bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changing treatment patterns among patients with HIV: Royal Free Hospital 1987–97
Authors: Mocroft A. , Sabin CA. , Youle M. , Swaden L. , Tyrer M. , Wilson D. , Madge S. , Johnson MA. , Phillips AN. 
Published: March 2003

Objective Following the publication of results of large‐scale clinical trials, antiretroviral treatment for HIV has changed dramatically. The aim of this study was to describe changes in antiretroviral treatment and the way treatments were combined among 1806 patients with HIV seen at a single centre at the Royal Free Hospital, London, UK. Design and method Each calendar year was divided into quarters, and the number of patients receiving treatment and participating in clinical trials was determined. Results The proportion of patients on no therapy decreased from over 90% at the beginning of 1988 to under 15% at the end of 1997. Monotherapy was the only form of treatment available before 1992 but its use dropped to 2% by the end of 1997. The standard of care at the end of 1997 was triple combination therapy, used in over 40% of patients. There were dramatic changes in the use of individual agents; use of zidovudine decreased from 50% during 1989 to 25% during 1997, while use of lamivudine and stavudine saw an exponential rise in 1997. The protease inhibitors were used in equal proportions in this clinic population; the use of dual protease therapy began in 1997 and was rising rapidly by the end of the year. Conclusions There have been major changes in the use of antiretroviral therapy at this centre, particularly during 1996 and 1997. The long‐term cost implications and side‐effects of intensive treatment regimens remain to be addressed.
The effect of ritonavir on saquinavir plasma concentration is independent of ritonavir dosage: combined analysis of pharmacokinetic data from 97 subjects
Authors: Kilby JM , Hill A , Buss N 
Published: March 2003

ObjectiveTo determine the correlation between ritonavir (RTV) dose and the degree of enhancement of saquinavir (SQV) exposure.MethodsCombined analysis of pharmacokinetic data at steady state obtained from two open‐label, randomized, parallel‐group, multiple‐dose, single‐centre studies involving healthy volunteers. Plasma samples for SQV assay were obtained from 97 healthy subjects following multiple dosing of a range of SQV (400–1800 mg) plus RTV (100–400 mg) dosages for 13–14 days. The pharmacokinetics of SQV were derived by model‐independent, noncompartmental methods. Data were analysed by multivariate regression of log transformed Cmin and Cmax (geometric means) of SQV dosage as the dependent variable and independent variables of SQV and RTV dosage. Ritonavir was fitted as both a continuous and a categorical variable.ResultsThere is a strong effect of any dose of RTV on Cmax and Cmin of SQV (P < 0.0001 for both parameters), but no greater effect of higher vs. lower RTV dosages on either parameter (Cmax: P=0.4373; Cmin: P=0.3393). Higher SQV dosage correlates linearly with higher Cmax (P=0.0093) and Cmin (P=0.0010), but the effects of increasing SQV dosages are less than with the addition of any RTV dose.ConclusionsRTV enhances SQV concentrations to increase Cmax and Cmin. This effect is similar for RTV dosages of 100–400 mg twice daily. Based on this concept of ‘mini‐dose’ RTV, once‐daily dosing of 1600 mg SQV/100 mg RTV and twice‐daily 1000 mg SQV/100 mg RTV are currently being evaluated in clinical trials.
Impact of adherence on duration of virological suppression among patients receiving combination antiretroviral therapy
Authors: Raboud JM , Harris M , Rae S , Montaner JSG 
Published: March 2003

ObjectiveTo assess the effect of adherence to antiretroviral therapy on the duration of virological suppression after controlling for whether or not the patient ever attained a plasma viral load below the limit of detection of sensitive HIV‐1 RNA assays.MethodsData were combined from three randomized, blinded clinical trials (INCAS, AVANTI‐2, and AVANTI‐3) that compared the antiviral effects of two‐ and three‐drug antiretroviral regimens. Virological suppression was defined as maintaining a plasma viral load below 1000 copies/mL. Adherence was defined prospectively and measured by patient self‐report.ResultsAdherence did not have a major impact on the probability of achieving virological suppression for patients receiving dual therapy. However, for patients receiving triple therapy, adherence increased the probability of virological suppression, whether the plasma viral load nadir was above or below the lower limit of quantification. Compared to adherent patients with a plasma viral load nadir below the lower limit of quantification, the relative risk of virological failure was 3.0 for non‐adherent patients with a nadir below the limit, 18.1 for adherent patients with a nadir above the limit, and 32.1 for non‐adherent patients with a nadir above the limit.ConclusionFor patients receiving current three‐drug antiretroviral regimens, adherence to therapy and plasma viral load nadir are important factors determining the duration of virological suppression.
Bath psoralen‐ultraviolet A therapy in atopic eczema
Authors: De Kort Wja , Van Weelden H 
Published: March 2003

