bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of environmental methods to control snails in an irrigation system in Central Morocco
Authors: Laamrani H. , Khallaayoune K. , Boelee E. , Laghroubi M. M. , Madsen H. , Gryseels B. 
Published: March 2003

SummaryThe Moroccan Ministry of Public Health has launched a programme to eliminate schistosomiasis. One of the components in this process is the control of Bulinus truncatus, the intermediate host snail of Schistosoma haematobium. We evaluated three environmentally safe measures to control B. truncatus in siphon boxes, the main breeding sites for these snails in the Tessaout Amont irrigation system. The first method involved covering the siphon boxes to exclude light and reduce algal growth, the second consisted of increasing the frequency of emptying and cleaning the siphon boxes, and the third method increased water velocity to hinder the establishment of the intermediate hosts. The results showed that covering had a pronounced effect on snail and egg mass density, was accepted by the local community and prevented water contact. Cleaning the siphons three times during the irrigation season led to a reduction in snail density although it was not statistically significant and recolonization was rapid. Increasing water velocity by reducing the dimensions of siphon boxes delayed recolonization, but such a control measure can be applied only in specific situations where it does not pose hydraulic problems. The three interventions were selectively effective against B. truncatus, whereas other snails such as Physa acuta and Lymnaea peregra were hardly affected. Covering, the most promising control measure, could be useful in the Moroccan schistosomiasis eradication programme. However, further investigations are needed to assess its impact on water quality.
The influence of prematurity and low birthweight on transplacental antibody transfer in a rural West African population
Authors: Okoko J. B. , Wesumperuma H. L. , Hart C. A. 
Published: March 2003

OBJECTIVE To determine the influence of prematurity and low birthweight (LBW) on transplacental antibody transfer. METHOD In a physician‐blinded, cross‐sectional study of 213 mother–baby pairs in the labour ward of Bansang Hospital, The Gambia, paired maternal and cord serum samples were tested for specific IgG antibody titres for measles virus (MeV), herpes simplex virus type 1 (HSV1), respiratory syncytial virus (RSV), varicella‐zoster virus (VZV), tetanus toxoid (TT) and diphtheria toxoid (DT) antigens using enzyme linked immunosorbent assay (ELISA). RESULTS Prematurity was significantly associated with reduced placental antibody transfer for MeV, HSV1, TT, DT, RSV and VZV. Maternal antibody transfer for MeV, HSV1, TT, DT, RSV and VZV was significantly lower in neonates with LBW than in babies with adequate birthweight (ABW). CONCLUSION Materno–foetal transfer of antibodies is impaired in prematurity and LBW babies in this Gambian population. Reduction in antibody transfer may further predispose these already vulnerable neonates to bacteria and viral infections. Therefore, alternative vaccination strategies, including earlier vaccination schedules, are needed to provide better protection to these young infants.
Sulphadoxine/pyrimethamine: an appropriate first‐line alternative for the treatment of uncomplicated falciparum malaria in Ghanaian children under 5 years of age
Authors: Driessen G. J. A. , Van Kerkhoven S. , Schouwenberg B. J. J. W. , Bonsu G. , Verhave J. P. 
Published: March 2003

OBJECTIVE  To assess whether chloroquine (CQ) still is an appropriate first‐line drug for the treatment of uncomplicated falciparum malaria in Ghana and whether sulphadoxine/pyrimethamine (SP) could be a good alternative. METHOD  The parasitological, clinical and haematological responses to CQ and SP were studied in children < 5 years of age according to a modified WHO 28‐day in vivo protocol. A total of 142 children attending the outpatients department meeting the inclusion criteria were randomly assigned to the CQ (n=72) or SP (n=70) group. RESULTS  In the CQ group, 15 children (20.8%) exhibited early clinical failure (within 3 days) compared with only 1 (1.4%) in the SP group (P < 0.01). The clinical failure rate before day 14 (early treatment failure plus late treatment failure before day 14) also showed a marked advantage in favour of the SP group (1.4 against 29.2%). The median time to clinical failure was 11.5 days in the CQ group and 26 days in the SP group (P < 0.01). Of the 72 children treated with CQ, 9 (12.5%) had RIII resistance and 19 (26.4%) had RII resistance. A total of 36 (50.0%) were sensitive to CQ. From the 70 children treated with SP, none had RIII or RII resistance. There was no difference in haematological response between the two treatment groups. CONCLUSION  Although there is little concordance on when to change treatment policy, the high resistance to CQ in this study supports the change to another first‐line drug for children under 5 years of age. SP seems to be a good alternative, although a high RII and RIII resistance against this drug has already been reported in the coastal zones of Ghana.
Alanine metabolism in acute falciparum malaria
Authors: Pukrittayakamee S. , Krishna S. , Ter Kuile F. , Wilaiwan O. , Williamson D. H. , White N. J. 
Published: March 2003

