bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case management of malaria in under‐fives at primary health care facilities in a Tanzanian district
Authors: Nsimba Stephen E. D. , Massele Amos Y. , Eriksen Jaran , Gustafsson Lars L. , Tomson Goran , Warsame Marian 
Published: March 2003

OBJECTIVE To study case management of malaria in children under 5 years of age at primary health care facilities in Kibaha district, Tanzania and to evaluate the accuracy of self‐reported mothers'/guardians' information on chloroquine use in children. METHOD A random sample of 652 mothers/guardians with sick children under 5 years of age attending 10 primary health care facilities was observed and interviewed. Blood samples for determination of chloroquine levels were taken from all children and thick smears for detection of malaria parasites were taken from the children who were prescribed chloroquine. Information on diagnoses and prescriptions was collected from recording books. RESULTS Fever and respiratory problems were the most common complaints and accounted for 75% and 46% of the presenting conditions, respectively (some complained of both). Fifty‐four per cent of the children received medication at home, most commonly antipyretics and chloroquine, 20% had been taken to another health facility and 3% to traditional healers before coming to the health facilities. There was a significantly higher use of antipyretics among home treated children compared with those taken previously to health facilities (P ≤ 0.001). Use of antibiotics was higher among children who had been taken to health facilities previously (P < 0.0001). Nine per cent had received injections. The average consultation time was 3.8 min. Thirty‐nine per cent of the children were physically examined, with large interfacility variations. In 71% of the children malaria was diagnosed, either as a single condition or in combination with others, and with respiratory problems as the leading overlapping condition (29%). Malaria parasites were found in 38% of the cases given a malaria diagnosis. A total of 81% of the health facility prescriptions included analgesics, 71% chloroquine and 54% antibiotics. A fourth of all prescriptions were injections. The proportions of chloroquine and antibiotic injections in relation to the total number of prescriptions varied between the facilities. Of the 529 blood samples successfully analysed for chloroquine, 98% had detectable blood drug levels. Ninety‐seven per cent of the children without history of prior chloroquine treatment had detectable drug levels in the blood, 11% had high levels (≥ 1000 nmol/l). Of those prescribed chloroquine, 16% already had high blood concentrations of the drug. CONCLUSION Health care services, i.e. presumptive malaria diagnosis, consultation time and procedure for physical examination need to be improved.
Genetic structure of Aedes aegypti populations in Chiang Mai (Thailand) and relation with dengue transmission
Authors: Mousson Laurence , Vazeille Marie , Chawprom Srisucha , Prajakwong Somsak , Rodhain François , Failloux Anna‐Bella 
Published: March 2003

SummaryWe analysed the population genetic structure and differentiation regarding vector competence for a dengue virus of 15 Aedes aegypti samples collected from Chiang Mai in northern Thailand. Based on polymorphism of 10 isoenzyme loci, genetic differentiation was confirmed among samples collected in different subdistricts (high FST values and P < 0.05). Based on infection rate for a dengue 2 virus, susceptibilities were similar in mosquitoes collected in San Nuea subdistrict and in Choeng Doi subdistrict, and were heterogeneous in populations sampled in other subdistricts. These findings are discussed and related to insecticide treatments.
In vitro activity of chloroquine, quinine, mefloquine and halofantrine against Gabonese isolates of Plasmodium falciparum
Authors: Ndong Jérôme Mezui Me , Atteke Christiane , Aubouy Agnès , Bakary Mohamed , Lébibi Jacques , Deloron Philippe 
Published: March 2003

Summaryobjectives  To determine the in vitro activity of antimalarial drugs against isolates of Plasmodium falciparum in Gabon.methods  Plasmodium falciparum isolates were collected from symptomatic infections in the hospitals of Bakoumba and Franceville, south‐east Gabon and in 2000. In vitro activity of chloroquine, quinine, mefloquine, halofantrine was measured by the isotopic microtest.results  A total of 60 and 62 isolates gave interpretable data in Franceville and Bakoumba, respectively. In Franceville, 50.0% (mean IC50 = 111.7 nm), 0% (mean IC50 = 156.7 nm), and 21.2% (mean IC50 = 12.4 nm) of isolates, respectively, showed in vitro resistance to chloroquine, quinine and mefloquine. In Bakoumba, we saw resistance to chloroquine, quinine, mefloquine and halofantrine in 95.0% (mean IC50 = 325.8 nm), 10.2% (mean IC50 = 385.5 nm), 47.5% (mean IC50 = 24.5 nm) and 18.2% (mean IC50 = 1.9 nm) of isolates, respectively. Activities of chloroquine and mefloquine, chloroquine and quinine, and mefloquine and quinine were positively correlated.conclusions  Antimalarial drug resistance is high in this area of Gabon. The extent of resistance is disparate, as all tested drugs were less efficacious in Bakoumba than in Franceville.
Notoedric mange in two free‐ranging North American racoons (Procyon lotor) in Japan
Authors: Ninomiya Hiroyoshi , Ogata Munetsugu 
Published: March 2003

Abstract Mange was diagnosed in two North American racoons (Procyon lotor) at Kamakura City in Kanagawa Prefecture, Japan. The mites were identified morphologically as Notoedres cati. Mite infestation affected the skin over the extremities and tail, and was characterized by moderate alopecia and erythematous dermatosis. Histopathologically, the affected skin showed marked epidermal hyperplasia and mites located within the parakeratotic stratum corneum. A slight dermal inflammatory response consisting principally of mononuclear cells was observed. N. cati mites were demonstrated in their tunnels using scanning electron microscopy (SEM). This is the first report of notoedric mange in racoons.
The effects of capsaicin topical therapy in dogs with atopic dermatitis: a randomized, double‐blinded, placebo‐controlled, cross‐over clinical trial
Authors: Marsella Rosanna , Nicklin Constance F. , Melloy Caroline 
Published: March 2003

Abstract The efficacy of twice daily topical application of capsaicin (0.025%) for the management of pruritus in dogs with atopic dermatitis (AD) was evaluated in double‐blinded, placebo‐controlled study. Twelve dogs with AD were randomly assigned to either 0.025% capsaicin or vehicle lotion applied twice daily for 6 weeks. After a 4‐week wash‐out period, treatments were switched. Significant improvement was reported by owners (P = 0.0006), but not by investigators. Owners noted temporary worsening of pruritus after the first week of capsaicin therapy. Overall capsaicin was well tolerated. Substance P (SP) concentrations in the skin did not correlate with the severity of the pruritus and did not change significantly over time and between treatments. Lesional skin had less SP than nonlesional skin (P = 0.03). These observations suggest that topical capsaicin should be further evaluated as an adjunctive antipruritic agent in dogs with AD.
A pilot trial on the effect of Cyclosporin A on intradermal skin test reactions in dogs with atopic dermatitis
Authors: Burton G. , Robson D. , Bassett R. , Kiermeier A. 
Published: March 2003

The purpose of this study was to determine if Cyclosporin A, given at a dose of 5 mg kg−1 per day for 42 days, negatively influenced intradermal skin test results in dogs with atopic dermatitis. Six mixed‐breed dogs of varying ages and sexes with a clinical diagnosis of atopic dermatitis were included in this study. All dogs were intradermally skin tested (IDT) with 61 allergens from varying groups, grass pollens, weed pollens, tree pollens, moulds, insects and dust mites. IDT reactions were recorded as absent, weak, moderate or strong reactions. All dogs showed several strong reactions in the initial IDT. On days 0 to 42, the dogs received 5 mg kg −1 per day of Cyclosporin A. On day 42, all dogs showed a marked reduction in pruritus. A second IDT was performed and the results of both tests compared. The χ2‐test was used to statistically analyse changes between pre‐ and post‐treatment reactions for each of the allergen groups. There were no mould reactions recorded and this group was discarded from analysis. When all reactions were used in analysis, Cyclosporin A tended to significantly reduce the number of IDT reactions. However, when only moderate and strong reactions were considered (weak reactions excluded) there were no significant differences between pre‐ and post‐treatment results for the other allergen groups. Cyclosporin A at a dose of 5 mg kg−1 per day for 42 days controlled pruritus, but did not significantly alter moderate and strong intradermal skin test reactions in the six dogs tested. This suggests that Cyclosporin A, at this dose, did not prevent mast cell degranulation. Funded by Novartis Animal Health, Australia.
Histopathologic features of the spontaneous pustular lesions of Behçet’s syndrome
Authors: Ergun MD Tülin , Gürbüz MD  , Dogˇusoy MD  , Mat MD Cem , Yazıcı MD Hasan 
Published: March 2003

BackgroundPapulopustular lesions are common in Behçet’s syndrome (BS). A debate exists as to whether they are different from ordinary acne. This has important clinical and pathophysiologic implications. ObjectiveThe aim of this study was to evaluate the histopathologic features of papulopustular lesions seen both in BS and acne vulgaris (AV). MethodsRepresentative samples were obtained from 17 patients with BS and six patients with AV. The detailed histopathologic features were evaluated by a dermatopathologist blinded to the diagnoses. ResultsConsidering the epidermis, follicle epithelium, and dermis separately, no differences could be found between the two groups. ConclusionsThe papulopustular lesions seen in these two disorders cannot be distinguished on the basis of clinical and histopathologic findings.
Lymphoscintigraphy in yellow nail syndrome
Authors: Bilen Nilgün , Bayramgürler Dilek , Devge Cem , Başdaş Füsun , Yıldız Füsun , Töre Güzin 
Published: March 2003

A 39‐year‐old‐man with yellow nail syndrome (YNS) presented to our dermatology department because of thickened slow growing, yellow–green nails, swelling of his legs, and periodic coughing, dyspnea, and headache of 4 years’ duration.Dermatologic examination showed yellow–green, thickened finger and toe nails, and excessive lateral nail curvature ( Fig. 1). There were bilateral ronchi and ralles in the basal lung fields and lymphedema of the legs.Thickened, yellow–green finger nails and excessive nail curvatureimageLaboratory tests, including complete blood count, erythrocyte sedimentation rate, urine analysis, thyroid function tests, and serum chemical tests, were normal. Anti‐human immunodeficiency virus antibody was negative. Direct microscopic examination revealed no mycotic organism. There was no growth of pathogenic mycotic organisms on Sabouraud’s agar. Chest X‐ray revealed evidence of chronic bronchitis. We detected septal thickening and fibrosis in high‐resolution computed tomography of the chest, and ethmoidal and maxillary sinusitis in computed sinus tomography.The pathology responsible for the syndrome is believed to be impaired lymphatic function. 1,2We demonstrated this by lymphoscintigraphy, which is a noninvasive method for evaluating the lymphatic circulation. Technetium‐99m sulfide colloid (2 mCi) was injected into the web space between the big and second toes. The activity of the tracer was monitored over the injection site. The lymphoscintigraphic examination revealed slowed lymphatic drainage in both legs (
Fig. 2).Lymphoscintigraphic examination revealed slowed lymphatic drainage in both legs. There was delayed visualization of the left and right inguinal lymph nodes, and lymph nodes were found in decreased numbers in the left inguinal regionimage
Detection and differentiation of causative fungi of onychomycosis using PCR amplification and restriction enzyme analysis
Authors: Baek Seung‐Cheol , Chae Hee‐Jae , Houh Dong , Byun Dae‐Gyoo , Cho Baik‐Kee 
Published: March 2003

AbstractBackground Onychomycosis, a fungal nail infection, has become one of the most important dermatophytoses. Unfortunately, a predictably successful diagnostic approach to onychomycosis does not yet exist.Objective The purpose of this study was to develop a deoxyribonucleic acid (DNA)‐based diagnostic method to improve the sensitivity and specificity of the detection and differentiation of the pathogenic fungi of onychomycosis.Methods We attempted to detect fungi in the nail using polymerase chain reaction (PCR) primer systems that were designed in conserved sequences of the small ribosomal subunit 18S‐rRNA genes shared by most fungi, and differentiated between species by restriction enzyme analysis of the amplified product.Results Fragments of the gene coding for 18S‐rRNA were amplified successfully from medically important fungi species, but not from normal nails. Restriction fragment length polymorphism patterns using HaeIII endonuclease were sufficiently different to allow the recognition of individual species.Conclusions The PCR–restriction enzyme analysis method appears to be a more sensitive detection and identification technique for onychomycosis than conventional methods, and has considerable diagnostic value.
Pemphigus in Kuwait
Authors: Alsaleh Qasem A. , Nanda Arti , Nbe . , Al‐Baghli Nazeeha M. , And MD. , Dvorak Richard 
Published: March 2003

Background Although pemphigus is a well‐characterized entity, detailed epidemiologic studies from the Arabian Peninsula are not available. The purpose of this study was to elucidate the clinical features, course, and prognosis of pemphigus patients followed at a national dermatology center in Kuwait. Methods Fifty‐four patients with pemphigus in this report were treated between 1981 and 1996, and were studied for several clinical features, treatment, course and prognosis. Results Around 80% of pemphigus patients were Arabs, and Kuwaitis constituted the largest number (46.3%) with a female predominance (F : M = 2:1). Pemphigus vulgaris (PV) was the commonest clinical type. The mean age of onset was 36 years. The follow‐up period ranged from 2 months to 12 years (mean, 4.5 years). The majority of the patients could be managed with low‐dose steroids (30–60 mg/day). Twenty per cent of the patients were in complete clinical remission and were off systemic therapy for an average of 3 years. No death secondary to the disease or its treatment was observed. Conclusions Kuwaiti patients with pemphigus were observed to have a relatively young age of onset and a female predominance. Low doses of steroids were enough to control the disease in the majority, and at least 20% of patients were off therapy and in complete remission on follow‐up.
Digital mucoid cyst: the ganglion type
Authors: Hernández‐Lugo Ana Marcela , Domínguez‐Cherit Judith , Vega‐Memije María Elisa 
Published: March 2003

A 43‐year‐old woman presented with a soft, smooth, cystic, slightly erythematous, dome‐shaped nodule, 6 × 8 mm in diameter, located on the dorsum of the middle finger of the right hand, between the proximal fold and the distal interphalangeal joint, lateral to the midline ( Fig. 1). The nail of the affected finger showed longitudinal grooving and mild distal transverse overcurvature. The lesion had been present for 3 months and was tender upon pressure.Digital mucoid cyst, lateral to the midline of the third finger, causing nail deformityimageClinical examination revealed early signs of osteoarthritis and Heberden’s nodes on the distal interphalangeal joints of both hands. Previous treatment included the intake of nonsteroidal anti‐inflammatory drugs (NSAIDs) indicated by a rheumatologist. An X‐ray of the right hand showed decreased joint spaces between the second and third phalanges of the middle finger.Diagnosis of a digital mucoid cyst (with nail deformity secondary to the former) was made. Surgical excision was performed. During surgery, a pedicle connecting the cyst to the joint capsule was clearly observed and two satellite lesions were also found ( Fig. 2). The cyst and its satellite lesion, including the communicating tract, were totally removed.(A) direct link of the cyst to the distal interphalangeal joint during surgery is clearly observedimageThe histopathologic study showed large cystic spaces containing mucin (colloidal iron stain) which were lined in some areas by synovial membrane ( Fig. 3). The histopathologic report was compatible with a digital mucoid cyst of the ganglion type.Large cystic spaces containing mucin lined, in some areas, by synovial membrane (×100, original magnification)imageSix months after excision, no recurrence has been detected, and the nail plate deformities have improved.
Unilateral transient forehead paralysis following injury to the temporal branch of the facial nerve
Authors: Flynn Timothy Corcoran , Emmanouil Panagiota , Limmer Bradley 
Published: March 2003

Abstract Background Cutaneous surgery in the temporal region of the forehead can lead to injury to the superficial temporal branch of the facial nerve. A flattened forehead and with ipsilateral forehead paralysis can occur with damage to this nerve. Methods A case is presented of transient forehead paralysis resulting from Mohs’ micrographic surgery with reconstruction of the defect. The paralysis resolved over a period of fifteen months. Results The anatomy of the nerve makes it susceptible to injury during cutaneous surgery. The area of danger is the area superior to the zygomatic arch and lateral to the lateral eyebrow where the nerve is closest to the skin. Conclusions Restoration of motor function usually occurs without intervention, but may take several months. Should motor function not recur, nerve grafting of a repair of the ptotic brow may be needed. The anatomy of the nerve is reviewed and brow lifting options are discussed.
‘Airborne’ contact dermatitis due to Leica immersion oil
Authors: Géraut Christian , Tripodi Dominique 
Published: March 2003

Abstract Background Contact dermatitis has often been described in healthcare staff, resulting essentially from the use of natural rubber latex gloves, antiseptics, and especially aldehydes. This study reports an unusual cause of contact dermatitis in laboratory technicians. Materials and methods Four patients working in the bacteriology departments of three different hospitals were seen for airborne contact dermatitis. All were patch tested for specific plastics and glues. Results For all patients, positive patch reactions were obtained with classic epoxy resins, such as diglycidylether of bisphenol, as well as with new types, such as diglycidylether of bisphenol F and an epoxyacrylate resin. Conclusions Although phenols and ether handled by the laboratory technicians and an epoxy mastic applied during floor repair were initially suspected, an immersion oil used in light microscopy proved to be the real cause of the dermatitis. To our knowledge, these are the first reported cases due to this type of contact.
Epidemiology of pemphigus in Sofia, Bulgaria. A 16‐year retrospective study (1980–1995)
Authors: Tsankov Nikolai , Vassileva Snejina , Kamarashev Jivko , Kazandjieva Jana , Kuzeva Vassilka 
Published: March 2003

Background Pemphigus is a disease showing an uneven geographical distribution. In Bulgaria pemphigus has always represented a substantial part of diagnosed bullous diseases, but previous epidemiological data are incomplete. Our purpose was to evaluate retrospectively the incidence and prevalence of pemphigus in the district of Sofia (the capital of Bulgaria; population 1 200 000) for a sixteen‐year period. Methods The files of all the newly registered patients with pemphigus in the City Hospital of Dermatology in Sofia during the period Jan 1 1980 to Dec 31 1995, were collected and analysed with regard to personal statistics, ethnic origin, profession, history of the disease including age and season of onset, symptoms, clinical diagnosis, severity, laboratory findings, associated illnesses, therapy, and cure rate. Special attention was paid to smoking, alcohol abuse, and the presence of triggering factors such as emotional stress, drug intake, underlying diseases, neoplasias, or others. Results During the 16‐year period studied, 74 newly diagnosed cases of pemphigus occurred in the district of Sofia, giving a prevalence of 0.38 per 100 000 inhabitants and a mean incidence of 0.47/100 000/year for the overall population and 0.51/100 000/year for the population aged above 20 years. The most common clinical variant is pemphigus vulgaris, frequently occurring in the fifth–sixth decades. The vast majority of the patients are workers or professionals. Conclusions The results of the present retrospective study reveal a relatively high prevalence and incidence of pemphigus in Bulgaria, compared to that encountered in other countries. Our data is similar to that reported from Greece. Whether the Balkan Peninsula represents a focus of population groups with high susceptibility to pemphigus is a problem which could be highlighted by further epidemiological studies in this geographic area.
In vitro tannin acantholysis
Authors: Brenner Sarah , Ruocco Vincenzo , Ruocco Eleonora , Russo Adolfo , Tur Ethel , Luongo Vincenza , Lombardi Maria Luisa 
Published: March 2003

Abstract Background  Exogenous factors, such as certain drugs, may be involved in the induction of pemphigus. Other offenders sharing a similar chemical composition to these drugs may also play a role. Tannins with their considerable biologic activity were suggested as possible factors. To substantiate the role of tannins in the pathomechanism of pemphigus, the present study examined the acantholytic potential of tannins in vitro.Methods  Normal human breast skin from patients without any bullous disease was cultured for 3 days in the presence of tannic acid at concentrations of 0.02, 0.05, 0.1, 0.25, 0.5, 1.0, and 2.0 m
m. The effect of the tannic acid was microscopically examined in a blind fashion by three independent investigators.Results  In addition to the cytotoxic effect, tannic acid caused marked acantholytic changes, with a clear suprabasal cleavage and intraepidermal acantholytic cells. The acantholytic changes were the most constant and specific effects. They were constantly observed at 1.0 and 2.0 m
m, whereas lower concentrations showed changes only in some of the explants. The concentrations needed to exert this effect were notably low. There was a remarkable variability among the subjects who had provided the explants.Conclusions  The results suggest a possible role of tannin in the disease process of pemphigus. The tannin acantholytic potential was much greater than the potential of known acantholytic drugs, such as penicillamine and captopril. The interindividual variability in susceptibility to acantholysis may explain the variability in the individual potential for developing pemphigus.