AbstractAims To evaluate the efficacy of bath psoralen‐ultraviolet A (PUVA) therapy in severe cases of atopic dermatitis (AD) in adults using the extended Six Area, Six Sign Atopic Dermatitis (SASSAD) score.Methods Thirty‐five adult subjects with severe AD underwent bath PUVA therapy for a maximum of 30 sessions ranging from one to three times a week. The only other treatment allowed during the study was topical application of hydrocortisone.Results There were a total of six drop‐outs, three due to aggravation of symptoms. After the maximum 30 sessions the remaining 29 subjects showed 82.1% improvement in the severity of lesions, 75.2% reduction in extension of lesions, 74% improvement in itching and 79% improvement in night‐time rest. Patient evaluations gave an overall score of 8.8 on a scale of 0–10.
Acitretin and treatment of the oral leucoplakias. A model to have an active molecules release
Authors: Gaeta Gm , Gombos F , Femiano F , Battista C , Minghetti P , Montanari L , Satriano Ra , Argenziano G 
Published: March 2003

AbstractAimsThe aim of this study was to investigate the effectiveness of acitretin in a new topical formulation (mucoadhesive two‐layer tablets) for the treatment of oral leucoplakias.MethodsTwenty‐one volunteers, 16 men, five women, with oral leucoplakia (histologically diagnosed), were included in this double‐blind placebo‐controlled study. Patients were randomized in three groups (A, B, C) of seven patients each. Groups A and B received tablets with different in vitro release profiles, and group C subjects (controls) received tablets without acitretin. The acitretin dose was 20 mg/day (two 10 mg tablets daily). Serum aspartate aminotransferase, alanine aminotransferase, cholesterol and triglycerides were evaluated before and after treatment. At the end of therapy the concentrations of acitretin in plasma, saliva and tissue were measured by high‐performance liquid chromatography.ResultsAt the end of the study 71% (groups A and B) of patients showed clinical remission or marked improvement. No improvement was noted in the control subjects (group C). These results were further confirmed by histological findings. There were no significant changes in laboratory values in the three groups. The acitretin concentration in plasma and tissue ranged from 0 to 50 mg with no difference between groups A and B, and it was very high in saliva (ranging from 4.9 to 43 mg) with higher concentrations in group A than in group B (due to a longer adhesion time in group A). Patients’ compliance was excellent. The results show that mucoadhesive tablets of topical acitretin are efficacious in the treatment of oral leucoplakia without systemic side‐effects.
Results of atopy patch tests with house dust mites in adults with ‘intrinsic’ and ‘extrinsic’ atopic dermatitis
Authors: Ingordo V , D’Andria G , D’Andria C , Tortora A 
Published: March 2003

AbstractBackground The most frequently employed diagnostic criteria of atopic dermatitis (AD) can be fulfilled in the absence of elevated total circulating IgE or specific IgE to food allergens or environmental aeroallergens and/or in the absence of personal or familial history of atopy as well. Therefore a distinction between ‘extrinsic’ or ‘allergic’ and ‘intrinsic’ or ‘non‐allergic’ AD has been suggested. Recently, a patch test with environmental aeroallergens, named atopy patch test (APT), has been proposed for use in the study of AD.Objective The aim of this study was to investigate the reactivity to APT in patients with ‘extrinsic’ and ‘intrinsic’ AD.Patients, materials and methods Two groups of adult male subjects with AD were examined consecutively in our department (Department of Dermatology, Italian Navy Main Hospital, Taranto, Italy) and patch tested with whole bodies of house dust mites (HDM) at a concentration of 20% in petrolatum (Dermatophagoides pteronyssinus 50%, D. farinae 50%). The groups included: (i) 95 patients affected by the adult clinical form of ‘extrinsic’ AD; (ii) 12 patients affected by the adult clinical form of ‘intrinsic’ AD; and (iii) a control group of 49 adult healthy male subjects with a negative anamnesis for eczema and atopy and negative skin prick test to aeroallergens/food allergens and/or normal level of total circulating IgE, also patch tested with the same allergen. The statistical differences were calculated by χ2 test and 95% confidence intervals (CI) were provided.Results The APT was positive in 47.4% (CI: 37–57%) of ‘extrinsic’ AD, in 66.6% (CI: 41–93%) of ‘intrinsic’ AD and in 12.2% (CI: 3–21%) of healthy subjects. The differences between the two AD subgroups and the control group were statistically significant (P < 0.001).Conclusions APT positivity is more frequent in both ‘extrinsic’ and ‘intrinsic’ AD than in unaffected subjects. Other studies are needed to confirm our data and to explain why the APT is positive in the ‘intrinsic’ form.
Elastosis perforans serpiginosa in an adult with Down's syndrome: report of a case with symmetrical localized involvement
Authors: De Pasquale R , Nasca MR , Musumeci ML , Micali G 
Published: March 2003

AbstractElastosis perforans serpiginosa (EPS) is a rare perforating dermatosis in which elastic fibers extrude from the papillary dermis producing umbilicated papules, characteristically arranged to form arciform or serpiginous patterns on the skin. It can be observed in patients with Down's syndrome, in whom in some cases the disease has been reported to be more widespread and to run a longer course. We present the case of a 20‐year‐old girl with Down's syndrome, hypothyroidism, acne and hypertrichosis, who had a 2‐year history of multiple atrophic lesions with an arciform pattern on the distal extensor portions of both thighs, histologically showing the typical features of EPS.
Linear childhood cutaneous lupus erythematosus following blaschko lines
Authors: Requena C , Torrelo A , De Prada I , Zambrano A 
Published: March 2003

ABSTRACTWe report a case of a 3‐year‐old Spanish boy with linear cutaneous lupus erythematosus following the lines of Blaschko on his face and neck. Histological examination established the diagnosis. Only eight cases of discoid lupus erythematosus following the lines of Blaschko have been reported previously.
A case of sarcomatoid carcinoma of the skin
Authors: Inaloz HS , Ayyalaraju RS , Holt PJA , Laidler P 
Published: March 2003

ABSTRACTWe describe the histological and immunocytochemical findings of an exophytic cutaneous tumour with mixed features of atypical fibroxanthoma (AFX) and basal cell carcinoma (BCC). A 73‐year‐old woman presented with a rapidly growing tumour measuring 35 mm in diameter and 10 mm in height on the left forearm. The tumour was excised and histology revealed a biphasic tumour with a pleomorphic spindle cell component and an associated tumour composed of discrete islands of atypical basaloid cells with peripheral palisading consistent with BCC. The two tumours merged into each other at one point. The spindle cell tumour showed a positive immunocytochemical reaction to fibrohistiocytic marker of KP‐1 (CD68) and a negative immunocytochemical reaction to AE1/AE3, CAM5.2, S‐100 and HMB‐45, features consistent with AFX. Immunocytochemistry of the basaloid tumour showed a positive reaction to epithelial markers AE1/AE3 and CAM5.2, and a negative reaction to S‐100, HMB‐45 and KP‐1 (CD68). To date, 15 cases of primary cutaneous carcinosarcoma have been reported in the literature. It has been postulated that these tumours may originate from undifferentiated progenitor cells capable of producing multiple cell lines.
Atrophodermia vermiculata: case report and review of the literature
Authors: Jansen T , Sander CA , Altmeyer P 
Published: March 2003

ABSTRACTA 21‐year‐old woman with an 11‐year history of symmetric reticular atrophy on both cheeks, pre‐auricular areas, and forehead is presented. The depressions gave a worm‐eaten appearance to the skin. Histopathological findings from a biopsy specimen of lesional skin revealed an atrophic follicle. The connective tissue showed mild inflammation in perifollicular and perivascular distribution. The hair follicle was widely dilated and was filled with a keratotic plug. This case points out many of the outstanding clinical and histopathological features of atrophodermia vermiculata as described previously. Atrophodermia vermiculata appears to be one of a group of closely related conditions characterized by keratosis pilaris and atrophy of the skin.
New established melanoma cell lines: genetic and biochemical characterization of cell division cycle
Authors: Vozza A , Borriello A , Criniti V , Vozza G , Della Ragione F 
Published: March 2003