SummaryWe investigated the integrity of the gluconeogenic pathway in severe malaria using alanine metabolism as a measure. Alanine disposition and liver blood flow, assessed by indocyanine green (ICG) clearance, were measured simultaneously in 10 patients with falciparum malaria (six severe and four moderately severe malaria). After intravenous infusion of alanine (0.3 g/kg), glucose increments (AUC0−55 min) were lower in patients with severe malaria than in those with moderately severe malaria (median = 508 vs. 808 mmol/min/l; P = 0.055). There were no significant differences in the other metabolite increments (alanine, lactate and pyruvate; P ≥ 0.27). The two fatal cases had markedly delayed alanine removal (larger AUC0−55 min), prolonged T½ and slower clearance (P ≤ 0.007). Overall the increments in blood alanine correlated directly with lactate increments (rs = 0.84; P = 0.002) and inversely with glucose (rs = −0.70; P = 0.025). Between acute and convalescent studies, the increments (AUC0−55 min) of alanine and glucose were not significantly different (P ≥ 0.07) but the increments of lactate and pyruvate were lower in convalescence. Thus, the ratio of the increments of alanine to those of lactate and pyruvate were significantly higher in the convalescent study (P ≤ 0.017). The mean (SD) ICG clearance during acute malaria was not significantly different to that in convalescence (21.6 ± 9.3 vs. 34.1 ± 15.5 ml/min/kg; P = 0.25). During the acute study, there was a significant inverse correlation between ICG clearance and the post‐infusion increments of lactate (rs = −0.63, P = 0.049) and pyruvate (rs = −0.74, P = 0.014). These data indicate that alanine clearance is impaired in acute falciparum malaria in proportion to the severity of illness and suggest an important role for anaerobic glycolysis in the pathogenesis of hypoglycaemia in severe malaria.
Plasmodium falciparum multiple infections in Mozambique, its relation to other malariological indices and to prospective risk of malaria morbidity
Authors: Mayor Alfredo , Saute Francisco , Aponte John J. , Almeda Jesús , Gómez‐Olivé F. Xavier , Dgedge Martinho , Alonso Pedro L. 
Published: March 2003

SummaryWe describe the frequency of Plasmodium falciparum clones infecting individuals living in a rural area of southern Mozambique and analyse the relationship between multiplicity of infection, age and other malariometric indices, including prospective risk of clinical malaria. The genotyping was based on the use of restriction fragment length polymorphism–polymerase chain reaction (RFLP–PCR) analysis of P. falciparum merozoite surface protein 2 (msp2). We analysed 826 samples collected during five cross‐sectional surveys from residents of Manhiça ranging in age from 4 months to 83 years. We also determined the multiplicity of infection in samples obtained from 6‐month‐old infants (n = 79) and children <10 years (n = 158) who were then treated and followed prospectively for 1 year or 75 weeks, respectively. Multiplicity of infection did not vary significantly during the first year of life, but increased thereafter, and decreased during adulthood to the levels found in infants. With increasing multiplicity of infection, there was a statistically significant decrease in the risk of submicroscopic infections. There was also a significant correlation between multiplicity of infection and parasite density in infants, children <4 years of age and adults, suggesting that high densities increase the probability of discriminating more clones in complex infections. We found that the relationship between multiple infections and malaria morbidity is age‐dependent. In infants, the risk of subsequent episodes of clinical malaria was related to the parasite density but not to baseline multiplicity of infection. In older children, however, the more clones a child carried, the more likely they were to have a clinical malaria episode, and this was true after adjusting for parasite densities. This change in the association between multiplicity and risk of clinical malaria may indicate a shift in the host response to P. falciparum.
The association of Staphylococcus schleiferi with canine pyoderma
Authors: Frank L. A. , Williamson N. L. , Wilkes R. P. , Kania S. A. , Hnilica K. A. , Bemis D. A. 
Published: March 2003

Staphylococcus schleiferi is a recently recognized organism with potential pathogenic implications in human and veterinary medicine. The purpose of this study was to determine the frequency of S. schleiferi in canine pyodermas and see if methicillin resistance (MR) is associated with this organism. Cultures were obtained from dogs with pyoderma over a 1‐year period. It was determined if the pyoderma was a first‐time or recurrent one, and if the dog was receiving antibiotics at the time of culture. Of 15 dogs with first‐time pyoderma, four dogs were receiving antibiotics at the time of culture: S. schleiferi was not cultured from any dog in this group. Cultures were obtained from 27 dogs with recurrent infection that were not receiving antibiotics: S. schleiferi was cultured from five of these dogs; three of the five S. schleiferi‐cultured isolates were MR. Cultures were obtained from 12 dogs with recurrent pyoderma while receiving antibiotics: S. schleiferi was cultured from nine of these dogs; eight of the nine S. schleiferi‐cultured isolates were MR. Five of the 12 dogs had been cultured previously while not receiving antibiotics. Three of these dogs cultured positive for S. intermedius initially, and then ‐cultured; one dog cultured S. schleiferi positive both times; and one dog cultured S. schleiferi positive, then S. intermedius positive. To the authors’ knowledge, this is the first report of S. schleiferi associated with canine pyoderma. Results indicate that S. schleiferi is cultured more often from dogs with recurrent pyodermas while receiving antibiotics. MR is frequently associated with S. schleiferi. Funded by the Department of Small Animal Clinical Sciences and a grant from the Center of Excellence.
Successful prenatal exclusion of an unspecified subtype of severe epidermolysis bullosa
Authors: Shimizu MD Hiroshi , Horiguchi MD Yuji , Suzumor MD Kaoru , Watanabe MD Isao , Owaribe PhD Katsushi , Nishikawa MD Takeji 
Published: March 2003

Background In most cases of prenatal diagnosis of epidermolysis bullosa (EB), the subtype of severe EB from which the fetus is at risk is identified by studying the specimens of the proband. In this study, the parents of a child with an unspecified subtype of severe EB sought prenatal diagnosis for their second and third pregnancies. Methods The firstborn of a couple (the proband) suffered generalized blistering and erosions of the skin present from delivery, and died on the 11th postnatal day of severe EB of an unspecified type. The only diagnostic specimen available from the first infant was a conventionally stained skin section for light microscopy that showed the dermo–epidermal separation. For prenatal diagnosis in the second and third pregnancies, fetal skin biopsies were performed at 19 weeks of gestation. Results In both cases, fetal skin showed no ultrastructural abnormalities and no evidence of dermo–epidermal separation. Indirect immunofluorescence was positive for monoclonal antibodies against type VII collagen, laminin 5, uncein, α6 and β4 integrins, BPAG2, and HD1/plectin, which are known to be reduced or absent in specific subsets of severe EB. The pregnancies were therefore continued, and normal healthy second and third children were delivered. Conclusions Fetal skin biopsy, together with a panel of newly developed monoclonal antibodies, provided reliable prenatal diagnosis in the present family in which preliminary information of the EB proband was limited.
Different patterns of in vitro acantholysis in normal human skin samples explanted from different sites of the body
Authors: Ruocco Vincenzo , Brenner Sarah , Ruocco Eleonora , De Angelis Francesca , Lombardi Maria Luisa 
Published: March 2003

Background The factors that contribute to a preferential anatomic localization of pemphigus lesions are not well known. In particular, the question arises as to whether certain skin areas may be more acantholysis‐prone than others. ObjectiveTo verify whether, in pemphigus patients, a different susceptibility to acantholysis exists among different cutaneous regions, the technique of tissue cultures was used. MethodsNormal human skin explants from two distinct anatomic regions (back and buttocks) of two former pemphigus patients were cultured in vitro in the presence of enalapril (6 mM) or cystamine (10 mM), two substances with a proven biochemical acantholytic effect. After 4 days of culture, the tissues were processed for standard histology. ResultsDiffuse acantholysis, with large intraepidermal splits, was observed in the explants taken from the backs of both subjects and cultured with either enalapril or cystamine. Mild to moderate acantholytic changes were detected in the explants taken from the buttocks of both subjects and cultured with either enalapril or cystamine. No structural changes were seen in the control cultures. ConclusionsPemphigus patients present different thresholds of acantholysis in different areas of their bodies. This might explain, at least in part, certain preferential anatomic localizations of pemphigus lesions.
A randomized, controlled and blinded study of papulopustular lesions in Turkish Behçet’s patients
Authors: Alpsoy Erkan , Aktekin Mehmet , Er Hanife , Durusoy Çiçek , Yilmaz Ertan 
Published: March 2003

AbstractBackground Papulopustular lesions (PPL), the commonest presentation of skin lesions in Behçet’s disease (BD) are cutaneous, sterile folliculitis or acne‐like lesions on erythematous base. Our purpose was to determine the true frequency and anatomic location of the PPL and compare this with controls. We also sought to determine whether or not there was any relationship between PPL and either disease activity or other manifestations of BD.Methods Fifty patients with BD, diagnosed according to the criteria of the International Study Group for Behçet’s Disease, were enrolled in the study. The control group consisted of 100 patients with other dermatologic diseases (21 acne and 79 non‐acne patients), selected randomly. A dermatologist counted the lesions, in a blind protocol, on seven anatomic locations: scalp, face, neck, trunk, upper and lower extremities and genitalia.Results The frequency of PPL in patients with BD was 96% and the most common location was the trunk, whereas in the control group the frequency was 89% and the most common location was the face. In acne and non‐acne patients, the frequency was 100% and 86.1% respectively. The total mean number, and mean numbers of PPL on the location of trunk, upper and lower extremities, and genitalia were higher in patients with BD than in controls. When the PPL in BD patients with a positive pathergy test was compared with that in patients with a negative pathergy test, the difference was significantly higher.Conclusions Our results indicate that PPL appear to be non‐specific. In the diagnosis of BD the mean number and anatomic location of the lesions are of more importance than the frequency.
A questionnaire study on the management of onychomycosis: a Canadian perspective
Authors: Gupta Aditya K. , Shear Neil H. 
Published: March 2003

Abstract Background Onychomycosis of the toenails is a condition that responds poorly to griseofulvin. The introduction of terbinafine in Canada in May 1993 resulted in a marked shift in the choice of treatment for pedal onychomycosis. Methods A questionnaire survey was carried out in 1996 among Canadian dermatologists regarding the management of onychomycosis. Results There were 160 respondents from the roughly 350 practicing dermatologists. The dermatologists saw 8 ± 0.6 patients per week (average ± standard error (SE)) with suspected or diagnosed onychomycosis, with 5 ± 0.5 patients per week consulting the dermatologists for the first time. Most dermatologists performed mycological testing prior to starting treatment for onychomycosis. The management options for onychomycosis (mean ± SE) were oral systemic antifungal therapy 51 ± 3%, no therapy 31 ± 3%, and nondrug therapy 9 ± 2%. The majority of dermatologists (83%) used terbinafine as first‐line therapy if, indeed, they used oral antifungal agents. In contrast, griseofulvin and ketoconazole were used as first‐line therapy in 5% and 1% of cases, respectively. In Canada, there are no monitoring requirements when using oral terbinafine for onychomycosis. Therefore, it is not surprising that only 30% of dermatologists performed monitoring with terbinafine. In contrast, the frequency of monitoring with griseofulvin and ketoconazole was 40% and 80%, respectively. The subset of dermatologists who reported monitoring carried it out in only a fraction of their patients: 47%, 53%, and 83% for terbinafine, griseofulvin, and ketoconazole, respectively. Therefore, the overall number of patients in whom regular monitoring was performed was 14.1%, 21.2%, and 71.4% for terbinafine, griseofulvin, and ketoconazole, respectively. The perceived cure rates with terbinafine and griseofulvin (mean ± SE) were 83.7 ± 1% and 41 ± 3.1%, respectively. Conclusions In May 1996, within three years of the introduction of terbinafine to Canada, this agent has become the drug of choice for the treatment of pedal onychomycosis (at the time of the survey neither itraconazole or fluconazole were approved for onychomycosis). Terbinafine has been found to be very effective and safe, and only a minority of dermatologists perform regular monitoring with this drug.
Fluconazole in the treatment of tinea capitis
Authors: Montero‐Gei Fernando 
Published: March 2003

Twenty white children (8 girls; 12 boys), ranging in age from 2 to 12 years (most in the age range 5–9 years), were enrolled in a clinical trial with their parents consent to assess the efficacy, safety, and tolerability of a single oral dose of fluconazole given once weekly for 4–8 weeks for the treatment of outpatients with mycologically proven tinea capitis.Ten children had previously undergone an unsuccessful course of treatment with griseofulvin liquid suspension or the ultramicronized formulation and desired alternative therapy. Factors possibly contributing to the lack of success of griseofulvin included living in a tropical area, poor hygiene, insufficient dosages, and malnutrition. Adverse reactions to griseofulvin included skin eruption, nausea, photosensitivity, and drug interactions. Furthermore, the patients became exasperated with the long duration of griseofulvin therapy.The diagnosis of tinea capitis was confirmed on the basis of microscopic examination of arthrospores of the infecting fungus located outside or inside the affected hairs. The primary isolation of the causative pathogens in culture was accomplished using Mycosel (BBL, Baltimore, MD) and Sabouraud dextrose agar. The pathogens recovered were Microsporum canis (13), M. gypseum (5), and Trichophyton tonsurans (2). All cases caused by M. canis were positive under Wood’s light.Patients underwent a physical examination, laboratory tests were performed, and a medical history was obtained from the mother or father of each patient. Any medications taken by the patients at study entry or during the study were recorded.Fluconazole therapy was administered once a week in the presence of the investigator. The dosage was based on body weight. Initially, the fluconazole dose was 6 mg/kg. The dose subsequently was increased to 8 mg/kg based on safety information, including laboratory test results. All patients, except for four, were treated at the higher dose. Shampoos were not used as adjunctive therapy.Patients were assessed weekly for clinical and mycologic response and for the occurrence of adverse events. Adverse event information included the date of onset, duration, severity, and relationship to drug therapy.
Epidemiology of onychomycosis in southern Greece
Authors: Rigopoulos Dimitrios , Katsiboulas Vassilios , Koumantaki Elma , Emmanouil Penny , Papanicolaou Assimina , Katsambas Andreas 
Published: March 2003

AbstractBackground Onychomycosis appears to be a variable entity: it presents in different forms in different parts of the world. It is probable that every country has its own particularities of presentation and it is also probable that different regions of the same country, with either different or equivalent environmental conditions, present with different levels of incidence. Large‐scale epidemiological studies performed worldwide have demonstrated different epidemiological results.Objective This study was undertaken to determine the epidemiology of onychomycosis in the population of southern Greece.Methods Direct microscopic examination and culture were performed on samples from patients with clinical suspected onychomycosis.Results The most frequently isolated fungus was Candida (52.44%), followed by dermatophytes (41.04%) and saprophytic molds (6.51%). Finger nails were infected more than toe nails in both sexes. The most frequently isolated fungus in finger nails was Candida (76%), followed by dermatophytes (23%), and molds (1%); toe nails were most often infected by dermatophytes (71%), Candida (13%) and molds (16%). Among the infected women patients, the most frequently isolated fungus was Candida (64%), followed by dermatophytes (30.58%); 5.33% were infected by saprophytic molds. Of the 101 men infected, dermatophytes were most frequently isolated (62.37%), followed by Candida (28.71%) and saprophytic molds (8.91%).Conclusions Comparison of the results of epidemiological studies of onychomycosis worldwide show great differences, not only between different countries and different climate zones, but also between studies performed in the same country. In our opinion such epidemiological studies should be performed in every country in order to determine the major fungal species responsible; such information is extremely useful in the treatment of nail onychomycosis.