bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Simulium damnosum complex in western Uganda and its role as a vector of Onchocerca volvulus
Authors: Krüger A. , Nurmi V. , Yocha J. , Kipp W. , Rubaale T. , Garms R. 
Published: March 2003

Summary The status of onchocerciasis vectors in the former Ruwenzori focus in western Uganda was re‐examined some 15 years after control measures against Simulium damnosum s.l. were suspended. The four cytoforms S. kilibanum, ‘Sebwe’, ‘Nkusi’ and S. pandanophilum were found. While the nonanthropophilic ‘Sebwe’ was still widely distributed in rivers north, east and south of the Ruwenzori, the only anthropophilic species and vector, S. kilibanum, had disappeared from most of its former habitats and was now restricted to two limited foci, where high biting densities were encountered. It was still a vector south of the Ruwenzori (Kasese focus), where 15.4% of the parous flies were infected with larval stages of Onchocerca volvulus and 34 infective larvae were found in the heads of 1000 parous flies. In the second focus along the Mahoma and Nsonge rivers, a chromosomally highly polymorphic population of S. kilibanum had replaced the former vector S. neavei, but does not act as a vector. Only 2.3% of the parous females were infected and just 1 infective larva was found in the heads of 1000 parous flies.
Markers of inflammation in children with severe malarial anaemia
Authors: Biemba Godfrey , Gordeuk Victor R. , Thuma Philip , Weiss Günter 
Published: March 2003

Summary OBJECTIVE   To investigate if severe malarial anaemia is associated with a specific immune response pattern, we determined serum levels of neopterin (a marker of activation of macrophages by interferon‐γ) and of the anti‐inflammatory cytokines, interleukins 4 and 10.METHODS   Zambian children < 6 years of age presenting to a rural hospital with cerebral malaria were studied. Twenty‐one children with admission haemoglobin concentrations ≤ 5 g/dl were classified as having severe anaemia and 40 with haemoglobin concentrations ≥ 7 g/dl served as a control group.RESULTS   Logistic regression modelling indicated that a 10‐fold rise in serum neopterin concentrations was associated with a 50‐fold increase in the estimated odds of having severe anaemia (P = 0.015), while a 10‐fold rise in serum interleukin 4 concentrations was associated with a 10‐fold decrease in the estimated odds of having severe anaemia (P = 0.023). Increasing serum interleukin 10 concentrations, measured in less than half of the subjects, were associated with a nonsignificant reduction in the odds of having severe anaemia (P = 0.095).CONCLUSION   Development of severe malarial anaemia may be directly associated with serum neopterin concentrations and inversely correlated with serum interleukin 4 levels.
Coping strategies of health personnel during economic crisis: A case study from Cameroon
Authors: Israr Syed Muhammad , Razum Oliver , Ndiforchu Victor , Martiny Patrick 
Published: March 2003

Summary OBJECTIVES   Severe economic crisis compelled many governments in Sub‐Saharan Africa to adopt structural adjustment programmes. This was accompanied by price increases and cuts in the salaries of civil servants. We explored how health personnel in one province of Cameroon coped with this situation, and what the perceived effects on service quality were.METHODS   Key informant and focus group interviews with government and mission (church) health personnel; interviews with service users to validate the findings.RESULTS   Government health personnel had experienced larger cuts in salaries than their mission counterparts; they no longer received allowances and incentives still available to mission personnel and appeared more demotivated. Most government and mission personnel reported legal after‐hours income raising activities. Government personnel frequently reported additional ‘survival strategies’ such as parallel selling of drugs, requesting extra charges for services, and running private practices during work hours. There was a high level of self criticism among government personnel indicating a dissonance between their attitude and practices. They considered these practices negative and harmful for service users.CONCLUSION   Remedial action is urgent. Options include reinstating allowances for good performance and ensuring regular supervision without blaming individual health workers for problems caused by the state of the health system.
AIDS caused by HIV1 and HIV2 infection: are there clinical differences? Results of AIDS surveillance 1986–97 at Fann Hospital in Dakar, Senegal
Authors: Ndour Marguerite , Salif Sow Papa , Coll‐Seck Awa Marie , Badiane Salif , Tidiane Ndour Cheik , Diakhaté Ndella , Diop Bernard , Faye Mame , Soumaré Masserigne , Diouf Georges , Colebunders Robert 
Published: March 2003

