bluuebunny/crossref_metadata_2025_split huggingface dataset:
Topical cidofovir for severe cutaneous human papillomavirus and molluscum contagiosum infections in patients with HIV/AIDS. A pilot study
Authors: Calista D 
Published: March 2003

AbstractBackgroundCidofovir is a nucleoside analogue of deoxycytidine with a strong activity against several DNA viruses, including herpes, pox and human papilloma virus (HPV).Material and methodsFourteen acquired immunodeficiency syndrome patients, 10 with extensive HPV lesions and four with molluscum contagiosum (MC) infections, unresponsive to conventional therapies, were treated with a cream containing cidofovir 1%. All the subjects had been on treatment with highly active antiretroviral therapy for almost 1 year before starting the cream. Measured end‐points of therapy were efficacy, tolerability, side‐effects and freedom from recurrence.ResultsThirteen of the 14 patients (92.8%) completed the therapy, one dropped out. These 13 eventually cleared their MC or warts, over varying periods of time. In nine, the lesions regressed 2 weeks from the end of the first cycle of therapy. Three patients needed two cycles and the last three consecutive courses of topical therapy before the cutaneous lesions healed. No recurrence was observed in nine patients over an average follow‐up period of 24.1 months (range 12–30 months). Four patients had isolated relapses, which were successfully treated with simple curettage.Side‐effectsAll the patients experienced side‐effects where they applied the cream. Inflammation, erosion and a burning sensation were the most frequent. Postinflammatory hyperpigmentation was observed in six cases, while two developed a transient alopecia on the beard area. No systemic side‐effects or alteration of laboratory data were noted.ConclusionCidofovir appears to offer an effective therapeutic alternative option for lesions that are unresponsive to conventional methods. Appropriate clinical trials are required, however, to confirm the true efficacy and safety of topical cidofovir.
Systemic ketoconazole for yeast allergic patients with atopic dermatitis
Authors: Bäck O , Bartosik J 
Published: March 2003

AbstractBackgroundAdult patients with atopic dermatitis (AD), especially with the head–neck distribution, are often sensitized to the lipophilic yeast Malassezia furfur/Pityrosporum orbiculare, which is considered to contribute to the pathogenesis of the dermatitis.ObjectiveEvaluation of the efficacy of oral ketoconazole on immunological and clinical parameters in yeast allergic adult patients with AD.Study designRandomized double‐blind placebo‐controlled study.SubjectsTwenty‐nine patients with specific IgE antibodies to M. furfur/P. orbiculare and with elevated serum IgE participated in the investigation. Fifteen subjects were treated with 200 mg ketoconazole daily and 14 received placebo for 3 months. Betamethasone cream was allowed as supplementary therapy and the consumption was registered. The clinical score (SCORAD), total serum IgE and specific IgE antibodies to M. furfur/P. orbiculare, Candida albicans and Dermatophagoides pteronyssinus were monitored at the starting point and by the end of the first and third month.ResultsIn the actively treated group the levels of specific IgE to M. furfur/P. orbiculare and C. albicans as well as total serum IgE decreased significantly. Sensitization to D. pteronyssinus was not influenced. The clinical score decreased in both groups, and the improvement was correlated to the consumption of topical steroids in the control group but not in the ketoconazole group.
The effect of hair loss on quality of life
Authors: Williamson D , Gonzalez M , Finlay AY 
Published: March 2003

AbstractBackgroundThe aim of this study was to quantify the effect of hair loss on quality of life. Patients were recruited from an alopecia support group, and were assessed using the Dermatology Life Quality Index (DLQI) and an adapted version of the DLQI. Financial utility questions, an abbreviated version of the Center for Epidemiologic Studies Depression Scale and open‐ended questions were also used.ObservationsSeventy (90% response rate) questionnaires were returned. DLQI scores in responders with hair loss (mean score = 8.3, SD = 5.6, range 0–23, n = 70) were similar to those recorded in severe psoriasis. The hair loss continued to have a significant impact on life quality well after the initial event (median duration of hair loss = 138 months ± 114; range 7–588, n = 70). Forty per cent of patients also felt dissatisfied with the way in which their doctor dealt with them.ConclusionsThis study specifically identifies the feelings of loss of self‐confidence, low self‐esteem and heightened self‐consciousness in people affected by hair loss.
Potential human papillomavirus reactivation following topical corticosteroid therapy of genital lichen sclerosus and erosive lichen planus
Authors: Von Krogh G , Dahlman‐Ghozlan K , Syrjänen S 
Published: March 2003

