bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study of the skin disease spectrum occurring in an Afro‐Caribbean population
Authors: Dunwell Patricia , Rose Arlene 
Published: December 2004

AbstractBackground There is a scarcity of recent up‐to‐date studies on the incidence of skin disease among Afro‐Caribbeans.Methods One thousand patients were retrospectively studied for the commonest diagnoses made over a 5‐month period from January to May 2001.Results The commonest skin diseases seen were acne vulgaris (29.21%), seborrhoeic eczema (22.02%), pigmentary disorders (16.56%), and atopic eczema (6.1%). Other notable common diagnoses included keratosis pilaris, tinea infection, hirsuitism, folliculitis keloidalis nuchae, viral warts, dermatosis papulosa nigra, and confluent and reticulate papillomatosis.Conclusion The pattern of skin disease seen in the Afro‐Caribbean population studied, more closely resembles those seen in developed countries than those seen in developing countries.
A clinical, prospective, randomized, double‐blind trial comparing skin whitening complex with hydroquinone vs. placebo in the treatment of melasma
Authors: Haddad Alessandra Lima , Matos Luiz Fernando , Brunstein Flavia , Ferreira Lydia Masako , Silva Ademir , Costa Divaldo 
Published: December 2004

AbstractObjectives To compare, in a double‐blind, randomized, prospective study, the clinical improvement of hyperpigmentation in 30 patients with melasma using hydroquinone or skin whitening complex topically on one side of the face vs. a placebo cream on the other. The study was performed during the period November 2000 to March 2001 at the Federal University of São Paulo, Escola Paulista de Medicina.Methods Thirty patients received three tubes of cream and were divided into two groups: group 1, one tube containing hydroquinone 4% cream and one tube containing placebo to be applied to opposite sides of the face at night, and standardized sunscreen [sun protection factor (SPF) 25] for daily use; group 2, one tube containing skin whitening complex 5% cream and one tube containing placebo to be applied to opposite sides of the face at night, and standardized sunscreen (SPF 25). All of the tubes had the same appearance and the creams had the same characteristics. The only person who knew what was being used by each patient on each side of the face was the pharmacist. A professional photographer took photographs before and after treatment, which lasted for 3 months. Clinical evaluation was performed by two independent observers and by the patients themselves. Statistical evaluation was by the chi‐squared and kappa methods.Results Twenty‐five patients completed the study, with an overall improvement of 72% in comparison with placebo. Group 1 (hydroquinone and placebo) presented an improvement of 76.9% with 25% side‐effects, and group 2 (skin whitening complex and placebo) presented an improvement of 66.7% with 0% side‐effects.Conclusions Both depigmentation agents were useful in the treatment of melasma. The hydroquinone group presented more collateral effects than the skin whitening complex group. Considering that the patients showed Fitzpatrick skin types IV to VI and the study was conducted in the summer, skin whitening complex seems to be an excellent choice for the treatment of melasma.
Cranial fasciitis of childhood
Authors: Larralde Margarita , Boggio Paula , Schroh Roberto , Cusumano Humberto 
Published: December 2004

A 2‐month‐old boy was seen at our pediatric dermatology department with a history of a tumoral lesion of the scalp since his birth. On examination he had a single, ovoid, firm, 2 × 1.8‐cm painless subcutaneous mass on the temporal left calvarium, covered by normal skin (Fig. 1). It had experienced explosive growth in the preceding 2 weeks. There was no history of previous trauma in the area. The remainder of the examination was normal. Roentgenographic studies of the skull revealed a soft‐tissue mass without involvement of the underlying bone. Ultrasonography of the lesion showed it to be an echolucid tumor. With the presumed diagnosis of dermoid cyst we sent the patient for surgical removal. At surgery, the lesion did not have the typical surgical appearance of a cyst. The histopathologic exam of the specimen was interpreted as cranial fasciitis of childhood (Fig. 2). Immunohistochemistry showed diffuse positivity for vimentin and muscle actin. After 1 year the patient is free of lesions.Lesion at the temporal left calvariumimageProliferation of loosely arranged spindle cells in a loose myxoid stroma (H&E stain, × 40)image
Mycosis fungoides associated with malignant melanoma and dysplastic nevus syndrome
Authors: Pielop J. A. , Brownell I. , Duvic M. 
Published: December 2004

AbstractBackground The increased risk of second malignancies, including nonmelanoma skin cancers, in cutaneous T‐cell lymphoma (CTCL) patients has been well documented. However, relatively few studies of malignant melanoma in CTCL patients have been reported.Methods A database of 250 CTCL patients registered over a 3‐year period was searched to identify patients with diagnoses of both mycosis fungoides (MF) and malignant melanoma.Results We identified six cases of MF associated with malignant melanoma and one associated with dysplastic nevus syndrome, which is a marker of increased risk of melanoma. In four patients, melanoma was diagnosed along with or before MF. In the remaining two patients, MF was diagnosed prior to melanoma, although dysplastic nevi were noted at the time MF was diagnosed. These two patients received treatment for their MF (one with topical nitrogen mustard and another with radiation therapy and nitrogen mustard) prior to the histologic confirmation of melanoma. Six patients had early stages of MF (IA or IB), while one patient presented with simultaneous erythrodermic mycosis fungoides involving the lymph nodes as well as melanoma metastatic to the lymph nodes from an unknown primary.Conclusion There is an elevated prevalence of malignant melanoma in MF patients compared to the general US population (P < 0.00001) with a relative risk of 15.3 for observing malignant melanoma in MF patients (95% confidence interval 7.0–33.8). Possible pathologic links between the two diagnoses include effects of mycosis fungoides therapies, immunosuppression secondary to mycosis fungoides, and genetic alterations in the p16 tumor suppressor protein.
An open trial of calcium dobesilate in patients with venous ulcers and stasis dermatitis
Authors: Kaur Charandeep , Sarkar Rashmi , Kanwar Amrinder J. , Attri Ashok K. , Dabra Ajay K. , Kochhar Suman 
Published: December 2004

AbstractBackground Venous leg ulcers and associated stasis dermatitis are a major cause of morbidity, economic loss, and decreased quality of life in afflicted patients. Hence, there has been a renewal of interest in the medical management of varicose veins and ulcers. Calcium dobesilate, a capillotropic agent, has been found to be beneficial in the treatment of varicose veins.Methods This is an open pilot study of 25 patients (15 with venous ulcers with/without stasis dermatitis, 10 with stasis dermatitis only) who were given calcium dobesilate, 500 mg twice daily, for 8 weeks. The clinical parameters were graded (0–4; 0, absent; 1, mild; 2, moderate; 3, severe; 4, very severe) both before and after therapy, and included pain, itching, tiredness, heaviness, paresthesia, cramps, and leg swelling. Evaluation also included subjective changes in tenderness, oozing, and pigmentation, and measurement of the circumference of the leg for swelling and malleolar edema (measured in millimeters). The venous ulcer sizes were also recorded both before and after therapy. Color Doppler studies were performed to confirm the diagnosis of varicose veins, determine the competence of the valves, and to rule out deep vein thrombosis. Serum biochemistry, hemogram, and urinalysis were performed both before and after treatment. The results were analyzed statistically using the Wilcoxon rank sum test and Student's t‐test.Results A statistically significant improvement was observed post‐therapeutically in the clinical parameters of pain, itching, tiredness, heaviness, and leg swelling. There was also a significant decrease in ulcer size. The serum biochemistry, hemogram, and urinalysis remained unaffected. Color Doppler studies before treatment revealed venous valvular incompetence in 20 patients. They were repeated in only 10 patients after treatment, four of whom showed improved valvular competence. Recurrence of venous ulcers was seen in five of 12 patients who were followed up after therapy. No significant side‐effects were noted.Conclusions Calcium dobesilate is an effective adjuvant therapy, with an absence of significant side‐effects, in patients with venous ulcers and stasis dermatitis. More double‐blind trials are required in the future to substantiate and evaluate the role of the drug in these two indications.
Characteristics of superficial mycoses in Malta
Authors: Vella Zahra Loranne , Gatt Paul. , Boffa Michael J. , Borg Eileen , Mifsud Edwin , Scerri Lawrence , Vella Briffa Dino , Pace Joseph L. 
Published: December 2004

AbstractBackground  A study was conducted to determine the chief agents of superficial mycoses in Malta. Data were collected over a 5‐year period from mycologic investigations carried out on all dermatologic specimens sent to the Mycology Laboratory at St. Luke's Hospital in Malta.Methods  In the period between January 1995 and December 1999, a total of 1271 specimens from skin, nails, or hair were collected from 1200 clinically suspected cases of dermatomycoses.Results  The fungi cultivated included dermatophytes (n = 371), yeasts (n = 33), and nondermatophyte filamentous fungi (n = 12). Trichophyton rubrum (n = 121) was the most prevalent, followed by Microsporum canis (n = 109), T. mentagrophytes (n = 80), M. gypseum (n = 27), Epidermophyton floccosum (n = 17), T. soudanense (n = 10), T. tonsurans (n = 2), T. verrucosum (n = 2), M. persicolor (n = 1), and T. violaceum (n = 1). Candida species were also cultivated, with C. parapsilosis (n = 14) being the most common, followed by C. albicans (n = 12) and C. tropicalis (n = 6). Nondermatophyte filamentous fungi were isolated from nail specimens only.Conclusions  In this study, superficial fungal infections were reported more commonly in female (n = 207) than in male (n = 182) patients. M. canis was the chief agent of tinea capitis and tinea corporis, whilst T. rubrum was the main causative agent of tinea pedis, tinea manuum, and tinea unguium. Onychomycosis due to Candida species was more common in female than in male patients.
Repeat courses of intravenous alefacept in patients with chronic plaque psoriasis provide consistent safety and efficacy
Authors: Lowe Nick J. , Gonzalez John , Bagel Jerry , Caro Ivor , Ellis Charles N. , Menter Alan 
Published: December 2004

AbstractBackground Psoriasis is a chronic, relapsing skin disease that may require multiple treatment courses. Alefacept targets the memory T cells implicated in psoriasis pathogenesis. This open‐label study evaluated the safety and tolerability, efficacy, and pharmacodynamics of repeat courses of alefacept in men and women with chronic plaque psoriasis. This article reports the interim results of this ongoing study.Methods Patients (n = 174) who participated in previous phase II studies of alefacept were included in this retreatment study. Intravenous alefacept (7.5 mg) was administered once weekly for 12 weeks followed by 12 weeks of observation. Initial and subsequent retreatment courses were only given when, in the opinion of the investigators, disease had returned and necessitated treatment; CD4+ T‐cell counts had to be at or above the lower limit of normal.Results Adverse events were similar regardless of the retreatment course. No opportunistic infections, rebound of disease, or flares were reported. Low titers of anti‐alefacept antibodies occurred in a few patients without related safety issues. Sixty‐six per cent of patients achieved a ≥ 50% reduction in the Psoriasis Area and Severity Index (PASI) at any time after the first dose of retreatment course 1. Patients who received two retreatment courses (n = 50) had consistent or improved responses after the second course; 64% and 68% of these patients achieved a ≥ 50% PASI improvement at any time after the first dose of retreatment courses 1 and 2, respectively. Alefacept selectively reduced memory T cells without cumulative effects.Conclusions Repeat courses of alefacept were well tolerated, and subsequent retreatment courses were at least as effective as the initial course of therapy.
American Cutaneous Leishmaniasis unresponsive to antimonial drugs: successful treatment using combination of N‐Methilglucamine Antimoniate plus Pentoxifylline
Authors: Báfica André , Oliveira Fabiano , Freitas Luiz A. R. , Nascimento Eliane G. , Barral Aldina 
Published: December 2004

SummaryBackground American cutaneous leishmaniasis is characterized by single or multiple ulcerations. Cytokines, among other factors, have been shown to influence lesion development and tumoral necrosis factor‐alpha is a major cytokine implicated in pathogenesis of ulcers.Observations We tested oral pentoxifylline, a known tumoral necrosis factor‐alpha inhibitor, at doses of 400 mg (2–3x/day), associated to N‐methylglucamine antimoniate (15 mg/kg/day) in two patients with American cutaneous leishmaniasis unresponsive to antimonial drugs. We observed a satisfactory response with quick cure of skin lesions of these patients.Conclusions Our results suggest that oral pentoxifylline in association to N‐methylglucamine antimoniate should be consider in refractory cutaneous leishmaniasis patients.
High incidence of demodicidosis in eyelid basal cell carcinomas
Authors: Erbagci Zülal , Erbagci Ibrahim , Erkiliç Suna 
Published: December 2004

AbstractBackground Although UV radiation is the major cause of basal cell carcinoma (BCC), local factors, such as chronic trauma, irritation, or inflammation, may also have some role in its etiopathogenesis. The pilosebaceous follicle mites, Demodex folliculorum and D. brevis, inhabit most commonly and densely certain facial skin areas, including the nose and periorbital regions, where BCC also develops most frequently.Aim To investigate, in a retrospective histopathologic study, whether a possible etiopathogenetic relationship exists between demodicidosis and eyelid BCCs.Methods We examined 32 eyelid BCC specimens that contained at least five eyelashes or five hair follicles with respect to the presence and density of Demodex mites. As controls, we evaluated 34 matched specimens consisting of benign eyelid skin lesions.Results Twenty‐one of 32 BCC cases (65.6%) and eight of 34 control cases (23.33%) had demodicidosis. Mean mite counts were 1.31 ± 1.57 and 0.47 ± 0.99 in BCC cases and controls, respectively. The differences were significant for both prevalence (P < 0.001) and density (P = 0.0052). Although there was a significant positive correlation between increasing mite number and patient age in the control group (r = 0.47, P < 0.05), no significant correlation was found between these two factors in BCC cases (r = −0.102, P > 0.05).Conclusions Demodicidosis may be one of the triggering factors of carcinogenesis in eyelid BCCs in otherwise predisposed people due to its traumatic/irritating effect or chronic inflammation.
Forage Chicory: A Plant Resource for Nutrient‐Rich Sites
Authors: Alloush G. A. , Belesky D. P. , Clapham W. M. 
Published: December 2004

AbstractGrazing livestock create localized nutrient patches that increase soil ionic strength (IS) and influence plant productivity. The ability of plant root systems to control ion absorption and flux to xylem, and to sequester ions reaching leaf tissue in bound, nontoxic forms are means of minimizing IS. A greenhouse experiment was conducted to determine the growth and mineral acquisition responses of forage chicory (Cichorium intybus L. cv. Grasslands Puna) to increasing (0.9, 4, 8, and 12 dS m−1) IS in the rhizosphere obtained by additions of NaCl/CaCl2 (1 : 1 m ratio). Plants were harvested four times after planting (20, 27, 34 and 41 d) to identify responses as a function of time. Increased accumulation and localization of Na in roots in comparison to shoots suggested that chicory restricted Na transport to shoots, and that insoluble Na in tissues increased with increasing IS. Soluble cations in shoots were about 50 % of total cations, irrespective of rhizosphere IS and Na uptake. Differences in the cation:anion ratio could not be accounted for by organic acid concentrations in chicory, but substantial accumulation of nonstructural carbohydrates as fructans in roots could contribute to charge balance. Our results demonstrate that forage chicory has moderate tolerance to IS, suggesting that it might be a useful species for sites with potential for IS. Chicory growth would probably be sustained under IS conditions, and the resultant vigorous growth and accumulation of mineral nutrients in shoots would contribute to acceptable nutritive value for grazing livestock. Plants capable of growing in and acquiring nutrients from nutrient‐laden patches in the sward would help minimize erosion and nutrient transport, with positive benefits for water and soil quality.
The Involvement of Cytokinin and Abscisic Acid Levels in Roots in the Regulation of Photosynthesis Function in Flag Leaves during Grain Filling in Super High‐yielding Rice (Oryza sativa)
Authors: Shu‐Qing C. , Rong‐Xian Z. , Wei L. , Zhi‐Rui D. , Qi‐Ming Z. 
Published: December 2004

AbstractA few rice cultivars with super high‐yielding potential have successfully been released. However, little is known about the physiological mechanisms underlying the formation of super high yield in rice. Here, we report changes of cytokinin (zeatin + zeatin riboside, ZR) and abscisic acid (ABA) contents in roots and leaves during grain filling and their relation to declining photosynthesis function of leaves in super high‐yielding rice cv. Xieyou 9308 and standard rice cv. Shanyou 63, as a control. ZR contents in roots and leaves decreased in a time‐dependent manner, while their ABA contents were relatively stable at earlier grain filling stage and rapidly increased at later grain filling stage in both cultivars. A rapid decrease in ZR content and a rapid increase in ABA content were observed earlier in roots than in leaves for both cultivars. Declining instantaneous photosynthesis rate (IAPS) of leaves in both cultivars coincided with decreasing ZR contents and increasing ABA contents in both roots and leaves. Leaves with 6‐benzyl aminopurine (6‐BA) treatment exhibited increased IAPS and extended active photosynthesis duration (APD), and the result was reversed in leaves with ABA treatment. A rapid decrease in ZR contents and a rapid increase in ABA contents of roots and leaves in Xieyou 9308 obviously lagged behind those in Shanyou 63. These results suggest that decreased ZR content and increased ABA content in roots cause the decline of photosynthetic function during grain filling stage. The highly efficient photosynthetic function of Xieyou 9308 is due to the delayed change of ZR and ABA contents in its roots.
Improving geriatric mental health nursing care: Making a case for going beyond psychotropic medications
Authors: Voyer Philippe , Martin Lori Schindel 
Published: December 2004

ABSTRACTProviding high‐quality mental health nursing care should be an important and continuous preoccupation in the gerontological nursing field. As the proportion of elderly people in our society is growing, the emphasis on high‐quality care will receive increasing attention from administrators, politicians, organized groups, researchers and clinical nurses. Recent findings illustrate unequivocally the important contribution of nurses to achieving the goal of high‐quality geriatric care. However, the quality of care for the elderly with psychological difficulties has not been addressed. The objective of this article is to illustrate that while nurses can accomplish much to improve the well‐being and mental health of the elderly, their skills are often underutilized. Psychotropic drugs are often the first‐line interventions used by health‐care professionals to treat mental health concerns of elderly persons. Alternative therapies that could be implemented and evaluated, such as psychological counselling, supportive counselling, education and life review, are infrequently used. Nevertheless, current scientific data suggest that it would be very advantageous if nurses were to play a dominant role in the care of elderly people who are depressed or experiencing sleep pattern disturbances. The same can be said about elderly chronic users of benzodiazepines, as well as those with cognitive impairment. Evidence for the use of psychotropic medications as a viable treatment option for the elderly both in the community and in the long‐term care setting who are experiencing mental health challenges is examined. Alternative non‐pharmacological approaches that nurses can use to augment care are also briefly discussed.
A survey of threats and violent behaviour by patients against registered nurses in their first year of practice
Authors: McKenna Brian G. , Poole Suzette J. , Smith Naumai A. , Coverdale John H. , Gale Chris K. 
Published: December 2004

ABSTRACTThe purpose of the present study was to determine the prevalence of aggressive behaviours by patients against nurses in the first year of practice, and to determine the psychological impact of this behaviour. An anonymous survey was sent to registered nurses in their first year of practice. From the 1169 survey instruments that were distributed, 551 were returned completed (a response rate of 47%). The most common inappropriate behaviour by patients involved verbal threats (n = 192, 35%), verbal sexual harassment (n = 167, 30%) and physical intimidation (n = 161, 29%). There were 22 incidents of assault requiring medical intervention and 21 incidents of participants being stalked by patients. Male graduates and younger nurses were especially vulnerable. Mental health was the service area most at risk. A most distressing incident was described by 123 (22%) of respondents. The level of distress caused by the incident was rated by 68 of the 123 respondents (55%) as moderate or severe. Only half of those who described a most distressing event indicated they had some undergraduate training in protecting against assault or in managing potentially violent incidents (n = 63 of 123; 51%). After registration, 45 (37%) indicated they had had such training. The findings of this study indicate priorities for effective prevention programmes. The issues highlighted need to be addressed in undergraduate nursing curricula and in the development of orientation programmes supporting new graduates.