Summary objective  To compare the clinical manifestations observed in AIDS patients infected with HIV2 and HIV1 infection.methods  The medical records of AIDS patients hospitalized between January 1986 and July 1997 at the Department of Infectious Diseases of Fann Hospital, Dakar, were reviewed.results  599 hospitalizations (76%) were HIV1 seropositive patients, 137 (17%) were HIV2 seropositive patients and 54 (7%) were patients serologically dually reactive to HIV1 and HIV2. There was no significant difference in medium CD4 lymphocyte count between patients with HIV1 and HIV2 infection. Chronic diarrhoea and diarrhoea caused by bacterial infections were more frequently observed in HIV2‐infected individuals. Oral candidiasis and chronic fever were more often noted in patients with HIV1 infection. Bacterial and cryptococcal meningitis was only observed among patients with HIV1 infection. conclusions  Certain clinical differences were observed comparing AIDS patients with HIV1 and those with HIV2 infection. As there is no clear physiopathological explanation for these differences, additional studies with larger numbers of AIDS patients are needed to determine whether these differences are real.
Pattern and associated factors of the neurolathyrism epidemic in Ethiopia
Authors: Getahun Haileyesus , Lambein Fernand , Vanhoorne Michel , Van der Stuyft Patrick 
Published: March 2003

OBJECTIVES To describe the neurolathyrism epidemic in Ethiopia and to identify associated household factors. METHODS We interviewed 589 randomly selected heads of household in Debre Sina district of Ethiopia, the area afflicted by the recent neurolathyrism epidemic. Disease information was obtained for 2987 family members. RESULTS Neurolathyrism patients were detected in 56 (9.5%) households (prevalence rate 2.38%). The mean number of affected family members per household was 1.27 (SD 0.65, range 1–3). Most (77.5%) patients developed the disability during the epidemic (1995–1999). The median age at onset of paralysis was 11 years with a range of 41 (range 3–44). Younger people were more affected during the epidemic than during the non‐epidemic period (P=0.01). The presence of a neurolathyrism patient in the family was associated with illiteracy [adjusted OR (95% CI)=2.23 (1.07–5.10)] of the head of household, with owning a grass pea farm [adjusted OR (95% CI)=2.01 (1.04–3.88)] and with the exclusive cooking of grass pea foods using handmade traditional clay pots [adjusted OR (95% CI=2.06 (1.08–3.90)]. CONCLUSION Males aged 10–14 years were most affected by neurolathyrism. Increased household risk was associated with illiteracy of the head of the household and exclusive cooking of grass pea foods with handmade traditional clay pots.
Deliberate self‐poisoning in Oman
Authors: Zaidan Ziad A. J. , Burke David T. , Dorvlo Atsu S. S. , Al‐Naamani Aziz , Al‐Suleimani Abdullah , Al‐Hussaini Ala'Adin , Al‐Sharbati Marwan M. , Al‐Adawi Samir 
Published: March 2003

OBJECTIVE  To describe the demographics, precipitating factors, substances and methods used for deliberate self‐harm in Oman.METHODS  Data were extracted from the Accident and Emergency (A & E) records of patients treated at the A & E units in Muscat from 1993 to 1998. Data were obtained form the history, and clinical findings resulting form deliberate self‐harm.RESULTS  During the 5‐year study period, 123 persons presented to various hospitals in the Muscat area with injuries that resulted form deliberate self‐harm. Most of these cases were women, students and unemployed. There was a high incidence of family, marital and psychiatric or social problems. The methods of self‐harm were most often analgesics (such as paracetamol) and non‐pharmaceutical chemicals.CONCLUSIONS  The rate of self‐injurious behaviour is low in Oman, compared with other countries, including other Islamic countries. The data illustrate a rising rate and a tendency to ingest toxic doses of analgesics or non‐pharmaceutical chemicals.
Renal dysfunction in falciparum– malaria is detected more often when assessed by serum concentration of cystatin C instead of creatinine
Authors: Günther A. , Burchard G. D. , Slevogt H. , Abel W. , Grobusch M. P. 
Published: March 2003

Summaryobjectives  To estimate the frequency of renal dysfunction in falciparum malaria by serum concentration of cystatin C, a new sensitive indicator of the glomerular filtration rate (GFR).methods  Retrospective study of stored sera and patient files. Assessment of renal function by serum concentration of creatinine and cystatin C and comparison of the results from both indicators of GFR.results  A total of 108 adult patients with falciparum malaria were included in the study. Concentration of creatinine and cystatin C correlated well (r = 0.706; P < 0.001). Elevated cystatin C was more frequent than elevated creatinine (54.6%vs. 20.4%; P < 0.001). Patients older than 50 years developed renal dysfunction more often (P < 0.05) than younger ones. Results from cystatin C and creatinine were concordant in 63 (58.3%) and contradictory in 45 (41.6%) cases. Four (3.7%) patients had elevated creatinine but normal cystatin C levels, hence 63 patients (58.3%) showed elevation of at least one indicator of GFR. The frequency of elevated cystatin C and elevated creatinine was unrelated to body weight, gender or bilirubin level.conclusions  The prevalence of impaired renal function in patients with falciparum malaria seems to have been underestimated in the past. Using a sensitive marker, 55% of the patients have a reduced GFR.
Increasing transparency in partnerships for health – introducing the Green Light Committee
Authors: Gupta Rajesh , Cegielski J. Peter , Espinal Marcos A. , Henkens Myriam , Kim Jim Y. , Lambregts‐van Weezenbeek Catherina S. B. , Lee Jong‐Wook , Raviglione Mario C. , Suarez Pedro G. , Varaine Francis 
Published: March 2003

SummaryPublic–private partnerships have become central to efforts to combat infectious diseases. The characteristics of specific partnerships, their governance structures, and their ability to effectively address the issues for which they are developed are being clarified as experience is gained. In an attempt to promote access to and rational use of second‐line anti‐tuberculosis (TB) drugs for the treatment of multidrug‐resistant TB, a unique partnership known as the Green Light Committee (GLC) was established by the World Health Organization. This partnership relies on five categories of actors to achieve its goal: academic institutions, civil society organizations, bilateral donors, governments of resource‐limited countries, and a specialized United Nations agency. While the for‐profit private sector is involved in terms of supplying concessionally priced drugs it is excluded from decision‐making. The effectiveness of the partnership emerges from its review process, flexibility to modify its modus operandi to overcome obstacles, independence from the commercial sector, and its ability to link access, rational use, technical assistance, and policy development. The GLC mechanism may be useful in the development of other partnerships needed in the rational allocation of resources and tools for combating additional infectious diseases.
Treatment seeking behaviour and costs due to acute and chronic forms of lymphatic filariasis in urban areas in south India
Authors: Nanda B. , Krishnamoorthy K. 
Published: March 2003

SummaryPrevious estimates on the economic burden of lymphatic filariasis (LF) in India and elsewhere were primarily based on studies in rural areas. We investigated the treatment costs due to acute and chronic forms of LF in urban areas, where nearly one‐third of the affected people live. Almost 98% of the patients with acute episodes of adenolymphangitis (ADL) underwent treatment and 49% of chronic patients also received treatment. The average treatment cost per ADL episode (n = 108) was Rs 22.21 ± 53.84 (US$ 0.46 ± 1.12). The overall (n = 200) treatment costs incurred by a chronic patient per visit were Rs 16.71 ± 62.36 (US$ 0.35 ± 1.30); for those who paid (n = 98) they were Rs 34.10 ± 85.90 (US$ 0.71 ± 1.79). These costs are considerably higher than in rural areas. Government health centres and private practitioners were important sources of treatment. Treatments received from private practitioners were considerably more expensive than those from government health facilities. The cost of medicine accounted for 44% and 50% of the total expenditure on treatment for acute and chronic disease patients, respectively. The medical personnel from these treatment sources need to be trained on the new morbidity management methods, which are likely to be more effective than the current methods of treatment.
Topical 0.1% tacrolimus for the treatment of discoid lupus erythematosus and pemphigus erythematosus in dogs
Authors: Griffies J. D. , Mendelsohn C. L. , Rosenkrantz W. S. , Muse R. , Boord M. J. , Griffin C. E. 
Published: March 2003

Skin lesions of discoid lupus erythematosus (DLE) and pemphigus erythematosus (PE) are often localized to the nasal planum, dorsal muzzle and less commonly, pinnae, periocular skin and lips. The objective of this study was to explore the use of 0.1% tacrolimus as a topical therapy in the management of localized DLE and PE lesions in dogs. Ten cases of DLE and two cases of PE in various breeds were included. Degree of erythema, crust, ulceration or erosion, depigmentation and scarring were evaluated at the start of the trial and after 2, 4 and 8 weeks of therapy. Complete blood count, serum chemistry and whole blood tacrolimus concentrations (Abbot IMx Microparticle Immunoassay; Abbot IMx, Chicago, IL, USA) were performed at each evaluation. Ten cases of DLE and two cases of PE were treated using the lotion either as a sole therapy (both DLE) or as an adjunctive treatment (eight DLE and two PE). Five of the cases evaluated had an excellent response (three DLE and two PE), five a partial response (all DLE), and two dogs (both DLE) showed no appreciable difference after receiving topical tacrolimus therapy. Concurrent medications were discontinued in eight of the ten dogs that improved. No adverse effects in clinical or laboratory parameters were noted throughout the study. However, measurement of tacrolimus concentrations by the MEIA assay was of little benefit due to false‐positive measurements. Results of this study indicate that topical 0.1% tacrolimus may be a safe and effective adjunctive therapy for DLE and PE, with fewer systemic and topical adverse effects than current treatment modalities.
AA line
Authors: Ahn MD Sung Ku , Kim MD Soo Jung , Choi MD Eung Ho , Lee MD Seung Hun , Lee MD Sungnack 
Published: March 2003

BackgroundThe transverse skin line of the upper part of the forearm is a common, easily recognized condition; however, this line has not been defined clearly and does not correspond to other previously reported skin lines. Our purpose was to assess the nature and associated conditions of this skin line, and characterize the histopathologic features. MethodsWe examined 1343 healthy Korean people. The persons showing this skin line were evaluated by history and physical examination. Skin biopsy was performed on 10 persons showing this line: on one side at both the lesion and contralateral, non‐lesion sites. ResultsA total of 480 persons (36.4%) showed this line. The incidence was significantly higher in the female group and in the group between 10 and 19 years of age. Histopathologic examination showed subtle edema, separation and fragmentation of collagen bundles, and vasodilation at the transverse skin line. ConclusionsWe conclude that this skin line represents a newly defined skin line, and propose the term AA line.
Leishmaniasis recidiva cutis in New World cutaneous leishmaniasis
Authors: Oliveira‐Neto Manoel Paes , Mattos Marise , da Silva Celeste , de Souza Freitas , Fernandes Octavio , Pirmez Claude 
Published: March 2003

AbstractBackground Leishmaniasis recidiva cutis (LRC) is rare in New World leishmaniasis. Only seven cases have been reported so far.Materials and methods Four cases are reported here. Parasite diagnosis was performed by classical methods of touch preparations, histopathologic sections, and cultures. In addition, the detection of parasite DNA by the polymerase chain reaction (PCR) was performed in all cases.Results Parasites were detected by at least one of the classical methods in all primary lesions; however, only the PCR was positive in the recidivant lesions.Discussion LRC cases most likely represent a reactivation of an initial infection, probably due to the persistence of parasites in scarred tissue. Although lupoid leishmaniasis (LL) has been used as a synonym of LRC, a clear difference between LRC and LL can be defined as LL is the initial clinical presentation while LRC is a recurrent lesion.Conclusions The results indicate that it is not appropriate to use these two denominations as synonyms. The designation of LRC should be maintained in order to define recidives occurring at the border of an old scar of cutaneous leishmaniasis, avoiding the confusion with the lupoid form of the disease.
Correspondence
Authors: Goihman‐Yahr Mauricio 
Published: March 2003

Pyoderma gangrenosum: unusual complication following mammoplasty reductionA 27‐year‐old woman, with unremarkable previous medical history, underwent a bilateral mammoplasty reduction. Four days afterwards, the surgical wound developed ulcers with pustulous, undermined borders. The patient's general status worsened and high fever (40 °C) developed. Local pain was absent. Initial diagnosis was wound infection, even though bacteriologic cultures were negative, and therapy consisted of oral antibiotics together with surgical debridement. Ten days after the mammoplasty, the ulcers had increased dramatically in size affecting most of the lower half of the breasts. The areolas were spared, and the lesions were strikingly symmetrical ( Fig. 1). The ulcers had a necrotic, hemorrhagic base with fibrin deposition, and pustulous borders. Perilesional edema and inflammation were noted. The patient did not reveal clinical manifestations of inflammatory bowel disease or other illnesses in addition to the skin lesions. At this time, the patient was sent to our department and a diagnosis of pyoderma gangrenosum (PG) was considered. The advancing edge of one ulcer was biopsied and, although histopathologic examination was unspecific, it was consistent with PG. Routine laboratory tests revealed a moderate leukocytosis (14,000/μL, 65% neutrophils), and an acute phase reaction with thrombocytosis (727,000/μL), elevated erythrocyte sedimentation rate (ESR) (84 mm/h), and increased levels of α‐1 and α‐2 globulins. Bacteriologic cultures were negative. Rheumatoid factor and antinuclear antibodies were also negative. Therapy was started with the local application of gauze impregnated with gentamicine ointment, and oral cyclosporine (5 mg/kg/day) and methylprednisolone (0.5 mg/kg/day). Twenty four hours after the onset of therapy, the fever had disappeared. In the first month, the perilesional edema and pustulation resolved, central areas of re‐epithelization were noted, and previously abnormal laboratory tests returned to normal limits. At the end of the second month, the ulcers had completely healed, with residual scarring (
Fig. 2).PG ulceration involving most of the lower half of both breasts. Note the sparing of areolasimageResidual scarring after resolution of the ulcersimage
Bleomycin‐induced urticarial flagellate drug hypersensitivity reaction
Authors: Rubeiz Nelly G.. , Salem Ziad , Dibbs Rania , Kibbi Abdul‐Ghani 
Published: March 2003

New York, NY 10022[TAB]A 70‐year‐old woman was found to have an infiltrating ductal carcinoma of the right breast in July 1992, for which she underwent a modified radical mastectomy and was started on tamoxifen. In May 1995, she presented with metastasis to the right lung and ribs. The patient received 60 mg of bleomycin intrapleurally, and was started on leucovorin, 5‐fluorouracil and mitoxantrone. One week following the administration of chemotherapy, she developed pruritic erythematous indurated dermal papules and plaques, arranged in a linear configuration over the face, trunk and extremities ( Fig. 1). The patient is right‐handed. Two skin biopsy specimens, obtained from the forehead and right anterior chest, exhibited similar histopathologic features. Beneath focal areas of parakeratosis, the dermis displayed papillary dermal edema and superficial and deep perivascular and interstitial mixed inflammatory cell infiltrate composed of lymphocytes, neutrophils and eosinophils (Fig. 2). These findings were consistent with an urticarial allergic drug hypersensitivity reaction. The eruption resolved over a period of 1 month leaving residual linear and flagellate hyperpigmentation.Flagellate erythema over the backimagePerivascular and interstitial mixed inflammatory cell infiltrate(× magnification)[TAB]image
Squamous cell carcinoma and keratoacanthoma of the lower lip associated with “Goza” and “Shisha” smoking
Authors: El‐Hakim Ibrahim E. , Uthman Mirghani A.E. 
Published: March 2003

AbstractBackground A positive correlation between lip and buccal cancers and pipe smoking has been suggested. Various types of crude and manufactured tobacco products are consumed by smoking, chewing, and snuff dipping habits. “Shisha” and “Goza” smoking are widely practiced in the Middle East. The “hubble‐bubble” method and apparatus are used. These smoking habits are hazardous to health, causing obstructive lung disease, and may be important predisposing factors for the development of oral cancers.Case reports Two cases of squamous cell carcinoma and a case of keratoacanthoma localized to the lower lip are presented in well‐known “Shisha” and “Goza” smokers.Conclusions“Shisha” and “Goza” smoking have adverse effects on general health and may predispose to oral cancer. An extensive epidemiological study should be performed to determine whether this type of smoking habit is associated with a statistically increased incidence of squamous cell carcinoma and keratoacanthoma of the lips.