AbstractUsing a highly sensitive polymerase chain reaction (PCR) technique, based on general GP5+/GP6+ PCR primers covering 34 different human papillomavirus (HPV) types, the presence of HPV DNA was studied in paraffin‐embedded penile biopsies from 20 men treated topically with corticosteroids. Clobetasol propionate was applied for 2–16 (mean 7) weeks by 19 men (age 18–73; mean 40) with lichen sclerosus. High‐risk HPV was detected prior to therapy in three patients (16%) who lacked clinical or histopathological signs of HPV infection. Following therapy high‐risk HPV was detected in biopsies from four men (21%), of whom three also exhibited clinical and/or light microscopic signs of HPV infection. Low‐risk HPV DNA was not detected in any of these samples. Four biopsies were collected during a 5‐year period from a 51‐year‐old man who was treated repeatedly with topical mild–moderate potent corticosteroids at intervals of up to 10 weeks for penile erosive lichen planus, followed by nine clinical outbreaks of typical condylomas that consistently showed the presence of low‐risk HPV DNA only. These observations indicate that long‐lasting topical corticosteroid therapy occasionally may be associated with opportunistic reactivation of a latent high‐ and low‐risk mucosotrophic HPV type infection. The importance of clinical follow‐up is underlined.
Dermatofibrosarcoma protuberans: a clinicopathological study of 20 cases
Authors: Oliveira‐Soares R , Viana I , Vale E , Soares‐Almeida LM , Picoto A 
Published: March 2003

AbstractAim To review the clinical and histological data of 20 cases of dermatofibrosarcoma protuberans presenting at two dermatology centres in Lisbon from 1978 to 1998.Patients and methods The 20 subjects comprised nine males and 11 females ranging in age from 25 to 79 years, with highest frequency of subjects in the 30–50 year olds. We reviewed the clinical features, histopathological aspects, including morphologic variants and immunohistochemical studies.Results Median age at diagnosis was 51 years and the trunk was the most frequent location. The characteristic histologic storiform pattern was seen in all cases. Three subjects presented fibrosarcomatous areas, one with myoid differentiation and another with multinucleated giant cells. Immunohistochemical stains revealed CD34 expression in the 18 specimens tested, FXIIIa was negative, and these two antigens proved important for the differential diagnosis of this neoplasm. Local wide excision was performed in 13 cases and seven patients underwent Moh's micrographic surgery. Follow‐up ranged from 2 months to 17 years and three recurrences were recorded, two following classical surgery and one after Moh's surgery; there was no difference in the rate of local recurrence (15%) for the two kinds of treatment in our series.
The ‘common mole’ from the point of view of digital dermoscopy analysis: subjective vs. objective evaluation of easy pigmented skin lesions
Authors: Burroni M , Rubegni P , Dell’eva G , Santini S , Perotti R , Biagioli M , Taddeucci P , Andreassi L 
Published: March 2003

ABSTRACTBackground The term ‘common mole’, often used to describe a subset of benign pigmented skin lesions, is traditionally defined on the basis of morpho‐chromatic features. In recent years, certain research groups have developed equipment and methods, such as digital dermoscopy analysis, that enable objective evaluation of pigmented skin lesions.Objective In this study we use a digital dermoscopy analyser trained for the recognition of pigmented skin lesions to compare the subjective definition of ‘common’ and the mathematical concept of ‘close to the mean of measurements’.Methods A subset (100) of digital images of flat pigmented lesions, obtained in daily practice, were classified by trained and non‐expert clinicians as common moles (60) or clear‐cut melanoma (40), and processed with a DB‐Mips analyser. The resulting parameters, validated by a classifier, were used to evaluate Hotelling's T2 multivariate distances from the mean.Results Common’ moles could not be clearly defined in terms of closeness to the means of objectively evaluated parameters. Their diagnosis includes many other evaluations and clusters of variables.Conclusion The clinical semantics of the term ‘common’ does not conform to any unambiguous mathematical definition.
Family Views of the Quality of Residential Supports
Authors: Walsh Patricia Noonan , Linehan Christine , Hillery John , Durkan Joe , Emerson Eric , Hatton Chris , Robertson Janet , Gregory Nicky , Kessissoglou Sophia , Hallam Angela , Knapp Martin , Jaerbrink Krister , Netten Ann 
Published: March 2003

The quality and costs of residential supports provided to adults with intellectual disabilities (IDs) living in the UK and Ireland were investigated. The present paper describes findings related to relatives' level of contact with their family members and their appraisal of current residential supports. The relatives (n = 210) of adults living in campus settings and dispersed housing completed a questionnaire devised to determine their satisfaction with their family members' current residential supports and were invited to name both the features which they like and features which they wish to see improved. Relatives whose family members with IDs lived closer to the family home, who were younger and who took part in more daily activities in their current residence reported higher levels of contact. The respondents believed that current residential supports were better than those previously received. While relatives of residents in campus settings reported higher levels of family contact, satisfaction ratings were similar for relatives of residents in both campus settings and dispersed housing. Staff support, physical aspects of the residences and the standard of care provided were the aspects of residential supports which were most liked; preferred improvements included higher staff ratios and better day activities. Levels of family contact may be predicted by distance as well as by residents' characteristics and type of residence. A considerable overlap among groups of relatives as to ratings of satisfaction and the aspects of residences which they liked was apparent. Research strategies targeting informed appraisals of service quality on the part of both residents and their relatives are proposed.
Happy families are all alike; every unhappy family is unhappy in its own way.– Leo Tolstoy, Anna Karenina, Part 1, Chapter 1
Home‐based Programmes for Parents with Intellectual Disabilities: Lessons from Practice
Authors: Llewellyn Gwynnyth , McConnell David , Russo Domenica , Mayes Rachel , Honey Anne 
Published: March 2003

Background Increasing emphasis is being given to carrying out parent education programmes at home with widely reported benefits. The purpose of this paper is to draw lessons for practitioners from implementing a randomized trial of a home‐based parent education programme for parents with intellectual disabilities that addressed child health and safety issues.Methods A thematic analysis of case notes and parent feedback from the 45 parent participants in this programme was conducted prior to two team sessions to discuss the findings.Results Programme‐specific issues included format, content and presentation style. Themes relevant to home‐based programmes for parents with intellectual disabilities more generally included the suitability of the home as a learning environment; identifying parent priorities; parent readiness to learn; and parent control (or lack of) over the home environment. In addition, practice points for parent educators were identified.Conclusions The home environment benefits both teaching and learning, however, as this paper highlights careful consideration needs to be given to each parent‐learner's home situation. We recommend that in future the processes involved in home‐based programmes be reported alongside programme outcomes.
Attitudes towards Sexuality, Sterilization and Parenting Rights of Persons with Intellectual Disabilities
Authors: Aunos M. , Feldman M. A. 
Published: March 2003

Background and Methods  We review articles pertaining to attitudes towards sexuality, sterilization, procreation and parenting by people with intellectual disabilities. Most empirical studies were conducted after the appearance of the principles of normalization and role valorization in the 1970s.Results  Across studies, special education teachers and university students appear to hold more positive attitudes towards sexuality and sexuality education programs than parents and service workers. People with intellectual disabilities have conservative attitudes towards sexual intercourse and homosexuality, but may be accepting intimate contact by familiar persons. Despite the ban on involuntary sterilization, it appears that many parents and teachers of persons with intellectual disabilities still support it as a form of contraception, especially for persons with severe intellectual disabilities. Likewise, attitudes towards parenting by persons with intellectual disabilities remain negative, and these attitudes may adversely affect the provision of competency‐enhancing supports and services for parents with intellectual disabilities and their children.Conclusions  It is recommended that new studies should be undertaken, comparing attitudes across different groups involved with persons with intellectual disabilities and examining the impact of prejudicial attitudes on sexual expression and parenting by persons with intellectual disabilities.
Children of Mothers with Intellectual Disability: Stigma, Mother–Child Relationship and Self‐esteem
Authors: Perkins Tiffany S. , Holburn Steve , Deaux Kay , Flory Michael J. , Vietze Peter M. 
Published: March 2003

Background  We investigated mother–child relationships and self‐esteem of typical children of mothers with intellectual disability.Methods  Eighteen girls and 18 boys from various ethnic groups were administered questionnaires to assess: (a) attachment style; (b) caregiver style; (c) perception of maternal stigma; and (d) self‐esteem. The children were also asked to list the identities or roles that they play in life.Results  Results suggested that: (a) the relationship between the child's perception of stigma and attachment to the mother is mediated by the warmth of the mother's caregiving style; and (b) if the child has an avoidant or anxious/ambivalent attachment to the mother, self‐esteem tends to be lower. Furthermore, multiple identities contribute to positive self‐esteem among these children.Conclusions  Results are discussed in relation to the model presented and the consistency of the findings with attachment theory.
Umbilical artery velocimetry and non‐stress test in monitoring high‐risk pregnancies. A comparative longitudinal study
Authors: Malcus P. , van Beek E. , Maršál K. 
Published: March 2003

AbstractIn a longitudinal comparative study, umbilical artery velocimetry and the non‐stress test were used in parallel for surveillance of 153 hospitalized high‐risk pregnancies. The occurrence of abnormal flow velocity waveforms of the umbilical artery, with increased pulsatility index but maintained diastolic flow velocity, was an inconsistent finding and often related to pregnancy complications other than intrauterine growth retardation. Among patients with small‐for‐gestational age fetuses or pre‐eclampsia with a small‐for‐gestational age fetus, there was a significantly higher frequency of abnormal umbilical flow velocity waveforms. This was a consistent finding and was often associated with an absence of diastolic flow velocity and operative delivery for fetal distress. An abnormal non‐stress test had a significant relationship with intrauterine growth retardation, but a lower predictive capacity for this condition than the abnormal umbilical artery flow velocity waveform. In patients with small‐for‐gestational age fetuses and no other complication of pregnancy, umbilical artery velocimetry can be used as a reliable tool for identifying those fetuses that need intensified surveillance. In cases with additional complications, a combined use of blood velocimetry and the non‐stress test is advocated. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Fetal tachyarrhythmias: transplacental and direct treatment of the fetus—a report of 60 cases
Authors: Hansmann M. , Gembruch U. , Bald R. , Manz M. , Redel D. A. 
Published: March 2003

AbstractFrom 1981 to 1990, 60 fetuses with tachyarrhythmia (21–39 weeks of gestation) were treated in utero. Of these, 54 were cases of supraventricular tachycardia, and six of atrial flutter. Non‐immune fetal hydrops was present in 21 cases with supraventricular tachycardia and in five cases with atrial flutter, a total of 26 cases.Transplacental treatment by maternally administered antiarrhythmic drugs (digoxin only or in combination with verapamil) produced good results in non‐hydropic fetuses. In this group, all 34 fetuses survived. In fetuses with hydrops, 20 out of 26 survived.In 13 fetuses of the 26 with hydrops, direct fetal therapy was performed in addition to the transplacental therapy when the tachyarrhythmia was refractory to transplacental treatment. During the 9 years of this study, a variety of direct treatment regimes have been used consisting of intraperitoneal and/or umbilical intravenous administrations of different drugs. Since 1988, umbilical vein punctures have shown that the transplacental passage of digoxin (and amiodarone) is hampered in the presence of hydrops, and direct treatment may he necessary in these cases. Amiodarone seems to he the drug of choice for direct therapy. It is highly effective in supraventricular tachycardia and atria1 flutter. The long elimination half‐time of amiodarone reduces the number of umbilical cord punctures needed to maintain the therapeutic drug level in the fetus. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Foramen ovale size in the normal and abnormal human fetal heart: an indicator of transatrial flow physiology
Authors: Feit L. R. , Copel J. A. , Kleinman C. S. 
Published: March 2003

AbstractWe used fetal echocardiography to measure the sizes of the foramen ovale and atrial septum in 80 human fetuses from 17.5 to 38 weeks gestation. Forty‐six fetuses had normal cardiac anatomy, 19 had left heart obstructive lesions, and 15 had right heart obstructive lesions. Pulsed and color flow Doppler studies were incorporated when available. We found that normal fetuses had a foramen ovale/atrial septum size ratio of 0.33 ± 0.04 (mean ± SD). In all (52%) fetuses in which it was available, pulsed Doppler study revealed bidirectional, but predominantly right‐to‐left, flow through the foramen ovale. Fetuses with left heart obstructive lesions had a foramen ovale/atrial septum size ratio smaller than normal (0.28 ± 0.05; p < 0.001). Seven of nine fetuses with left heart obstructive lesions who had color Doppler studies demonstrated reversal of the normal flow pattern, exhibiting unidirectional left‐to‐right transforamenal flow. Those with right heart obstructive lesions had a larger than normal foramen ovale/atrial septum size ratio (0.47 ± 0.04; p < 0.001). Nine fetuses with right heart obstructive lesions had color Doppler studies which demonstrated almost exclusive right‐to‐left transforamenal flow. We conclude that foramen ovale/atrial septum size ratio and Doppler interrogation of transatrial flow are helpful adjuncts in determining the presence of congenital heart disease in utero. In addition, early detection of abnormal foramen ovale/atrial septum size ratio may predict whether left or right ventricular development will be impaired throughout gestation, even before gross disparity of ventricular size is apparent. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Continuous maternal hyperoxygenation in the treatment of early fetal growth retardation
Authors: Ribbert L. S. M. , van Lingen R. A. , Visser G. H. A. 
Published: March 2003

AbstractContinuous maternal hyperoxygenation treatment (2.5 l/min by means of a nasopharyngeal cannula) was given in four patients presenting with intrauterine growth‐retarded (IUGR) fetuses and decelerative fetal heart rate (FHR) patterns at 27–28 weeks of gestation. The effect of maternal hyperoxia was studied longitudinally. Neither the incidence of generalized fetal movements (FGM%) nor the pulsatility index of the internal carotid artery increased under hyperoxia. In fact, both variables decreased progressively. FHR variation was abnormal prior to the start of hyperoxygenation and showed a slight but transient increase. On average, maternal hyperoxygenation ‘resulted’ in a prolongation of the duration of pregnancy of 9 days. The neonatal mortality was similar in the study group as compared to a control group of IUGR infants. However, hypoglycemia, thrombocytopenia and disseminated intravascular coagulation at birth were found more frequently in the study group. Conversely, blood gas abnormalities were less frequent in the fetuses of mothers that were treated with oxygen. We conclude that positive effects of oxygen therapy in IUGR fetuses remain uncertain and that detrimental effects due to prolongation of intrauterine malnutrition have not as yet been sufficiently excluded. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Early sonographic diagnosis of intrapericardial teratoma
Authors: Catanzarite V. , Mehalek K. , Maida C. , Mendoza A. 
Published: March 2003

AbstractAn intrapericardial teratoma associated with a large pleural effusion and elevated aortic outflow velocity was diagnosed at 23.6 weeks' gestation. Less than 4 weeks earlier, an obstetric scan, including a four‐chamber heart view, had been normal. In less than a week following diagnosis, fetal hydrops and bradycardia developed. ‘Heroic’ pericardiocentesis was declined by the patient, and the fetus died. This case demonstrates the potential for rapid growth in pericardial teratomas, and illustrates the possibility of anticipating fetal compromise from tumor mass effect, when intracardiac Doppler studies are abnormal. Implications for management of these rare tumors, and specifically for the hypothetical role of fetal surgery, are discussed. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology