts of events and resist questions designed to alter their account.
Fetal and uteroplacental blood flow in prolonged pregnancies. A clinical study
Authors: Malcus P. , Maršál K. , Persson P‐H. 
Published: March 2003

AbstractIn a prospective study during 1 year, 102 women with prolonged pregnancies (more than 294 completed gestational days) were followed with serial pulsed Doppler blood flow examinations every 2nd day, either to spontaneous onset of labor (n = 82) or to induction of labor due to subsequently occurring complications (n = 20). Mean aortic blood velocity did not change significantly with gestational age beyond 294 days either in fetuses with normal outcome or in fetuses that developed asphyxia at birth. The flow velocity waveforms in the descending aorta, the umbilical artery, the common carotid artery and the uterine artery did not change significantly compared to the values at term. Abnormal flow velocity waveforms in the fetal descending aorta, umbilical artery or uterine artery had no significant relationship to fetal asphyxia. Absence of diastolic flow velocities was not found in any of the vessels examined, indicating that the fetuses did not suffer from chronic hypoxia in utero and that aging of the placenta did not alter fetal and uteroplacental blood flow. Notching of the aortic flow velocity waveform was a common finding among prolonged pregnancies. The hemodynamic implications and consequences of this phenomenon are discussed. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology