bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of community‐acquired and nosocomial bloodstream infections in tropical Australia: a 12‐month prospective study
Authors: Douglas Mark W. , Lum Gary , Roy Jhumur , Fisher Dale A. , Anstey Nicholas M. , Currie Bart J. 
Published: July 2004

AbstractObjectives  To define the relative incidence of organisms causing blood stream infections in a tropical setting with a very low prevalence of human immunodeficiency virus infection (<1%).Methods  A 12‐month prospective study of blood stream infections in 2000 at Royal Darwin Hospital in the tropical north of Australia.Results  Significant isolates were grown from 257 sets of blood cultures. Staphylococcus aureus was the most common isolate overall (28%); 26% of these were methicillin‐resistant (MRSA). Escherichia coli was the most common cause of community‐acquired bacteraemia. Burkholderia pseudomallei caused 32% of community acquired, bacteraemic pneumonia; 6% of bacteraemias overall. Vancomycin‐resistant enterococci were not isolated. Crude mortality rates (13% overall; 9% attributable mortality) were lower than in most comparable studies.Conclusions  The major difference between these findings and surveys performed elsewhere is the presence of B. pseudomallei as a significant cause of bacteraemic community‐acquired pneumonia. Our results demonstrate the effects of local environmental and patient characteristics on the range of organisms causing blood stream infections, and emphasize the important role of local microbiology laboratories in guiding empiric antibiotic therapy.
Spatial clustering of malaria and associated risk factors during an epidemic in a highland area of western Kenya
Authors: Brooker Simon , Clarke Siân , Njagi Joseph Kiambo , Polack Sarah , Mugo Benbolt , Estambale Benson , Muchiri Eric , Magnussen Pascal , Cox Jonathan 
Published: July 2004

SummaryThe epidemiology of malaria over small areas remains poorly understood, and this is particularly true for malaria during epidemics in highland areas of Africa, where transmission intensity is low and characterized by acute within and between year variations. We report an analysis of the spatial distribution of clinical malaria during an epidemic and investigate putative risk factors. Active case surveillance was undertaken in three schools in Nandi District, Western Kenya for 10 weeks during a malaria outbreak in May–July 2002. Household surveys of cases and age‐matched controls were conducted to collect information on household construction, exposure factors and socio‐economic status. Household geographical location and altitude were determined using a hand‐held geographical positioning system and landcover types were determined using high spatial resolution satellite sensor data. Among 129 cases identified during the surveillance, which were matched to 155 controls, we identified significant spatial clusters of malaria cases as determined using the spatial scan statistic. Conditional multiple logistic regression analysis showed that the risk of malaria was higher in children who were underweight, who lived at lower altitudes, and who lived in households where drugs were not kept at home.
Tuberculosis control in resource‐poor countries: have we reached the limits of the universal paradigm?
Authors: Lienhardt Christian , Ogden Jessica Ann 
Published: July 2004

SummaryThe aim of TB control is to break the cycle of transmission by treating TB cases as early and efficiently as possible. In its efforts to promote a model of worldwide TB control, WHO defined specific targets and launched the ‘Directly Observed Therapy, Short‐course’ (DOTS) strategy as the main tool to reach them. However, the diversity of patients’ attitudes towards the disease and the extreme variability of access to care, especially in resource‐poor countries, are amongst the many factors of social context that profoundly affect the ability of control programmes to implement this policy effectively. There are multiple reports of TB control programmes using various types of intervention to promote adherence and enhance case‐holding, but most of these interventions depend on external funding, which bring into question their long‐term sustainability. In this paper, we address the problems related to operational variabilities in the implementation of the DOTS strategy in resource‐poor countries and question the appropriateness of a universal paradigm for global TB control. This analysis is of particular importance as programmers consider using this model in the delivery of anti‐retroviral therapies for the treatment of HIV in resource‐limited settings.
Placebo‐controlled evaluation of direct electrical current administration for palmoplantar hyperhidrosis
Authors: Karakoc Yunus , Aydemir Ertugrul H. , Kalkan M. Tunaya 
Published: July 2004

AbstractBackground  Direct electrical current (d.c.) administration based on tap water iontophoresis has been used as a therapeutic option for palmoplantar hyperhidrosis. The placebo effect of this technique has not been investigated adequately.Aim  To investigate whether d.c. administration has a possible placebo effect in the treatment of palmoplantar hyperhidrosis.Methods  As a placebo, low alternating electrical current (a.c.; 9–12 mA, 10–15 V, and 8–10 Hz) was applied to the palms of 15 patients with idiopathic palmoplantar hyperhidrosis. The placebo effect was evaluated by inspection and sweat intensity measurements performed before and after placebo application. Patients then received d.c. treatment (18–22 mA, 40–60 V) according to the same procedure as applied for placebo. The final sweat intensity measurements of the patients were performed 1 week after the last session of d.c. treatment. Sweat intensities measured before and after placebo and at the end of d.c. treatment were analyzed statistically by paired t‐test.Results  The initial sweat intensity measurements of the palms, before placebo application, were 3.12 ± 0.39 g/h on the right side and 3.17 ± 0.28 g/h on the left side. The second sweat intensity measurements, 1 week after the last session of placebo, were 3.08 ± 0.46 g/h on the right side and 3.16 ± 0.21 g/h on the left side. There were no significant differences between the initial and second sets of sweat intensity measurements of the hands (P > 0.05 for both sides). The final sweat intensity measurements, 1 week after the last session of d.c. treatment, were 0.38 ± 0.06 g/h on the right side and 0.39 ± 0.07 g/h on the left side.Conclusions  Statistical evaluation of sweat intensity measurements and inspections revealed that d.c. administration had no placebo effect in the treatment of palmoplantar hyperhidrosis.
Onychomycosis in central India: a clinicoetiologic correlation
Authors: Garg Amit , Venkatesh Vimala , Singh Mastan , Pathak Kushal P. , Kaushal Gyan P. , Agrawal Surendra K. 
Published: July 2004

AbstractBackground  Onychomycosis is mainly caused by dermatophytes, but yeasts and nondermatophyte molds have also been implicated, giving rise to diverse clinical presentations. The etiological agents of the disease may show geographic variation. The aim of the present study was to isolate the causative pathogens and to determine the various clinical patterns of onychomycosis in central India.Methods  The study population comprised 90 patients with onychomycosis. Nail samples were collected for direct microscopic examination and culture. Clinical patterns were noted and correlated with causative pathogens.Results  The male : female ratio was 3:1 and the mean age was 29.40 ± 13.61 years. Fingernails were involved in 60%, toenails in 26.67% and both fingernails and toenails in 13.34% of the 90 patients. The clinical types noted were distolateral subungual onychomycosis (64.44%), total dystrophic onychomycosis (17.78%), proximal subungual onychomycosis with paronychia (12.2%), proximal subungual onychomycosis without paronychia (4.44%) and superficial white onychomycosis (1.11%). Dermatophytes were the most common pathogens isolated, being found in 24 patients (26.36%) [Tricophyton rubrum (23.07%), Tricophyton verrucosum (2.22%) and Epidermophyton floccosum (1.11%)], followed by Candida albicans, which was found in 22 patients (24.27%). Thirty‐six (39.58%) nondermatophyte molds were isolated from 29 patients. Of these 29 cases, six were associated with Tricophyton rubrum, which was considered the primary pathogen.Conclusions  Distolateral subungual onychomycosis was the most common clinical presentation; however, total dystrophic onychomycosis and proximal subungual onychomycosis were not uncommon in this part of India. Tricophyton rubrum and Candida albicans were the major pathogens. The clinicoetiologic correlation revealed that a single pathogen could give rise to more than one clinical type.
Plasma reactive oxygen species activity and antioxidant potential levels in rosacea patients: correlation with seropositivity to Helicobacter pylori
Authors: Baz Kiymet , Cimen M. Y. Burak , Kokturk Aysin , Aslan Gonul , Ikizoglu Guliz , Demirseren D. Deniz , Kanik Arzu , Atik Ugur 
Published: July 2004

AbstractBackground  Recent studies have suggested that there might be an etiologic role for Helicobacter pylori (HP) in rosacea. HP is a Gram‐negative bacterium that colonizes the gastric mucosa, increases the generation of reactive oxygen species (ROS), and decreases plasma antioxidants such as ascorbic acid.Aim  To investigate plasma ROS activities and antioxidant status, and their relationship with HP infection, in rosacea patients.Methods  Twenty‐nine rosacea patients and 20 age‐ and sex‐matched healthy controls were examined for specific immunoglobulin G (IgG) and IgM against HP, plasma malondialdehyde (MDA), and antioxidant potential (AOP) levels.Results  Compared with controls, the seropositivity of HP for IgM was significantly higher (P = 0.03) and the seropositivity of HP for IgG was significantly lower (P = 0.0001) in patients with rosacea. Plasma MDA levels were higher (P = 0.0001) and AOP levels were lower (P = 0.019) in patients than in controls, regardless of the severity of the disease. Plasma MDA and AOP levels were not affected by the seropositivity of HP for IgM and/or IgG in either group.Conclusion  Our results suggest that rosacea is an oxidative stress condition, as reflected by the increased ROS activity and decreased AOP, regardless of HP infection.
Systemic sarcoidosis presenting with alopecia of the scalp
Authors: Cho Hang Rae , Shah Arpana , Hadi Suhail 
Published: July 2004

A 39‐year‐old African‐American woman was referred to the department of dermatology, Mount Sinal Hospital, New York for evaluation of a skin lesion on her scalp which had been present for 3 years and had recently changed in appearance. On examination, she was found to have erythematous plaques with hair loss extending from the frontal hairline on the right side in a “C‐shaped” distribution, terminating behind the left ear. Two years later the lesion had rapidly extended to the vertex of the scalp and left temporal area (Fig. 1). There was a 10 cm × 12 cm area of alopecia at the vertex with slight erythema, but there was no evidence of scarring, inflammation or nodularity of the scalp (Fig. 2). A skin biopsy taken from the forehead revealed granulomatous dermatitis showing noncaseating granuloma with negative acid fast bacilli (AFBC) and ammonical‐silverstain for fungus (GMS) (Fig. 3).Erythematous plaque with hair loss on the left temporal areaimageNonscarring alopecia at the vertex with slight erythemaimageNoncaseating granuloma consisting of lymphocytes, histiocytes, plasma cells and multinucleated giant cells (hematoxylin and eosin staining; magnification ×100)imageShe complained of chronic nasal congestion for 8 months. Nasal cavity examination and laryngeal endoscopy showed multiple nodules on the nasal septum and vocal cord. At that time, a presumptive diagnosis of sarcoidal nodule of the nasal septum and vocal cord was made and corticosteroids were administered orally.A chest X‐ray demonstrated prominence of the right peritracheal and perihilar regions consistent with sarcoid. A 67 Gallium scan disclosed increased uptake in the lung and perihilar lymph nodes.A skull X‐ray showed soft tissue density of the skull, probably indicating a subcutaneous sarcoidal nodule. Computed tomography (CT) scanning of her brain and skull base showed a soft tissue mass along the outer table of the calvarium within the frontal region.Six years ago, she experienced visual changes: blurred vision, tearing, floaters on both eyes and a 1 cm × 1 cm subcutaneous, painful, firm mass on the lateral side of her left upper eyelid. A skin biopsy was performed in another hospital and revealed noncaseating granuloma.A diagnosis of sarcoidosis involving the central nervous system, lacrimal gland, nasal septum, vocal cord, lung and scalp was made, and the patient was treated with 20 mg of methylprednisone on alternate days with intralesional triamcinolone injection for skin lesions. During the follow‐up period, nasal, laryngeal, pulmonary, ocular and cutaneous lesions were slightly improved and magnetic resonance imaging (MRI) scanning will be carried out for further evaluation of the brain lesion.
Cutaneous larva migrans (creeping eruption) in an urban slum in Brazil
Authors: Heukelbach Jörg , Wilcke Thomas , Feldmeier Hermann 
Published: July 2004

AbstractBackground Cutaneous larva migrans (CLM) is caused by the penetration of larvae of animal hookworms into the skin. Knowledge about this ectoparasitosis is mainly based on the examination of travelers or other expatriates. Population‐based studies in an endemic area have never been performed.Methods A representative population sample of an urban slum in a Brazilian city was examined for the presence of CLM and asked about symptoms associated with the ectoparasitosis.Results In total, 3.1% (95% confidence interval, 2.2–4.3%) of the 1185 inhabitants examined presented CLM. Forty‐three per cent had more than one larval track (range, 1–17). The prevalence rate in males was 4.2% vs. 2.3% in females. CLM occurred at similar prevalence rates in all age groups. All patients complained of moderate or severe itching. In three cases (8.1%), superinfection was present. Most lesions were located on the trunk, legs, and arms. Not a single lesion was located on the feet.Conclusions This population‐based study showed that CLM is endemic in this deprived community. The number of lesions and their topographic localization are in contrast with those obtained in previous reports based on the examination of individuals or groups affected in small outbreaks. We conclude that the clinico‐epidemiologic pattern of CLM in a deprived community is different from that observed in travelers.
Granulomatous cheilitis resulting from a tuberculide
Authors: Kavala Mukaddes , Südoğan Sibel , Can Burçe , Sarıgül Şükran 
Published: July 2004

Granulomatous cheilitis (GC) is a chronic granulomatous inflammation of the lips of unknown etiology. The possible relationship with tuberculosis has been described although most of the studies excluded infectious agents as potential causes of the granulomatous response.To our knowledge only one case of granulomatous cheilitis resulting from a tuberculide has been reported in the literature but accompanying internal involvement has not been previously described.We report a case of GC resulting from a tuberculide. Investigations showed pulmonary involvement compatible with tuberculosis and improvement following antituberculous chemotherapy for 3 months.
Association of p53 arginine polymorphism with skin cancer
Authors: De Oliveira Walmar Roncalli P. , Rady Peter L. , Grady James , Hughes Thomas K. , Neto Cyro F. , Rivitti Evandro A. , Tyring Stephen K. 
Published: July 2004

AbstractBackground  The presence of arginine at codon 72 in p53 protein is proposed to be a genetic risk factor in human papillomavirus (HPV)‐related carcinogenesis.Objective  To study the prevalence of p53 polymorphism at codon 72 in skin biopsies of epidermodysplasia verruciformis (EV) patients compared to DNA samples from healthy individuals.Patients and methods  DNA samples extracted from normal skin and tumor biopsies of 22 Brazilian patients with EV and blood samples from 27 healthy Brazilian individuals were studied for p53 codon 72 polymorphisms using restriction fragment length polymorphism (RFLP) analysis.Results  All EV patients with the malignant form of EV were homozygous for arginine (Arg/Arg) at codon 72 of the p53 gene, in contrast to none with the benign form (P < 0.0001).Conclusions  p53 arginine polymorphism is likely to be associated with the development of skin malignancies in EV patients from Brazil.
Tangential excision of nevocellular nevus on the face
Authors: Pereira Carlos Augusto Zanardini , Alchorne Alice de Oliveira de Avelar 
Published: July 2004

AbstractBackground  Tangential excision (shaving) is an effective surgical technique for the excision of nevocellular nevi on the trunk, limbs, and scalp. There are few studies on the application of this technique to lesions on the face.Aims  To demonstrate the technique of tangential excision for the removal of nevocellular nevi on the face and to evaluate the cosmetic results, recurrence index, and possible complications.Methods  Two hundred and fifteen patients with multiple nevocellular nevi on different aesthetic units of the face (total of 225 lesions) were selected. All the lesions were removed by tangential excision. The patients returned for postsurgical evaluation at 30, 60, and 90 days.Results  The results were evaluated in relation to the skin type, sex, age, and histologic type of the lesions. An excellent result was achieved in 90.7%, good in 8.4% and poor in 0.9%, with a low index of complications. For comparison, the face was divided into seven aesthetic units.Conclusion  Tangential excision is an alternative surgical technique for the treatment of nevi. It is simple, fast, and efficient, has low risks and low cost for the patient, and yields excellent results when used for cosmetic purposes.
N95 acne
Authors: Tan Kian Teo , Greaves Malcolm W. 
Published: July 2004

Two women, aged 27 and 45 years, presented to the Dermatology Outpatient Clinic with acne vulgaris. Both had nodular acne in a similar distribution over the cheeks, chin, and perioral areas (Fig. 1). Each had a history of acne vulgaris as a teenager. Both were healthcare assistants working in the Singapore General Hospital throughout the severe acute respiratory syndrome (SARS) crisis, had worn N95 masks continuously for about 3 months whilst on the wards, and had suffered an outbreak of acne of the skin occluded by the mask. They were treated with topical retinoid and systemic antimicrobials, and both responded well.Twenty‐seven‐year‐old woman with acne papules and nodules on the face over the area occluded by the N95 maskimage
Effect of inhalation aspirin challenge on exhaled nitric oxide in patients with aspirin‐inducible asthma
Authors: Rolla G. , Di Emanuele A. , Dutto L. , Marsico P. , Nebiolo F. , Corradi F. , Brussino L. , Bucca C. 
Published: July 2004

Background:  A complex relationship between arachidonic acid metabolites and nitric oxide (NO) synthesis has been reported in asthma. The effects of inhaled aspirin on fractional exhaled NO (FENO) in patients with aspirin‐tolerant (ATA) and aspirin‐inducible (AIA) asthma compared with normal controls have been investigated.Methods:  The FENO was measured baseline, after saline and lysine‐aspirin (L‐ASA) bronchial challenge in 10 patients with ATA and in 10 patients with AIA [mean (PD20FEV1 L‐ASA): 14.7 ± 12.7 mg], who had comparable age and baseline FEV1. Ten healthy subjects served as controls. Sputum eosinophils were counted after saline and after L‐ASA challenge in the two groups of asthmatics.Results:  Asthmatic patients had baseline FENO significantly higher than controls (29.7 ± 6.8 vs 9.8 ± 2.05 p.p.b. respectively, P < 0.0001). No difference was observed in methacholine PD20FEV1 and baseline FENO between ATA and AIA patients. After L‐ASA inhalation, FENO increased significantly only in patients with AIA, reaching the peak value 4 h after bronchoconstriction (from 31.1 ± 6 to 43 ± 4.8 p.p.b., P < 0.001), while no change was observed in patients with ATA and in controls. Sputum eosinophils increased significantly after L‐ASA inhalation only in patients with AIA (from 8.1 ± 2.7 to 11.1 ± 2.8%, P < 0.005) and there was a significant relationship between the increase in sputum eosinophils and the increase in FENO after ASA challenge.Conclusion:  Exhaled NO may indicate eosinophilic airway inflammation during ASA exposure in patients with ASA inducible asthma.
Lower prevalence of reported asthma in adolescents with symptoms of rhinitis that received neonatal BCG
Authors: da Cunha S. S. , Cruz A. A. , Dourado I. , Barreto M. L. , Ferreira L. D. A. , Rodrigues L. C. 
Published: July 2004

Background:  BCG is a vaccine used against tuberculosis and leprosy and is an immunostimulant that primes TH1 lymphocytes to produce cytokines that antagonize atopy both in animal models and in man. Considering that atopy is the main risk factor for asthma, one can hypothesize that vaccination inducing TH1 responses, such as BCG, can be protective against asthma.Methods:  Objective: To estimate the association between neonatal BCG vaccination and prevalence of asthma among adolescents. Study design: Cross‐sectional study with schoolchildren aged 12–16 years. The presence of a scar compatible with BCG was used as a surrogate of neonatal vaccination. A self administered structured questionnaire was prepared based on that used by the International Study of Asthma and Allergies in Childhood. The prevalence of asthma was categorized according to the report of lifetime wheeze, lifetime asthma, lifetime asthma among those referring allergy and among those referring allergy and sneezing.Results:  Neonatal BCG vaccination was not associated with the overall prevalence of reported wheezing or asthma. However, in the subgroup reporting current allergy and sneezing, neonatal BCG was associated with a 37% reduction of prevalence of lifetime asthma.Conclusions:  In the population we surveyed, neonatal BCG scar was associated with a reduction in the risk of asthma only in individuals with a past history suggestive of allergic rhinitis.
Association study of polymorphisms within interleukin‐18 in juvenile idiopathic arthritis and bronchial asthma
Authors: Heinzmann A. , Gerhold K. , Ganter K. , Kurz T. , Schuchmann L. , Keitzer R. , Berner R. , Deichmann K. A. 
Published: July 2004

Background:  Interleukin‐18 (IL‐18) plays an important role in the regulation of TH1 as well as TH2 immunologic responses and thus in the development of chronic inflammatory diseases. Positive association studies of polymorphisms in IL‐18 with different diseases have underlined the involvement of IL‐18 in the pathogenetics processes. Our interest was to test polymorphisms of IL‐18 for association with a typical TH1‐mediated disease – juvenile idiopathic arthritis – and the TH2‐mediated disease bronchial asthma in Caucasian children.Methods:  We genotyped five polymorphisms that were in association with chronic inflammatory diseases (−607C, −137C, 113G, 127T, and −133G). This was performed by restriction fragment length polymorphism in populations of asthmatic children, control individuals, and children with antinuclear antibodies (ANA)‐positive juvenile idiopathic arthritis. Statistical analysis was performed by the Armitage trend test; haplotypes were calculated by the Arlequine program.Results:  No significant association was found between any single nucleotide polymorphism or any haplotype and bronchial asthma or ANA‐positive juvenile idiopathic arthritis.Conclusion:  We conclude that the effect of IL‐18 in the immunologic context of diseases like bronchial asthma or juvenile arthritis might be too complex to be reflected in a simple one‐way association study. Furthermore, the polymorphisms under investigation might be nonfunctional.