bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prostate cancer: another aspect of the insulin‐resistance syndrome?
Authors: Barnard R. J. , Aronson W. J. , Tymchuk C. N. , Ngo T. H. 
Published: March 2003

SummaryInsulin resistance and compensatory hyperinsulinaemia are thoughtto be the underlying factors in the metabolic or insulin‐resistancesyndrome and can be controlled by diet and exercise. Hyperinsulinaemiahas been shown to have a direct effect on the liver, suppressingthe production of sex hormone‐binding globulin (SHBG) and insulin‐likegrowth factor‐binding proteins 1 and 2 (IGFBP‐1, ‐2) while stimulatingthe production of insulin‐like growth factor 1 (IGF‐1). These factorshave been proposed to be important modulators of hormone‐related cancers,such as prostate cancer. Men adopting a low‐fat diet and daily exercise reducedtheir levels of serum insulin and IGF‐1, while increasing theirlevels of IGFBP‐1 and sex hormone‐binding globulin (SHBG). Cell‐culturestudies with LNCaP prostate cancer cells showed apoptosis of tumourcells and a reduction in serum‐stimulated cell growth in the postdiet and exercise serum. These results suggest that prostate cancermay be another aspect of the insulin‐resistance syndrome and thatadopting a low‐fat diet combined with regular exercise may reducethe risk for prostate and other hormone‐related cancers. This needsto be tested with prospective studies.
Does European or non‐European origin influence health care and prognosis for HIV patients in Europe?
Authors: Blaxhult A. , Mocroft A. , Phillips A. , Van Lunzen J. , Bentwich Z. , Stergiou G. , Colebunders R. , Benfield TL. , Mulcahy F. , Lundgren JD. , Group The EuroSidA. Study 
Published: March 2003

Background Previous studies, especially in North America, have shown that socio‐economic factors may influence the prognosis for patients with HIV. This study was performed in order to determine if European or non‐European origin influence provision of health‐care and survival among HIV patients in Europe. Methods Fifty HIV clinics in 17 European countries are involved in a European prospective, observational multicentre study. In total, 7230 consecutive patients with HIV attending a routine clinic visit were included in the study. Data on demographics, treatment and laboratory results were collected at time of recruitment into the study and thereafter every 6 months. Results The median CD4+ lymphocyte count at AIDS diagnosis was 60/mm3, and was similar for all ethnic groups (P = 0.87, Kruskall–Wallis test). The median terminal CD4+ lymphocyte count was 17/mm3 and, again, there was no significant difference between continents of origin (P = 0.35, Kruskall–Wallis test). Antiretroviral drugs were initiated at similar median CD4+ lymphocyte counts and there was no statistically significant difference in survival after a diagnosis of AIDS. Conclusions AIDS was diagnosed at the same level of immunodeficiency independent of European or non‐European origin and antiretroviral drugs were provided at similar levels of immunodeficiency. No differences in survival depending on continent of origin was found. In spite of these encouraging findings concerns remain that belonging to an ethnic minority can be an obstacle in getting into contact with treatment facilities and thus benefiting from developments in the management of HIV.
Participation in clinical studies among patients infected with HIV‐1 in a single treatment centre over 12 years
Authors: Madge S , Mocroft A , Wilson D , Youle M , Lipman MCI , Phillips A , Tyrer M , Cozzi‐Lepri A , Swaden L , Johnson MA 
Published: March 2003

Objective  To examine a complete population of clinic attenders in order to compare the demographics of patients who participated in a clinical study with those who had not. These were subdivided into trials of antivirals, trials for drugs used in opportunistic infections or symptomatic HIV and epidemiological studies. The setting was an established London teaching hospital. All patients diagnosed HIV‐positive and attending between July 1983 and 1 January 1999 with one measured CD4 count and at least one follow‐up visit were included.Methods  The demographics of those participating in a clinical study were compared to those not enrolling using χ2 tests and Wilcoxon tests. Cox models were used to determine factors related to participation in clinical studies.Results  Data from 2703 patients representing 5342.7 person‐years' follow‐up were assessed. Median time of follow‐up was 23.6 months. Six hundred and eighty‐seven (33%) patients had ever participated in a clinical study. After adjustment for demographic factors in multivariate analysis using Cox models, homosexuals were more likely to participate compared with heterosexuals or injecting drug users (IDU) (P = 0.0035 and P = 0.0001, respectively). Women were more likely to enter a study (P = 0.02) and there was no difference between Caucasians and black Africans (P = 0.35). Between the three types of studies few differences were seen.Conclusion  High rates of participation in clinical trials and epidemiological studies were seen in this cohort. In keeping with other studies, homosexual men were well represented but IDU were under‐represented. However, women and black African patients showed good uptake of all clinical studies. Hence in this population there is some success in targeting representative groups to participate in clinical studies, but more effort needs to be made with IDU.
Molecular correlates in AIDS patients following antiretroviral therapy: diversified T‐cell receptor repertoires and in vivo control of cytomegalovirus replication
Authors: Worrell S , Deayton J , Hayes P , Emery Vc , Gotch F , Gazzard B , Larsson‐Sciard E‐L 
Published: March 2003

1

Department of Immunology and

2

The Kobler Centre, Chelsea and Westminster Hospital, and

3

Royal Free Hospital and University College Medical School, London, UK
Objectives  To evaluate whether successful, long‐term immune reconstitution in vivo can be achieved in end‐stage AIDS patients following antiretroviral therapy (ART).Methods  A 1‐year prospective study of changes of CD4+ and CD8+ T‐cell surface phenotypes, T‐cell receptor (TCR) repertoires and capacity to control in vivo replication of cytomegalovirus (CMV) was performed in five treatment‐naive end‐stage AIDS patients (median CD4+ T‐cell counts of 19 cells/μL) following therapy. Proportions of CD45RA+, CD45RO+ and CD28+ cells within the CD4+ and CD8+ subsets, were determined by flow cytometry. Changes in TCR Vβ repertoires within the CD4+ and CD8+ T‐cell compartments were evaluated using CDR3 spectratyping. CMV replication was determined by a sensitive polymerase chain reaction (PCR) assay using whole blood.Results  Following ART, proportionate increases in ‘naive’ (CD45RA+) and ‘memory’ (CD45RO+) T cells were observed within both CD4+ and CD8+ T‐cell subsets, while increased numbers of CD28+ T cells were mainly observed within the CD4+ subset. Diversification of CD4+ and CD8+ TCR repertoires was established concomitantly with renewed in vivo control of CMV replication.Conclusions  An important degree of molecular and functional immune recovery is possible in end‐stage AIDS patients introduced to therapy. Diversification of TCR repertoires and the in vivo restoration of immunocompetence to control opportunistic infections clearly show that an important degree of molecular immune reconstitution is established following the initiation of ART even in late‐stage AIDS.
The use of calcium carbonate in nelfinavir‐associated diarrhoea in HIV‐1‐infected patients
Authors: Jensen‐Fangel S , Justesen US , Black FT , Pedersen C , Obel N 
Published: March 2003

ObjectivesTo evaluate the efficacy of oral calcium supplements in HIV‐infected patients with nelfinavir (NFV)‐associated diarrhoea, and to investigate the influence on the pharmacokinetics of nelfinavir and the active metabolite M8.MethodsAn open‐label prospective trial with enrolment of 15 patients with NFV‐associated diarrhoea. Study subjects received either calcium carbonate or calcium gluconate/calcium carbonate in addition to highly active antiretroviral therapy (HAART), and were randomized to (i) calcium supplements for 14 days followed by 14 without calcium supplements, or (ii) 14 days without calcium supplements followed by calcium supplements for 14 days. Clinical endpoint was the severity of diarrhoea, graded and summarized for the specific 14 day‐period. In the pharmacokinetic evaluation concentrations of NFV and M8 were measured before morning dosing, and 3 h after dosing.ResultsNine patients were treated with calcium carbonate, and six with calcium gluconate/calcium carbonate. In the paired analysis, neither of the groups had a significant improvement in diarrhoea score when treated with calcium supplements (P = 0.34 and 0.46, respectively). We found no significant differences in the concentrations of NFV and M8 between the calcium and control periods.ConclusionsOral calcium supplements did not significantly improve nelfinavir‐associated diarrhoea. In the pharmacokinetic analysis calcium supplements did not induce major alterations in plasma concentrations of NFV and M8.
Amiodarone pigmentation, eye and thyroid alterations
Authors: Bahadır S , Apaydın R , Çobanoılu Ü , Kapıcıoılu Z , Özoran Y , Gökçe M , Alpay K 
Published: March 2003

AbstractAmiodarone is an effective cardiac antiarytmic drug. Long‐term, high dose use of the drug is associated with skin discolouration, corneal deposition and alterations in thyroid hormone levels. We present the case of a 61‐year‐old woman suffering from the combination of these three side‐effects.
Darier’s disease complicated by Kaposi’s varicelliform eruption due to herpes simplex virus
Authors: Pantazi Vassiliki , Potouridou Irene , Katsarou Alexandra , Papadogiorgaki Helen , Katsambas Andreas 
Published: March 2003

AbstractDarier’s disease is an autosomal dominant dermatosis. It may rarely be complicated by localized or widespread cutaneous viral infections. We describe a case of Kaposi’s varicelliform eruption due to herpes simplex virus type 1 presenting in a patient with Darier’s disease.
Biosurgery in wound healing – the renaissance of maggot therapy
Authors: Wollina Uwe , Karte Kerstin , Herold Claudia , Looks Annette 
Published: March 2003

AbstractChronic wounds are a challenge for modern health care. A basic principle of treatment is the removal of sloughy, necrotic, devitalized tissue to prevent wound infection and delayed healing. Biosurgery (syn. maggot or larval therapy) is a promising adjunct to the whole spectrum of topical treatment methods, in particular for debridement. The term ‘biosurgery’ describes the use of living maggots on wounds to remove devitalized tissue, decrease the risk of infection and improve wound healing. The present paper gives a brief review of history, entomology, biochemistry and medical indications of biosurgery and the practical handling of maggots. We also provide some clinical data from the literature and our own experience in a wound care unit. Biosurgery is an effective and safe treatment option for debridement and disinfection.
Eosinophilic pustular eruption associated with transdermal fentanyl
Authors: Mancuso G , Berdondini RM , Passarini B 
Published: March 2003

AbstractA 70‐year‐old man developed a widespread eruption of sterile pustules on normal skin, mainly on the trunk, face and base of the limbs, 2 days after application of a fentanyl‐transdermal therapeutic system (fentanyl‐TTS) patch. The eruption was not accompanied by fever. The main histopathological finding was an intraepidermal pustule filled almost exclusively with eosinophils. Suspension of the fentanyl‐TTS led to rapid and definitive spontaneous regression of the pustules in about 10 days. A similar pustular reaction related temporally to fentanyl‐TTS administration had appeared several weeks before the current eruption.
Eccrine syringofibroadenoma: case report and review of the literature
Authors: Takeda H , Mitsuhashi Y , Hayashi M , Kondo S 
Published: March 2003

AbstractEccrine syringofibroadenoma (ESFA) is a rare disorder that shows differentiation toward eccrine sweat apparatus. There is a controversy concerning the pathogenesis and differentiation of this tumour. We report a case of ESFA in a 63‐year‐old Japanese man. We review the literature presenting a classification, including a newly reported subtype. Clinically and pathogenically, ESFA is probably a group of heterogeneous disorders.
Junctional epidermolysis bullosa gravis (Herlitz): diagnostic and genetic aspects
Authors: Hauschild R , Wollina U , Bruckner‐Tuderman L 
Published: March 2003

AbstractWe report on a boy suffering from lethal junctional epidermolysis bullosa gravis (JEBH) (Herlitz‐type) (OMIM 226700). Screening for mutations of LAMB3 gene with polymerase chain reaction (PCR) amplification of all exons from genomic DNA and subsequent heteroduplex analysis and dideoxynucleotide sequencing of heteroduplex forming PCR products disclosed two mutations: the recurrent maternal mutation R635X and the novel paternal mutation 1629insG, both in exon 14 of LAMB3. Both mutations lead to a premature termination code, non‐sense mediated mRNA decay and to absence of the synthesis of the β3 chain of laminin 5. During the mutation screening of the index patient a second pregnancy was ascertained. After amniocentesis (14 + 1 week of pregnancy), prenatal diagnosis from fetal cells was performed and compound heterozygosity for both mutations was evident. The consultants decided to have a termination of pregnancy shortly after the diagnosis. Remarkable skin fragility of the fetus was evident by clinical examination. Complete absence of laminin 5 could be demonstrated by immunofluorescence staining. By the third pregnancy of this couple so far screened for mutations by chorionic villus sampling for prenatal molecular diagnosis a healthy but heterozygous child is expected.
Cutaneous umbilical endosalpingiosis with severe abdominal pain
Authors: Redondo P , Idoate M , Corella C 
Published: March 2003

AbstractCutaneous endosalpingiosis is a very rare entity, and to our knowledge umbilical location has been reported in only one patient who developed salpingectomy shortly after. We report cutaneous umbilical endosalpingiosis associated with severe abdominal pain that disappeared after surgical treatment.
Histiocytic necrotizing lymphadenitis preceding systemic lupus erythematosus
Authors: Komócsi A , Tóvári E , Pajor L , Czirják L 
Published: March 2003

AbstractNecrotizing histiocytic lymphadenopathy (NHL) is a rarely observed clinical entity that is occasionally associated with systemic lupus erythematosus (SLE). The histological features of the condition have been considered to be indistinguishable from those of lymphadenitis in subjects with SLE, and the clinical symptoms of the two disorders share common features. This report presents the case history of a subject who developed SLE with central nervous system involvement 3 years following onset of Kikuchi’s disease (histiocytic necrotizing lymphadenitis). Repeated lymph node biopsies confirmed the diagnosis in relation to the clinical progression. A review of the literature on this topic is also presented.
Calciphylaxis in two patients with end‐stage renal disease
Authors: Filosa G , Bugatti L , Nicolini M , Verdolini R 
Published: March 2003

AbstractFatal calciphylaxis (CPX) occurred in two 71‐year‐old females both requiring haemodialysis for end‐stage renal disease. Case 2 also had an associated follicular lymphoplasmocytoid lymphoma. Although laboratory tests disclosed normal coagulation parameters, this woman had a striking cutaneous histological picture of vessel thrombosis and finally died of disseminated intravascular coagulation. CPX is a rare but potentially life‐threatening complication of renal failure. The clinical picture is primarily characterized by livedoid purpura with subsequent cutaneous ischaemia and painful ulcerations. Cutaneous ischaemic phenomena are sustained by a progressive process of vascular calcification and thrombosis involving small to medium size arteries of the dermis and subcutis. Although not yet clearly explained, the pathogenetic role of a predisposing hypercoagulability state is currently the most frequently considered hypothesis.
Dermatological immune restoration syndrome: does it exist?
Authors: Handa S , Bingham JS 
Published: March 2003

AbstractDermatological conditions are often an early clue to HIV infection and are common. As the disease progresses patients develop a dominant Th‐2 immunological response that may facilitate the development of a number of skin conditions. With antiretroviral therapy the Th‐1 response is restored and some skin problems regress. But, paradoxically, some cutaneous conditions may worsen, such as herpes zoster, mucocutaneous herpes, eosinophilic folliculitis and mycobacterial infections. This may be because immune restoration of a host’s immunity causes recognition of silent or latent infection and results in development of the condition.
High‐dose cytosine arabinoside‐induced cutaneous reactions
Authors: Cetkovská P , Pizinger K , Cetkovský P 
Published: March 2003

AbstractBackground High‐dose cytosine arabinoside (HDAC) is being used increasingly to treat haematological malignancies. The therapy is associated with various non‐haematological negative side‐effects, frequently involving the skin.Objective Our aim was to evaluate the actual occurrence of adverse skin reactions to HDAC over the 10‐year period from 1989 to 1999.Methods One hundred and seventy‐two subjects, 118 with acute myelogenous leukaemia and 54 with acute lymphoblastic leukaemia, between 16 and 71 years of age were treated with 226 post‐remission consolidation regimens with HDAC (54 subjects underwent two cycles of treatment). Treatment was combined with standard doses of other cytotoxic drugs. A prospective study of the skin changes was then performed.Results The overall incidence of cutaneous reactions was almost 53%, with rashes occurring in 72.7% and 40.6% of subjects who received total doses of 30 and 24 g/m2, respectively. In the group of subjects who received a second cycle of treatment not all of those who experienced exanthema after the first cycle (44.4%) experienced this reaction after the second cycle (only 33.3%). The most commonly observed reactions were morbilliform eruptions on the trunk and extremities and acral erythema, although severe reactions with swelling and generalized urticaria developed in some cases.Conclusions HDAC‐induced cutaneous reactions in 53% of subjects. The skin changes were found to be dose related and most cleared spontaneously without requiring treatment. A clinical grading of cutaneous toxicity has been proposed to allow better comparison of cutaneous adverse effects in different reports.
Pseudoverrucous papules: an aspect of incontinence in children
Authors: Coppo P , Salomone R 
Published: March 2003

AbstractPseudoverrucous papules and nodules can be observed on skin surrounding urostomies and colostomies. These lesions appear to be uncommon, and sometimes can be misdiagnosed, even leading to surgical removal. We report the case of a 12‐year‐old boy whose lesions appeared in crops in an area subjected to urine leakage and spontaneously regressed in time. In this patient, anogenital warts had to be ruled out, but many skin diseases must be considered in the differential diagnosis of these misunderstood lesions. We stress the importance of a skin examination by a trained professional aware of these problems to avoid unnecessary investigations and treatments.
A case of loiasis in Rome
Authors: Morrone A , Franco G , Toma L , Tchangmena OB , Marangi M 
Published: March 2003

AbstractBackground  Owing to the increase of an immigrant population and of Italian citizens travelling for tourism or on business, it is nowadays possible to observe clinical pictures characteristic of tropical regions, often with indistinct symptoms. One of these is Loa loa infestation, or loiasis, a form of filariasis caused by Loa loa and transmitted by the Chrysops fly. We present the case of a male immigrant from Cameroon. Characteristic symptoms were intense xerosis, mostly of the third inferior part of the legs, intensely pruritic, with numerous lesions from scratching. No benefit was obtained by emollient topics, anti‐acarus and systemic antihistamines.Method  Serum samples and Giemsa, haematoxylin, haematoxylin + Giemsa concentration‐on‐membrane stains, have evidenced the presence of Loa loa microfilariae.Results  A diagnosis for L. loa (loiasis) infestation was made.Conclusions  At the beginning of the migration phenomenon, particularly from Africa, Italian physicians, especially dermatologists, were eagerly looking for ‘tropical’ diseases; this approach can be defined as ‘Salgari's syndrome’ from the name of the Italian novelist who, though never travelling out of Italy, had perfectly described environments and habits typical of far away countries. Now, conversely, we have to avoid the opposite approach of considering real tropical diseases as related to social or psychological difficult conditions.
Varicella zoster viraemia during herpes zoster is not associated with neoplasia
Authors: Bezold G , Lange M , Pillekamp H , Peter RU 
Published: March 2003

AbstractBackground Shingles are caused by an endogenous or exogenous reinfection with varicella zoster virus (VZV). Up to 50% of individuals with Hodgkin's disease develop herpes zoster; however, no association could be shown between the occurrence of herpes zoster and underlying subclinical malignancies.Objective This study was conducted to investigate whether VZV DNA could be detected by polymerase chain reaction (PCR) in the blood of herpes zoster patients and whether there was an association between VZV viraemia and previous or concurrent neoplasias.Methods At least five blood samples from 28 patients with herpes zoster were investigated by internally controlled PCR enzyme‐linked immunosorbent assay prior to and during therapy with aciclovir.Results None of 13 patients, two with a history of neoplasia and two with a neoplasia at the time of the study, showed any signs of viraemia with VZV, and 14 patients had inconsistent viraemia, one with a history of neoplasia and two with neoplasia at the time of the study. In one patient VZV DNA was detected in the blood for 6 days. This patient died soon after from metastatic malignant melanoma.Conclusions VZV viraemia may occur during herpes zoster episodes, even in patients without evidence of immunosuppression; however, this viraemia is, in most cases, inconsistent and does not provide any specific information concerning underlying unrecognized malignancies.