bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral Manifestations of Paracoccidioidomycosis. Report of 21 Cases from Argentina
Authors: Godoy H. , Reichart P. A. 
Published: October 2003

SummaryThe present study describes 21 Argentinian patients living in the province of Corrientes, who had developed oral manifestations due to Paracoccidioides brasiliensis infection. Of these, 20 patients were men and one a woman. Patients were of an average age of 39 years (range 25 to 72 years). Approximately, 76.2% of the patients were farmers. Gingival lesions were observed in 76%. Also, the tongue (71%) and the lips (62%) were frequently affected. Cytological smears and histopathology showed the characteristic fungal cells with the characteristic granulomatous inflammatory reaction consisting of lymphocytes, epithelioid cells and giant cells of the Langhans type. All patients except one had detectable pulmonary involvement. Therapy consists of long‐term administration of itraconazole. Oral manifestations of paracoccidioidomycosis are characteristic in their clinical presentation. Early diagnosis and adequate therapy may prevent extensive tissue destructions. Long‐term follow‐up is mandatory.
Fatal pulmonary scedosporiosis
Authors: Horré R. , Jovanić B. , Marklein G. , Schumacher G. , Friedrichs N. , Neuhaus T. , de Hoog G. S. , Becker W. H. J. , Choi S. M. , Schaal K. P. 
Published: October 2003

SummaryWe report on a case of scedosporiosis in a 72‐year‐old German woman. Her disease started with a purulent ulceration of unknown course at her left foot. Soon after onset of oral antibacterial therapy she needed in‐hospital treatment because of an acute pneumonia. The infection progressed despite the application of different antibiotics. Microscopic examination of tracheal fluid revealed fungal hyphae and therefore treatment with itraconazole was initiated. However, the patient developed renal failure, required mechanical ventilation and finally died in treatment‐resistant septic shock. Post‐mortem Scedosporium apiospermum was cultured from lung tissue taken during autopsy. This is the fourth case of human infection caused by Scedosporium species diagnosed in our laboratory during the last 4 years.
Adhesion and cell‐surface‐hydrophobicity of sequentially isolated genetic isotypes of Candida albicans in an HIV‐infected Southern Chinese cohort
Authors: Samaranayake Y. H. , Samaranayake L. P. , Yau J. Y. Y. , Ellepola A. N. B. , Anil S. , Yeung K. W. S. 
Published: October 2003

SummaryObjectives of the study were to investigate the variability in yeast adhesion and cell‐surface‐hydrophobicity (CSH) during human immunodeficiency virus (HIV) disease progression, using a total of 60 sequential Candida albicans isolated from oral rinse samples of seven HIV‐infected individuals with (4) and without (3) clinical symptoms of oropharyngeal candidosis. Significant differences in the adhesion to buccal epithelial cells (BECs) during sequential visits were observed for all genetic isotypes in five of the seven individuals and three isotypes belonging to the sixth individual. A single isotype of patient HK1 and another of HK4 (genotype I) demonstrated significant variations in their CSH during sequential visits whereas no such differences were noted for the remaining genotypes. On Spearman correlation analysis an isotype from HK1 demonstrated a significant increased adherence to BECs and CSH during HIV disease progression whereas no such correlation was noted for the remaining isotypes studied. No significant differences in adherence to BECs or CSH values were observed between the symptomatic oral candidosis and the asymptomatic carrier group. Further, on regression analysis only the single isotype of HK1 demonstrated a significant positive correlation between adherence to BECs and CSH whereas no such correlation was observed when all tested Candida isolates were pooled and evaluated as a single, large group.
Morphological observations on Absidia corymbifera and Absidia blakesleeana strains preserved under mineral oil
Authors: Santos Manoel J. S. , de Oliveira Pedrina C. , Trufem Sandra F. B. 
Published: October 2003

SummaryMacro‐ and micromorphology of 30 living subcultures of Absidia corymbifera (10 strains plus three strains of Absidia ramosa) and Absidia blakesleeana (two strains) preserved under mineral oil at room temperature for periods ranging from 3 to 44 years in The Fungal Culture Collection of Instituto Oswaldo Cruz (IOC) were observed and described by permanent mycological preparations mounted in a glycerol 10% and/or Amann lactophenol solution. Vegetative and asexual reproductive structures are illustrated by drawings made with the aid of a camera‐lucida. The study showed that the period of maintenance under mineral oil and the stress which took place during the period of storage did not affect the vegetative and asexual reproductive morphology of the Absidia strains and species studied here.
Comparison of morning and evening administration of rabeprazole for gastro‐oesophageal reflux and nocturnal gastric acid breakthrough in patients with reflux disease: a double‐blind, cross‐over study
Authors: Pehlivanov N. D. , Olyaee M. , Sarosiek I. , McCallum R. W. 
Published: October 2003

SummaryAim:  To assess the effect of timing of rebeprazole (RB) 20 mg/d administration on oesophageal acid exposure and nocturnal gastric acid breakthrough (NGAB) in patients with GERD.Methods:  20 GERD patients received two 7‐day treatments of RB in the morning (a.m.) or in the evening (p.m.) hours. The regimens were randomized in a double‐blind fashion and separated by a 7‐day washout period. The tablets were taken 30 min before standardized meals. A combined (oesophageal & gastric) 24‐hour pH monitoring was performed before and on day 7 of each treatment.Results:  Total oesophageal acid exposure was normalized in 10/14 (71.4%) patients with RB p.m. and in 6/15 (42.8%) with RB a.m. RB p.m. significantly decreased the nocturnal supine oesophageal acid exposure vs. RB a.m., 0.2% vs. 3.4%. The mean NGAB duration was significantly shortened with RB a.m. and p.m. vs. the baseline recording, 4.1±1.8 and 3.4±1.5 hours vs. 7.8±1.7 hours.Conclusions:  Rabeprazole significantly reduced the NGAB duration and significantly increased the mean nocturnal gastric pH; RB p.m. normalized more effectively the total oesophageal exposure than RB‐a.m.; RB p.m. provided significantly better control of nocturnal supine gastro‐oesophageal reflux than a.m. dosing. These data suggest that administration of a PPI before the evening meal maximizes acid control and would be the preferred dosing schedule in GERD patients, particularly those with nocturnal symptoms.
The basis for the decreased response to proton pump inhibitors in gastro‐oesophageal reflux disease patients without erosive oesophagitis
Authors: Gardner J. D. , Gallo‐Torres H. , Sloan S. , Robinson M. , Miner P. B. 
Published: October 2003

SummaryBackground : The reason why heartburn in gastro‐oesophageal reflux disease subjects without oesophagitis is less responsive to proton pump inhibitors than heartburn in those with erosive oesophagitis is not known.Methods : Gastric and oesophageal pH were determined in 26 subjects with gastro‐oesophageal reflux disease at baseline and on days 1, 2 and 8 of treatment with 20 mg omeprazole or 20 mg rabeprazole in a randomized, two‐way cross‐over fashion. The presence or absence of erosive oesophagitis at baseline was documented by upper gastrointestinal endoscopy.Results : At a given value of the integrated gastric acidity during treatment with a proton pump inhibitor, the probability of pathological oesophageal reflux was significantly higher in subjects with no oesophagitis than in those with erosive oesophagitis. This occurred because the post‐prandial gastric acidity in subjects with no oesophagitis showed a decreased response to the antisecretory agent.Conclusions : Compared with gastro‐oesophageal reflux disease subjects with erosive oesophagitis, those with no oesophagitis are relatively refractory to the pharmacodynamic effects of proton pump inhibitors on the post‐prandial integrated gastric acidity.
Drug interaction between infliximab and azathioprine in patients with Crohn's disease
Authors: Roblin X. , Serre‐Debeauvais F. , Phelip J.‐M. , Bessard G. , Bonaz B. 
Published: October 2003

SummaryBackground : A drug interaction has been observed between infliximab and methotrexate in rheumatoid arthritis.Aim : To look for an interaction between infliximab and azathioprine in Crohn's disease patients using the active metabolites of azathioprine: 6‐tioguanine nucleotides.Methods : Patients receiving azathioprine who required infliximab for ileo‐colonic or ano‐perineal Crohn's disease were recruited prospectively. 6‐tioguanine nucleotide levels were evaluated before infusion, within 1–3 weeks after the first infusion and 3 months after the first infusion. The clinical outcome was evaluated by the Harvey–Bradshaw index or the closure of ano‐perineal fistulas.Results : Thirty‐two patients were included (17 received one infusion and 15 received three infusions). The mean 6‐tioguanine nucleotide level was comparable before and 3 months after the first infusion, but a significant increase was observed within 1–3 weeks after the first infusion (P < 0.001). In parallel, a significant decrease in leucocyte count and increase in mean corpuscular volume were observed; these modifications were normalized 3 months after infusion. An increase in 6‐tioguanine nucleotide level of greater than 400 pmol/8 × 108 erythrocytes was strongly related to good tolerance and a favourable response to infliximab, with a predictive value of 100%.Conclusions : This prospective study provides evidence for a drug interaction between azathioprine and infliximab.
Oral and intestinal mucositis — causes and possible treatments
Authors: Duncan M. , Grant G. 
Published: October 2003

SummaryChemotherapy and radiotherapy, whilst highly effective in the treatment of neoplasia, can also cause damage to healthy tissue. In particular, the alimentary tract may be badly affected. Severe inflammation, lesioning and ulceration can occur. Patients may experience intense pain, nausea and gastro‐enteritis. They are also highly susceptible to infection. The disorder (mucositis) is a dose‐limiting toxicity of therapy and affects around 500 000 patients world‐wide annually.Oral and intestinal mucositis is multi‐factorial in nature. The disruption or loss of rapidly dividing epithelial progenitor cells is a trigger for the onset of the disorder. However, the actual dysfunction that manifests and its severity and duration are greatly influenced by changes in other cell populations, immune responses and the effects of oral/gut flora. This complexity has hampered the development of effective palliative or preventative measures. Recent studies have concentrated on the use of bioactive/growth factors, hormones or interleukins to modify epithelial metabolism and reduce the susceptibility of the tract to mucositis. Some of these treatments appear to have considerable potential and are at present under clinical evaluation.This overview deals with the cellular changes and host responses that may lead to the development of mucositis of the oral cavity and gastrointestinal tract, and the potential of existing and novel palliative measures to limit or prevent the disorder.Presently available treatments do not prevent mucositis, but can limit its severity if used in combination. Poor oral health and existing epithelial damage predispose patients to mucositis. The elimination of dental problems or the minimization of existing damage to the alimentary tract, prior to the commencement of therapy, lowers their susceptibility. Measures that reduce the flora of the tract, before therapy, can also be helpful. Increased production of free radicals and the induction of inflammation are early events in the onset of mucositis. Prophylactic administration of scavengers or anti‐inflammatories can partially counteract or limit some of these therapy‐mediated effects, as can the use of cryotherapy. The regular use of mouthwashes, mouth coatings, antibiotics and analgesics is essential, prior to and during loss and ablation of the epithelial layer. Granulocyte–macrophage colony‐stimulating factor/granulocyte colony‐stimulating factor or the use of laser light therapy may aid restitution and repair. Glutamine supplements may be beneficial in the repair/recovery phase.
Re‐treatment of patients with anti‐HBe‐positive chronic hepatitis B who relapsed after an initial course of lamivudine
Authors: Niro G. A. , Santantonio T. , Fontana R. , Insalata M. , Facciorusso D. , Signorile F. , Perri F. , Guastadisegni A. , Gioffreda D. , Palmieri O. , Pastore G. , Andriulli A. 
Published: October 2003

SummaryAim : To evaluate the efficacy of a long‐term course of lamivudine monotherapy in patients with anti‐HBe‐positive chronic hepatitis B who relapsed after the first course of either lamivudine/interferon (n = 16; Group 1) or lamivudine (n = 20; Group 2).Methods : Biochemical and virological tests were performed every 3 months. At baseline and breakthrough, the region coding for the YMDD amino acid motif was sequenced.Results : The length of re‐treatment averaged 24 months. The virological response peaked at 6 months (94.4%), and declined to 66.7% and 50% at 12 and 24 months, respectively. The rates of breakthrough were 2.9%, 31.4% and 48.6% at 6, 12 and 24 months, respectively. By the second year, responders amounted to 62.5% and 40% in Groups 1 and 2, respectively (P = 0.10). The 18 responders at month 24 are still on therapy after 25–51 months of treatment: 14 still maintain a response, nine from Group 1 and five from Group 2.Conclusions : Re‐treatment with lamivudine can control viral replication. This effect is maintained for the initial 12 months in two‐thirds of patients, but afterwards the duration of response lessens due to the development of viral resistance.
Occult hepatitis C virus infection in type II mixed cryoglobulinaemia
Authors: Casato M. , Lilli D. , Donato G. , Granata M. , Conti V. , Del Giudice G. , Rivanera D. , Scagnolari C. , Antonelli G. , Fiorilli M. 
Published: October 2003

Summary. Mixed cryoglobulinaemia, when not secondary to other well‐defined immunological disorders, is commonly associated with hepatitis C virus (HCV) infection. However, a minority of cases lack evidence of HCV infection and are, therefore, defined as ‘true essential’ mixed cryoglobulinaemias. We thoroughly investigated three such patients to determine the aetiology of this disorder.Antibodies to HCV (anti‐HCV) and HCV RNA, detected by sensitive enzyme‐linked immunosorbent and polymerase chain reaction assays in serum and in concentrated cryoglobulins, were repeatedly negative in the three patients. Despite the lack of evidence for HCV infection, two of them were still treated with interferon α‐2a assuming unrecognized viral infection. Both patients demonstrated excellent clinical and laboratory responses, but cryoglobulinaemia relapsed after the withdrawal of therapy. At the time of relapse, HCV RNA genomic sequences were detected for the first time in the cryoprecipitates of both patients. In the third case, HCV RNA was demonstrated for the first time during a flare of cryoglobulinaemia coincident with varicella infection. In all three patients anti‐HCV antibodies remained negative throughout follow‐up.We conclude that some apparently ‘essential’ forms of mixed cryoglobulinaemia can be caused by occult HCV infection. Interferon therapy can be taken into consideration in such HCV‐negative cases.
Genetic mosaic in a marine species flock
Authors: Mccartney Michael A. , Acevedo Jenny , Heredia Christine , Rico Ciro , Quenoville Brice , Bermingham Eldredge , Mcmillan W. Owen 
Published: October 2003

AbstractWe used molecular approaches to study the status of speciation in coral reef fishes known as hamlets (Serranidae: Hypoplectrus). Several hamlet morphospecies coexist on Caribbean reefs, and mate assortatively with respect to their strikingly distinct colour patterns. We provide evidence that, genetically, the hamlets display characteristics common in species flocks on land and in freshwaters. Substitutions within two mitochondrial DNA (mtDNA) protein‐coding genes place hamlets within a monophyletic group relative to members of two related genera (Serranus and Diplectrum), and establish that the hamlet radiation must have been very recent. mtDNA distances separating hamlet morphospecies were slight (0.6 ± 0.04%), yielding a coalescent estimate for the age of the hamlet flock of approximately 430 000 years. Morphospecies did not sort into distinct mtDNA haplotype phylogroups, and alleles at five hypervariable microsatellite loci were shared broadly across species boundaries. None the less, molecular variation was not distributed at random. Analyses of mtDNA haplotype frequencies and nested clades in haplotype networks revealed significant genetic differences between geographical regions and among colour morphospecies. We also observed significant microsatellite differentiation between geographical regions and in Puerto Rico, among colour morphospecies; the latter providing evidence for reproductive isolation between colour morphospecies at this locale. In our Panama collection, however, colour morphospecies were mostly genetically indistinguishable. This mosaic pattern of DNA differentiation implies a complex interaction between population history, mating behaviour and geography and suggests that porous boundaries separate species in this flock of brilliantly coloured coral reef fishes.
Population genetic structure of mahogany (Swietenia macrophylla King, Meliaceae) across the Brazilian Amazon, based on variation at microsatellite loci: implications for conservation
Authors: Lemes Maristerra R. , Gribel Rogério , Proctor John , Grattapaglia Dario 
Published: October 2003

AbstractMahogany (Swietenia macrophylla, Meliaceae) is the most valuable and intensively exploited Neotropical tree. No information is available regarding the genetic structure of mahogany in South America, yet the region harbours most of the unlogged populations of this prized hardwood. Here we report on the genetic diversity within and the differentiation among seven natural populations separated by up to 2100 km along the southern arc of the Brazilian Amazon basin. We analysed the variation at eight microsatellite loci for 194 adult individuals. All loci were highly variable, with the number of alleles per locus ranging from 13 to 27 (mean = 18.4). High levels of genetic diversity were found for all populations at the eight loci (mean HE = 0.781, range 0.754–0.812). We found moderate but statistically significant genetic differentiation among populations considering both estimators of FST and RST, θ = 0.097 and ρ = 0.147, respectively. Estimates of θ and ρ were significantly greater than zero for all pairwise population comparisons. Pairwise ρ‐values were positively and significantly correlated with geographical distance under the isolation‐by‐distance model. Furthermore, four of the populations exhibited a significant inbreeding coefficient. The finding of local differentiation among Amazonian mahogany populations underscores the need for in situ conservation of multiple populations of S. macrophylla across its distribution in the Brazilian Amazon. In addition, the occurrence of microgeographical genetic differentiation at a local scale indicates the importance of maintaining populations in their diverse habitats, especially in areas with mosaics of topography and soil.
High caffeine consumption in the third trimester of pregnancy: gender‐specific effects on fetal growth
Authors: Vik Torstein , Bakketeig Leiv S. , Trygg Kerstin Ulla , Lund‐Larsen Kari , Jacobsen Geir 
Published: October 2003

SummaryIt has been suggested that a high caffeine intake in pregnancy may be a risk factor for fetal growth retardation. We have tested this hypothesis in a population‐based case‐control study. Caffeine intake among 111 mothers of small‐for‐gestational‐age (SGA) infants (56 boys, 55 girls) was compared with the intake among 747 mothers of non‐SGA infants (368 boys, 379 girls). Food records for 3 days were collected in the second (week 17–20) and in the third (week 33) trimester, and caffeine intake from coffee, tea, soft drinks and chocolate was calculated and dichotomised as low or high, based upon the median value. Mothers of SGA infants had higher mean intake of caffeine [281 ± 210 (SD) mg/day] in the third trimester than mothers of non‐SGA infants (212 ± 150 mg/day; P < 0.001). The risk of SGA birth was nearly doubled if the mother had a high rather than a low caffeine intake in the third trimester [odds ratio (OR) 1.8; 95% confidence intervals (CI) 1.2, 2.5]. The increased risk was mainly found in boys (OR 2.8; 95% CI 1.5, 5.2), and not in girls (OR 1.2; 95% CI 0.7, 2.1). The increased risk for boys persisted after adjustment for cigarette smoking alone, or for smoking and various other SGA risk factors together. Our results suggest that a high caffeine intake in the third trimester may be a risk factor for fetal growth retardation, in particular if the fetus is a boy.
Rates of twinning before and after fortification of foods in the US with folic acid, Texas, 1996 to 1998
Authors: Waller D. K. , Tita A. T. N. , Annegers J. F. 
Published: October 2003

SummarySeveral investigators have reported a 40% increase in the prevalence of twinning among women who have taken folic acid or multivitamins containing folic acid at the time of conception. Given that infant morbidity and mortality are greatly increased among twins, such a large increase in twinning could have serious implications. We undertook this study to determine if US fortification of enriched cereal‐grain products with folic acid was associated with an unexpected increase in the prevalence of twinning in the state of Texas. We examined 1 003 207 deliveries conceived in Texas, between 1 January 1996 and 31 December 1998. We compared the prevalence of twin deliveries conceived before, during and after fortification with folic acid, mandated to begin on 1 January 1998. Comparing pregnancies conceived in 1997 with those conceived in 1996, we observed a 2.4% yearly increase in twinning, 1.024 [0.98, 1.07]. Comparing pregnancies conceived in 1998 with those conceived in 1997, we observed a 4.6% yearly increase in twinning, 1.046 [1.00, 1.09]. These increases were adjusted for maternal age, race, education, parity and season of conception. The size and pattern of these increases are consistent with the ongoing increase in twinning of 1–4% per year which began in the US prior to fortification.