ABSTRACTBackground Cancer might be envisaged as the result of a genetic process causing the unregulated proliferation of a given cell as well as its inability to undergo differentiation and/or apoptosis. Alterations of genes regulating cell division cycle appear to play a key role in the development of human cancer.Objective On the bases of the above considerations, we decided to establish new cell lines from human melanoma specimens, in order to analyse the molecular alterations in primary preparations of malignant cells.Results The present paper describes two new established cell lines and their genetic and biochemical features. Both the melanoma cell lines show inactivation of the cyclin‐dependent kinase inhibitor gene, CDKN2A/p16INK4A, thus demostrating that this alteration occurs in primary human melanomas. No other alterations were observable when we investigated several different cell cycle genes including those encoding cyclins, cyclin‐dependent kinases and cyclin‐dependent kinase inhibitors. Analyses at protein level by means of immunoblotting confirmed the results obtained at the genetic level. Moreover, the inducibility of a pivotal cyclin‐dependent kinase inhibitor gene, namely p21CIP1 gene, was obtained by treating the cells with histone deacetylase inhibitors, namely butyrate and phenylbutyrate.Conclusions Our results suggest a primary role of cyclin‐dependent kinase inhibitor genes inactivation in the origin of human melanoma and allow the proposal of new therapeutic strategies based on the transcriptional activation of p21CIP1 gene.
Maternal Employment and Family Responsibilities: the Perspectives of Mothers of Children with Intellectual Disabilities
Authors: Shearn Julia , Todd Stuart 
Published: March 2003

AbstractOver recent decades, there has been a substantial increase in the proportion of women in the workforce with dependent children. However, this trend is not evident for mothers of children with disabilities. Their employment levels are greatly reduced. The present paper examines the nature of the restrictions which affect the employment participation of these mothers and explores the meaning work has for them. The data presented in this paper were derived from qualitative interviews with 18 mothers of children with disabilities aged between 5 and 15 years. These mothers found employment difficult. They encountered unusual time demands, and a lack of adequate and affordable child care. Furthermore, they felt that their employment opportunities were restricted by attitudes prevalent in society concerning appropriate roles for women, especially mothers of children with disabilities. The lack of opportunities to engage in employment led, in varying degrees, to feelings of isolation, a lack of fulfilment and low self‐esteem. The mothers felt that they were on the periphery of society with little release from the pressures of caring. Mothers who had part‐time jobs often did poorly paid work of low status, thereby encountering few opportunities to use their skills and abilities to the full. Those who attempted a full‐time job experienced stress from the dual demands of home and work, and from a fear that they were failing as mothers. The present paper highlights areas which require attention to improve the employment experience of these mothers.
Human fetal foramen ovale flow velocity waveforms relative to fetal breathing movements in normal term pregnancies
Authors: van Eyck J. , Stewart P. A. , Wladimiroff J. W. 
Published: March 2003

AbstractThe relationship between foramen ovale flow velocity waveforms and high‐amplitude fetal breathing movements was studied in ten normal term pregnancies using Doppler ultrasonography. Peak systolic and averaged flow velocities demonstrated a statistically significant increase during fetal breathing activity, suggesting a raised pressure gradient between the right and left atria. This could be explained by a temporal reduction in pulmonary venous return to the left atrium during the inspiratory phase of the fetal breathing cycle. The breathing‐related increase in foramen ovale flow velocity suggests that fetal breathing activity facilitates the distribution of well‐oxygenated blood to the aorta and cerebral circulation. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Is the quality of transvaginal images superior to transabdominal ones under matched conditions?
Authors: Kossoff G. , Griffiths K. A. , Dixon C. E. 
Published: March 2003

AbstractTransvaginal images, under matched conditions, are in general superior in quality to transabdominal sonograms. The difference is, however, not dramatic and instances frequently occur when the same quality and even inferior images are obtained on transvaginal examinations.The dominant factor is the amount of overlying tissues. For the same thickness, subcutaneous tissues have greater degrading characteristics. Subcutaneous tissues also mar the quality of images by giving rise to strong multiple reflection artifacts.The major factors for image degradation are associated with a moderate increase in the width of the ultrasonic beam and a large increase in the side lobes.The dramatic superiority of transvaginal imaging described in previous comparison studies is due principally to the use of higher frequencies, more strongly focused beams and closer positioning of tissues to the transducer. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
The influence of angiotensin II‐induced vasoconstriction on common carotid artery blood flow and velocity—time profiles in normal women
Authors: Loquet Ph. , Pipkin F. Broughton , Symonds E. M. , Rubin P. C. 
Published: March 2003

AbstractNon‐invasive methods of measuring blood velocity, especially Doppler velocimetry, are being increasingly used in obstetrics to provide observational information. We report a preliminary study of their usefulness in experimental studies.Doppler velocimetry was used to assess blood flow and velocity–time profiles in the common carotid artery of seven women of reproductive age before and during the incremental administration of angiotensin II.Angiotensin II infusion evoked the expected increments in systolic and diastolic arterial pressure and fall in heart rate. Angiotensin II was associated with a dose‐dependent fall in maximum blood velocity, which, at an average rise in systolic blood pressure of 23 mmHg, had fallen from 91 ± 16 to 52 ± 4 (mean ± SD, p < 0.01). Absolute maximum blood velocity was strongly correlated with systolic and diastolic blood pressures (p < 0.001 for both). The minimum velocity was unaltered throughout, and the calculated flow did not change significantly (490 ± 100 cf. 380 ± 50 ml/min). Overall, these findings are in agreement with those previously reported using invasive methods of monitoring flow during angiotensin II infusion, and further support the usefulness of Doppler velocimetry as an investigative tool in human physiology and pharmacology.However, the pulsatility index, resistance index and systolic/diastolic velocity ratio all fell significantly during angiotensin II infusion (p < 0.01 for all). The conventional interpretation of a fall in these indices, i.e. reduced downstream resistance, is clearly erroneous under these circumstances, since angiotensin II induces arteriolar vasoconstriction. This illustrates the importance of interpretation of Doppler velocity envelopes in the light of pharmacological mechanisms likely to be evoked by the experimental procedure. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Doppler ultrasonography in early pregnancy does not predict adverse pregnancy outcome
Authors: Arduini D. , Rizzo G. , Romanini C. 
Published: March 2003

AbstractA transvaginal color and pulsed Doppler study was performed on 330 pregnancies at 7–16 weeks of gestation. Blood flow velocity waveforms were recorded from the main uterine arteries and their branches (arcuate and trophoblastic vessels) and from the umbilical arteries. The systolic/diastolic velocity ratio and the pulsatility index were calculated as indices of vascular resistance, respectively, at uterine and umbilical levels. A total of 282 patients had an uneventful pregnancy outcome, 19 developed an early pregnancy failure (missed abortion, n = 8; anembryonic pregnancy, n = 11) and 29 developed later complications such us hypertension (n = 10), fetal growth retardation (n = 13) or both n = 6). In normal pregnancies, Doppler‐measured vascular resistances significantly decreased with advancing gestation at the level of both uterine and umbilical circulations. When the Doppler indices of the patients with early pregnancy failure or with later complications were compared to those of normal pregnancies, no evident differences were found in either of the vascular districts considered. However, in the patients who developed hypertension and/or fetal growth retardation, abnormal velocity waveforms were frequently present in uterine and umbilical arteries during second‐ or third‐trimester examinations. Our results suggest a limited clinical value of Doppler velocimetry in early pregnancy. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Increased middle cerebral artery blood flow impedance in fetal subdural hematoma
Authors: Ben‐Chetrit A. , Anteby E. , Lavy Y. , Zacut D. , Yagel S. 
Published: March 2003

AbstractThis case describes the prenatal diagnosis at 30 weeks' gestation of a posterior fossa subdural hematoma. Doppler velocimetry studies of the middle cerebral artery at that time showed an abnormally high resistance pattern with reverse end‐diastolic flow. Ultrasonic assessment of the fetus indicated that there was associated quadriplegia. No cause for the lesion was demonstrated. A fetal blood sample, obtained by cordocentesis, revealed a normal karyotype. Fetal blood gas analysis was also normal. The pregnancy was terminated at the parents' request. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology